Health literacy (HL) is defined as a cognitive and social skill that determines the motivation and ability of individuals to understand and use information to promote and maintain proper health. Inadequate HL has been associated with worse outcomes in diabetes control, poor self-care, and higher hospitalization rates for some chronic diseases. We hypothesized that HL influences the prevalence of diabetic retinopathy (DR) among individuals with type 2 diabetes mellitus (T2DM) and that inadequate glycemic control would mediate this association. This was a cross-sectional study carried out with 288 participants of the “Brazilian Diabetes Study” cohort. Inclusion criteria were people diagnosed with T2DM aged between 40 and 70 years and ability to read and write. In the adequate HL group, DR was found in 16.5% of participants and in the inadequate HL group, it was found in 32.8% (P=0.0081). Individuals with inadequate HL had a higher risk of having DR, and this association was still statistically significant after adjusting for HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure. In conclusion, HL is related to DR without the mediation of classical clinical variables.

ABSTRACT Dialdehyde starches (DAS) have been used as biomaterials due to their biocompatibility and biodegradability; nonetheless, sweet potato (Ipomea batatas L.) starch has not been researched. Films based on sweet potato DAS, mixed with native starch (NS), poly-vinyl alcohol (PVA) and glycerin have been developed with protein encapsulation, using central composite design (CCD) and response surface methodology (RSM). Input variables were oxidation degree, NS concentration and polymeric mixture volume, while output variables were film's thickness, equilibrium swelling and BSA (Bovine serum albumin) release. DAS was obtained through hydrogen peroxide (H2O2) oxidation, and the oxidation degree is referred to as H2O2 concentration. Films presented rough surfaces, and formulations containing 10% H2O2 DAS presented micropores. Water uptake was greater with higher DAS content. Film thickness depended on the volume of the polymeric suspension and influenced swelling capacity. According to RSM, the optimal formulation was DAS with 5% H2O2 and 35% NS. These results demonstrate that oxidized sweet potato starch has potential for protein encapsulation and delivery.

RESUMEN Almidones dialdehído (DAS) se han utilizado como biomateriales por su biocompatibilidad y biodegradabilidad; sin embargo, el almidón de camote (Ipomea batatas L.) no ha sido investigado. Se han desarrollado películas de DAS de camote, con almidón nativo (NS), alcohol polivinílico (PVA) y glicerina con encapsulación de proteínas, utilizando un diseño central compuesto (CCD) y metodología de superficie de respuesta (RSM). Las variables de entrada fueron: grado de oxidación, concentración de NS y volumen de la mezcla polimérica, mientras que las variables de salida fueron: espesor de la película, hinchamiento y liberación de BSA (Albúmina de Suero Bovino) en equilibrio. DAS se obtuvo mediante oxidación con peróxido de hidrógeno (H2O2), y el grado de oxidación se define como concentración de H2O2. Las películas presentaron superficies rugosas y las formulaciones con 10% H2O2 DAS presentaron microporos. La absorción de agua fue mayor con mayor contenido de DAS. El espesor de la película dependió del volumen de la mezcla polimérica e influyó en la capacidad de hinchamiento. Según RSM, la formulación óptima fue DAS con 5% H2O2 y 35% NS. Estos resultados demuestran que el almidón de camote oxidado tiene potencial para aplicaciones en la encapsulación y liberación de proteínas.

A paralisia periódica hipocaliémica é uma doença rara, causada por variantes em canais de cálcio ou sódio dependentes de voltagem. Caracteriza-se por episódios frequentes de fraqueza muscular associados a hipocaliémia, frequentemente despoletados por situações de stress físico ou emocional. Relatamos o caso de um adulto do sexo feminino que se apresentou com um quadro de tetraparésia flácida e hipocaliémia grave, cuja caracterização genética permitiu identificar uma nova variante no gene CACNA1S. Após o diagnóstico iniciou terapêutica com acetazolamida, com redução da frequência e intensidade das crises. A paralisia periódica hipocaliémica constitui uma causa rara de fraqueza muscular súbita. Pode evoluir com fraqueza dos músculos respiratórios ou mesmo arritmias cardíacas, pelo que deve ser reconhecida de forma célere pelos clínicos.

