RESUMEN

The selection pressure imposed by the host immune system impacts on hepatitis B virus (HBV) variability. This study evaluates HBV genetic diversity, nucleos(t)ide analogs resistance and HBsAg escape mutations in HBV patients under distinct selective pressures. One hundred and thirteen individuals in different phases of HBV infection were included: 13 HBeAg-positive chronic infection, 9 HBeAg-positive chronic hepatitis, 47 HBeAg-negative chronic infection (ENI), 29 HBeAg-negative chronic hepatitis (ENH) and 15 acute infected individuals. Samples were PCR amplified, sequenced and genetically analyzed for the overlapping POL/S genes. Most HBV carriers presented genotype A (84/113; 74.3%), subgenotype A1 (67/84; 79.7%), irrespective of group, followed by genotypes D (20/113; 17.7%), F (8/113; 7.1%) and E (1/113; 0.9%). Clinically relevant mutations in polymerase (tL180M/M204V) and in the Major Hydrophilic Region of HBsAg (sY100C, T118A/M, sM133T, sD144A and sG145R) were observed. Our findings, however, indicated that most polymorphic sites were located in the cytosolic loops (CYL1-2) and transmembrane domain 4 (TMD4) of HBsAg. Lower viral loads and higher HBV genetic diversity were observed in ENI and ENH groups (p < 0.001), suggesting that these groups are subjected to a higher selective pressure. Our results provide information on the molecular characteristics of HBV in a diverse clinical setting, and may guide future studies on the balance of HBV quasispecies at different stages of infection.

Asunto(s)

Variación Genética , Genotipo , Antígenos de Superficie de la Hepatitis B , Virus de la Hepatitis B , Hepatitis B Crónica , Humanos , Virus de la Hepatitis B/genética , Hepatitis B Crónica/virología , Hepatitis B Crónica/genética , Brasil/epidemiología , Masculino , Adulto , Femenino , Persona de Mediana Edad , Antígenos de Superficie de la Hepatitis B/genética , Mutación , Farmacorresistencia Viral/genética , ADN Viral/genética , Adulto Joven , Filogenia , Antígenos e de la Hepatitis B/genética

RESUMEN

Aim: To evaluate the action of promethazine, fluoxetine and carbonyl cyanide 3-chlorophenylhydrazone as efflux pump inhibitors (EPIs) against multidrug-resistant Pseudomonas aeruginosa. Methods: The effect of the compounds was evaluated in planktonic cells and bacterial biofilms. Accumulation tests were performed with ethidium bromide to prove their action as EPIs. Then, they were associated with antimicrobials. Results: Effect on planktonic cells and biofilms was found. Assays with ethidium bromide indicate their action as EPIs. Significant reductions in the metabolic activity of biofilms were observed after the association with the antimicrobials, especially for meropenem. Conclusion: It is possible to prove the action of these compounds as EPIs for P. aeruginosa and demonstrate the relevance of efflux pumps in antimicrobial resistance.

---

[Box: see text].

Asunto(s)

Antibacterianos , Biopelículas , Reposicionamiento de Medicamentos , Farmacorresistencia Bacteriana Múltiple , Pruebas de Sensibilidad Microbiana , Pseudomonas aeruginosa , Pseudomonas aeruginosa/efectos de los fármacos , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Carbonil Cianuro m-Clorofenil Hidrazona/farmacología , Prometazina/farmacología , Proteínas de Transporte de Membrana/metabolismo , Humanos , Proteínas Bacterianas/metabolismo , Proteínas Bacterianas/antagonistas & inhibidores , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones por Pseudomonas/microbiología , Hidrazonas

RESUMEN

Morphological studies applied to the taxonomy of the Triatominae cover various structures (head, wing, thorax, genitalia, and eggs). Exochorial structures of hybrid eggs were characterized and compared with the parents, demonstrating that hybrids presented characteristics identical to the exochorial pattern observed in the females of the crosses, which resulted in the hypothesis that the pattern of triatomine eggs is possibly a characteristic inherited from females. Thus, we characterized the exochorium of the eggs of several triatomine hybrids and compared them with the parents, to assess the pattern of segregation and test the hypothesis of maternal inheritance. Hybrids were obtained in at least one direction from all crosses. The analysis of the exochorium of the eggs of the hybrids showed different patterns of segregation: "exclusively paternal", "predominantly maternal", "predominantly paternal", "mutual", and "differential". Curiously, none of the hybrids evaluated presented characteristics that segregated exclusively from the female parental species. Thus, we demonstrate that the hypothesis of maternal inheritance of the exochorium pattern of eggs is not valid and we emphasize the importance of alternative/combined tools (such as integrative taxonomy) for the correct identification of these insect vectors (mainly in view of possible natural hybridization events due to climate and environmental changes).

