The effect of abiotic stresses on plant C:N:P homeostasis and their mitigation by silicon

In crop plants, various environmental stresses affect the balance of carbon, nitrogen, and phosphorus(C:N:P), leading to biochemical and physiological alterations and reductions in yield. Silicon(Si) is a beneficial element that alleviates plant stress. Most studies involving silicon have focused on physiological responses, such as improvements in photosynthetic processes, water use efficiency, and antioxidant defense systems. But recent research suggests that stressed plants facing either limited or excessive resources(water, light, nutrients, and toxic elements), strategically employ Si to maintain C:N:P homeostasis, thereby minimizing biomass losses. Understanding the role of Si in mitigating the impact of abiotic stresses on plants by regulating C:N:P homeostasis holds great potential for advancing sustainable agricultural practices in crop production. This review presents recent advances in characterizing the influence of environmental stresses on C:N:P homeostasis, as well as the role of Si in preserving C:N:P equilibrium and attenuating biological damage associated with abiotic stress. It underscores the beneficial effects of Si in sustaining C:N:P homeostasis and increasing yield via improved nutritional efficiency and stress mitigation.

MicroRNAs in inflammatory bowel disease:What do we know and what can we expect?

MicroRNAs(miRNAs),small non-coding RNAs composed of 18–24 nucleotides,are potent regulators of gene expression,contributing to the regulation of more than 30%of protein-coding genes.Considering that miRNAs are regulators of inflammatory pathways and the differentiation of intestinal epithelial cells,there is an interest in exploring their importance in inflammatory bowel disease(IBD).IBD is a chronic and multifactorial disease of the gastrointestinal tract;the main forms are Crohn's disease and ulcerative colitis.Several studies have investigated the dysregulated expression of miRNAs in IBD,demonstrating their important roles as regulators and potential biomarkers of this disease.This editorial presents what is known and what is expected regarding miRNAs in IBD.Although the important regulatory roles of miRNAs in IBD are clearly established,biomarkers for IBD that can be applied in clinical practice are lacking,emphasizing the importance of further studies.Discoveries regarding the influence of miRNAs on the inflammatory process and the exploration of their role in gene regulation are expected to provide a basis for the use of miRNAs not only as potent biomarkers in IBD but also as therapeutic targets for the control of inflammatory processes in personalized medicine.

Solar-driven CO_(2) conversion to methane and methanol using different nanostructured Cu_(2)O-based catalysts modified with Au nanoparticles

This work describes the use of TiO_(2)nanotubes-based electrodes(TNT)modified with Cu_(2)O nanostructures and gold nanoparticles for the photoelectroreduction of CO_(2)to produce value-added compounds.A thin layer of polydopamine was used as both an adherent agent and an electron transfer mediator,due to itsπ-conjugated electron system.The highest production yield was achieved using a TNT@PDA/Nc/Au40%electrode,with Faradaic efficiencies of 47.4%(110.5μM cm^(-2))and 27.8%(50.4μM cm^(-2))for methanol and methane,respectively.The performance of the photoelectrodes was shown to be Cu_(2)O facet-dependent,with cubic structures leading to greater conversion of CO_(2)to methanol(43%)and methane(27%),compared to the octahedral morphology,while a higher percentage of metallic gold on the nanostructured Cu_(2)O surface was mainly important for CH4production.Density functional theory(DFT)calculations supported these findings,attributing the superior photoelectrocatalytic performance of the TNT@PDA/Nc/Au40%electrode for CH4generation to the formation of an OCH3intermediate bonded to Au atoms.Studies using isotope-labeling and analysis by gas chromatograph-mass(GC-MS)demonstrated that13CO_(2)was the source for photoelectrocatalytic generation of13CH3OH and13CH313CH2OH.

Plant growth and metabolism of exotic and native Crotalaria species for mine land rehabilitation in the Amazon