Hypokalemic periodic paralysis is a rare condition secondary to a genetic abnormality in calcium or sodium voltage dependent ion channels. It typically presents with muscle weakness and concomitant low serum concentration of potassium after exercise or emotional distress. We report the case of a woman who presented with flaccid tetraparesis and severe hypokalemia in which we have identified a novel probably disease-causing variant in the CACNA1S gene. After the diagnosis, the patient started acetazolamide treatment, resulting in a reduction in the intensity and number of episodes. Hypokalemic periodic paralysis is a rare cause of sudden muscle weakness. It may cause life-threatening respiratory involvement and cardiac arrhythmias, so all the clinicians should be aware of this condition in order to recognize it quickly.

A marcroglobulinemia de Waldenström (MW) é uma doença linfoproliferativa pouco comum, sendo raros os casos de atingimento intestinal. Neste artigo descrevemos o caso de uma doente com atingimento intestinal difuso por marcroglobulinemia de Waldenström, cujas manifestações iniciais foram diarreia persistente com síndrome de má absorção, perda ponderal significativa e sintomas dispépticos. Os estudos endoscópicos revelaram atingimento de toda a mucosa do intestino delgado por depósitos de Imunoglobulina M e cadeias leves kappa. Posteriormente, a doente foi avaliada em consulta de Hemato-oncologia, apresentando baixo risco de mortalidade a 5 anos, pelo que não foram sugeridas propostas terapêuticas específicas. A doente permaneceu clinicamente estável até Dezembro de 2015, altura em que desenvolveu quadro de choque séptico com disfunção múltipla de órgãos de evolução rapidamente progressiva, acabando por falecer poucas horas após admissão no serviço de urgência. Os autores descrevem o caso desta doente e elaboram uma revisão da literatura sobre esta patologia. Pretende-se chamar a atenção para a necessidade de pensar na marcroglobulinemia de Waldenström como hipótese diagnóstica a considerar perante um doente com síndrome de má absorção.

Gastrointestinal involvement in Waldenström macroglobulinemia is an extremely rare lymphoproliferative disorder. We describe a Waldenström macroglobulinemia patient presenting with diarrhea, dyspepsia, weight loss and malabsorption. Endoscopic studies revealed diffuse deposition of immunoglobulin M and kappa light chains in the mucosa of the small intestine. Later, on evaluation in the Haemato-Oncology clinic, the risk of death at 5 years was considered low, and thus no further therapeutic measures were proposed. The patient remained stable for three years, when she developed septic shock with rapidly progressive multiple organ failure and died a few hours after admission to hospital. The authors describe the case and elaborate a review of the literature on this pathology. We draw attention to this rare manifestation of an uncommon lymphoproliferative disorder to be considered in the differential diagnosis in a patient with a malabsorption syndrome.

ABSTRACT Chitosan (QT) is a biopolymer that has been used in widely used in bone tissue engineering applications, demonstrating great potential for that purpose. Therefore, the present study aims to develop an in situ crosslinking hydrogel system, composed of chitosan and hydroxyapatite (HAP). Briefly, chitosan was modified, using carbodiimide chemistry, with lactobionic and azidobenzoic acid to make it soluble at physiological pH and photo-crosslinkable, respectively. The modified chitosan was mixed with HAP, in different proportions, and later exposed to UV light, yielding hydrogels. Mesenchymal stem cells, from rat bone marrow, were seeded onto the hydrogels and cultured for 4, 10 and 16 days, under osteogenic and non-osteogenic conditions. Through cell proliferation and alkaline phosphatase activity assays, and confocal microscopy, it was observed that the majority of formulations supported cell adhesion and proliferation, and a significant early osteogenic differentiation in formulations 70:30 and 50:50, QT:HAP. According to these results, the proposed photo-crosslinking system has potential for tissue engineering applications, and further specific studies are proposed for cell differentiation.

RESUMEN El quitosano (QT) es un biopolímero que ha sido ampliamente utilizado en aplicaciones de ingeniería de tejido óseo, demostrando un gran potencial para este propósito. El presente estudio tiene como objetivo desarrollar un sistema de hidrogel entrecruzable in situ, compuesto de quitosano y nano-partículas de hidroxiapatita (HAP), un equivalente al componente mineral del hueso. El quitosano fue modificado, utilizando reacciones de carbodiimida, con ácido lactobiónico y ácido azidobenzoico para hacerlo soluble a pH fisiológico y foto-entrecruzable, respectivamente. El quitosano modificado fue mezclado en diferentes proporciones con HAP, y luego de una corta exposición a luz UV, se formaron hidrogeles. Células madre mesenquimales de médula ósea de rata (MSC) fueron sembradas sobre estos hidrogeles y cultivadas por 4, 10 y 16 días, bajo condiciones osteogénicas y no-osteogénicas. A través de ensayos de proliferación celular, actividad de fosfatasa alcalina, y microscopía confocal, se observó que la mayoría de las formulaciones soportan la adhesión y proliferación celular, mostrando importantes interacciones célula-biomaterial, y una diferenciación osteogénica temprana destacada en las formulaciones 70:30 y 50:50, QT:HAP. Algunas formulaciones del sistema foto-entrecruzable tienen potencial en aplicaciones de ingeniería de tejido óseo, y se propone estudios más detallados de diferenciación celular.

