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Objective: To investigate whether a combined hip and knee muscle strengthening program is superior to a knee strengthening program for people after lateral patellar dislocation (LPD). Design: Single-blind, superiority, randomized controlled trial with 48 weeks follow-up. Setting: Physiotherapy out-patient clinic. Participants: Forty individuals aged 16 or older, with a history of non-traumatic LPD were randomized to a knee-based strengthening (KBSG) or quadriceps and hip strengthening exercise (HQSG) program (N=40). Inclusion criteria included a positive apprehension sign, pain on palpation along the medial retinaculum, and J sign. Exclusion criteria included restricted range of motion (<90° knee flexion), and traumatic or postsurgical LPD. Interventions: Concealed randomization was performed using random permuted blocks of size 4. Individuals received their corresponding exercise program according to randomization and group allocation: knee-based strengthening (n=20) or combined hip and quadriceps strengthening (n=20) twice weekly for 8 weeks over 16 appointments. Main Outcome Measures: Primary outcome was the Lysholm Knee Score. Secondary outcomes included Numerical Pain Ratings Scale (NPRS) at rest and during effort, Norwich Patellar Instability Score (NPIS), Kujala Anterior Knee Pain Scale (AKPS), Lower Extremity Functional Scale (LEFS), 4 domains of the WHOQOL-Bref, and recurrence rate. Patient-reported outcome measures were assessed from the baseline to 48 weeks. Assessments were performed by a physiotherapist who was blinded to the group allocation. Data were analyzed by using a repeated-measures ANOVA model with Tukey's post hoc test after an intention-to-treat principle. Results: At the primary time-point of 8 weeks, there were no substantial between-group differences in the Lysholm Knee Score: mean difference=-6.8 (95% CI -14.3 to 3.7); NPIS: mean difference=23.5 (95% CI 5.6 to 41.3); AKPS: mean difference=-1.54 (95% CI -8.6 to 5.6), NPRS at rest and during effort (mean difference=0.32 (95% CI -0.37 to 1); and mean difference=0.68 (95% CI -0.9 to 1.86); LEFS mean difference=-1.08 (95% CI -5.9 to 2.4), WHOQOL-Bref domains (physical health: mean difference=-0.12, (95% CI -1.26 to 1.02); psychological: mean difference=-0.32 (95% CI -2.04 to 1.4); social relations: mean difference=-0.7 (95% CI -2.2 to 0.82); environment: mean difference=0.44 (95% CI -1 to 1.9), and recurrence rate (P=.69). Conclusion: This study indicates that combined hip and knee muscle strengthening is not superior to knee-based strengthening for LPD treatment. The limitations stemming from the underpowered nature of the trial must be acknowledged, concerning the potential oversight of moderate intervention effects.

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BACKGROUND: In general, patients are referred for rheumatological evaluation due to isolated laboratory abnormalities, especially antinuclear antibody (ANA) positivity, with the risk of more severe patients remaining on the waiting list for longer than desired. The aim of this study was to analyze the demographic, clinical, and laboratory information of patients referred to a specialized rheumatological care unit because of positive antinuclear antibody. METHODS: This is a retrospective study of 99 out of 1670 patients seen by the same rheumatologist between 01/01/2011 and 01/01/2019. Patients whose referrals were exclusively due to the ANA test result and the specialist's final diagnosis being "abnormal finding of serum immunological test" (ICD-10 R769) were included. Sociodemographic, clinical, and laboratory information were extracted from the consulting rheumatologist's chart. Descriptive statistics were used for data analysis. RESULTS: A total of 99 patients were included, most of whom were female (84.8%) with a median age of 49 years. At the moment of specialist's appointment, 97 patients (97.9%) repeated the ANA test, and 77 patients remained positive. Of these, only 35 (35.35%) were in a high titer range (greater than or equal to 1:320). Complete blood count for cytopenia's investigation was not performed in a high percentage of patients (22.2%), as well as urinalysis (31.3%). In addition, more than 70% of patients score 0 to 1 classification criteria for Systemic Lupus Erythematosus, according to SLE - ACR 1987 (American College of Rheumatology) and SLICC 2012 (Systemic Lupus International Collaborating Clinics). CONCLUSIONS: Most patients are still referred for specialized evaluation due to the misinterpretation of laboratory tests that were inappropriately requested in patients without clinical evidence of autoimmune rheumatic disease.

