Abstract In the last few decades, there have been considerable improvements in the diagnosis and care of Duchenne muscular dystrophy (DMD), the most common childhood muscular dystrophy. International guidelines have been published and recently reviewed. A group of Brazilian experts has developed a standard of care based on a literature review with evidence-based graded recommendations in a two-part publication. Implementing best practice management has helped change the natural history of this chronic progressive disorder, in which the life expectancy for children of the male sex in the past used to be very limited. Since the previous publication, diagnosis, steroid treatment, rehabilitation, and systemic care have gained more significant insights with new original work in certain fields. Furthermore, the development of new drugs is ongoing, and some interventions have been approved for use in certain countries. Therefore, we have identified the need to review the previous care recommendations for Brazilian patients with DMD. Our objective was to create an evidence-based document that is an update on our previous consensus on those topics.

Resumo Nas últimas décadas, houve progressos significativos no diagnóstico e no tratamento da distrofia muscular de Duchenne (DMD), considerada a distrofia muscular mais comum na infância. Diretrizes internacionais foram publicadas e revisadas recentemente. Um grupo de especialistas brasileiros desenvolveu um padrão de atendimento baseado em revisão de literatura, com recomendações graduadas pautadas em evidências compiladas em uma publicação dividida em duas partes. A implementação de melhores práticas de manejo ajudou a modificar a história natural desta doença crônica, progressiva, que, no passado, oferecia uma expectativa de vida muito limitada para crianças do sexo masculino. Desde a publicação desse consenso anterior, o diagnóstico, o tratamento com esteroides, a reabilitação e os cuidados sistêmicos ganharam novas possibilidades a partir da divulgação dos resultados de trabalhos originais em algumas dessas áreas. Além disso, as pesquisas e o desenvolvimento de novos fármacos estão em andamento, e algumas intervenções já foram aprovadas para uso em determinados países. Nesse contexto, identificamos a necessidade de rever as recomendações anteriores sobre o manejo dos pacientes brasileiros com DMD. Nosso objetivo principal foi elaborar uma atualização baseada em evidências sobre esses tópicos do consenso.

Abstract The objective of this study was to obtain and characterize a freeze-dried powder of taioba leaves (Xanthosoma taioba) as a source of bioactive substances and potential food applications. The fresh leaves were cooked and lyophilized for further analysis. Its bioactive contents expressed in flavonoids, ascorbic acid and total polyphenols were quantified. Total antioxidant activity (TAA) was determined by ABTS assays. The chemical composition via infrared spectroscopy (FTIR) and its microstructure were visualized by scanning electron microscopy (SEM). The bioactive contents of flavonoids, ascorbic acid and polyphenols were 17.15 mg/100 g, 58.3 mg/100 g and 24.15 mg Eq. of gallic acid/100 g, respectively. A high content of TAA was found. ABTS 37.35 (µg TE/g). The FTIR spectrum revealed high-intensity bands at 3350 cm-1, 2928 cm-1, 1637 cm-1, and 1055 cm-1 related to vibrations associated with typical bands of −OH groups present in cellulose membranes, hemicellulose, carbohydrates, lignin and water. The micrographs showed irregular structures of the ground leaves with a fibrous structure. These results indicate a high potential of this raw material in food formulations as a source of bioactives suitable for applications in various industrial segments.

ABSTRACT: The objective this study was to determine mean values of masseter muscle thickness in male and female, at rest and contraction, in healthy individuals. At first, 102 questionnaires were distributed between students. Thirty patients were selected, 15 male and 15 female, according to the inclusion criteria, excluding all individuals with symptoms of temporo-mandibular dysfunction or syndromes with craniofacial disorders. Masseter muscle thickness was determined bilaterally, at rest and contraction. As a reference point for the measurement of thickness (axial plane), the posterior prolon gation of the labial commissure was used. Normality values of the masseter muscle in females were 11.75 ± 1,14 mm in contraction and 10.19 ± 1.04 mm in relaxation; and in the male were 13.95 ± 1.62 mm in contraction and 11.64 mm ± 1.68 mm in relaxation. The results obtained are in agreement with those described in the literature. Demonstrating the accuracy and reproductibility of the ultrasound if a protocol is applied, mainly aimed at controlling the pressure applied by the transducer.