Asunto(s)

Enfermedad de Chagas , Triatominae , Animales , Femenino , Herencia Materna , Enfermedad de Chagas/genética , Triatominae/genética , Clima , Insectos Vectores/genética

RESUMEN

BACKGROUND: Viral hepatitis is a significant health concern among indigenous population in the Americas. In Brazil, reports find high endemicity of HBV and HDV infections has been reported in several indigenous groups. However, few studies have documented the prevalence of HBV, HCV and HDV in the Yanomami. In this study, the prevalence of hepatitis B, C, and D serological markers and potential risk factors were investigated to provide guidance for the development of strategies aimed at reducing viral transmission in the Yanomami indigenous villages. METHODS: This cross-sectional study was carried out in March 2015 and included 430 individuals from four Yanomami villages: Alapusi (n = 78), Castanha/Ahima (n = 126), Gasolina (n = 105), and Taibrapa (n = 121). A rapid test was used for detection of HBsAg and anti-HCV and chemiluminescent immunoassay for anti-HBs, anti-HBc, and anti-HDV antibodies. RESULTS: HBsAg, anti-HBc, and anti-HBs were detected in 8.8, 45.5, and 49.4% of the participants, respectively. The estimated HBV status: current infection 9.6% (38/395); resolved infection 43.3% (171/395); vaccine immunity 20.5% (81/395), and susceptible to HBV 26.6% (105/395). Gasolina presented the lowest prevalence of HBV infection (6.5%) and the highest prevalence of vaccine immunity (26.9%). Children < 15 years old were highly susceptible to infection, as 53.1% did not have antibodies to HBV, while more than 80% of individuals over 45 years of age had been exposed to HBV. The markers for HDV were founded among 12.5% (4/32) of the HBsAg carriers. Anti-HCV was identified in all villages, with the highest prevalence in Alapusi (5.1%). Possible risk factors such as the use of piercings, tattoos, and contact with prospectors showed no statistical difference between the groups. CONCLUSIONS: Viral hepatitis B and serological markers for HCV and HDV were found to be widely distributed among the Yanomami indigenous community, while the prevalence of vaccine immunity to HBV was low. This finding reinforces the importance of promoting systematized diagnostic and vaccination strategies in indigenous communities. Our data confirm that isolated and difficult-to-reach indigenous communities lack appropriate access to diagnosis, treatment, and vaccination.

Asunto(s)

Hepatitis B , Hepatitis C , Hepatitis Viral Humana , Vacunas , Niño , Humanos , Adolescente , Antígenos de Superficie de la Hepatitis B , Estudios Seroepidemiológicos , Estudios Transversales , Hepatitis B/epidemiología , Hepatitis B/diagnóstico , Anticuerpos contra la Hepatitis B , Virus de la Hepatitis B , Hepatitis Viral Humana/epidemiología , Anticuerpos contra la Hepatitis C , Prevalencia , Hepatitis C/epidemiología

RESUMEN

Investigation of the endophytic fungi Nigrospora sphaerica, Nigrospora oryzae, and Pseudofusicoccum stromaticum MeOH fractions isolated from the leaves of Vochysia divergens, a medicinal species from the Brazilian Pantanal, led to the identification of five compounds, namely a new compound (1E,8Z)-10,11-dihydroxy-5,5,8-trimethyl-4-oxocycloundeca-1,8-diene-1-carbaldehyde (1) and four known compounds: 5-methylmellein (2), sclerone (3), daldinone A (4), and lasiodiplodin (5). All compounds were identified using spectroscopic methods, and 1 was corroborated with mass spectrometry, while the known compounds were compared with data in the literature. The relative configuration of compound 1 was determined based on theoretical conformational studies as well as the J experimental values between the hydroxymethyne hydrogens. The antimicrobial activity of the compounds was evaluated. Promising results were obtained for compounds 2, 4, and 5 since they inhibited the bacterium Pseudomonas aeruginosa, an opportunistic pathogen, suggesting the potential of these microorganisms as a source of new antibacterial agents.