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Objetivo: Avaliar o risco de Lesão por Pressão em pessoas acamadas assistidas pela Estratégia Saúde da Família. Método: Estudo transversal, com abordagem quantitativa, realizado com 62 pacientes. A coleta de dados sucedeu-se por meio de questionário semiestruturado com dados sociodemográficos, clínicos e a avaliação do risco de Lesão por Pressão por meio da Escala de Braden. Os dados foram analisados pelo softwareestatístico Statistical Package for Social Science, versão 20.0. Resultados: Prevaleceram os pacientes do sexo feminino (61,3 %), cor branca (43,5%), viúvos (35,5%), aposentados (66,1%) e não alfabetizados (62,9%). O principal motivo de estar acamado foi devido a sequelas do Acidente Vascular Encefálico (35,5%). Evidenciou-se prevalência de risco muito alto em 59,7% das pessoas acamadas. Conclusão: O risco para Lesão por Pressão foi elevado, e a identificação dos fatores de risco é necessária e pode contribuir para estratégias preventivas ou redutoras deste agravo. (AU)

Objective: To assess the risk of pressure ulcers in bedridden individuals assisted by the Family Health Strategy. Method: A cross-sectional study employing a quantitative approach was conducted with 62 patients. Data collection was performed through a semi-structured questionnaire, encompassing sociodemographic and clinical data, as well as the assessment of pressure ulcer risk using the Braden Scale. Data were analyzed using the Statistical Package for the Social Sciences software, version 20.0. Results: Female patients (61.3%), Caucasians (43.5%), widows (35.5%), married individuals (66.1%), and those with no formal education (62.9%) predominated. The primary reason for being bedridden was sequelae from a stroke (35.5%). A prevalence of very high risk was observed in 59.7% of bedridden individuals. Conclusion: The risk of pressure ulcers was high, emphasizing the necessity of identifying risk factors to inform preventive or mitigating strategies for this condition. (AU)

Objetivo: Evaluar el riesgo de Úlceras por Presión en personas encamadas atendidas por la Estrategia Salud de la Familia. Método: Se realizó un estudio transversal con enfoque cuantitativo con 62 pacientes. La recolección de datos se realizó a través de un cuestionario semiestructurado con datos sociodemográficos y clínicos, así como la evaluación del riesgo de úlceras por presión utilizando la Escala de Braden. Los datos fueron analizados utilizando el softwareStatistical Package for Social Science, versión 20.0. Resultados: Predominaron pacientes de sexo femenino (61,3%), raza blanca (43,5%), viudas (35,5%), jubiladas (66,1%) y analfabetas (62,9%). El principal motivo de encamación fue por las secuelas de un accidente cerebrovascular (35,5%). Hubo una prevalencia de riesgo muy alta en el 59,7% de las personas encamadas. Conclusión: El riesgo de úlceras por presión fue alto, y la identificación de los factores de riesgo es necesaria y puede contribuir a estrategias preventivas o reductoras de esta condición. (AU)

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Breast cancer stands as one of the foremost cause of cancer-related deaths globally, characterized by its varied molecular subtypes. Each subtype requires a distinct therapeutic strategy. Although advancements in treatment have enhanced patient outcomes, significant hurdles remain, including treatment toxicity and restricted effectiveness. Here, we explore the anticancer potential of novel 1,4-naphthoquinone/4-quinolone hybrids on breast cancer cell lines. The synthesized compounds demonstrated selective cytotoxicity against Luminal and triple-negative breast cancer (TNBC) cells, which represent the two main molecular types of breast cancer that depend most on cytotoxic chemotherapy, with potency comparable to doxorubicin, a standard chemotherapeutic widely used in breast cancer treatment. Notably, these derivatives exhibited superior selectivity indices (SI) when compared to doxorubicin, indicating lower toxicity towards non-tumor MCF10A cells. Compounds 11a and 11b displayed an improvement in IC50 values when compared to their precursor, 1,4-naphthoquinone, for both MCF-7 and MDA-MB-231 and a comparable value to doxorubicin for MCF-7 cells. Also, their SI values were superior to those seen for the two reference compounds for both cell lines tested. Mechanistic studies revealed the ability of the compounds to induce apoptosis and inhibit clonogenic potential. Additionally, the irreversibility of their effects on cell viability underscores their promising therapeutic utility. In 3D-cell culture models, the compounds induced morphological changes indicative of reduced viability, supporting their efficacy in a more physiologically relevant model of study. The pharmacokinetics of the synthesized compounds were predicted using the SwissADME webserver, indicating that these compounds exhibit favorable drug-likeness properties and potential as antitumor agents. Overall, our findings underscore the promise of these hybrid compounds as potential candidates for breast cancer chemotherapy, emphasizing their selectivity and efficacy.

