ABSTRACT BACKGROUND AND OBJECTIVES: Fibromyalgia is a clinical condition that presents generalized and chronic musculoskeletal pain. With the COVID-19 pandemic, factors such as social distancing and a reduction in the search for and supply of care for chronic diseases may have contributed to worsening the quality of life (QoL) of people with fibromyalgia. The aim of this study was to investigate the relationship between access to health care and the QoL of women with fibromyalgia during the COVID-19 pandemic. METHODS: This was a descriptive cross-sectional observational study of 30 women diagnosed with fibromyalgia, with a mean age of 56.3±10.4 years, who took part in group therapy promoted by the Fibro Dance (Dança Fibro) extension project at the Trairi Health Science Faculty of the Federal University of Rio Grande do Norte (Faculdade de Ciência da Saúde do Trairi da Universidade Federal do Rio Grande do Norte - FACISA/ UFRN). QoL was evaluated using the Short Form 36 Health Survey (SF-36) and access to health care was investigated using a questionnaire developed by the researchers, which also included sociodemographic questions and questions about health conditions. Descriptive and inferential statistics were used to analyze the data. The Shapiro-Wilk normality test was used to check the distribution of the data, and the t-test was used to compare the means of the variables with normally distributed data, while the Mann-Whitney non-parametric test was used for the variables without normal distribution. A 5% significance level was adopted for the inferential analysis. RESULTS: 66.7% of the participants received care in primary care, while 36.7% and 26.7% received care in specialized care and hospitals, respectively. As for QoL, the domains that showed the greatest impairment, with the lowest mean score, were limitation of physical aspects (9.2; 95%CI: 1.6; 16.7), limitation of emotional aspects (11.1; 95%CI: 0.6; 21.6), pain (29.9; 95%CI: 23.9;35.8), general state of health (35.8; 95%CI: 32.2; 39.4) and vitality (38.7; 95%CI: 31.9; 45.4). In the inferential analysis, there was no statistically significant difference in QoL between the group of women who received primary care or hospital care compared to the group who did not receive care at these levels (p > 0.05). On the other hand, there were statistically significant differences when the comparison was analyzed in specialized care. In the functional capacity domain (p = 0.005), the average score for the group that received specialized care was higher than the score for the group that did not, 38.2 and 24.2, respectively. For the social aspects domain (p = 0.045), the average score was 54.5 for those who received care and 37.5 for the group who did not receive care at the level of care in question. CONCLUSION: This study concluded that access to specialized care during the COVID-19 pandemic contributed to women with fibromyalgia showing better results in QoL domains such as functional capacity and social aspects.