Despite its enormous benefits,mining is respon-sible for intense changes to vegetation and soil properties.Thus,after extraction,it is necessary to rehabilitate the mined areas,creating better conditions for the establishment of plant species which is challenging.This study evaluated mineral and organic fertilization on the growth,and carbon and nitrogen(N)metabolism of two Crotalaria species[Cro-talaria spectabilis(exotic species)and Crotalaria maypu-rensis(native species from Carajás Mineral Province(CMP)]established on a waste pile from an iron mine in CMP.A control(without fertilizer application)and six fertilization mixtures were tested(i=NPK;ii=NPK+micronutrients;iii=NPK+micronutrients+organic compost;iv=PK;v=PK+micronutrients;vi=PK+micronutrients+organic compost).Fertilization contributed to increased growth of both species,and treatments with NPK and micronutrients had the best results(up to 257%cf.controls),while organic fertilization did not show differences.Exotic Crotalaria had a greater number of nodules,higher nodule dry mass,chlorophyll a and b contents and showed free ammonium as the predominant N form,reflecting greater increments in biomass compared to native species.Although having lower growth,the use of this native species in the rehabilitation of mining areas should be considered,mainly because it has good development and meets current government legislation as an opportunity to restore local biodiversity.

Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

Contributions on Selective Waste Collection and Recycling Cooperatives in Municipalities in the State of São Paulo,Brazil

The collection and proper disposal of MSW(Municipal Solid Waste)is one of the biggest challenges faced by Brazilian public managers.Dry recyclable waste represents about 33.6%of the gravimetric composition of MSW,with a tendency to increase in the next few years,due to the increasing consumption of processed products,with short life cycles and excess packaging.The inadequate management of these residues results in a series of social,environmental and economic problems.In recent years,there has been a great advance in Brazilian laws,assigning responsibilities and regulating waste management in the country,optimizing the use of infrastructure and human and financial resources.Scarce resources and insufficient infrastructure demand actions based on a lot of planning.One of the main limiting factors for the planning and development of public policies for the sector is the lack of reliable data and information on the generation and management of waste,that allow the creation of future scenarios and the definition of adequate strategies for minimization,valorization of waste and final disposal of waste that no longer can be processed.Thus,this work sought to analyze the current situation of selective waste collection and recycling cooperatives in 211 municipalities in the State of São Paulo,evaluating the issues and opportunities for the applicability of Law n.12,305/2010,Brazilian PNRS(in Portuguese)(National Policy of Solid Waste)in the management of this waste in small,medium and large cities.A bibliographic research was carried out on the panorama of solid waste management in Brazil and in the State of São Paulo,as well as a contextualization on selective waste collection and recycling cooperatives.Following that,data from 211 municipalities taking part in the survey Solid Waste Management—Municipalities of the State of São Paulo were analyzed,focusing on answers that correlated with the topics covered in this research.For this work,questions were used in order to obtain a basic overview of solid waste management in the municipalities,identifying the characteristics of selective waste collection and recycling cooperatives in the municipalities and to verify the similarity,benefits and difficulties of selective waste collection and waste cooperatives in the municipalities studied.After tabulating and analyzing the data,a matrix was prepared to compare the results obtained in relation to selective waste collection and recycling cooperatives and the guidelines of the PNRS(National Solid Waste Policy)in urban environmental management,which allowed the conclusion that all municipalities participating in the research have a good understanding of solid waste management practices,as well as seek to comply with the guidelines of the PNRS.However,the results of this matrix indicated that there are important points that need to be considered in the planning of actions for a better management of recyclable waste,such as the implementation of inter-municipal consortiums in the management of solid waste,investment in environmental education,stimulation to create recycling cooperatives and adoption of social inclusion regulations for informal waste collectors.

Acute heart failure as an adverse event of tumor necrosis factor inhibitor therapy in inflammatory bowel disease:A review of the literature

Tumor necrosis factor inhibitors(anti-TNFs)are widely used therapies for the treatment of inflammatory bowel diseases(IBD);however,their administration is not risk-free.Heart failure(HF),although rare,is a potential adverse event related to administration of these medications.However,the exact mechanism of development of HF remains obscure.TNFαis found in both healthy and damaged hearts.Its effects are concentration-and receptor-dependent,promoting either cardio-protection or cardiomyocyte apoptosis.Experimental rat models with TNFαreceptor knockout showed increased survival rates,less reactive oxygen species formation,and improved diastolic left ventricle pressure.However,clinical trials employing anti-TNF therapy to treat HF had disappointing results,suggesting abolishment of the cardioprotective properties of TNFα,making cardiomyocytes susceptible to apoptosis and oxidation.Thus,patients with IBD who have risk factors should be screened for HF before initiating anti-TNF therapy.This review aims to discuss adverse events associated with the administration of anti-TNF therapy,with a focus on HF,and propose some approaches to avoid cardiac adverse events in patients with IBD.