Introdução:A pneumonia é uma infecção do parênquima pulmonar. O agente classicamente considerado mais frequente é o Streptococcus pneumoniae, contudo, o vírus influenza é também comum e associa-se a doença grave. A etiologia vírica da pneumonia é subdiagnosticada. Comparámos as pneumonias por Streptococcus pneumoniae e por influenza A do ponto de vista das características dos doentes, dados laboratoriais e radiológicos, gravidade na admissão e evolução. Métodos:Análise retrospectiva de dados clínicos e epidemiológicos dos doentes internados entre 1 de Outubro de 2013 e 31 de Março de 2014 num Hospital de dimensão média, com pneumonia por Streptococcus pneumoniae e/ou influenza A confirmada. Resultados: Identificados 40 casos de pneumonia por Streptococcus pneumoniae e 40 por influenza A. No grupo da pneumonia vírica a idade média foi 65,8 anos (vs 74,6 (p = 0,017)). Os doentes com pneumonia pneumocócica apresentavam índice de comorbilidades de Charlson superior (mediana 7 vs 4; p < 0,001), CURB-65 mais alto (p = 0,001) e leucócitos (15 273 vs 9656/µL; p < 0.001) e proteína C reactiva na admissão (191 vs 115 mg/L; p = 0,014) superiores. Nos casos víricos houve maior necessidade de escalar cuidados (43% vs 18%, p = 0,015), sem diferença significativa na mortalidade intra-hospitalar. Conclusões: Obtivemos igual número de doentes em cada grupo, o que revela prevalência de influenza superior à que habitualmente esperamos. Comparativamente aos doentes com pneumonia pneumocócica, os doentes com pneumonia vírica apresentavam idade menor e índice de comorbilidades tendencialmente mais baixo; na admissão apresentavam parâmetros inflamatórios e CURB-65 inferiores; a necessidade de escalar cuidados foi maior, contudo a mortalidade não foi significativamente diferente.

Introduction:Pneumonia is defined as an infection of the lung parenchyma. The most common overall pathogen is Streptococcus pneumoniae, however, influenza virus is also common and is associated with severe disease. The viral etiology of pneumonia is underdiagnosed. We analyzed and compared the clinical, laboratory and radiological data, severity at admission and outcome of patients with influenza A pneumonia and pneumococcal pneumonia. Methods:Retrospective analysis of clinical and epidemiological data of hospitalized patients between October 1, 2013 and March 31, 2014, in a medium-sized Hospital, with confirmed influenza A pneumonia and/or pneumococcal pneumonia. Results:We identified 40 cases of pneumococcal pneumonia and 40 cases of influenza A pneumonia. In the viral pneumonia group the mean age was 65.8 years (vs 74.6 (p = 0.017)). Pneumococcal pneumonia patients had higher Charlson comorbidities index (median 7 vs 4, p < 0.001), higher CURB-65 (p = 0.001) and white blood cells count (15273 vs 9656 / µL, p < 0.001) and C-reactive protein at admission (191 vs 115 mg / L, p = 0.014) were higher. In viral cases there was more need to escalate level of medical care (43% vs 18%, p = 0.015), with no significant difference in in-hospital mortality. Conclusion: We obtained the same number of patients in each group, which reveals a higher prevalence of influenza than we normally expect. Compared to patients with pneumococcal pneumonia, patients with viral pneumonia were younger and had a lower comorbidities index; on admission, they presented lower inflammatory parameters and CURB-65; the need to escalate care was higher, however mortality was not significantly different.

Abstract Microcrystalline powders of the nonstoichiometric Ge0.74V0.21 □0.05O2 compound were prepared by conventional high temperature solid-state reactions. The powders were characterized by X-ray diffraction (XRD); scanning electron microscopy (SEM); X-ray photoelectron spectroscopy (XPS); diffuse reflectance ultraviolet-visible spectroscopy (DRUV-VIS) and electron spin resonance (ESR) spectroscopy. From the analysis performed on compound, it was found that: The powders showed a rutile type crystalline structure with a rectangular prismatic crystalline habit. The XPS analysis, confirm the presence of V4+ and V5+ vanadium ions, the DRUV-VIS spectra show absorption bands in the 200-800 nm wave length interval and the ESR analysis confirms that the V4+ ions are within microcrystals, hosted as VO2+ at sites of rhombic (C 2v ) symmetry.