Asunto(s)

Antiinfecciosos , Antiinfecciosos/química , Hongos/metabolismo , Antibacterianos/farmacología , Antibacterianos/metabolismo , Hojas de la Planta/microbiología , Brasil , Endófitos/metabolismo

RESUMEN

Vulvovaginal candidiasis (VVC) is a fungal infection caused mainly by Candida albicans. The treatment of VVC with azoles has been impaired due to the increased cases of resistance presented by this pathogen. The aim of the present study was to investigate the antifungal activity of mucoadhesive chitosan nanoparticles encapsulating both green propolis and fluconazole for topical use in the treatment of VVC. The nanoparticles were prepared by the ionic gelation method, resulting in a size of 316.5 nm containing 22 mg/kg of green propolis and 2.4 mg/kg of fluconazole. The nanoparticles were non-toxic in vitro using red blood cells or in vivo in a Galleria mellonella toxicity model. The treatment of female BALB/c mice infected by C. albicans ATCC 10231 with topical nanoparticles co-encapsulating fluconazole and green propolis was effective even using a fluconazole amount 20 times lower than the amount of miconazole nitrate 2% cream. Considering that the mucoadhesive property of chitosan, which is known to allow a prolonged retention time of the compounds at the mucous epithelia, the antifungal potential of the phenols and flavonoids present in green propolis may have favored the effectiveness of this treatment. These results indicate that this formulation of topical use for fluconazole associated with green propolis can be used as a promising approach to therapy for the treatment of VVC, thus contributing to reducing the development of resistance to azoles.

---

Vulvovaginal candidiasis is a fungal infection for which we search for alternatives for its treatment. Thus, a nanoparticle formulation based on fluconazole and green propolis was developed. These nanoparticles were tested, and we obtained adequate results in laboratory tests.

Asunto(s)

Candidiasis Vulvovaginal , Quitosano , Nanopartículas , Própolis , Femenino , Animales , Ratones , Fluconazol/uso terapéutico , Candidiasis Vulvovaginal/tratamiento farmacológico , Candidiasis Vulvovaginal/microbiología , Candidiasis Vulvovaginal/veterinaria , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Própolis/uso terapéutico , Modelos Animales de Enfermedad , Candida albicans , Pruebas de Sensibilidad Microbiana/veterinaria

RESUMEN

Caffeic acid (CA) exhibits a myriad of biological activities including cardioprotective action, antioxidant, antitumor, anti-inflammatory, and antimicrobial properties. On the other hand, CA presents low water solubility and poor bioavailability, which have limited its use for therapeutic applications. The objective of this study was to develop a nanohybrid of zinc basic salts (ZBS) and chitosan (Ch) containing CA (ZBS-CA/Ch) and evaluate its anti-edematogenic and antioxidant activity in dextran and carrageenan-induced paw edema model. The samples were obtained by coprecipitation method and characterized by X-ray diffraction, Fourier transform infrared (FT-IR), scanning electron microscope (SEM) and UV-visible spectroscopy. The release of caffeate anions from ZBS-CA and ZBS-CA/Ch is pH-dependent and is explained by a pseudo-second order kinetics model, with a linear correlation coefficient of R2 ≥ 0.99 at pH 4.8 and 7.4. The in vivo pharmacological assays showed excellent anti-edematogenic and antioxidant action of the ZBS-CA/Ch nanoparticle with slowly releases of caffeate anions in the tissue, leading to a prolongation of CA-induced anti-edematogenic and anti-inflammatory activities, as well as improving its inhibition or sequestration antioxidant action toward reactive species. Overall, this study highlighted the importance of ZBS-CA/Ch as an optimal drug carrier.

Asunto(s)

Quitosano , Humanos , Quitosano/química , Preparaciones de Acción Retardada/química , Espectroscopía Infrarroja por Transformada de Fourier , Antioxidantes/farmacología , Antiinflamatorios/farmacología , Edema/patología , Zinc/química