RESUMO JUSTIFICATIVA E OBJETIVOS: A fibromialgia é uma condição clínica que apresenta dor musculoesquelética generalizada e crônica. Com a pandemia da COVID-19, fatores como distanciamento social e redução na busca e oferta por cuidados para as doenças crônicas podem ter contribuído para piorar a qualidade de vida (QV) das pessoas com fibromialgia. O objetivo deste estudo foi investigar a relação entre o acesso aos níveis de atenção à saúde e a QV de mulheres com fibromialgia durante a pandemia da COVID-19. MÉTODOS: Trata-se de um estudo observacional transversal descritivo com 30 mulheres diagnosticadas com fibromialgia, apresentando média de idade de 56,3±10,4 anos, que participaram da terapia em grupo promovida pelo projeto de extensão Dança Fibro, da Faculdade de Ciência da Saúde do Trairi da Universidade Federal do Rio Grande do Norte (FACISA/UFRN). A QV foi avaliada usando o Short Form 36 Health Survey (SF-36) e o acesso aos níveis de atenção à saúde foi investigado por meio de um questionário desenvolvido pelos pesquisadores, que também contemplou questões sociodemográficas e sobre condições de saúde. Para a análise de dados, foram usadas a estatística descritiva e a inferencial, sendo aplicado o teste de normalidade de Shapiro-Wilk para verificação da distribuição dos dados, e o teste t para comparar as médias das variáveis que apresentaram os dados normalmente distribuídos, enquanto que para as variáveis que não apresentaram distribuição normal, foi utilizado o teste não paramétrico de Mann-Whitney. Na análise inferencial, foi adotado um nível de significância de 5%. RESULTADOS: Foi observado que 66,7% das participantes receberam cuidados na atenção básica, enquanto que 36,7% e 26,7% foram assistidas na atenção especializada e hospitalar, respectivamente. No que diz respeito à QV, os domínios que apresentaram maior comprometimento, com menor escore médio, foram limitação dos aspectos físicos (9,2; IC95%: 1,6; 16,7), limitação dos aspectos emocionais (11,1; IC95%: 0,6; 21,6), dor (29,9; IC95%: 23,9;35,8), estado geral de saúde (35,8; IC95%: 32,2; 39,4) e vitalidade (38,7; IC95%: 31,9; 45,4). Na análise inferencial, não foi observada diferença estatisticamente significativa na QV entre o grupo de mulheres que foram assistidas na atenção básica ou na atenção hospitalar em comparação com o grupo que não recebeu assistência nestes níveis de atenção (p > 0,05). Em contrapartida, constatou-se diferenças estatisticamente significativas quando a comparação foi analisada no âmbito da atenção especializada. No domínio capacidade funcional (p = 0,005), o escore médio para o grupo que recebeu cuidados na atenção especializada foi superior ao escore do grupo que não recebeu, 38,2 e 24,2, respectivamente. Para o domínio aspectos sociais (p = 0,045), o escore médio foi de 54,5 para aquelas que foram assistidas e de 37,5 para o grupo que não recebeu assistência no nível de atenção em questão. CONCLUSÃO: Este estudo concluiu que o acesso à atenção especializada durante a pandemia da COVID-19 contribuiu para que as mulheres com fibromialgia apresentassem melhores resultados nos domínios da QV, tais como capacidade funcional e aspectos sociais.

Connaraceae is a plant family usually used in traditional medicine. Recently, we have reported the chemical composition and biological activity of 39 species around the world. This work highlights the application of these species to diabetes control, which has been reported at least to half of this family. In this line, there are several species of the Connaraceae without scientific evidence of traditional use, among these the four species study here. Thus, this work aims the chemical composition prospection of Connarus blanchetii, Connarus regnellii, Connarus suberosus and Rourea glazioui, as well as the identification of possible bioactivity. The leaves of these four species were collected, prepared and submitted to different extractive methods (aqueous decoction and infusion and ethanolic maceration), these being tested in a preliminary phytochemical investigation and subjected to antioxidant assay with 2,2-diphenyl-1-picrylhydrazyl and ferric reducing antioxidant power. Then, we selected the maceration extract to continue for fractions, with the ethyl acetate and n-butanol presenting the best results with antioxidant and anti-advanced glycation end products (AGEs) activity potential. Finally, the chemical composition was determinate by high-resolution mass spectrometry (HRMS) in combination with Global Natural Products Service (GNPS) data bank. As a result, this study indicated the presence of 29 phenolics compounds with reported activity as antioxidant and with potential of protein glycation, supported the diabetes activity of this plants. The n-butanolic fraction of R. glazioui showed compounds such as apigenin, kaempferol, quercetin, myricetin and chlorogenic acid, which have generated a half maximal inhibitory concentration (IC50) of 36.5 µg mL 1 for oxidative glycation inhibition, being highlighted as the most active.

RESUMO O óleo de Caryocar villosum é usado na medicina popular amazônica para tratar dores e condições inflamatórias. Assim, avaliamos as propriedades antiinflamatórias e antinociceptivas do extrato etanólico obtido das cascas dos frutos desta espécie. Os testes de contorções induzidas por ácido acético, hiperalgesia mecânica induzida por carragenina, formalina, edema de pata induzido por carragenina e peritonite induzida por carragenina foram usados em camundongos. O extrato etanólico de C. villosum obtido das cascas dos frutos inibiu significativamente o número de contorções abdominais, a hiperalgesia mecânica e o tempo de lambida da pata na segunda fase do teste de formalina. Na dose de 300 mg kg-1, o extrato também reduziu significativamente o volume de edema formado na fase tardia e reduziu o recrutamento de leucócitos e neutrófilos na cavidade peritoneal, bem como os níveis de quimiocina CXCL1. Sugere-se que o extrato atenua o recrutamento de leucócitos por meio da inibição da ativação de CXCL1. A atividade antinociceptiva periférica ocorre por meio da modulação da via opioide pois o pré-tratamento com o extrato etanólico de C. villosum reverteu a antinocicepção induzida pela naltrexona.