El uso de hongos de la podredumbre blanca (HPB) ha generado un gran interés debido a su potencial enzimático, permitiendo a estos organismos degradar una amplia gama de compuestos xenobióticos. Los consorcios fúngicos pueden mejorar dichos procesos de degradación con respecto a los monocultivos y para su asociación debe establecerse previamente su compatibilidad. En este trabajo se evaluó la influencia de dos condiciones nutricionales sobre el crecimiento y la compatibilidad entre tres especies de los HPB, Trametes versicolor, Pleurotus ostreatus y Pleurotus pulmonarius, para su futura utilización como consorcios en el tratamiento de contaminantes orgánicos. Discos de dos especies de los hongos evaluados crecieron por siete días sobre los medios de cultivo agar papa dextrosa (PDA) y agar salvado de trigo (AST). Se evaluaron tres tratamientos, T1: T. versicolor vs P. ostreatus, T2: T. versicolor vs P. pulmonarius y T3: P. ostreatus vs P. pulmonarius con sus respectivos controles (crecimiento libre). El porcentaje de inhibición micelial obtenido (< 70 %) mostró compatibilidad entre los hongos evaluados en los distintos tratamientos bajo las condiciones nutricionales utilizadas. Con respecto a la tasa de crecimiento, se observó que el medio AST favoreció un rápido desarrollo para los tres hongos en comparación con PDA.

The use of white rot fungi (WRF) has generated a great interest due to its enzymatic potential, allowing these organisms to degrade a wide range of xenobiotic compounds. The fungal consortia can improve these degradation processes with regard to monoculture and for its association, the compatibility should be established beforehand. In this study was evaluated the influence of two nutritional conditions on growth and compatibility between three species of WRF, Trametes versicolor, Pleurotus ostreatus and Pleurotus pulmonarius, for future use as consortia in the treatment of organic contaminants. Two discs of the tested fungal species grew for seven days over the culture medium, potato dextrose agar (PDA) and wheat bran agar (WBA). Three treatments were evaluated, T1: T. versicolor vs P. ostreatus, T2: T. versicolor vs P. pulmonarius and T3: P. ostreatus vs P. pulmonarius with their respective controls (free growth). The obtained percentage of mycelial inhibition (< 70 %) showed compatibility between the evaluated fungi in the different treatments under the used nutritional conditions. Regarding to growth rate, it was observed that WBA medium favored a rapid growth for the three fungi compared with PDA.

In this work we present the results obtained through electron paramagnetic resonance (EPR) spectroscopy of the study of the hyperfine interaction of the Vk centres in the Cesium, sodium, yttrium hexachloride (Cs2NaYCl6) crystals. These electron defect centres are created by γ-irradiation at liquid nitrogen temperature of the Cs2NaYCl6 crystals. Our results are: g|| =2.008, g┴ =2.023, A|| =91.21 (gauss) and A┴ =3.10 (gauss) and these results are compared with those obtained by Th. Pawlik and J.M. Spaeth [24] for the same system and those of D. Shoemaker [23] for sodium chloride.

Presentamos los resultados obtenidos por medio de la espectroscopía de resonancia paramagnética electrónica (EPR) del estudio de la interacción hiperfina de centros Vk en los cristales de hexacloruro de cesio, sodio, itrio (Cs2NaYCl6). Éstos centros de defecto electrónico se crean por irradiación γ a temperatura de nitrógeno líquido en los cristales de Cs2NaYCl6. Nuestros resultados son: g|| =2.008, g┴ =2.023, A|| =91.21 (gauss) and A┴ =3.10 (gauss) y éstos resultados se comparan con los obtenidos por Th. Pawlik y J.M. Spaeth [24] para el mismo sistema y los de D. Shoemaker [23] para cloruro de sodio.

In this paper we describe the design and use of a sample holder for measurements of colour centers in elpasolite crystals irradiated at liquid nitrogen temperatures and measured at the same temperature by electron paramagnetic resonance spectroscopy.

Se presenta el diseño y uso de un portamuestras para mediciones de centros de color en cristales de elpasolita irradiados a temperaturas de nitrogeno líquido y medidos a la misma temperatura por medio de espectroscopía de Resonancia Paramagnética Electrónica.