RESUMEN

The Brazilian Amazon rainforest region has a significant prevalence of malarial and intestinal parasitic infections in indigenous populations, accounting for a disproportionate burden. Thus, a cross-sectional study was conducted to assess the prevalence and association between malarial and intestinal protozoan and helminth infections in four remote indigenous villages in the Brazilian Amazon Forest. A total of 430 individuals participated in the study, and Plasmodium infections were diagnosed by examination of thick blood smears and PCR. Stool samples 295 individuals (69%) were examined by direct smear and the Kato-Katz technique. The overall prevalence of malaria, intestinal protozoan infection, and intestinal helminth infection was 14.2%, 100%, and 39.3%, respectively. Polyparasitism was predominant (83.7%), and most infected individuals had at least two or more different species of intestinal protozoan and/or helminth parasites. The prevalence of co-infection was 49.5%, and in individuals with intestinal protozoa and helminth infections (34%), Entamoeba. coli, Entamoeba histolytica, and Ascaris lumbricoides were the most common parasites. In individuals with malaria and protozoa infections (10.2%), P. vivax, E. coli, and E. histolytica predominated, and in individuals with malaria, protozoa, and helminth infections (5.4%). P. vivax, E. coli, E. histolytica, and A. lumbricoides predominated. Intestinal polyparasitism was common in the study population, and the presence of helminths was associated with an increased number of intestinal parasitic species. However, Plasmodium infections were neither a risk nor a protective factor for helminth infections; the same was true for helminth infections in relation to Plasmodium. The high prevalence of intestinal polyparasitism with Plasmodium co-infections highlights the need for combining strategies that may help control both malaria and intestinal parasite and generate a health approach aligned with indigenous perspectives.

Asunto(s)

Coinfección , Helmintiasis , Helmintos , Parasitosis Intestinales , Enfermedades Intestinales , Malaria Vivax , Malaria , Animales , Humanos , Coinfección/complicaciones , Estudios Transversales , Brasil/epidemiología , Bosque Lluvioso , Escherichia coli , Parasitosis Intestinales/complicaciones , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Helmintiasis/complicaciones , Helmintiasis/epidemiología , Malaria/complicaciones , Malaria/epidemiología , Pueblos Indígenas , Prevalencia , Heces/parasitología

RESUMEN

The COVID-19 pandemic has brought negative impacts to global supply chains, in particular to the agricultural sector. Although these companies have been developing programs to mitigate the impacts caused by COVID-19, researchers have been worried about a possible weakening of the adoption of sustainable initiatives due to a focus on dealing with the consequences of the pandemic. Grounded on the Resource Orchestration Theory, the goal of this study was to assess the effects of the COVID-19 outbreak on sustainable (environmental, social, and economic) performance in the context of agri-food supply chains. To do so, a questionnaire survey was used to collect data from 349 different medium and large agri-food companies in Brazil. Data were analyzed using Structural Equation Modeling-Partial Least Squares technique. This study has found out that, under the impacts arising from COVID-19 pandemic (1) supply management and transportation and logistics management had a positive impact on food supply chains' sustainable performance; (2) the effects of relationship management and supply chain wide impact management were found to be negative on sustainable performance; and (3) the effects of demand and production management on sustainable performance were not considered significant. We propose a framework that clearly represents the relationship between the disrupted supply chain areas and sustainable performance through the development of orchestration capabilities. By knowing which kinds of impacts produce the most significant effects on sustainable performance, policy makers and managers will be able to make decisions and take actions to avoid negative effects and to improve firms' sustainable performance.

RESUMEN

The state of Ceará, in the Northeast Region of Brazil, presents the simultaneous circulation of Zika (ZIKV), dengue (DENV) and chikungunya (CHIKV) viruses. In 2017 there were a high number of cases of these three arboviruses, especially CHIKV. Here, we detected the presence of arboviruses ZIKV, DENV and CHIKV and their coinfections in women in endemic regions of the city of Fortaleza, Ceará in a post-Zika epidemic year. Sociodemographic and environmental characteristics associated with arbovirus positivity were also analyzed. Women (n = 1289) between 15 and 39 years old were included. RT-qPCR was performed for virus detection and IgM antibody positivity was also analyzed. One hundred and six (8.3%) participants were positive for one or more arboviruses. Monoinfections (76; 5.9%) were distributed between 22 (1.7%) for ZIKV, 39 (3.1%) for DENV and 15 (1.2%) for CHIKV. Co-infections were detected in 30 (2.3%) of the positive participants and one case with triple infection was found. IgM positivity was found in 2.4% of ZIKV RT-qPCR, 9.6% of DENV and 16.3% of CHIKV. RT-qPCR positivity for arboviruses was associated with low socioeconomic class and presence of a water box sealing in the household. A higher positivity to the three viruses occurred in the month with the lowest wind velocity, which was also preceded by the highest peak of rain and humidity. We identified the simultaneous circulation and co-infection of ZIKV, DENV and CHIKV in Fortaleza in a post-Zika epidemic year. We also highlight the need for continuous epidemiological surveillance combined with molecular diagnostic tools.