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Objetivo: Analisar a interação dos usuários em publicações de saúde com informações sobre covid-19 nas redes sociais da Prefeitura Municipal de Macapá (capital do estado do Amapá). Métodos: Trata-se de uma pesquisa de abordagem qualitativa, do tipo descritivo-exploratório, realizada com os usuários que interagiram com as publicações sobre covid-19 das redes sociais do Facebook, Instagram e Twitter da Prefeitura de Macapá. A coleta de dados ocorreu através de entrevista semiestruturada e os dados foram analisados por meio da análise de conteúdo de Bardin. Resultados: Com base nos discursos dos participantes, emergiram quatro categorias: 1 - Importância de informação clara e de fácil compreensão para todos os tipos de público; 2 - O compartilhamento de informações nas redes sociais como incentivo à prevenção; 3 - A responsabilidade de checar as informações nas redes sociais de fontes não oficiais; e 4 - A comunicação como uma via de mão dupla: postagem e resposta. Conclusão: As redes sociais institucionais podem ser um importante espaço para a disseminação de informações relacionadas à covid-19, porém se torna necessário qualificar o trabalho dessas redes através de estratégias que articulem a gestão destas em todos os âmbitos. (AU)

Objective: To analyze the interaction of users in publications of health with informations about covid-19 in Macapá's city hall (capital of the state of Amapá) social media. Methods: It is about a qualitative approach research, exploratory-descriptive type, performed with users that interacted with publications about covid-19 at this social medias: Facebook, Instagram and Twitter's city hall. The data collection occurred through semi-structured interviews and the data were analyzed through the Bardin' content analysis. Results: Based on the participants' speeches, four categories emerged: 1 - Importance of clear and easy-to-understand information for all types of public; 2 - Sharing information on social networks as an incentive for prevention; 3 - The responsibility to check information on social networks from unofficial sources; and 4 - Communication as a two-way street: post and reply. Conclusion: The institutional social medias are able to be an important space for the dissemination of information related to covid-19, however, it becomes necessary to qualify the work of those networks through strategies that can articulate better with the management of those in the whole sphere. (AU)

Objetivo: Analizar la interacción de los usuarios de publicaciones de salud con información sobre covid-19 en las redes sociales del Municipio de Macapá (capital del estado de Amapá). Métodos: Se trata de una investigación cualitativa, de tipo descriptiva-exploratoria, realizada con usuarios que interactuaron con las publicaciones sobre covid-19 de las redes sociales de Facebook, Instagram y Twitter del Municipio de Macapá. La recolección de datos ocurrió a través de entrevistas semiestructuradas y los datos fueron analizados utilizando el análisis de contenido de Bardin. Resultados: Con base en los discursos de los participantes, surgieron cuatro categorías: 1 - Importancia de la información clara y fácil de entender para todo tipo de público; 2 - Compartir información en las redes sociales como incentivo para la prevención; 3 - La responsabilidad de verificar la información en las redes sociales de fuentes no oficiales; y 4 - La comunicación como vía de doble sentido: post y respuesta. Conclusión: Las redes sociales institucionales pueden ser un espacio importante para la difusión de información relacionada con Covid-19, sin embargo, se hace necesario capacitar el trabajo de estas redes a través de estrategias que articulen su gestión en todos los ámbitos. (AU)

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The CRISPR/Cas9 system is a simpler and more versatile method compared to other engineered nucleases such as Zinc Finger Nucleases (ZFNs) and Transcription Activator-Like Effector Nucleases (TALENs), and since its discovery, the efficiency of CRISPR-based genome editing has increased to the point that multiple and different types of edits can be made simultaneously. These advances in gene editing have revolutionized biotechnology by enabling precise genome editing with greater simplicity and efficacy than ever before. This tool has been successfully applied to a wide range of animal species, including cattle, pigs, dogs, and other small animals. Engineered nucleases cut the genome at specific target positions, triggering the cell's mechanisms to repair the damage and introduce a mutation to a specific genomic site. This review discusses novel genome-based CRISPR/Cas9 editing tools, methods developed to improve efficiency and specificity, the use of gene-editing on animal models and translational medicine, and the main challenges and limitations of CRISPR-based gene-editing approaches.

