Abstract The pathogenesis of systemic lupus erythematosus (SLE) is complex. Few studies in Brazilian population have addressed cell phenotypes associated with immunological responses and their associations with SLE activity. The aim of this study is to investigate cell phenotypes associated to SLE diagnosis, treatment and activity. Twenty-eight SLE female patients (17 inactive, 11 active) and 10 healthy women were included in this study. Markers of natural killer (Nk), T and B cells in peripheral blood were evaluated by flow cytometry. Nkt cells were decreased only in SLE active patients. Activated CD4+, regulatory T FoxP3+ and B cells were decreased in both active and inactive SLE patients, compared to control group. The data corroborate the disruption of immune regulatory response in SLE patients and suggest phenotipic changes as possible biomarkers of SLE activity.

ABSTRACT BACKGROUND: The thrombin generation test (TGT) has shown promise for investigation of hemorrhagic and thrombotic diseases. However, despite its potential, it still needs standardization. Moreover, few studies have established reference values for TGT parameters. In Brazil, these values have not yet been established. OBJECTIVE: To determine TGT performance and reference intervals for TGT parameters in healthy individuals. DESIGN AND SETTING: Cross-sectional study conducted among participants in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). METHODS: The reference sample consisted of 620 healthy individuals. The calibrated automated thrombogram (CAT) method, under low and high tissue factor (TF) conditions, was used to assess thrombin generation. Test performance was analyzed using intra and interassay coefficients of variation (CV) and reference intervals were calculated using the nonparametric method proposed by the International Federation of Clinical Chemistry and the Clinical and Laboratory Standards Institute. RESULTS: The intraassay CV ranged from 1.4% to 2.2% and the interassay CV, 6.8% to 14.7%. The reference intervals for TGT parameters under low and high TF conditions were, respectively: lagtime: 3.0-10.3 and 1.4-3.7 min; endogenous thrombin potential (ETP): 1134.6-2517.9 and 1413.6-2658.0 nM.min; normalized ETP: 0.6-1.3 and 0.7-1.4; peak: 103.2-397.7 and 256.4-479.0 nM; normalized peak: 0.3-1.3 and 0.7-1.2; and time-to-peak: 5.6-16.0 and 3.4-6.7 min. These parameters were categorized relative to sex. Conclusion: TGT performance was adequate and the proposed reference intervals were similar to those of other studies. Our findings may be useful for consolidating the TGT, through contributing to its standardization and validation.

Abstract Chronic Lymphocytic Leukemia (CLL) has shown great biological heterogeneity, with a variable prognosis, and a short survival in some patients. In this light, the present study focused on the prognostic utility of circulating microparticles (MPs) and a Thrombin Generation (TG) Profile for thrombotic risk and disease progression in CLL patients. Circulating microparticles and TG were evaluated in 35 patients with CLL and 35 healthy individuals. For circulating microparticles, significant differences were observed among the following groups: MPs derived from endothelial cells (p = 0.002), B lymphocytes (p < 0.001), platelets (p = 0.003), and Tissue Factor MPs in monocytes (p < 0.001). In all cases, MP values were higher for the CLL group. When compared to the controls, CLL patients presented a decrease in TG, characterized by a reduced endogen thrombin potential (ETP) (p = 0.031). When the results were analyzed according to the Binet stage, as compared to the controls, the Binet B+C group also presented lower ETP values (p = 0.009). No significant differences were observed between the control and the Binet A groups or between the Binet A and the Binet B + C groups. Although hemostatic alterations may occur in patients with CLL, these parameters do not seem to be useful to indicate disease progression.