Asunto(s)

Arbovirus , Fiebre Chikungunya , Virus Chikungunya , Coinfección , Virus del Dengue , Dengue , Infección por el Virus Zika , Virus Zika , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Infección por el Virus Zika/epidemiología , Fiebre Chikungunya/epidemiología , Brasil/epidemiología , Dengue/epidemiología , Coinfección/epidemiología

RESUMEN

PURPOSE: To evaluate the additional effect of high frequency (HF) or low frequency (LF) transcutaneous electrical nerve stimulation (TENS) in a specific therapeutic exercise program for the treatment of patients with chronic neck pain. METHODS: A randomized controlled trial. Sixty participants of both sexes and with chronic neck pain were randomized into three groups: therapeutic exercise group + placebo TENS (n = 20), therapeutic exercise group + HF TENS (n = 20) and therapeutic exercise group + low TENS frequency (n = 20). The following assessment instruments were used: Numerical Pain Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale and Tampa Scale for Kinesiophobia. Participants were evaluated before the interventions, after eight treatment sessions and 1 month after the end of treatment. Primary outcome was disability measured after the eight treatment sessions. Secondary outcomes were pain intensity, catastrophizing, and kinesiophobia after eight treatment sessions and pain intensity 4 weeks after the end of the treatment sessions. RESULTS: The three groups were similar at baseline for personal and clinical characteristics. Regarding the main study analyses, there were no significant (p > 0.05) or clinical (d < 0.80) differences between the groups for the main variable (disability), nor for the secondary variables (pain intensity, catastrophizing and kinesiophobia). CONCLUSION: HF or LF TENS, compared to placebo TENS, does not provide additional clinical benefits to an exercise program for patients with chronic neck pain.

Asunto(s)

Dolor Crónico , Estimulación Eléctrica Transcutánea del Nervio , Masculino , Femenino , Humanos , Dolor de Cuello/terapia , Resultado del Tratamiento , Dolor Crónico/terapia , Terapia por Ejercicio

RESUMEN

Introdução: O sedentarismo em adolescentes contribui para a ocorrência de diferentes doenças, sendo relevante investigar sobre fatores associados. Objetivo: Analisar a associação entre sedentarismo e nível socioeconômico em adolescentes de escolas públicas. Materiais e métodos: Estudo transversal, realizado com 347 adolescentes matriculados em escolas públicas do ensino médio do município de Divinópolis, Minas Gerais. A coleta de dados ocorreu no ano de 2017. O sedentarismo foi avaliado utilizando-se o International Physical Activity Questionnaire e o nível socioeconômico pelo critério da Associação Brasileira de Empresas de Pesquisa. Foi realizada estatística descritiva e analítica através de modelo de regressão logística multivariada. Resultados: Participaram da investigação 347 adolescentes. A média de idade do grupo foi de 16,4 ± 1,0 anos. Os indivíduos caracterizados como sedentários constituíram 38,9% da amostra, sendo que, destes, 66,7% eram do sexo feminino. Possuir maior nível socioeconômico diminui a probabilidade de ser sedentário (OR=0,235; p=0,021), assim como ser estudante das escolas públicas da região sudoeste aumenta essa chance(OR=2,680; p=0,04). Discussão: Os motivos pelos quais as condições socioeconômicas podem influenciar o sedentarismo são variados. A ausência de espaços públicos pode contribuir para a elevação do sedentarismo em adolescentes com menor nível socioeconômico. Conclusão: Esta investigação sinaliza a importância de investimentos públicos em políticas de estímulo à prática de atividade física para os adolescentes, em especial para os do sexo feminino e de menor nível socioeconômico.

---

Introduction: A sedentary lifestyle in adolescents contributes to the occurrence of different diseases, making it relevant to investigate associated factors. Objective: To analyze the association between sedentary lifestyle and socioeconomic status in adolescents from public schools. Materials and methods: Cross-sectional study, carried out with 347 adolescents enrolled in public high schools in the city of Divinópolis, Minas Gerais. Data collection took place in 2017. Sedentary lifestyle was assessed using the International Physical Activity Questionnaire and socioeconomic status using the criteria of the Brazilian Association of Research Companies. Descriptive and analytical statistics were performed using a multivariate logistic regression model. Results: 347 adolescents participated in the investigation. The mean age of the group was 16.4 ± 1.0 years. Individuals characterized as sedentary constituted 38.9% of the sample, of which 66.7% were female. Having a higher socioeconomic level decreases the probability of being sedentary (OR = 0,235; p = 0.021), just as being a student in public schools in the southwest region increases this chance (OR = 2,680; p = 0.04). Discussion: The reasons why socioeconomic conditions can influence a sedentary lifestyle are varied. The absence of public spaces can contribute to the increase in sedentary lifestyles in adolescents with lower socioeconomic status. Conclusion: This investigation highlights the importance of public investments in policies to encourage the practice of physical activity for adolescents, especially for females and lower socioeconomic status.