ABSTRACT The oil of Caryocar villosum is used in Amazonian folk medicine to treat pain and inflammatory conditions. So, we assessed the anti-inflammatory and antinociceptive properties of the ethanolic extract obtained from the fruit peels of this species. The acetic acid-induced writhing, carrageenan-induced mechanical hyperalgesia, formalin, carrageenan-induced paw edema and carrageenan-induced peritonitis tests were used on mice. The C. villosum ethanolic extract significantly inhibited the number of abdominal writhes, mechanical hyperalgesia and paw licking time in the second phase of the formalin test. At a dose of 300 mg kg-1, the extract also significantly reduced the volume of edema formed in the late phase and reduced the recruitment of leukocytes and neutrophils in the peritoneal cavity, as well as CXCL1 chemokine levels. It is suggested that the extract attenuates the leukocyte recruitment by inhibiting the CXCL1 activation. The peripheral antinociceptive activity occured through opioid pathway modulation because pretreatment with C. villosum ethanolic extract reversed the naltrexone-induced antinociception.

Resumo O Departamento de Injúria Renal Aguda (IRA) da Sociedade Brasileira de Nefrologia elaborou o presente documento para fins de padronização da terminologia em IRA e modalidades dialíticas na língua portuguesa para o Brasil. Diversos termos com significados semelhantes têm sido empregados em IRA e suas modalidades dialíticas, causando confusão e disparidades entre pacientes, nefrologistas, instituições de saúde, empresas privadas de assistência, seguradoras e entidades governamentais. Essas disparidades podem impactar a assistência médica, a organização e o atendimento hospitalares, assim como o financiamento e reembolso dos procedimentos relacionados com a IRA. Assim, nomenclatura e definições consensuais foram elaboradas, incluindo-se as definições de IRA, doença renal aguda (DRA) e doença renal crônica (DRC). Adicionalmente, todas as modalidades dialíticas e os procedimentos extracorpóreos relacionados a IRA, atualmente aprovados e disponíveis no país, foram abordados. A Sociedade Brasileira de Nefrologia espera que este Consenso possa padronizar a nomenclatura e prover suporte técnico para todos os atores envolvidos na assistência à IRA no Brasil.

Abstract The Department of Acute Kidney Injury (IRA) of the Brazilian Society of Nephrology prepared this document for the purpose of standardizing AKI terminology and dialysis modalities in the Portuguese language for Brazil. Several terms with similar meanings have been used in AKI and its dialysis modalities, causing confusion and disparities among patients, nephrologists, health institutions, private care companies, insurance companies and government entities. These disparities can impact medical care, hospital organization and care, as well as the funding and reimbursement of AKI-related procedures. Thus, consensual nomenclature and definitions were developed, including the definitions of AKI, acute kidney disease (AKD) and chronic kidney disease (CKD). Additionally, we addressed all dialysis modalities and extracorporeal procedures related to AKI, currently approved and available in the country. The Brazilian Society of Nephrology hopes that this Consensus can standardize the terminology and provide technical support to all involved in AKI care in Brazil.