Piezomagnetic vibration energy harvester with an amplifier

We study the effect of an amplification mechanism in a nonlinear vibration energy harvesting system where a ferromagnetic beam resonator is attached to the vibration source through an additional linear spring with a damper.The beam moves in the nonlinear double-well potential caused by interaction with two magnets.The piezoelectric patches with electrodes attached to the electrical circuit support mechanical energy transduction into electrical power.The results show that the additional spring can improve energy harvesting.By changing its stiffness,we observed various solutions.At the point of the optimal stiffness of the additional spring,the power output is amplified a few times depending on the excitation amplitude.

Shared-role of vegetation types,elevation and soil affecting plant diversity in an old-tropical mountain hotspot

Despite the exceptional species richness and endemism,the environmental drivers of plant diversity along old tropical mountains remain underexplored.The respective importance of vegetation types,elevation,slope,and soil to drive diversity across life-forms is poorly addressed.Here,we tested whether environmental variables drove local and regional plant diversity along an old tropical mountain according to the three main life-forms:graminoids,herbaceous and woody species.We sampled all Angiosperm species on 180 plots across five elevations,at the tropical old-mountain region of Serra do Cipó,South-eastern Brazil.We assessed soil,slope,and vegetation types,and calculated richness and beta-diversity,applying generalized least square models,linear mixed-models and partial Mantel tests to test for relationships.Richness of graminoids and herbaceous species increased with greater elevation and more nutrient-impoverished soils,while woody richness showed the inverse pattern.Beta-diversity was primarily driven by species turnover,correlated with elevation and soil and higher in less dominant vegetation types,with unique species.Despite the limited elevational range in these old mountains,it still played an important role in filtering woody species,while fostering graminoid and herbaceous species.Conservation and restoration actions need to foster the high regional diversity supported by the old mountain heterogeneous landscape and the diversity of life-forms,especially the dominant and highly diverse grassy component.

MicroRNAs expression influence in ulcerative colitis and Crohn's disease:A pilot study for the identification of diagnostic biomarkers

BACKGROUND Inflammatory bowel disease(IBD)comprises two distinct diseases,Crohn’s disease(CD)and ulcerative colitis(UC),both of which are chronic,relapsing inflammatory disorders of the gastrointestinal tract with a mostly unknown etiology.The incidence and prevalence of IBD are continually increasing,indicating the need for further studies to investigate the genetic determinants of these diseases.Since microRNAs(miRNAs)regulate protein translation via complementary binding to mRNA,discovering differentially expressed miRNAs(DE)in UC or CD patients could be important for diagnostic biomarker identification,assisting in the appropriate disease differentiation progressing the understanding of IBD pathogenesis.AIM To determine the miRNA expression profile in UC and CD patients and the potential pathophysiological contributions of differentially expressed miRNA.METHODS A total of 20 formalin-fixed paraffin-embedded colonic samples were collected from the Pathology Department of Botucatu Medical School at São Paulo State University(Unesp).The diagnosis of UC or CD was based on clinical,endoscopic,radiologic,and histological criteria and confirmed by histopathological analysis at the time of selection.The TaqMan™Array Human MicroRNA A+B Cards Set v3.0(Applied Biosystems™)platform was used to analyze 754 miRNAs.Targets of DE-miRNAs were predicted using miRNA Data Integration Portal(mirDIP)and the miRNA Target Interaction database(MiRTarBase).All statistical analyses were conducted using GraphPad Prism software.Parametric and nonparametric data were analyzed using t-tests and Mann-Whitney U tests,respectively.RESULTS The results showed that of the 754 miRNAs that were initially evaluated,643 miRNAs were found to be expressed in at least five of the patients who were diagnosed with either CD or UC;the remaining 111 miRNAs were not considered to be expressed in these patients.The expression levels of 28 miRNAs were significantly different between the CD and UC patients(P≤0.05);13 miRNAs demonstrated a fold-change in expression level greater than 1.Five miRNAs with a downregulated expression were selected for enrichment analysis.The miRNAs whose expression levels were significantly lower in UC patients than in CD patients were enriched in certain signaling pathways that were mostly correlated with cancer-related processes and respective biomarkers.CONCLUSION MiRNAs could be used to differentiate UC from CD,and differently expressed miRNAs could help explain the distinct pathophysiology of each disease.