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Introdução: As cefaleias são consideradas um importante problema de saúde pública e estima-se que são a segunda queixa mais comum de dor, sendo a enxaqueca uma das mais presentes. O tratamento da enxaqueca pode ser sintomático ou profilático, a fim de reduzir os sintomas em períodos de crise e evitar que novas crises se instalem, destacando a importância da adoção de hábitos saudáveis e uma alimentação equilibrada. Objetivo: O objetivo deste estudo foi realizar uma revisão integrativa da literatura, destacando os principais achados sobre a importância da alimentação e nutrição para indivíduos acometidos pela enxaqueca. Metodologia: foi realizado um levantamento de estudos nas bases de dados: Biblioteca Virtual em Saúde (BVS); Medline, LILACS, SciELO e Google Acadêmico, além de ter sido considerada a lista de referências dos trabalhos consultados, utilizando a estratégia PECO, onde P (population) indica a população, a letra E (exposure) exposição, C (comparison) comparação e a letra O (outcome) se refere aos desfechos esperados, assim gerou a pergunta norteadora do estudo: "Qual é a importância da alimentação e nutrição para indivíduos com enxaqueca?". Resultados: Foram selecionados 15 estudos para a produção do presente trabalho e foi realizada uma síntese descritiva dos resultados obtidos da relação e influência de hábitos alimentares com a enxaqueca. Conclusões: Conclui-se que os hábitos alimentares e a nutrição adequada têm grande influência e importância para indivíduos com enxaqueca, pois dessa forma, podem reduzir os sintomas apresentados e crises, já que as substâncias presentes nos alimentos estão relacionadas com o início e intensificação das crises (AU).

Introduction: Headaches are considered an important public health problem and are estimated to be the second most common pain complaint, with migraines being one of the most common. Migraine treatment is symptomatic and prophylactic to reduce symptoms when an attack starts and prevent new ones from forming, highlighting the importance of adopting healthy habits and a balanced diet. Objective: The purpose of this study was to carry out an integrative review of the literature in order to highlight the main findings on the influence of eating habits and the importance of nutrition for migraine patients. Methodology:A survey study was performed in the following databases: Virtual Health Library (VHL); Medline, LILACS, SciELO, and Google Scholar, in addition to considering the reference list of the consulted works. The PECO P (population) E (exposure) C (comparison) O (outcome) strategy was used, which generated the guiding question of the study: 'How important is food and nutrition for people with chronic migraines?'. Results:A total of 15 studies were selected to analyze in this work and a descriptive synthesis of the results was performed on the relationship and influence of eating habits of people with chronic migraines. Conclusions:It was concluded that eating habits and adequate nutrition have great influence and importance for migraine patients, as they are one of the main culprits of triggering and intensifying attacks (AU).

Introducción: Las cefaleas son consideradas un importante problema de salud pública y se estima que son la segunda queja más común de dolor, siendo la jaqueca una de las más frecuentes. El tratamiento de la jaqueca puede ser sintomático o profiláctico, con el fin de reducir los síntomas en periodos de crisis y evitar que nuevas ocurran, destacando la importancia de una adopción de hábitos saludables y una alimentación equilibrada. Objetivo: El objetivo de este estudio fue realizar una revisión integrativa de la literatura, destacando los principales hallazgos sobre la importancia de la alimentación y nutrición en personas afectadas por la jaqueca. Metodología: Fue realizada una investigación de los estudios en las bases de dados: Biblioteca Virtual en Salud (BVS); Medline, LILACS, SciELO y Google Académico, además de considerar la lista de referencias de los trabajos consultados, utilizando la estrategia PECO, donde P (population) indica la población, la letra E (exposure) exposición, C (comparison) comparación y la letra O (outcome) se refiere a los resultados esperados, así fue generada la pregunta guía del estudio: "¿Cuál es la importancia de la alimentación y nutrición para las personas con jaqueca?" Resultados: Fueron seccionados 15 estudios para la producción del presente trabajo y fue realizada una síntesis descriptiva de los resultados obtenidos de la relación e influencia de los hábitos alimentarios con la jaqueca. Conclusiones: Se concluye que los hábitos alimentarios y la nutrición adecuada tienen gran influencia e importancia para las personas conjaqueca, pues de esta forma, pueden reducir los síntomas presentados y crisis, ya que las sustancias presentes en los alimentos están relacionadas con el inicio e intensificación de las crisis (AU).