RESUMO Muitos alimentos interagem com medicamentos e podem causar alterações nos efeitos farmacológicos do agente terapêutico coadministrado. A enzima CYP3A4, que pertence ao complexo enzimático do citocromo P450, é responsável pelo metabolismo da maioria dos medicamentos atualmente no mercado e está envolvida em muitas interações medicamentosas. Assim, a interação dessa enzima com sucos de algumas frutas, como a toranja, pode afetar a farmacocinética de vários medicamentos. No entanto, frutas nativas da região amazônica ainda não foram alvo desse tipo de pesquisa. Determinamos polifenóis e flavonoides totais dos frutos amazônicos de açaí (Euterpe precatoria), buriti (Mauritia flexuosa), camu-camu (Myrciaria dubia), cubiu (Solanum sessiliflorum), cupuaçu (Theobroma grandiflorum), jenipapo (Genipa americana) e taperebá (Spondias mombin) e avaliamos os efeitos de cada suco de fruta sobre a atividade de CYP3A4, utilizando o suco de carambola (Averrhoa carambola) como controle positivo. O suco de açaí apresentou o maior teor de polifenóis totais e flavonóides (102,6 ± 7,2 µg equivalente de ácido gálico (GAE) por mL e 7,2 ± 0,6 µg equivalente de quercetina (QE) por mL, respectivamente). Todos os sucos foram capazes de inibir a atividade de CYP3A4. Não houve atividade residual da enzima metabolizadora de fármacos para os sucos de açaí, buriti, cubiu, camu-camu e taperebá, enquanto para cupuaçu, jenipapo e o controle positivo, a atividade residual foi de 44,3, 54,3 e 20,2%, respectivamente. Estudos adicionais devem identificar o(s) fitocomposto(s) responsável(is) por esta atividade de inibição, para esclarecer os mecanismos envolvidos neste fenômeno.

ABSTRACT Many foods interact with drugs and may cause changes in the pharmacological effects of the co-administered therapeutic agent. The enzyme CYP3A4, which belongs to the cytochrome P450 enzyme complex, is responsible for the metabolism of most drugs currently on the market and is involved in many drug interactions. Hence, the interaction of this enzyme with juices of some fruits, such as grapefruit, can affect the pharmacokinetics of various drugs. However, native fruits from the Amazon region have not yet been the target of this type of research. We determined total polyphenols and flavonoids of the Amazonian fruits açaí (Euterpe precatoria), buriti (Mauritia flexuosa), camu-camu (Myrciaria dubia), cubiu (Solanum sessiliflorum), cupuaçu (Theobroma grandiflorum), jenipapo (Genipa americana), and taperebá (Spondias mombin) and evaluated the effects of each fruit juice on CYP3A4 activity, using the star fruit (Averrhoa carambola) juice as positive control. Açaí juice presented the highest content of total polyphenols and flavonoids (102.6 ± 7.2 µg gallic acid equivalent (GAE) per mL and 7.2 ± 0.6 µg quercetin equivalent (QE) per mL, respectively). All juices were able to inhibit the activity of CYP3A4. There was no residual activity of the drug-metabolizing enzyme for açai, buriti, cubiu, camu-camu, and taperebá juice, while for cupuaçu, jenipapo and the positive control, the residual activity was 44.3, 54.3 and 20.2%, respectively. Additional studies should identify the phytocompound(s) responsible for this inhibition activity, to clarify the mechanisms involved in this phenomenon.

ABSTRACT Background: Aedes aegypti is currently controlled with synthetic larvicides; however, mosquitoes have become highly resistant to these larvicides and difficult to eradicate. Studies have shown that insecticides derived from fungal extracts have various mechanisms of action that reduce the risk of resistance in these mosquitoes. One possible mechanism is uncontrolled production of reactive oxygen species (ROS) in the larvae, which can cause changes at the cellular level. Thus, the crude extract of Xylaria sp. was evaluated to investigate the oxidative effect of this extract in A. aegypti larvae by quantifying the oxidative damage to proteins and lipids. Methods: The larvicidal potential of the crude extract of Xylaria sp. Was evaluated, and the extract was subsequently tested in human lung fibroblasts for cytotoxicity and ROS production. ROS level was quantified in the larvae that were killed following exposure to the extract in the larvicide test. Results: The crude extract of Xylaria sp. Caused cytotoxicity and induced ROS production in human lung fibroblasts and A. aegypti larvae, respectively. In the larvicide trial, the extract showed an LC50 of 264.456 ppm and an LC90 of 364.307 ppm, and was thus considered active. The extract showed greater oxidative damage to lipids and proteins, with LC90 values of 24.7 µmol MDA/L and 14.6278 ×10-3 nmol carbonyl/ mg protein, respectively. Conclusions: Crude extracts of Xylaria sp. induced oxidative stress that may have caused the mortality of A. aegypti larvae.