RESUMEN: El objetivo de este estudio fue determinar los valores medios del grosor del músculo masetero, en reposo y contracción, en hombres y mujeres sanos. Inicialmente se distribuyeron 102 cuestionarios entre los estudiantes. Se seleccionaron 30 pacientes, 15 hombres y 15 mujeres, según los criterios de inclusión, excluyendo a todos los individuos con síntomas de disfunción temporo-mandibular o síndromes con alteraciones craneofaciales. El grosor del músculo masetero se determinó de forma bilateral, en reposo y contracción. Como punto de referencia para la medición del espesor (plano axial), la prolongación posterior de la comisura labial. Los valores de normalidad del músculo masetero en las mujeres fue de 11,75 ± 1,14 mm en contracción y 10,19 ± 1,04 mm en relajación; y en los varones 13,95 ± 1,62 mm en contracción y 11,64 mm ± 1,68 mm en relajación. Los resultados obtenidos coinciden con los descritos en la literatura, señalando la precisión y reproducibilidad del ultrasonido si se aplica un protocolo, principalmente dirigido a controlar la presión aplicada por el transductor.

Resumo Toxoplasmose é uma zoonose cosmopolita causada pelo Toxoplasma gondii. A ingestão de carne crua ou mal cozida é considerada uma importante forma de infecção. A ingestão de carne de equídeos é comum nos países europeus e asiáticos e, no Brasil, tem sido observado um aumento no consumo. O objetivo deste estudo foi avaliar a ocorrência de anticorpos anti-T.gondii e correlacionar com possíveis fatores de risco relacionados à infecção em equídeos, os quais foram abatidos para consumo humano em Minas Gerais, Brasil. Amostras de sangue de 192 equinos e 208 asininos foram coletadas na área de sangria durante o abate. As amostras de soro foram analisadas pela Reação de Imunofluorescência Indireta (RIFI). A análise estatística foi realizada, usando-se o teste qui-quadrado de Pearson (χ2) ou o teste exato de Fisher, buscando relacionar possíveis fatores de risco com a prevalência de anticorpos. Estes foram encontrados em 13,5% dos equídeos, com maior ocorrência em equinos (18,75%) do que em asininos (8,65%). Foram encontradas associações entre soropositividade e as seguintes variáveis (p ≤ 0,05): espécie, origem animal, finalidade da criação e fonte de água para consumo animal e contato com gatos. Os produtores precisam implementar medidas para controlar a infecção nessas espécies, evitando, assim, a transmissão do parasita à população humana que consumirá sua carne.

Abstract Toxoplasmosis is a worldwide zoonosis caused by Toxoplasma gondii. Ingestion of raw/undercooked meat is considering an important route of infection. Consumption of meat from equids is common in European and Asian countries and an increase in Brazil has been observed. The aim of this study was to evaluate occurrences of anti-T. gondii antibodies and risk factors relating to infection in equids slaughtered for human consumption in Minas Gerais, Brazil. Blood samples from 192 horses and 208 donkeys were collected in the exsanguination area during the slaughter. Serum samples were subjected to the indirect fluorescent antibody test (IFAT). Association analysis was performed using Pearson’s chi-square test (χ2) or Fisher’s exact test, to evaluate risk factors relating to the prevalence of seroreagents. Antibodies against T. gondii were found in 13.5% of the equids, with higher occurrence in horses (18.75%) than in donkeys (8.65%). Associations between seropositivity and the following variables were found (p ≤ 0.05): species, animal origin, purpose of rearing and source of water for animal consumption and contact with cats. Farms need to implement preventive measures to control T. gondii infection in these species and avert transmission of the parasite to the human population that will consume their meat.