---

Introducción: El sedentarismo en los adolescentes contribuye a la ocurrencia de diferentes enfermedades, por lo que es relevante investigar los factores asociados. Objetivo: Analizar la asociación entre sedentarismo y nivel socioeconómico en adolescentes de escuelas públicas. Materiales y métodos: Estudio transversal, realizado con 347 adolescentes matriculados en escuelas secundarias públicas de la ciudad de Divinópolis, Minas Gerais. La recolección de datos tuvo lugar en 2017. El estilo de vida sedentario se evaluó mediante el Cuestionario Internacional de Actividad Física y el nivel socioeconómico según los criterios de la Asociación Brasileña de Empresas de Investigación. La estadística descriptiva y analítica se realizó mediante un modelo de regresión logística multivariante. Resultados: 347 adolescentes participaron en la investigación. La edad media del grupo fue de 16,4 ± 1,0 años. Los individuos caracterizados como sedentarios constituyeron el 38,9% de la muestra, de los cuales el 66,7% eran mujeres. Tener un nivel socioeconómico más alto disminuye la probabilidad de ser sedentario (OR = 0,235; p = 0,021), al igual que ser alumno de escuelas públicas de la región suroeste aumenta esta posibilidad (OR = 2,680; p = 0,04). Discusión: Las razones por las que las condiciones socioeconómicas pueden influir en un estilo de vida sedentario son variadas. La ausencia de espacios públicos puede contribuir al aumento de estilos de vida sedentarios en adolescentes de menor nivel socioeconómico. Conclusión: Esta investigación destaca la importancia de la inversión pública en políticas para incentivar la práctica de actividad física en adolescentes, especialmente en mujeres y estrato socioeconómico más bajo.

Asunto(s)

Humanos , Masculino , Femenino , Adolescente , Servicios de Salud Escolar , Clase Social , Adolescente , Conducta Sedentaria

RESUMEN

BACKGROUND: Interscalene brachial plexus block is associated with phrenic nerve paralysis. The objective of this study was to evaluate an alternative approach to interscalene brachial plexus blocks in terms of efficacy, grade of motor and sensory blockade, and phrenic nerve blockade. METHODS: The study was prospective and interventional. The ten living patients studied were 18 to 65 years old, ASA physical status I or II, and submitted to correction of rotator cuff injury. A superior trunk blockade was performed at the superior trunk below the omohyoid muscle, without blocking the phrenic nerve. The needle was advanced below the prevertebral layer until contacting the superior trunk. In order to guarantee the correct positioning of the needle tip, an intracluster pattern of the spread was visualized. The block was performed with 5.ßmL of 0.5% bupivacaine in ten patients. In the six cadavers, 5.ßmL of methylene blue was injected. Diaphragmatic excursion was assessed by ultrasonography of the ipsilateral hemidiaphragm. In three patients, pulmonary ventilation was evaluated with impedance tomography. Pain scores and analgesic consumption were assessed in the recovery room for 6.ßhours after the blockade. RESULTS: In the six cadavers, methylene blue didn...t reach the phrenic nerve. Ten patients underwent arthroscopic surgery, and no clinically phrenic nerve paralysis was observed. No patient reported pain during the first 6.ßhours. CONCLUSIONS: This study suggests that this new superior trunk approach to block the superior trunk may be an alternative technique to promote analgesia for shoulder surgery in patients with impaired respiratory function.

Asunto(s)

Bloqueo del Plexo Braquial , Plexo Braquial , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Estudios Prospectivos , Azul de Metileno , Bloqueo del Plexo Braquial/métodos , Artroscopía/métodos , Parálisis , Cadáver , Dolor , Ultrasonografía Intervencional/métodos , Anestésicos Locales , Hombro/inervación , Dolor Postoperatorio

RESUMEN

[This corrects the article DOI: 10.1099/acmi.0.000245.].