Abstract Passiflora nitida Kunth, an Amazonian Passiflora species, is little studied, although the specie’s high biological potential. Herein the plant’s pharmacognostic characterization, extract production, antioxidant potential evaluation, and application of this extract in cosmetic products is reported. The physical chemical parameters analyzed were particle size by sieve analysis, loss through drying, extractive yield, total ash content, laser granulometry, specific surface area and pore diameter (SBET), differential scanning calorimetry, thermogravimetry (TG), and wave dispersive X-Ray fluorescence (WDXRF). Total phenol/flavonoid content, LC-MS/MS analysis, DPPH and ABTS antioxidant radical assays, cytotoxicity, melanin, and tyrosinase inhibition in melanocytes test provided evidence to determine the content of the major constituent. P. nitida dry extract provided a fine powder with mesopores determined by SBET, with the TG curve showing five stages of mass loss. The antioxidant potential ranged between 23.5-31.5 mg∙mL-1 and tyrosinase inhibition between 400-654 μg∙mL-1. The species presented an antimelanogenic effect and an inhibitory activity of cellular tyrosinase (26.6%) at 25 µg/mL. The LC-MS/MS analysis of the spray-dried extract displayed the main and minor phenolic compounds constituting this sample. The results indicate that P. nitida extract has promising features for the development of cosmetic formulations.

RESUMO Objetivo Esta revisão de escopo teve como objetivo mapear evidências sobre a suplementação com açaí combinada com exercícios físicos em estudos experimentais em animais e / ou humanos. Métodos A busca considerou seis bases de dados eletrônicas além da triagem de referências relevantes. O processo de seleção e extração de dados foi realizado por dois autores independentes. As características do estudo, estratégias de suplementação de açaí (forma, tempo de intervenção, e quantidade ingerida) e exercícios (tipos, intensidade e duração), seus resultados foram resumidos. Resultados Um total de 342 estudos foram inicialmente alcançados e somente 11 foram elegíveis (5 com animais e 6 com humanos). Em animais, a suplementação de açaí e os exercícios indicaram benefícios na tolerância ao exercício e melhorias em vários parâmetros hemodinâmicos, bem como melhorias significativas nos marcadores hepáticos e no metabolismo da glicose. Em humanos, a suplementação de açaí indicou resultados positivos no aumento do tempo de exaustão para 90% do VO2máx e no aumento da intensidade correspondente ao limiar anaeróbio. Conclusão Concluiu-se que pesquisas futuras envolvendo animais e humanos devem examinar a suplementação de açaí e exercícios com (a) modelos de obesidade para testar o efeito da adiponectina na composição corporal por meio de parâmetros histológicos e histoquímicos (b) protocolos de dano muscular excêntrico com incorporação de variáveis de qualidade muscular para avaliação da recuperação; (c) suplementação crônica de açaí e treinamento de força; (d) comparação das diferentes formas de suplementação de açaí em protocolos de exercícios.

ABSTRACT Objective This scoping review aimed to map evidence on açai supplementation combined with exercise in animal and/or human experimental studies. Methods The search considered six electronic databases and screening of relevant references. The selection process and data extraction were performed by two independent authors. The study characteristics, and AS (e.g., form, intervention time, amount ingested) and exercise (e.g., types, intensity, and duration) strategies were summarized, as well as their reported results. Results From an initial total of 342 studies identified; 11 (5 with animal and 6 with human models) were eligible. In animals, açai supplementation and exercise led to benefits in exercise tolerance and improvements in several hemodynamic parameters, as well as significant improvements in liver markers and glucose metabolism. In humans, açai supplementation indicated positive results in increasing exhaustion time to 90% of VO2max and increasing intensity at the anaerobic threshold. Conclusion We conclude that future research involving animals and humans should examine açai supplementation and exercise with (a) obesity models to test the effect of adiponectin on body composition with analysis of histological and histochemical parameters; (b) eccentric injury protocols with the incorporation of muscle quality variables to assess recovery; (c) chronic açai supplementation and strength training; (d) comparison of different forms of açai supplementation in exercise protocols.