Abstract Chronic lymphocytic leukemia (CLL) is a blood cancer characterized by the accumulation of clonal B-lymphocytes. This study evaluated the mRNA gene expression of miR-15a, miR-16- 1, ZAP-70, and Ang-2 by qPCR, as well as the plasma levels of Bcl-2 by Elisa immunoassay, in CLL patients and healthy controls. Significant differences were observed when comparing patients and controls regarding miR-15a (p < 0.001), miR-16-1 (p < 0.001) mRNA, Ang-2 gene expression, and Bcl-2 plasma levels (p < 0.001). When stratified by risk, differences were maintained with a significantly reduced expression in high-risk patients. A positive correlation was observed between miR-15a and platelets (R2 = 0.340; p = 0.009) as well as between Bcl-2 and leukocytes (R2 = 0.310; p = 0.019). Conversely, negative correlations were observed between ZAP-70 and platelets (R2 = - 0.334; p = 0.011), between miR-15a and lymphocytes (R2 = - 0.376; p = 0.004), as well as between miR-16-and lymphocytes (R2 = - 0.515; p = 0.00004). The data suggest that a reduction in miR-15a and miR-16-1 expressions, in addition to an overexpression of Bcl-2, are associated with the reduction in apoptosis and, consequently, to a longer survival of lymphocytes, thus contributing to lymphocyte accumulation and aggravation of the disease. By contrast, Ang-2 expression was significantly higher in A than in B + C Binet groups. This context leads to the speculation that this biomarker should be investigated in more robust studies within populations with a still relevantly indolent form of the disease in an attempt to identify those patients with a greater potential for an aggravation of the disease.

Abstract The present study evaluated 56 patients diagnosed with Chronic Lymphocytic Leukemia (CLL) and a control group of 44 clinically healthy subjects with no previous history of leukemia. Genetic expressions of AKT and microRNAs were evaluated by quantitative PCR (qPCR). A significant increase in AKT gene expression in patients when compared to controls was observed (p = 0.017). When the patients were stratified according to Binet subgroups, a significant difference was observed between the subgroups, with this protein kinase appearing more expressed in the B+C subgroup (p = 0.013). Regarding miRNA expression, miR-let-7b and miR-26a were reduced in CLL patients, when compared to controls. However, no significant differences were observed in these microRNA expressions between the Binet subgroups (A versus B+C). By contrast, miR-21 to miR-27a oncogenes showed no expression difference between CLL patients and controls. AKT protein kinase is involved in the signaling cascade that occurs with BCR receptor activation, leading to increased lymphocyte survival and protection against the induction of cell death in CLL. Thus, increased AKT protein kinase expression and the reduction of miR-let-7b and miR-26a, both tumor suppressors, may explain increased lymphocyte survival in CLL patients and may be promising markers for the prognostic evaluation of this disease.

Resumen Marco contextual: El acoso escolar (bullying) es un fenómeno mundial. Los observadores son fundamentales para comprender el fenómeno y desarrollar acciones de prevención. Objetivo: Conocer la experiencia de los estudiantes identificados como testigos de situaciones de acoso escolar. Metodología: Estudio cualitativo y exploratorio desarrollado en una escuela brasileña, a partir de la teoría social cognitiva. Participaron 20 estudiantes con edades comprendidas entre los 13 y los 18 años. Los datos se recopilaron mediante entrevistas semiestructuradas y grupos de discusión. Se aplicó el análisis temático a los datos. Resultados: La tasa de prevalencia de los estudiantes que observaron el acoso escolar fue del 64%. Los participantes tienen buenos conocimientos sobre el acoso escolar, evalúan el comportamiento agresivo como negativo o perjudicial, pero esa comprensión no se traduce en autoeficacia y acciones para ayudar a las víctimas. Se construyó una categoría temática - Toma de actitud, refuerzo y sentimientos - “Lo que motivaba al acosador era el público”. Conclusión: La experiencia de los estudiantes está marcada por cuestiones individuales, escolares y contextuales. Se enuncian las implicaciones para la atención primaria de la salud.