Modern surgical strategies for perianal Crohn's disease

One of the most challenging phenotypes of Crohn’s disease is perianal fistulizing disease(PFCD).It occurs in up to 50%of the patients who also have symptoms in other parts of the gastrointestinal tract,and in 5%of the cases it occurs as the first manifestation.It is associated with severe symptoms,such as pain,fecal incontinence,and a significant reduction in quality of life.The presence of perianal disease in conjunction with Crohn’s disease portends a significantly worse disease course.These patients require close monitoring to identify those at risk of worsening disease,suboptimal biological drug levels,and signs of developing neoplasm.The last 2 decades have seen significant advancements in the management of PFCD.More recently,newer biologics,cell-based therapies,and novel surgical techniques have been introduced in the hope of improved outcomes.However,in refractory cases,many patients face the decision of having a stoma made and/or a proctectomy performed.In this review,we describe modern surgical management and the most recent advances in the management of complex PFCD,which will likely impact clinical practice.

MicroRNA expression in inflammatory bowel disease-associated colorectal cancer

MicroRNAs(miRNAs)are non-coding RNA molecules composed of 19–25 nucleotides that regulate gene expression and play a central role in the regulation of several immune-mediated disorders,including inflammatory bowel diseases(IBD).IBD,represented by ulcerative colitis and Crohn’s disease,is characterized by chronic intestinal inflammation associated with an increased risk of colorectal cancer(CRC).CRC is one of the most prevalent tumors in the world,and its main risk factors are obesity,physical inactivity,smoking,alcoholism,advanced age,and some eating habits,in addition to chronic intestinal inflammatory processes and the use of immunosuppressants administered to IBD patients.Recent studies have identified miRNAs associated with an increased risk of developing CRC in this population.The identification of miRNAs involved in this tumorigenic process could be useful to stratify cancer risk development for patients with IBD and to monitor and assess prognosis.Thus,the present review aimed to summarize the role of miRNAs as biomarkers for the diagnosis and prognosis of IBD-associated CRC.In the future,therapies based on miRNA modulation could be used both in clinical practice to achieve remission of the disease and restore the quality of life for patients with IBD,and to identify the patients with IBD at high risk for tumor development.

Challenges in the diagnosis of intestinal neuronal dysplasia type B:A look beyond the number of ganglion cells

Intestinal neuronal dysplasia type B(IND-B)is a controversial condition among gastrointestinal neuromuscular disorders.Constipation is its most common clinical manifestation in patients.Despite intense scientific research,there are still knowledge gaps regarding the diagnostic criteria for IND-B in the histopathological analysis of rectal biopsies.The guidelines published in the past three decades have directed diagnostic criteria for quantifying the number of ganglion cells in the nervous plexus of the enteric nervous system.However,it is very complex to distinguish numerically what is pathological from what is normal,mainly because of the difficulty in determining a reliable control group composed of healthy children without intestinal symptoms.Thus,a series of immunohistochemical markers have been proposed to assist in the histopathological analysis of the enteric nervous system.Several of these markers facilitate the identification of other structures of the enteric nervous system,in addition to ganglion cells.These structures may be related to the etiopathogenesis of IND-B and represent new possibilities for the histopathological diagnosis of this disease,providing a view beyond the number of ganglion cells.This review critically discusses the aspects related to the disease definitions and diagnostic criteria of this organic cause of constipation.

Antiglycation,antioxidant,antiacne,and photoprotective activities of crude extracts and triterpene saponin fraction of Sapindus saponaria L.fruits:An in vitro study

Objective:To evaluate the photoprotective,antioxidant,antiglycation,and antiacne activities of crude extract(CESs)and triterpene saponin fraction(TSSs)of Sapindus saponaria.Methods:HPLC-MS purification was performed on a Symmetry TM C18 column.The saponins were identified by a UV detector.Antioxidant activity was evaluated by DPPH and O_(2)^(−)radicals scavenging,and FRAP and TBARS assays.Glycation activity was assessed by relative electrophoretic mobility and inhibition of advanced glycation end products(AGEs)formation.Additionally,antiacne activity was determined by inhibition of Cutibacterium acnes,and photoprotective effect was evaluated by Mansur’s method.Results:Most of the triterpene saponins detected in the fraction by HPLC-MS analysis were hederagenin as the aglycon.CESs and TSSs presented varying antioxidant activity in DPPH(CESs:75.69%and TSSs:83.65%),FRAP(CESs:425.39μM TE/g DW and TSSs:649.36μM TE/g DW),TBARS(CESs:42.96%and TSSs:52.16%)and O_(2)^(−)radicals scavenging(CESs:61.33%and TSSs:86.69%)tests.CESs and TSSs also exhibited antiglycation activity comparable to bovine serum albumin treated with aminoguanidine.In addition,CESs and TSSs showed inhibition of AGE formation(34.48%and 61.85%,respectively).Antiacne activity against Cutibacterium acnes was observed with a minimum inhibitory concentration equal to minimum bactericidal concentration(CESs:36.11µg/mL and TSSs:18.34µg/mL).In photoprotective assays,CESs and TSSs showed maximum absorbance of 1.42 to 0.20 and 2.80 to 1.30,respectively,in the wavelength range of 260 to 400 nm.Furthermore,CESs and TSSs showed sun protection factors of 8.89 and 14.89,respectively.Conclusions:Sapindus saponaria fruit extracts show strong antioxidant potential and antiglycation activity against bovine serum albumin glycation and AGE formation.Besides,they presented antibacterial activity against Cutibacterium acnes and photoprotective effect against UV-A and UV-B.