Resumo Objetivo: Identificar os fatores de risco para o desenvolvimento de lesão renal aguda, mortalidade a curto e em longo prazo de pacientes com lesão renal aguda após internação em Unidade de Terapia Intensiva Pediátrica. Materiais e métodos: Análise retrospectiva de pacientes internados em unidade de terapia intensiva pediátrica de janeiro de 2004 a dezembro de 2008. Lesão renal aguda foi definida pelo critério KDIGO. Fatores de risco para lesão renal aguda, mortalidade hospitalar e em longo prazo foram obtidos através de análise multivariada por regressão logística. Mortalidade em longo prazo (até 2011) foi obtida através de busca no banco de dados da instituição e contato telefônico com parentes dos pacientes. Resultados: Foram avaliados 434 pacientes e a incidência de lesão renal aguda foi de 64%. A maioria dos episódios de lesão renal aguda (78%) ocorreu nas primeiras 24 horas após internação na Unidade de Terapia Intensiva Pediátrica. Os fatores de risco para o desenvolvimento de lesão renal aguda encontrados foram: baixo volume de diurese, menoridade, uso de ventilação mecânica, droga vasoativa, diurético e anfotericina. Menor peso, balanço hídrico positivo, lesão renal aguda, uso de dopamina e ventilação mecânica foram fatores de risco independentes para mortalidade hospitalar. A mortalidade em longo prazo foi de 17,8%. Pressão arterial sistólica, escore PRISM, baixo volume de diurese e ventilação mecânica foram fatores de risco independentes associados à mortalidade em longo prazo após internação na Unidade de Terapia Intensiva Pediátrica. Conclusão: Lesão renal aguda foi um evento frequente, precoce e esteve associada à mortalidade hospitalar e em longo prazo após internação na Unidade de Terapia Intensiva Pediátrica.

Abstract Objective: To identify the risk factors for the development of acute kidney injury and for short and long-term mortality of patients with acute kidney injury after admission to the Pediatric Intensive Care Unit. Materials and methods: Retrospective analysis of patients admitted to the Pediatric Intensive Care Unit from January 2004 to December 2008. Acute kidney injury was defined by the KDIGO criterion. Risk factors for acute kidney injury, in-hospital, and long-term mortality were obtained through multivariate logistic regression analysis. Long-term mortality (up to 2011) was obtained by searching the institution's database and by telephone contact with patients' family members. Results: A total of 434 patients were evaluated and the incidence of acute kidney injury was 64%. Most acute kidney injury episodes (78%) occurred within the first 24hours after admission to the Pediatric Intensive Care Unit. The risk factors for the development of acute kidney injury were: low volume of diuresis, younger age, mechanical ventilation, vasoactive drugs, diuretics, and amphotericin. Lower weight, positive fluid balance, acute kidney injury, dopamine use and mechanical ventilation were independent risk factors for in-hospital mortality. Long-term mortality was 17.8%. Systolic blood pressure, PRISM score, low volume of diuresis, and mechanical ventilation were independent risk factors associated with long-term mortality after admission to the Pediatric Intensive Care Unit. Conclusion: Acute kidney injury was a frequent, early event, and was associated with in-hospital mortality and long-term mortality after admission to the Pediatric Intensive Care Unit.

RESUMEN La oleorresina producida por especies del género Protium sp. es rica en amirinas alfa y beta, dos triterpenos con muchas actividades farmacológicas. Esta investigación buscó optimizar las técnicas de extracción y aislamiento de amirinas de la resina para hacer factible la obtención mejorada de esos productos. Se compararon dos métodos de extracción (maceración y sonicación) con diferentes solventes con aislamiento directo de la resina cruda. El aislamento de los triterpenos se realizó mediante columnas cromatográficas y los rendimientos de extractos y fracciones fueron hechos mediante análisis de varianza. El mejor solvente para la extracción de amirinas fue el hexano para ambos métodos de maceración y sonicación (38,16±2,06% y 37,67±8,21%, respectivamente). No hubo diferencia estadística entre estos métodos y el método directo (32,05±2,40%). Además, el método directo es más barato y ecológico. De este modo, esta investigación demostró que es posible obtener una gran cantidad de amirinas a través de métodos rápidos, baratos y ecológicos.