Resumo Enquadramento: O Bullying escolar é um fenómeno mundial. Os observadores são centrais à compreensão do fenómeno e ao desenvolvimento de ações de prevenção. Objetivo: Conhecer a vivência de estudantes identificados como testemunhas de situações de bullying. Metodologia: Estudo qualitativo e exploratório desenvolvido numa escola brasileira, à luz da teoria social cognitiva. Participaram 20 estudantes com idades entre 13 e 18 anos. Os dados foram colhidos através de entrevistas semiestruturadas e grupos focais. A análise temática foi aplicada aos dados. Resultados: A taxa de prevalência de estudantes que observaram situações de bullying foi de 64%. Os participantes possuem bom conhecimento sobre o bullying, avaliam o comportamento agressivo como negativo ou prejudicial, mas esse entendimento não se converte em senso de autoeficácia e ações de ajuda às vítimas. Uma categoria temática foi construída - Tomada de atitude, reforço e sentimentos - “O que motivava o agressor era a plateia”. Conclusão: A vivência dos estudantes é assinalada por questões individuais, escolares e contextuais. Implicações para a atenção primária em saúde são enunciadas.

Abstract Background: Bullying at school is a worldwide phenomenon. Observers are central to understanding the phenomenon and developing preventive actions. Objective: To know the experience of students identified as witnesses of bullying situations. Methodology: Qualitative and exploratory study developed in a Brazilian school, in the light of the social cognitive theory. Twenty students aged between 13 and 18 years participated. Data were collected through semi-structured interviews and focus groups. Thematic analysis was applied to the data. Results: The prevalence rate of students who observed bullying was 64%. Participants have good knowledge about bullying, assess aggressive behavior as negative or harmful, but this understanding does not translate into a sense of self-efficacy and actions to help victims. A thematic category was built - Taking action, reinforcing and feeling - “What was also motivating the aggressor to do this is the audience”. Conclusion: The students’ experience is marked by individual, school and contextual issues. Implications for primary health care are spelled out.

Abstract Background Traditionally, the most effective therapy in the prevention of stroke in patients with atrial fibrillation (AF) has been oral anticoagulation with vitamin K inhibitors, particularly warfarin, whose disadvantages and adverse effects have led to their replacement by "direct oral anticoagulants", as factor X inhibitor. Objectives This study aimed to conduct a brief approach on atrial fibrillation (AF) and use of Rivaroxaban, and to comparatively evaluate the prothrombin time / International Normalized Ratio (PT/INR) in patients with AF in use of this oral anticoagulant, depending on the time elapsed between the last administration of the drug and the time of blood sample venipuncture. Methods We evaluated 34 patients with AF in use of Rivaroxaban by using PT / INR, distributed into a subgroup with blood collection time ≤ 12 hours (n = 7) and > 12 hours after the last drug intake (n = 27). Mann-Whitney test was used to compare the groups and p < 0.05 was considered significant. Results An analysis as a function of time between the Rivaroxaban intake and blood collection, revealed that PT / INR suffers the greatest effect up to 12 hours after ingestion of the drug, dropping to levels close to normal in subsequent hours before the next dose. Conclusion We concluded that, in contrast to warfarin, the knowledge of the time interval between drug intake and blood collection from patients taking Rivaroxaban is essential to properly interpret a laboratory test to assess hemostasis, particularly PT and its derivatives. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

