Systematic Review of Human and Animal Studies Examining the Efficacy and Safety of Acetylcysteine (NAC) and Acetylcysteine Amide (NACA) in Traumatic Brain Injury: Impact on Neurofunctional Outcome and Biomarkers of Oxidative Stress and Inflammation.

Background: No new therapies for traumatic brain injury (TBI) have been officially translated into current practice. At the tissue and cellular level, both inflammatory and oxidative processes may be exacerbated post-injury and contribute to further brain damage. acetylcysteine (NAC) has the potential to downregulate both processes.

Mixture Design and Doehlert Matrix for the Optimization of the Extraction of Phenolic Compounds from L Apple Bagasse Agroindustrial Residues.

In this study, we have determined, using RSM (mixture design and Doehlert matrix), the optimum values of the independent variables to achieve the maximum response for the extraction of total phenolic compounds from L bagasse agroindustrial residues in order to preserve their antioxidant activity. The extraction of phenolic compounds, as well as their antioxidant capacity and the capacity to scavenge ABTS, was determined by the modified DPPH method at different periods of time, temperature, velocity of rotation and solvents concentration. We observed that the optimum condition for the highest antioxidant yield was obtained using water (60.

Value of the Electrocardiographic (P Wave, T Wave, QRS) Axis as a Predictor of Mortality in 14 Years in a Population With a High Prevalence of Chagas Disease from the Bambuí Cohort Study of Aging.

We sought to investigate the prognostic value of the electrocardiogram (ECG) electrical axes (P wave, T wave and QRS) as predictors of mortality in the 14-year follow-up of the prospective cohort of all residents ≥60 years living in the southeastern Brazilian city of Bambuí, a population with high prevalence of Chagas disease (ChD). Baseline ECG axes were automatically measured with normal values defined as follows: P-wave axis 0° to 75°, QRS axis -30° to 90°, and T axis 15° to 75°. Participants underwent annual follow-up visits and death was verified using death certificates.

Hypothermia indices among severely injured trauma patients undergoing urgent surgery: A single-centred retrospective quality review and analysis.

Background: Hypothermia (<36°C) exacerbates trauma-induced coagulopathy and worsens morbidity and mortality among severely injured trauma patients; there is a paucity of published data describing how well trauma centres adhere to standards regarding measurement of temperature, and best practices for preventing and treating hypothermia.

Methods: We completed a retrospective quality audit of all severely injured trauma patients (Injury Severity Score (ISS≥20)) who had urgent surgery at Sunnybrook Health Sciences Centre (SHSC) between 2010 and 2014. Information regarding temperature monitoring was evaluated over the course of the initial resuscitation and admission.

Functional aspects of salivary nitric oxide synthase of Rhodnius prolixus (Hemiptera, Reduviidae) and nitric oxide trafficking at the vector-host interface.

Rhodnius prolixus expresses nitric oxide synthase (NOS) in the cytosol of the salivary gland (SG) cells. The NO produced is stored in the SG lumen bound to NO-carrier haemeproteins called nitrophorins (NPs). NPs bind tightly to NO in the acidic SG lumen, but release NO when the pH becomes high, e.

Influence of indigenous microbiota on experimental toxoplasmosis in conventional and germ-free mice.

Toxoplasmosis represents one of the most common zoonoses worldwide. Its agent, Toxoplasma gondii, causes a severe innate pro-inflammatory response. The indigenous intestinal microbiota promotes host animal homoeostasis and may protect the host against pathogens.

A focussed single-view hand-held echocardiography protocol for the detection of rheumatic heart disease.

Background: Echocardiographic screening represents an opportunity for reduction in the global burden of rheumatic heart disease. A focussed single-view screening protocol could allow for the rapid training of healthcare providers and screening of patients.

Objective: The aim of this study was to determine the sensitivity and specificity of a focussed single-view hand-held echocardiographic protocol for the diagnosis of rheumatic heart disease in children.

Global, Regional, and National Burden of Rheumatic Heart Disease, 1990-2015.

Background: Rheumatic heart disease remains an important preventable cause of cardiovascular death and disability, particularly in low-income and middle-income countries. We estimated global, regional, and national trends in the prevalence of and mortality due to rheumatic heart disease as part of the 2015 Global Burden of Disease study.

Methods: We systematically reviewed data on fatal and nonfatal rheumatic heart disease for the period from 1990 through 2015.

Net atrioventricular compliance is an independent predictor of cardiovascular death in mitral stenosis.

Objectives: Rheumatic mitral stenosis (MS) is a progressive disease, and risk of death may persist despite relief of the obstruction. Net atrioventricular compliance (C) modulates the overall haemodynamic burden of the MS and may be useful in predicting cardiovascular death after percutaneous mitral valvuloplasty (PMV).

Methods: A total of 427 patients (mean age 50±16 years, 84% female) with severe MS undergoing PMV were enrolled.

The Anticoagulated trauma patient in the age of the direct oral anticoagulants: a Canadian perspective.

Background: The anticoagulated trauma patient presents a particular challenge to the critical care physician. Our understanding of these patients is defined and extrapolated by experience with patients on warfarin pre-injury. Today, many patients who would have been on warfarin are now prescribed the Direct Oral Anticoagulants (DOACs) a class of anticoagulants with entirely different mechanisms of action, effects on routine coagulation assays and approach to reversal.

Variations and particularities in cardiovascular disease mortality in Brazil and Brazilian states in 1990 and 2015: estimates from the Global Burden of Disease.