SUMMARY The oleoresin produced by species of genus Protium sp. is rich in alpha and betaamyrins, two triterpenes with many pharmacogical activities. Considering the need to make the improved obtainment of these products feasible, this study sought to optimize techniques for the extraction and isolation of amyrins from resin. Two methods of extraction (maceration and sonication) with different solvents were compared to direct isolation from crude resin. The isolation of triterpenes was performed by chromatographic columns and the yields of extracts and fractions were analyzed by analysis of variance. The best extraction solvent for amyrins was hexane for both maceration and sonication methods (38.16±2.06% and 37.67±8.21%, respectively). There was no statistical difference between these methods and the direct method (32.05±2.40%). Additionally, the direct method is cheaper and more environmentally friendly. Thus, this study showed that it is possible to obtain a large quantity of amyrins by means of cheap, fast and ecological methods.

A novel anti-inflammatory hybrid 3-ibuprofenyl-copalic acid (3-IbuCA) was synthesized from 3-hydroxy-copalic acid isolated from Amazonian copaiba oil (Copaifera multijuga Hayne), and the anti-inflammatory ibuprofen. After full characterization, several assays to verify its anti-inflammatory effects were performed in vitro, in vivo and in silico (molecular docking). Induced fit docking was performed to observe the interactions with the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). In vitro tests of cytotoxicity and tumor necrosis factor (TNF)-α inhibition, and in vivo tests of pleurisy, protein expression and gastrocytotoxicity were performed. Molecular docking studies with COX-1 and 2 showed binding free energies (ΔG) of -2.2 and -7.8 kcal mol-1, respectively, while for mofezolac and indomethacin, the binding free energies ΔG presented values of -8.5 and -10.1 kcal mol-1, which makes 3-IbuCA selective for COX-2 inhibition. This hybrid showed no toxicity against human macrophage at concentrations up to 2 µM, and inhibited TNF-α production in lipopolysaccharide (LPS)-stimulated macrophages. In the pleurisy assays, 3-IbuCA reduced the total leukocytes and mononuclear cells, which was followed by reduction of p-IKBα (phosphorylated nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, alpha) protein expression. Compared with ibuprofen alone, the hybrid caused less gastric damage. Thus, the docking, together with in vitro and in vivo studies suggest that this novel hybrid has potential as a new anti-inflammatory agent.

Phytochemical investigation of Endopleura uchi led to the isolation of a gallic acid derivate, known as bergenin (2) and friedelin (1), a pentacyclic triterpene. The present work also reports the bergenin quantification in different Endopleura uchi bark, twig and leaves extracts. Our findings showed the highest bergenin concentration in bark methanol extracts (4.75%) and the lowest concentration in twig aqueous extracts (1.89%). Phenolics quantification by Folin-Ciocalteu, revealed phenolic compounds level values from 16.69 to 43.02 mg GAE g-1 dry extract. The ferric reducing antioxidant activity ranged from 230.43 to 567.89 mmol Fe+2 g-1 dry extract. DPPH IC50 free radicals showed to range from 12.04 to 24.20 μg mL-1. Leaves’ chloroform fraction exhibited the highest nitric oxide inhibiting activity bearing IC50= 3.2 μg mL-1. Results show this species to hold significant bergenin concentrations as well as phenolic and anti-inflammatory compounds in all extracts suggesting it bear therapeutic potential.

RESUMO Este documento foi desenvolvido para trazer informações pertinentes à prática nefrológica em relação ao conhecimento sobre o acometimento renal da COVID-19, conduta frente aos casos de injúria renal aguda e orientações práticas sobre a provisão do suporte dialítico.Como as informações sobre a COVID-19 evoluem a uma velocidade jamais vista na ciência médica, as orientações apresentadas, embora baseadas em evidências científicas recentes, referem-se ao momento presente. Essas orientaços poderão ser atualizadas à medida que dados publicados e outras informações relevantes venham a ser disponibilizadas.

ABSTRACT We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.