RESUMO: Os pacientes com doença renal crônica (DRC) apresentam um potencial hemostático paradoxal, pois apresentam episódios de sangramento, mas também são propensos à trombose. Poucos estudos avaliaram as propriedades viscoelásticas sanguíneas em cães com doenças renais, entretanto, a hipercoagulabilidade já foi observada nestes pacientes. Ressalta-se ainda que a função plaquetária e sua participação neste processo ainda não foram totalmente esclarecidas. O objetivo foi avaliar e comparar o teste de geração de trombina (TGT) e as propriedades viscoelásticas sanguíneas medidas pela tromboelastometria (TEM) em cães com DRC proteinúrica. Foram selecionados 20 cães saudáveis (grupo controle) e 19 cães com DRC em estágios III ou IV classificados segundo o IRIS e a relação proteína/creatinina urinária maior que um (grupo DRC). As amostras de sangue para a realização da tromboelastometria (TEM), geração de trombina, tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA) e concentração de fibrinogênio foram colhidas em momento único para ambos os grupos após os critérios de inclusão confirmados. A análise estatística foi realizada de acordo com a distribuição das variáveis, ao nível de 5% de significância. Foi observada diferença entre os cães saudáveis e os com DRC proteinúrica observados na TEM. O teste de geração de trombina não foi capaz de diferenciar os grupos doente e saudável. Entretanto, quando os nefropatas foram analisados de forma estratificada, foram observados aumentos do ETP e da concentração máxima de trombina (peak) pelo TGT em fêmeas e em cães com mais de 30 dias de diagnóstico da DRC. Ambos os testes sinalizando para um discreto estado de hipercoagulabiliade. A tromboelastometria é mais sensível para detectar a hipercoagulabilidade em cães com DRC. Entretanto, o teste de geração de trombina tem melhor aplicabilidade por permitir o armazenamento da amostra em longo prazo.

ABSTRACT: Patients with chronic kidney disease (CKD) have paradoxical hemostatic potential because they have bleeding episodes but are also prone to thrombosis. Few studies have evaluated blood viscoelastic properties in dogs with kidney disease; on the other hand, hypercoagulability has been observed in these patients. It is also emphasized that the platelet function and its participation in this process have not yet been fully understood. The objective of this study was to evaluate and compare the Thrombin Generation Test (TGT) and also viscoelastic properties of the blood measured by thromboelastometry (TEM) in dogs with proteinuria in CKD. Twenty healthy dogs (Control Group) and 19 dogs with CKD in stage III or IV, classified according to International Renal Interest Society - IRIS, were selected, and the reference test of urine protein:creatinine ratio (UPCR) should be greater than one (CKD group). Blood samples for TEM, thrombin generation, Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), and fibrinogen concentration was collected at a single time for both groups after inclusion criteria being confirmed. Statistical analysis was performed according to the distribution of variables at 5% significance level. Differences were observed between healthy dogs and those with proteinuria in CKD noted in TEM. The TGT was unable to differentiate between sick and healthy groups. However, when the nephropathy was stratified, increases in TTP and peak thrombin concentration by TGT were observed in females and dogs over 30 days of diagnosis of CKD. Both tests signaled a discrete state of hypercoagulability. In fact, TEM is more sensitive to detect hypercoagulability in dogs with CKD. However, the TGT has potential clinical application by allowing long-term sample storage.

RESUMO A COVID-19, causada pelo Sars-CoV-2, pode apresentar complicações respiratórias que, muitas vezes, levam o paciente a depender da ventilação mecânica por vários dias. Sabe-se que a Pneumonia Associada à Ventilação Mecânica (PAVM) é frequente nos pacientes que utilizam esse equipamento por um longo período de tempo e que sua ocorrência, consequente à COVID-19, pode cursar com um pior prognóstico para o paciente. Por esse motivo, e somado à insuficiência de aparelhos para atendimento da demanda atual, faz-se necessária a adoção de medidas que visem à prevenção de complicações que possam agravar o quadro clínico do paciente e, consequentemente, aumentar o tempo médio de internação e os respectivos custos da assistência. Sendo assim, o objetivo deste estudo foi discorrer de forma concisa e prática, com base na literatura disponível, sobre a importância da adoção de protocolos adequados de higiene oral nos pacientes em ventilação mecânica. Com base nos dados obtidos, identificou-se que a adoção de medidas efetivas de higiene oral, principalmente sob a supervisão do profissional dentista, pode contribuir para a redução da morbimortalidade associada à PAVM, resultando em maior disponibilidade de equipamentos de ventilação mecânica. Desde que tais equipamentos estão sendo muito demandados durante a pandemia da COVID-19, o conhecimento e a implantação de medidas efetivas de higiene oral, indubitavelmente, repercutirão na melhoria da qualidade da assistência oferecida aos pacientes, portanto, beneficiando todos aqueles em situação crítica de saúde e assistidos em UTIs.