RESUMEN

BACKGROUND: Piper hispidinervum is a species native from the Amazon region with great economic potential, given its scientifically proven insecticidal properties. In this study, an efficient protocol of plant regeneration via indirect somatic embryogenesis has been established for the first time. In a first experiment, for the induction of calluses, foliar explants of non-discriminated accesses of P. hispidinervum were inoculated in MS medium supplemented with α-naphtalenacetic acid (NAA) and 6-benzylaminopurine (BAP), in different combinations. For a second experiment, foliar explants from five different accesses of P. hispidinervum (PH17, PH21, PH28, PH37, and PH39) were analyzed regarding the formation of calluses when cultivated in MS medium with 5 mg L-1 NAA + 2.5 mg L-1 BAP. To obtain somatic embryos-like structures, calluses were cultivated in MS medium with 10 mg L-1 NAA + 2.5 mg L-1 of BAP. The somatic embryos-like structures obtained were inoculated in MS medium devoid of growth regulators and the plantlets were subjected to acclimatization. Calluses and somatic embryos-like structures were subjected to anatomical analysis and genetic stability of regenerated plants was analyzed by flow cytometry. RESULTS: The treatments 2.5 mg L-1 BAP and 5 mg L-1 NAA + 2.5 mg L-1 BAP, after 60 days of cultivation, provided each 32% of primary callus, not being verified the formation of calluses in medium devoid of BAP. It was found that accesses differed among them with respect to the formation of primary calluses, with emphasis on accesses PH28, PH37, and PH39, with mean percentage of 95.3%. Regarding the percentage of embryogenic calluses and formation of somatic embryos-like structures, there were no statistical differences between accesses, with mean values of 90.6% and 77.3%, respectively. The somatic embryos-like structures of P. hispidinervum have conspicuous morphoanatomical similarities with the zygotic embryo, and flow cytometry analysis showed no significant variation in nuclear DNA size among plants regenerated in vitro and plants coming from seed germination, which indicates ploidy level stability. CONCLUSION: This protocol is the first cited in the literature that demonstrates an efficient micropropagation process by somatic embryogenesis of P. hispidinervum. It can be used either to enable large-scale vegetative production or to subsidize germplasm conservation or genetic engineering of P. hispidinervum.

RESUMEN

BACKGROUND AND AIMS: Chagas disease is a common cause of heart failure (HF) and death in developing countries. Although stroke is known to occur in these patients, an accurate estimate of stroke incidence is lacking. We aimed to determine the incidence of stroke and death in patients with HF, comparing Chagas and non-Chagas etiologies. METHODS: Cohort of stroke-free patients with HF (Framingham criteria) followed in a university-based outpatient clinic in Brazil. Baseline characteristics included sociodemographic, risk factor assessment, echocardiographic and electrocardiographic findings. Chagas disease was defined by appropriate serologic tests. Cause-specific Cox regression was used to search for predictors of stroke or death as separate outcomes. RESULTS: We studied 565 patients with HF between January 2003 and December 2018, mean age 54.3 ± 12.9 years, 305 (54.0%) females, 271/535 (50.7%) with Chagas disease. Chagas patients were older (55.5 vs. 53.1 years), more frequently women (60.5% vs. 47.3%), less frequently harbored coronary artery disease (14.5% vs. 34.1%) when compared to non-Chagas patients. Echocardiography showed more severe disease among non-Chagas patients [median left ventricle ejection fraction (LVEF) 37.3% vs. 47.0%]. Over a mean 42.9 (±34.4) months, we followed 404 (71.5%) patients, completing 1442 patient-years of follow-up. Stroke incidence was higher in Chagas when compared to non-Chagas patients (20.2 vs. 13.9 events per 1000 patient-years), while death rate was similar (41.6 vs. 43.1 deaths per 1000 patient-years). In the multivariable analysis for stroke outcome adjusted for LVEF and arrhythmias, cause-specific hazard ratio (CSHR) for Chagas was 2.54 (95% confidence interval 1.01-6.42, p = 0.048). Chagas disease was also associated with increased risk of death (CSHR 1.83; 95% confidence interval 1.04-3.24, p = 0.037). CONCLUSION: Chagas disease is associated with increased risk of stroke and death when compared to other etiologies of HF, independently of HF severity or cardiac arrhythmias, suggesting other factors contribute to increased stroke risk and mortality in Chagas disease. Early prevention and treatment of Chagas disease is imperative to reduce a later risk of stroke in endemic areas.