Resumo Virola venosa, popularmente conhecida como ucuuba-da-mata, ocorre naturalmente na região amazônica e tem potencial para fornecer compostos naturais úteis, como já foi mostrado para outras espécies de Virola. Por isso, o objetivo deste estudo foi determinar a composição química dos extratos do tronco e das folhas de V. venosa e os possíveis potenciais antioxidantes e de inibição contra α-glucosidase de seus compostos. Os extratos polares mostraram-se mais ativos em ambos os testes, portanto, um fracionamento guiado por bioatividade foi realizado para designar os compostos responsáveis pelas atividades registradas. Através da combinação de análise CL-EM/EM e isolamento com identificação por RMN, foram identificados oito compostos fenólicos. Testes com os compostos puros principais das frações mais ativas indicaram o ácido ferúlico como o principal contribuinte das atividades biológicas observadas para os extratos brutos, e, consequentemente, o princípio ativo principal de V. venosa.

ABSTRACT Virola venosa, popularly known in Brazil as ucuuba-da-mata, occurs naturally in the Amazon region and has potential to provide useful natural compounds, as already known for other Virola species. Therefore, the objective of this study was to determine the chemical composition of bark and leaf extracts of V. venosa, and to test the antioxidant capacity and α-glucosidase inhibition potential of their compounds. Polar extracts showed to be more active in both assays, therefore a bioactivity-guided fractionation was performed to identify the compounds that were responsible for the recorded activities. Using a combination of LC-MS/MS analysis and isolation with NMR identification, eight phenolic compounds were identified. Assays with pure compounds of the active fraction revealed that ferulic acid was the main contributor compound to the observed bioactivity in the crude extracts.

RESUMO Objetivo O objetivo deste estudo foi investigar os efeitos do exercício contínuo, com ou sem a ingestão da polpa de camu-camu, em um modelo de ratos obesos. Métodos Ratos machos neonatos Wistar receberam glutamato monossódico subcutaneamente e foram separados em três grupos. grupo de exercício E (treinamento de natação contínuo); grupo exercitado e suplementado com camu-camu – EC (natação contínua e administração de camu-camu); e grupo sedentário S (sem tratamento), como controle. Concluído o experimento, os animais sofreram eutanásia. Resultados O experimento teve a duração de doze semanas. O protocolo de exercício de natação (120min) e a ingestão da suplementação com camu-camu de polpa (25mL) tiveram a mesma duração e foram feitas simultaneamente cinco vezes por semana. Os resultados apontaram redução significativa (p<0,001) dos níveis relativos das variáveis colesterol, triglicérides, glicose, High Density Lipoprotein e Low Density Lipoprotein nos dois primeiros grupos, quando comparados ao grupo controle. Quanto a peso corporal e consumo de ração, depósitos de gordura epididimal e visceral, não houve diferença significativa entre as médias dos grupos C e E – porém, estes grupos apresentaram diferença significativa quando comparados ao grupo suplementado com camu-camu (p<0,001). Conclusão Os resultados demonstraram a efetividade do exercício contínuo e da dieta suplementada com a polpa de camu-camu para o controle da obesidade.

ABSTRACT Objective The goal of this study were to investigate the effects of continuous exercise with/or without the ingestion the Camu-camu pulp in a rat model of obesity. Methods Neonate male Wistar rats, receiving monosodium glutamate, subcutaneously were separated into foour groups: sedentary group S (no treatment), exercise group E (continuous swimming training), Camu-camu group C (25mL of pulp of Camu-camu/day) and exercise and Camu-camu group EC (25mL of pulp of Camu-camu/day, continuous swimming). After 12 weeks, the animals were received euthanasia. Results The exercise program was conducted for five days for 12 weeks and the effects of supplementation with or without Camu-camu in obese rats were analyzed, showing that the relative levels of the variables cholesterol, triglycerides, glucose, High Density Lipoprotein and Low Density Lipoprotein and in all groups there was a significant reduction (.<0.001), except for the control group. Body weight and feed intake, epididymal and visceral fat deposits were not significantly different between the means of groups C and E, but these groups showed a significant difference when compared to the EC group (.<0.001). Conclusion The results demonstrate the effectiveness of continuous exercise and diet supplemented with Camu-camu fruit pulp to control obesity.