Objective:: To analyze variations and particularities in mortality due to cardiovascular disease (CVD) in Brazil and in Brazilian states, in 1990 and 2015.

Methods:: We used data compiled from the Global Burden of Disease (GBD) 2015, obtained from the database of the Mortality Information System (SIM) of the Brazilian Ministry of Health. Correction of the sub-registry of deaths and reclassification of the garbage codes were performed using specific algorithms.

Establishment and cryptic transmission of Zika virus in Brazil and the Americas.

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease.

Factors associated with compliance to AHA/ACC performance measures in a myocardial infarction system of care in Brazil.

Objective: To evaluate compliance with American Heart Association/American College of Cardiology (AHA/ACC) performance measures for adults with acute myocardial infarction (AMI) and to investigate the factors associated with compliance, in an AMI System of Care in Brazil.

Design: Observational longitudinal study.

Setting: A high-complexity University Hospital, part of the AMI System of Care implemented in Belo Horizonte, Brazil, in 2010.

Blood transfusion and coagulopathy in geriatric trauma patients.

Background: Trauma resuscitation has undergone a paradigm shift with new emphasis on the early use of blood products and increased proportions of plasma and platelets. However, it is unclear how this strategy is applied or how effective it is in the elderly population. The study aim is to identify differences in transfusion practices and the coagulopathy of trauma in the elderly.

Efficacy and safety of the drugs used to reverse direct oral anticoagulants: a systematic review and meta-analysis.

Background: Direct oral anticoagulants (DOACs) are effective and safe for prophylaxis and treatment of thromboembolic phenomena. However, managing DOACs during bleeding emergencies is challenging. A systematic review and meta-analysis was conducted on studies addressing efficacy and safety of the drugs used for reversal of DOACs.

Catecholamines as outcome markers in isolated traumatic brain injury: the COMA-TBI study.

Background: Elevated catecholamine levels might be associated with unfavorable outcome after traumatic brain injury (TBI). We investigated the association between catecholamine levels in the first 24 h post-trauma and functional outcome in patients with isolated moderate-to-severe TBI.

Methods: A cohort of 174 patients who sustained isolated blunt TBI was prospectively enrolled from three Level-1 Trauma Centers.

Evaluation of colonisation resistance in stool of human donors using ex vivo, in vitro and in vivo assays.

The indigenous microbiota is the population of microorganisms normally present on the surface and mucosa of an individual, where it performs essential health functions, including the colonisation resistance (CR) against pathogens. To identify the bacteria responsible and the mechanisms involved in the CR, the germ-free (GF) animal model has been used, because in vitro studies cannot always be extrapolated to what occurs in vivo. In this study, ex vivo antagonism assays against seven enteropathogenic bacteria using stools from 15 healthy human donors confirmed that the CR showed individual variation.

Fibrinogen in the initial resuscitation of severe trauma (FiiRST): a randomized feasibility trial.

Background: Decreased plasma fibrinogen concentration shortly after injury is associated with higher blood transfusion needs and mortality. In North America and the UK, cryoprecipitate transfusion is the standard-of-care for fibrinogen supplementation during acute haemorrhage, which often occurs late during trauma resuscitation. Alternatively, fibrinogen concentrate (FC) can be beneficial in trauma resuscitation.

Telehealth solutions to enable global collaboration in rheumatic heart disease screening.

Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais.

Disruption of beta3 adrenergic receptor increases susceptibility to DIO in mouse.

The brown adipose tissue (BAT) mediates adaptive changes in metabolic rate by responding to the sympathetic nervous system through β-adrenergic receptors (AR). Here, we wished to define the role played by the ARβ isoform in this process. This study focused on the ARβ knockout mice (ARβKO), including responsiveness to cold exposure, diet-induced obesity, intolerance to glucose, dyslipidaemia and lipolysis in white adipose tissue (WAT).

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid.

Background: Hyperfibrinolysis may occur due to systemic inflammation or hepatic injury that occurs during liver resection. Tranexamic acid (TXA) is an antifibrinolytic agent that decreases bleeding in various settings, but has not been well studied in patients undergoing liver resection.

Methods: In this prospective, phase II trial, 18 patients undergoing major liver resection were sequentially assigned to one of three cohorts: (i) Control (no TXA); (ii) TXA Dose I - 1 g bolus followed by 1 g infusion over 8 h; (iii) TXA Dose II - 1 g bolus followed by 10 mg/kg/hr until the end of surgery.

A systematic review on the rotational thrombelastometry (ROTEM®) values for the diagnosis of coagulopathy, prediction and guidance of blood transfusion and prediction of mortality in trauma patients.

Introduction: Viscoelastic assays have been promoted as an improvement over traditional coagulation tests in the management of trauma patients. Rotational thromboelastometry (ROTEM®) has been used to diagnose coagulopathy and guide hemostatic therapy in trauma. This systematic review of clinical studies in trauma investigates the ROTEM® parameters thresholds used for the diagnosing coagulopathy, predicting and guiding transfusion and predicting mortality.

Goat sausages containing chitosan towards a healthier product: microbiological, physico-chemical textural evaluation.

Goat meat is extensively known for its interesting nutritional value and for being an important source of protein with high quality. Its food derivatives are, therefore, a good alternative to develop new products addressed to health conscious consumers. In this work, a healthier goat product, namely, a low fat fresh sausage, was produced with the objective of evaluating the effect of inclusion of chitosan on quality, stability and shelf life.