Visual-Motor Perceptual and Reading Processes of Schoolchildren With Attention Deficit Hyperactivity Disorder

Objectives:Compare and relate the performance of schoolchildren with Attention Deficit Hyperactivity Disorder(ADHD)and with good academic performance in the visual-motor perceptual and reading processes.Method:Twenty schoolchildren,of both genders,aged between nine and 11 years old,participated in this study.They were divided into two groups:Group I(GI):comprising 10 students diagnosed with ADHD;and Group II(GII):10 students with good academic performance paired according to gender,age group,and educational level with GI.All students were submitted to the Developmental Test of Visual Perception(DTVP 3)and Reading Processes Assessment Protocol(PROLEC).Results:There was lower performance of GI compared to GII in the subtests of copying,eye-hand coordination,and figure-ground in the standard score of general visual perception and visual-motor integration.GI presented lower performance in all reading processes except for the punctuation marks test.There was a statistically significant difference in the comparison between GI and GII regarding the classification of reading processes.A relationship was identified between the reading and visual perception subtests in the GI students,demonstrating a relationship between the visual perceptual motor skills and the reading processes in the group of students with ADHD.Conclusion:Schoolchildren with ADHD performed less well than their peers with good academic performance in the visual-motor perceptual and reading skills;such that the worse their performance in the visual-motor perceptual processes,the worse their performance in the reading processes.

Enamel microabrasion: An overview of clinical and scientific considerations

Superficial stains and irregularities of the enamelare generally what prompt patients to seek dental intervention to improve their smile. These stains or defects may be due to hypoplasia, amelogenesis imperfecta, mineralized white spots, or fluorosis, for which enamel microabrasion is primarily indicated. Enamel microabrasion involves the use of acidic and abrasive agents, such as with 37% phosphoric acid and pumice or 6% hydrochloric acid and silica, applied to the altered enamel surface with mechanical pressure from a rubber cup coupled to a rotatory mandrel of a lowrotation micromotor. If necessary, this treatment can be safely combined with bleaching for better esthetic results. Recent studies show that microabrasion is a conservative treatment when the enamel wear is minimal and clinically imperceptible. The most important factor contributing to the success of enamel microabrasion is the depth of the defect, as deeper, opaque stains, such as those resulting from hypoplasia, cannot be resolved with microabrasion, and require a restorative approach. Surface enamel alterations that result from microabrasion, such as roughness and microhardness, are easily restored by saliva. Clinical studies support the efficacy and longevity of this safe and minimally invasive treatment. The present article presents the clinical and scientific aspects concerning the microabrasion technique, and discusses the indications for and effects of the treatment, including recent works describing microscopic and clinical evaluations.

Is there a window of opportunity for the therapeutic use of vitamin D in multiple sclerosis?

Multiple sclerosis is an autoimmune treatable but not curable disease.There are a multiplicity of medications for multiple sclerosis therapy,including a class entitled disease-modifying drugs that are mainly indicated to reduce the number and severity of disease relapses.Not all patients respond well to these therapies,and minor to severe adverse effects have been reported.Vitamin D,called sunshine vitamin,is being studied as a possible light at the end of the tunnel.In this review,we recapitulated the similar immunopathogenesis of multiple sclerosis and experimental autoimmune encephalomyelitis,the immunomodulatory and neuroprotective potential of vitamin D and the state-of-art concerning its supplementation to multiple sclerosis patients.Finally,based on our and other groups’experimental findings,we analyzed the need to consider the relevance of the route and the different time-point administration aspects for a more rational indication of this vitamin to multiple sclerosis patients.