Abstract Human T-cell lymphotropic virus type 1 (HTLV-1) has low prevalence rates, but is endemic in some regions of the world. It is usually a chronic asymptomatic infection, but it can be associated with serious neurologic and urinary conditions. Hepatitis C virus (HCV) is broadly spread out worldwide. The majority of these infections have a chronic course that may progress to cirrhosis and hepatocellular carcinoma. Objectives: To compare sociodemographic and mental health (risk behaviors, depression, and suicide) aspects, and quality of life among patients with HCV or HTLV-1. Methods: Observational, comparative and cross-sectional study involving outpatients with HCV or HLTV-1 infection. Sociodemographic characteristics, risk behaviors and quality of life were assessed through the questionnaires Mini International Neuropsychiatric Interview - MINI Plus (depression and suicide) and Medical Outcomes Study 36-Item Short-Form Health Survey (quality of life). Univariate and multivariate statistical analyses (hierarchical logistic regression) were conducted. Results: 143 individuals with HCV and 113 individuals with HTLV-1 infection were included. Males were predominant in the HCV group (68.8%) and females in the HTLV-1 group (71.7%). The frequency of risk behaviors (sexual and drug use) was greater in those with HCV (p < 0.05). A past depressive episode was more common in the HTLV-1 group (p = 0.037). Quality of life was significantly worse in the physical functioning, vitality, mental health, and social functioning domains in those with HTLV-1 (p < 0.05). HTLV-1 infection remained independently associated with worse quality of life in multivariate analysis. Conclusions: Risk behaviors are frequent among those infected with HCV. Additionally, despite HTLV-1 being considered an infection with low morbidity, issues related to mental health (depressive episode) and decreased quality of life are relevant.

This study was conducted to evaluate the effects of digestible lysine levels in diets with and without supplementation of industrial amino acids on performance and fat deposition in the carcass of broilers in the starter phase. One thousand four hundred and forty chickens with initial weight of 168.1±5.0 g were distributed in a completely randomized experimental design, in a 5 × 2 factorial arrangement, composed of five digestible lysine levels (10.0, 11.0, 12.0, 13.0 and 14.0 g/kg) and two types of diet (diet with different proportions of corn and soybean meal and diet supplemented with industrial amino acids to obtain the digestible lysine levels), with eight replications and 18 birds per replication. There was interaction effect only on weight gain and fat deposition in the birds. The lysine levels reduced feed intake linearly in both diets, but caused a linear increase in lysine intake. The lysine levels quadratically affected weight gain and feed conversion, which improved up to the estimated levels of 13.0 and 12.8 g/kg lysine, respectively, when the corn:soybean meal ratio of the diet changed. In the diets supplemented with amino acids, the lysine levels increased weight gain and improved feed conversion linearly. Regardless of the type of diet, protein deposition increased linearly, whereas fat deposition reduced also linearly, as the lysine levels in the diets were increased. The levels of 13.0 and 14.0 g/kg digestible lysine provide, respectively, the best performance in birds fed a diet in which the proportion of corn and soybean meal varies and a diet supplemented with industrial amino acids, in the period from 8 to 21 days of age.

This study was conducted to verify the effects of dietary crude protein reduction on growth and carcass performance of 22-42-day-old broilers reared under different temperatures. Treatments were set up in a five by two factorial arrangement, with five crude protein levels (220, 210, 200, 190 and 184 g/kg) and two temperatures (21.6 and 32.2 ºC). Diets were isocaloric and essential amino acid-to-lysine ratio was maintained constant in all treatments. There was no interaction between crude protein reduction and environmental temperature for any of the parameters evaluated. Crude protein had no influence on feed intake. Nevertheless, weight gain and feed conversion ratio were linearly influenced by crude protein reduction. Worse performance was also observed in birds exposed to heat stress as compared with birds kept under thermoneutral temperature. There was no effect of crude protein reduction on breast and legs. Birds kept under heat stress had lower breast yield and higher leg yield as compared with broilers reared at 21.6 ºC. Any crude protein reduction in the range of 220 to 184 g/kg for 22 to 42-day-old broilers has a negative effect on their performance. Heat stress worsens broiler performance and breast yield.