SUMMARY COVID-19, caused by SARS-CoV-2, can present respiratory complications that often lead patients to depend on mechanical ventilation (MV) for several days. It is known that Pneumonia Associated with Mechanical Ventilation (PAMV) is frequent in patients who use this equipment for a long time. As a consequence of COVID-19, its prolonged use can lead to a worse prognosis for the patients. For this reason, in addition to the insufficiency of devices for mechanical ventilation to meet the current demand, it is necessary to adopt measures aimed at preventing complications that may aggravate the patient’s clinical condition and, consequently, increase the average hospital stay and the respective hospital care costs. Therefore, the objective of this study was to discuss, in a concise and practical way, and based on the available literature, the importance of adopting adequate oral hygiene protocols for patients on mechanical ventilation. Based on the data obtained, it was identified that the adoption of effective oral hygiene measures, especially under the supervision of dental professionals, can contribute to the reduction of morbidity and mortality associated with MV, resulting in greater availability of mechanical ventilation equipment. Since such equipment is in great demand during the COVID-19 pandemic, the knowledge and implementation of effective oral hygiene measures will undoubtedly have an impact on improving the quality of care offered to patients, therefore benefiting all those in critical health conditions and assisted in ICUs.

RESUMO O objetivo do estudo foi caracterizar o acesso ao tratamento da mulher com diagnóstico de câncer de mama no estado do Piauí, Brasil. Estudo transversal analítico, desenvolvido em duas instituições hospitalares de referência, no período de janeiro a junho de 2018. A população compreendeu mulheres diagnosticadas com câncer de mama que realizaram tratamento no período de 2016 a 2017. A amostra foi de 155 participantes. A amostragem foi estratificada proporcional. Os dados foram processados no IBM® SPSS®, e calculadas estatísticas uni e bivariadas. Constatou-se que o tempo para o tratamento foi de, em média, 112,7 (±93,6) dias, variando de 12 a 550 dias (≡18,3 meses ou 1,5 anos), sendo que 71,6% das mulheres iniciaram o tratamento em um período superior a 60 dias do diagnóstico do câncer de mama. Foram verificadas associações estatisticamente significativas entre o atraso para início do tratamento e o território estadual de residência (p=0,041) e o estágio da doença (p=0,037). Dessa forma, o acesso ao tratamento do câncer de mama não está acontecendo como preconizado. Ressalta-se, portanto, a necessidade de uma maior organização dos serviços de saúde em rede, levando em conta as necessidades da população, por meio do atendimento em tempo oportuno.

ABSTRACT This study was aimed at characterizing the access to treatment of women diagnosed with breast cancer in the state of Piauí, Brazil. A cross-sectional analytical study was developed in two referral hospital institutions from January/2018 to June/2018. The population comprised women diagnosed with breast cancer who underwent treatment in the period from 2016 to 2017. The sample amounted to 155 participants. Sampling was proportionally stratified. The data was processed in IBM® SPSS®, and uni and bivariate statistics were calculated. It was noted that the average time for treatment was of 112.7 (± 93.6) days, varying from 12 to 550 days (≡18.3 months or 1.5 years), with 71.6 % of the women starting treatment within a period higher than 60 days following breast cancer diagnosis. Statistically significant associations were verified between the delay to start treatment and the state territory of residence (p = 0.041) and the disease stage (p = 0.037). The conclusion is that women are not having access to breast cancer treatment as recommended. Therefore, it is worth noting the need for greater organization in the network of health services, taking into account the needs of the population through timely health care.