Asunto(s)

Enfermedad de Chagas , Insuficiencia Cardíaca , Accidente Cerebrovascular , Adulto , Anciano , Enfermedad de Chagas/complicaciones , Enfermedad de Chagas/epidemiología , Femenino , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/epidemiología , Humanos , Persona de Mediana Edad , Pronóstico , Factores de Riesgo , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/epidemiología , Volumen Sistólico , Función Ventricular Izquierda

RESUMEN

Transfusion transmissible infections (TTIs), caused by hepatitis B virus (HBV), human immunode-ficiency virus (HIV), hepatitis C virus (HCV), and syphilis, have a high global impact, especially in sub-Saharan Africa. We evaluated the trend of these infections over time in blood donors in Angola. A retrospective cross-sectional study was conducted among blood donors in Angola from 2005 to 2020. Additionally, frozen samples obtained from blood donors in 2007 were investigated to identify chronic HCV carriers and possible occult HBV infection (OBI). The overall prevalence of HBV, HCV, HIV, and syphilis was 8.5, 3, 2.1, and 4.4%, respectively, among 57,979 blood donors. HBV was predominant among male donors, while the remaining TTIs were predominant among women. Donors >50 years had a significantly high prevalence for all TTIs. Chronic HCV infection was ab-sent in 500 samples tested and OBI was present in 3%. Our results show the continued high prev-alence of TTIs among blood donors in Angola. Most infections showed a significantly low preva-lence in years with campaigns seeking voluntary blood donors, thus, reinforcing the importance of this type of donor to ensure safe blood. Africa, with a high prevalence of diverse pathogens, should consider cost-effective pathogen reduction technologies, once they are commercially accessible, to increase the availability of safe blood.

RESUMEN

Tuberculosis (TB) affects around 10 million people worldwide in 2019. Approximately 3.4 % of new TB cases are multidrug-resistant. The gold standard method for detecting Mycobacterium tuberculosis, which is the aetiological agent of TB, is still based on microbiological culture procedures, followed by species identification and drug sensitivity testing. Sputum is the most commonly obtained clinical specimen from patients with pulmonary TB. Although smear microscopy is a low-cost and widely used method, its sensitivity is 50-60 %. Thus, owing to the need to improve the performance of current microbiological tests to provide prompt treatment, different methods with varied sensitivity and specificity for TB diagnosis have been developed. Here we discuss the existing methods developed over the past 20 years, including their strengths and weaknesses. In-house and commercial methods have been shown to be promising to achieve rapid diagnosis. Combining methods for mycobacterial detection systems demonstrates a correlation of 100 %. Other assays are useful for the simultaneous detection of M. tuberculosis species and drug-related mutations. Novel approaches have also been employed to rapidly identify and quantify total mycobacteria RNA, including assessments of global gene expression measured in whole blood to identify the risk of TB. Spoligotyping, mass spectrometry and next-generation sequencing are also promising technologies; however, their cost needs to be reduced so that low- and middle-income countries can access them. Because of the large impact of M. tuberculosis infection on public health, the development of new methods in the context of well-designed and -controlled clinical trials might contribute to the improvement of TB infection control.

RESUMEN

Vitamins are organic compounds essential for normal physiological functioning and they need to be provided in adequate amounts by the diet. They are nutrients mainly associated to fruit consumption, playing an important role in the cellular function, growth and development of individuals. The present study aimed to analyze levels of vitamins B, C and carotenoids of fruits from the agrobiodiversity of Northeastern Brazil, among them cajuí (Anacardium spp), murici (Byrsonima crassifolia (L.) Kunth), pequi (Caryocar coriaceum Wittm.), jenipapo (Genipa americana L.), mangaba (Hancornia speciosa Gomes), bacuri (Platonia insignis Mart.), cajá (Spondias mombin L.), umbu-cajá (Spondias bahiensis P. Carvalho, Van den Berg & M. Machado), umbu (Spondias tuberosa Arruda), pitanga (Eugenia uniflora L.), araçá (Psidium sobralianum Landrum & Proença). The vitamins were quantified using the analytical method High Performance Liquid Chromatography (HPLC). Vitamin B complex levels varied from 0.003 ± 0.01 mg/100 g to 6.107 ± 0.06 mg/100 g. Vitamin C ranged from 0.36 ± 0.06 mg/100 g to 253.92 ± 9.02 mg/100 g. Carotenoid values ranged from 0.12 ± 0.02 µg/100 g to 395.63 ± 113.69 µg/100 g. Thus, the profile of water-soluble vitamins and carotenoids of the fruits analyzed was quantified. Therefore, these fruits can provide varied amounts of vitamins important to human health. However, it is interesting for the individual to consume fruits in a diversified manner, avoiding monotony and thus guaranteeing the daily intake of more nutrients.