A implantação do PROEJA na rede federal de Educação Profissional e Tecnológica fomentou a necessidade de investigar as possibilidades da construção de atividades experimentais e interdisciplinares para o curso de Agente Comunitário de Saúde, a fim de proporcionar ao estudante uma formação integral. Esse recorte faz parte da dissertação do Mestrado Profissional em Ensino de Ciências e Matemática da PUC- Minas, na qual foi produzido o caderno temático Saúde e Números. Uma das atividades do material foi aplicada com caráter exploratório-investigativo, descrita e analisada com o propósito de analisar a sua potencialidade e instrumentalizar o professor quanto às possibilidades investigativas, manipulativas e interdisciplinares de trabalho com a Matemática e a Química junto a jovens e adultos. Verificou-se que a potencialidade do material produzido, a receptividade dos jovens e adultos e as possibilidades de atividades experimentais na transposição de barreiras entre a teoria e prática.

The Youth and Adult Education Program (PROEJA) of the Federal Professional and Technological Education network promoted the need to investigate the possibilities of developing experimental and interdisciplinary activities for the Community Health Agent course, to provide the student with a comprehensive training. This article presents part of a study conducted for the Professional Masters degree in Teaching of Science and Mathematics at PUC-Minas, which resulted in a textbook on the theme Health and Numbers. One of the activities in the textbook was carried out using an exploratoryinvestigative approach, described and analyzed in order to analyze their potential and to prepare the teacher regarding the investigative, manipulative and interdisciplinary possibilities of working with mathematics and chemistry with young people and adults. The findings point to the potential of the material produced, the receptiveness of young people and adults, and the possibilities of experimental activities for overcoming barriers between theory and practice.

Perante a recente inserção da Educação de Jovens e Adultos na rede federal de Educação Profissional e Tecnológica, por meio da implantação do PROEJA - Programa de Integração à Educação Básica na Modalidade Educação de Jovens e Adultos nos Institutos Federais de Educação, Ciência e Tecnologia, percebeu-se a necessidade de investigar as possibilidades da construção de um material didático para ensino de Matemática para um curso de Agente Comunitário de Saúde nesta modalidade. Este artigo apresenta resultado de uma pesquisa de mestrado: o Caderno Temático Saúde e Números, composto por 10 unidades e um projeto interdisciplinar, cuja finalidade é proporcionar ao estudante o desenvolvimento dos conhecimentos matemáticos de forma interdisciplinar, permitindo uma formação integral do cidadão. Além disso, espera-se que os professores possam, a partir deste, produzir seu próprio material didático.

With the recent inclusion of youth and adults in the federal system of vocational and technological education, through the PROEJA (Program to Integrate Youth and Adults in Basic Education, in Federal Institutions of Education, Science and Technology), there was a need to investigate the possibilities of creating educational material for teaching a mathematics course for Community Health Agents. This article presents the results of a sudy: the Notebook theme "Health and Figures", comprising 10 units and an interdisciplinary project whose aim is to provide the student with the development of mathematical knowledge in an interdisciplinary way, allowing an integral formation of the citizen. Moreover, it is expected that teachers can, from this, produce their own materials.

A canulação percutânea da artéria radial é uma abordagem útil na realização de cateterismos coronários pela menor incidência de complicações e pelas vantagens, como deambulação precoce, maior conforto e menores custos. Nos pacientes em que essa técnica não é possível, a abordagem ulnar mostra-se uma alternativa exequível e segura. Neste artigo, os autores descrevem um caso de angioplastia coronária pela abordagem transulnar após insucesso na canulação da artéria radial ipsilateral, sem complicações isquêmicas, seguido de uma revisão da literatura sobre o tema.

Percutaneous cannulation of the radial artery is a useful approach in coronary catheterization due to the lower incidence of complications and advantages such as early ambulation, greater comfort and lower costs. In patients where this technique is not possible, the ulnar approach proved to be a feasible and safe alternative. In this article, the authors describe a case of coronary angioplasty by transulnar approach after failure of the ipsilateral radial artery cannulation without ischemic complications, followed by a literature review on the subject.