ABSTRACT Background: In order to standardize a thrombin generation() protocol, we analyzed the analytical variables and sensitivity of this test to hypo/hypercoagulability states. Methods: The effect of the tissue factor concentration and the intra- and interassay precision were analyzed. To evaluate the hypercoagulability status, the plasma of women under an oral contraceptive was tested, while plasma from hemophilia A patients at 1, 3 and 7 days after recombinant FVIII infusion, and lyophilized plasma deficient in FVII or FVIII were used for the evaluation of hypocoagulability. Results: The intra-assay coefficient of variation was <10% with 1 and 5 pM of low and high TF. The oral contraceptive users showed increased thrombin generation in comparison to non-users, which was more pronounced with low TF (endogenous thrombin potential ETP) p = 0.0009; peak p = 0.0009; lagtime p = 0.0008). In relation to the FVIII-deficient plasma, a higher TG was observed as FVIII levels were increased and a better discrimination was obtained for different concentrations of FVIII with low TF (ETP p < 0.0001; peak p < 0.0001; lagtime p = 0.0004). Using low TF, plasma from hemophilia A patients showed higher TG values after 1 day of recombinant FVIII infusion vs after 3 days (ETP p < 0.0001; peak p < 0.0001; lagtime p = 0.0407), while the lowest values were observed after 7 days. With FVII-deficient plasma, thrombin generation was lower than normal plasma and a more pronounced difference was observed with high TF compared to low TF (ETP p < 0.0001; peak p < 0.0001; lagtime p < 0.0001). Conclusion: Under our conditions the thrombin generation test seems to be sensitive to evaluation of hyper/hypocoagulability states. Standardization of the thrombin generation test may have an application in the evaluation of bleeding and thrombotic disorders.

RESUMO O objetivo do estudo foi caracterizar o acesso ao tratamento da mulher com diagnóstico de câncer de mama no estado do Piauí, Brasil. Estudo transversal analítico, desenvolvido em duas instituições hospitalares de referência, no período de janeiro a junho de 2018. A população compreendeu mulheres diagnosticadas com câncer de mama que realizaram tratamento no período de 2016 a 2017. A amostra foi de 155 participantes. A amostragem foi estratificada proporcional. Os dados foram processados no IBM® SPSS®, e calculadas estatísticas uni e bivariadas. Constatou-se que o tempo para o tratamento foi de, em média, 112,7 (±93,6) dias, variando de 12 a 550 dias (≡18,3 meses ou 1,5 anos), sendo que 71,6% das mulheres iniciaram o tratamento em um período superior a 60 dias do diagnóstico do câncer de mama. Foram verificadas associações estatisticamente significativas entre o atraso para início do tratamento e o território estadual de residência (p=0,041) e o estágio da doença (p=0,037). Dessa forma, o acesso ao tratamento do câncer de mama não está acontecendo como preconizado. Ressalta-se, portanto, a necessidade de uma maior organização dos serviços de saúde em rede, levando em conta as necessidades da população, por meio do atendimento em tempo oportuno.

ABSTRACT This study was aimed at characterizing the access to treatment of women diagnosed with breast cancer in the state of Piauí, Brazil. A cross-sectional analytical study was developed in two referral hospital institutions from January/2018 to June/2018. The population comprised women diagnosed with breast cancer who underwent treatment in the period from 2016 to 2017. The sample amounted to 155 participants. Sampling was proportionally stratified. The data was processed in IBM® SPSS®, and uni and bivariate statistics were calculated. It was noted that the average time for treatment was of 112.7 (± 93.6) days, varying from 12 to 550 days (≡18.3 months or 1.5 years), with 71.6 % of the women starting treatment within a period higher than 60 days following breast cancer diagnosis. Statistically significant associations were verified between the delay to start treatment and the state territory of residence (p = 0.041) and the disease stage (p = 0.037). The conclusion is that women are not having access to breast cancer treatment as recommended. Therefore, it is worth noting the need for greater organization in the network of health services, taking into account the needs of the population through timely health care.