Molecular detection and genetic diversity of Dientamoeba fragilis and Enterocytozoon bieneusi in fecal samples submitted for routine parasitological examination

Objective:To detect Dientamoeba(D.)fragilis and Enterocytozoon(E.)bieneusi and to assess their genetic characteristics in stool samples submitted for routine examination in a clinical laboratory in Southeastern Brazil.Methods:In this survey,348 stool samples from female and male individuals with age ranging from 0 to≥55 years were analyzed by PCR amplifying and sequencing based on the small subunit ribosomal RNA(SSU r RNA)gene of D.fragilis and the internal transcribed spacer of E.bieneusi.Results:D.fragilis and E.bieneusi isolates were observed in 2.29%(8/348)and 4.59%(16/348)of the samples,respectively.These parasites were detected in stool samples from individuals of both genders,including young children under nine until adults over 55 years old.No statistically significant differences were found.All D.fragilis isolates were classified as genotype 1 and E.bieneusi isolates included genotypes D(n=15)and A(n=1).Conclusions:The findings provide relevant findings on occurrence and genetic diversity of D.fragilis and E.bieneusi,pointing to the need for the diagnosis of these parasites in routine examinations in clinical laboratories.In addition to sensitive diagnostic methods,it is mandatory that these parasites be considered relevant for physicians and laboratory staff.

Anti-inflammatory effects ofα-humulene andβ-caryophyllene on pterygium fibroblasts

AIM:To investigate the anti-inflammatory effects of the sesquiterpenesα-humulene andβ-caryophyllene on pterygium fibroblasts.METHODS:Primary cultures of pterygium fibroblasts were established.Third passage pterygium fibroblasts were exposed toα-humulene andβ-caryophyllene separately and together.The cell viability was assessed by 3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide(MTT)assay at 12,24,48,and 72h after exposure.The levels of the inflammatory cytokines interleukin(IL)-1β,IL-6,IL-8,tumor necrosis factor(TNF)-αand IL-10 in the conditioned culture medium were assessed by enzymelinked immunosorbent assay(ELISA)at 12,24 and 48h after exposure.Data were statistically analyzed using Friedman repeated measures analysis of variances on ranks.RESULTS:The 25μmol/Lβ-caryophyllene induced significant decrease in the IL-6 production by pterygium fibroblasts 48h after the exposure(P=0.041).The levels of IL-1β,IL-8,IL-10,and TNF-αwere very low and had no statistically significant variations af ter exposure toα-humulene,β-caryophyllene,or both compounds together.CONCLUSION:The exposure to 25μmol/L ofβ-caryophyllene significantly reduce the production of IL-6 by pterygium fibroblasts after 48h.This sesquiterpene may be a potential alternative adjuvant agent for the treatment of pterygium.

Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature

BACKGROUND Anti-tumor necrosis factor agents were the first biologic therapy approved for the management of Crohn's disease(CD).Heart failure(HF)is a rare but potential adverse effect of these medications.The objective of this report is to describe a patient with CD who developed HF after the use of infliximab.CASE SUMMARY A 50-year-old woman with a history of hypertension and diabetes presented with abdominal pain,diarrhea,and weight loss.Colonoscopy and enterotomography showed ulcerations,areas of stenosis and dilation in the terminal ileum,and thickening of the intestinal wall.The patient underwent ileocolectomy and the surgical specimen confirmed the diagnosis of stenosing CD.The patient started infliximab and azathioprine treatment to prevent post-surgical recurrence.At 6 mo after initiating infliximab therapy,the patient complained of dyspnea,orthopnea,and paroxysmal nocturnal dyspnea that gradually worsened.Echocardiography revealed biventricular dysfunction,moderate cardiac insufficiency,an ejection fraction of 36%,and moderate pericardial effusion,consistent with HF.The cardiac disease was considered an infliximab adverse effect and the drug was discontinued.The patient received treatment with diuretics for HF and showed improvement of symptoms and cardiac function.Currently,the patient is using anti-interleukin for CD and is asymptomatic.CONCLUSION This reported case supports the need to investigate risk factors for HF in inflammatory bowel disease patients and to consider the risk-benefit of introducing infliximab therapy in such patients presenting with HF risk factors.