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BACKGROUND: Crocodilians are one of the oldest extant vertebrate lineages, exhibiting a combination of evolutionary success and morphological resilience that has persisted throughout the history of life on Earth. This ability to endure over such a long geological time span is of great evolutionary importance. Here, we have utilized the combination of genomic and chromosomal data to identify and compare the full catalogs of satellite DNA families (satDNAs, i.e., the satellitomes) of 5 out of the 8 extant Alligatoridae species. As crocodilian genomes reveal ancestral patterns of evolution, by employing this multispecies data collection, we can investigate and assess how satDNA families evolve over time. RESULTS: Alligators and caimans displayed a small number of satDNA families, ranging from 3 to 13 satDNAs in A. sinensis and C. latirostris, respectively. Together with little variation both within and between species it highlighted long-term conservation of satDNA elements throughout evolution. Furthermore, we traced the origin of the ancestral forms of all satDNAs belonging to the common ancestor of Caimaninae and Alligatorinae. Fluorescence in situ experiments showed distinct hybridization patterns for identical orthologous satDNAs, indicating their dynamic genomic placement. CONCLUSIONS: Alligators and caimans possess one of the smallest satDNA libraries ever reported, comprising only four sets of satDNAs that are shared by all species. Besides, our findings indicated limited intraspecific variation in satellite DNA, suggesting that the majority of new satellite sequences likely evolved from pre-existing ones.

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ABSTRACT Introduction: Immune checkpoints are regulators of the immune system response that allow self-tolerance. Molecules such as Programmed Cell Death Protein 1 (PD-1) and its Ligand (PD-L1) participate in the immune checkpoint by signaling co-inhibition of lymphocyte responses. In cancers, PD-L1 expression is associated with the immune evasion mechanism, which favors tumor growth. The use of anti-PD-1/PD-L1 drugs is already well described in solid tumors, but still not fully understood in hematologic malignancies. Myelodysplastic neoplasms (MDSs) are heterogeneous bone marrow disorders with an increased risk of progression to Acute Myeloid Leukemia (AML). The MDS affects hematopoietic stem cells and its pathogenesis is linked to genetic and epigenetic defects, in addition to immune dysregulation. The influence of the PD-L1 on the MDS remains unknown. Methods: In this study, we evaluated the mRNA expression of the PD-L1 in 53 patients with MDS, classified according to the WHO 2016 Classification. Results: Patients with dyserythropoiesis presented significantly higher PD-L1 expression than patients without dyserythropoiesis (p = 0.050). Patients classified as having MDS with an excess of blasts 2 (MDS-EB2) presented a significant upregulation in the mRNA expression of the PD-L1 compared to the MDS with an excess of blasts 1 (MDS-EB1) (p = 0.050). Furthermore, we detected three patients with very high levels of PD-L1 expression, being statistically classified as outliers. Conclusion: We suggested that the high expression of the PD-L1 is associated with a worse prognosis in the MDS and functional studies are necessary to evaluate the possible use of anti-PD-L1 therapies for high-risk MDS, such as the MDS-EBs.

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Canned fish is one of the most popular forms of fish consumption due to its high nutritional value, availability, and practicality. However, canning may induce lipid oxidation. Thus, this study provides in-depth information on the impact of high temperatures applied during canning on fish lipids. The thermo-oxidation is evidenced, for example, by the high levels of both primary and secondary oxidation products determined in fish after canning, as well as the presence of harmful compounds such as cholesterol oxides. Given the role of lipid oxidation in canned fish, this study also presents a comprehensive review on using natural antioxidants to control it. The antioxidant properties of common liquid mediums (vegetable oils and sauces) are highlighted. Moreover, adding algae extracts, spices, and condiments to the liquid medium to enhance its antioxidant potential has been considered, while the exploitation of by-products and wastes from the food industry also emerges as a suitable strategy. Besides the promising results, these practices may promote positive impacts on other quality parameters (e.g. water and oil holding capacities, texture, microbiological growth). However, further studies are needed, including research on aspects related to safety, effective concentrations and application methods, without ignoring consumers' sensory acceptance.

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