RESUMO O Babaçu (Orbignya sp) é uma planta lignocelulósica, disponível em larga escala no norte-nordeste do Brasil, que vem despontado como uma boa fonte de biomateriais, sendo utilizados em vários estudos como adsorventes. Diante disso, o presente trabalho teve como objetivo realizar um estudo prospectivo do uso de subprodutos do babaçu (endocarpo, mesocarpo, epicarpo e carvão ativado) como um material com excelentes propriedades adsortivas, em potencial, para moléculas inorgânicas e orgânicas.O estudo foi realizado através de uma revisão de literatura (artigos e patentes), no intervalo temporal de julho de 2015 a fevereiro de 2018. As bases de dados utilizadas foram: Instituto Nacional de Propriedade Industrial do Brasil, World Intellectual Property Organization, European Patent Office, United States Patent and Trademark Office e Patentes públicas da América latina e Espanha, para busca de patentes; e Pubmed, Scopus, Web of Science e Scientific Electronic Library Online, para os artigos. A partir da análise criteriosa do levantamento bibliográfico foram selecionados 18 artigos científicos e 1 patente, sobre o tema. Dentre os quais o mesocarpo, epicarpo (naturais e modificados) e o carvão ativado do babaçu foram substratos de adsorção bastante eficientes. Onde os resultados foram satisfatórios, de modo que o babaçu desponta como um bom adsorvente e de baixo custo, sendo assim um biomaterial de qualidade e acessível.

ABSTRACT Babaçu (Orbignya sp) is a lignocellulosic plant, available in large scale in the north-northeast of Brazil, which has been emerging as a good source of biomaterials, being used in several studies as adsorbents. The objective of this study was to prospectively study the use of babaçu by-products (endocarp, mesocarp, epicarp and activated carbon) as a material with the exception of potential adsorptive target species for inorganic and organic molecules. was carried out through a literature review (article and patents), in the time period of July 2015 and February 2018. The databases used were: National Institute of Industrial Property of Brazil, World Intellectual Property Organization, Patents, Patent and Trademark Office of the United States of America and Spain for Patent Search; and Pubmed, Scopus, Web of Science and Scientific Electronic Library Online, for articles. From the careful analysis of the bibliographical survey, 18 scientific papers and 1 patent on the subject were selected. Among them, the mesocarp, epicarp (natural and modified) and the activated charcoal of babassu were very efficient adsorption substrates. The results were satisfactory, so that babassu was shown as a good indicator of cost and benefit, thus being a quality and accessible biomaterial.

RESUMO Introdução: A trombose arterial é considerada uma doença multifatorial, resultante da interação de fatores de risco genéticos e adquiridos. Objetivos: O objetivo deste estudo foi investigar a presença dos polimorfismos nos genes do inibidor da ativação do plasminogênio tipo 1 (PAI-1) e da apolipoproteína E (ApoE), bem como suas interações com níveis de PAI-1 e lipídios e perfis de apolipoproteína, respectivamente, além das frequências desses polimorfismos e sua associação com trombose. Métodos: Noventa e sete pacientes [48 com acidente vascular cerebral isquêmico arterial (AVC) e 49 com doença arterial periférica (DAP)], tratados no serviço médico de hematologia, foram incluídos neste estudo. Os polimorfismos também foram investigados em 201 indivíduos-controle. Os polimorfismos foram investigados por reação em cadeia da polimerase-fragmento de restrição polimorfismo (PCR-RFLP). Resultados: Para o polimorfismo PAI-1, havia 54,2% genótipos heterozigotos (HT) e 12,5% genótipos de homozigoto (HM) no grupo dos pacientes, e 52,7% genótipos HT e 21,3% genótipos HM nos grupos-controle. Para o polimorfismo da ApoE, havia 56,3% (ε3ε3), 6,3% (ε4ε4), 8,3% (ε2ε3), 4,2% (ε2ε4) e 24,9% (ε3ε4) nos pacientes, e 61,2% (ε3ε3), 4,5% (ε4ε4), 8% (ε2ε3), 4,5% (ε2ε4) e 21,8% (ε3ε4) nos controles. Conclusão: Nenhuma diferença significativa foi observada comparando pacientes e controles. Neste estudo, não foi encontrada associação entre a presença dos polimorfismos avaliados e a ocorrência de eventos trombóticos.

ABSTRACT Introduction: Arterial thrombosis is considered a multifactorial disease, resulting from the interaction of genetic and acquired risk factors. Objectives: The aim of this study was to investigate the presence of the polymorphism in inhibitor of plasminogen activator type 1 (PAI-1) and apolipoprotein E (ApoE) genes and its interactions with PAI-1 levels and lipids and apolipoprotein profiles, respectively, as well as the frequencies of these polymorphisms and their association with thrombosis. Methods: Ninety-seven patients [48 with arterial ischemic stroke (IS) and 49 with peripheral arterial disease (PAD)], treated at the hematology medical service were included in this study. Polymorphisms were also investigated in 201 control subjects. Polymorphisms were investigated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: For the PAI-1 polymorphism, there were 54.2% heterozygous (HT) genotypes and 12.5% homozygous (HM) genotypes in the patients' group, and 52.7% HT genotypes and 21.3% HM genotypes in the controls. For the ApoE polymorphism, there were 56.3% (ε3ε3), 6.3% (ε4ε4), 8.3% (ε2ε3), 4.2% (ε2ε4) and 24.9% (ε3ε4) in the patients, and 61.2% (ε3ε3), 4.5% (ε4ε4), 8% (ε2ε3), 4.5% (ε2ε4) and 21.8% (ε3ε4) in the controls. Conclusion: No significant difference was observed by comparing patients and controls. In this study, no association was found between the presence of the evaluated polymorphisms and the occurrence of thrombotic events.

RESUMO Objetivo: O objetivo deste estudo foi caracterizar o perfil lipídico convencional, os níveis de LDL-ox e o polimorfismo da ApoE em pacientes com doença de Alzheimer (DA) e em indivíduos idosos sem comprometimento cognitivo. Métodos: Foram selecionados oitenta indivíduos idosos. Os níveis de LDL-ox foram determinados usando o kit ELISA e a investigação do polimorfismo do gene da ApoE por PCR-RFLP. Resultados: Níveis significativamente reduzidos de LDL-ox foram observados em pacientes com DA comparado ao grupo controle. Uma maior frequência do alelo ε4 da ApoE foi observada nos pacientes com DA em relação aos controles. Nenhuma diferença foi observada para os níveis de colesterol total, HDL-C e LDL-C entre os dois grupos, enquanto níveis de triglicérides foram mais altos em controles comparados aos pacientes com DA. Conclusão: Os dados analisados em conjunto não revelaram diferenças significativas no perfil lipídico, incluindo os níveis de LDL-ox. No entanto, não se pode excluir a importância de alterações lipídicas na gênese da doença. Não obstante, o alelo ε4 da ApoE foi signicativamente mais frequente nos pacientes com demência de Alzheimer em concordância com achados prévios da literatura, mas esse componente genético não interferiu nos níveis de LDL-ox.

ABSTRACT Objective: The objective of this study was to characterize the conventional lipid profile, oxLDL levels and ApoE polymorphism in patients with Alzheimer's disease (AD) and in elderly individuals without cognitive impairment. Methods: Eighty elderly individuals were selected and the levels of oxLDL were determined using the ELISA kit, and ApoE gene polymorphism was investigated using polymerase chain reaction-restriction fragment length polymorphism. Results: Significantly reduced levels of oxLDL were observed in patients with AD compared to the control group. A higher frequency of the ApoE ε4 allele was observed in patients with AD compared to controls. No difference was observed for total cholesterol, HDL-C, and LDL-C levels between the two groups, while triglyceride levels were higher in controls compared with patients with AD. Conclusion: The data analyzed together did not reveal significant differences in lipid profiles, including oxLDL levels. However, the importance of lipid changes in the genesis of the disease cannot be ruled out. Nevertheless, the ApoE ε4 allele was significantly more frequent in patients with Alzheimer's dementia in agreement with previous findings in the literature, but this genetic component did not change the levels of oxLDL.