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To investigate the effects of 8-weeks of full versus split body resistance training (RT) on appetite and energy intake in non-obese untrained men. The participants were pair-matched based on their initial fat mass and then randomly allocated into one of two treatment groups: Full body (FB, n = 20), in which all muscle groups were trained in every session, or Split body (SB, n = 15), in which upper and lower muscle groups were trained alternated per session; both groups trained in non-consecutive days, three times per week with total number of sets performed equated between groups. Energy intake, body composition, and strength performance were evaluated at pre-training, and after 8-weeks of RT, as well as self-reported hunger, fullness, and desire to eat, that were assessed at fasted and feed states pre- and post-intervention. FB and SB resistance training increased fat-free mass (FFM) (p < 0.001); and FB induced greater maximal strength improvement (p = 0.027). At fasted state self-reported hunger increased, and fullness decreased, while in feed state desire to eat something fatty increased in both groups. Carbohydrate intake (p = 0.011) decreased in both groups. In conclusion, FB and SB training increased orexigenic drive (increasing hunger and decreasing fullness), however, total energy intake and fat mass did not change after 8-weeks of RT in non-obese untrained men.Registered under Brazilian Registry of Clinical Trials no. RBR-3wkcvyw.
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Apetito , Composición Corporal , Ingestión de Energía , Entrenamiento de Fuerza , Humanos , Masculino , Entrenamiento de Fuerza/métodos , Ingestión de Energía/fisiología , Apetito/fisiología , Adulto , Adulto Joven , Hambre/fisiología , Fuerza Muscular/fisiologíaRESUMEN
Capsiate (CAP) is a nonpungent capsaicin analog (Capsicum annuum L. extract) that has been studied as a potential antiobesity agent. However, the interaction between chronic CAP supplementation and resistance training is not clear. The purpose of this study was to examine the changes in adipose tissue-derived hormones, body composition, appetite, and muscle strength after 10 weeks of resistance training, combined with chronic CAP supplementation in healthy untrained men. We hypothesized that CAP could induce higher benefits when combined with resistance training after 10 weeks of intervention compared to resistance training alone. Twenty-four young men (age, 22.0 ± 2.9) were randomized to either capsiate supplementation (CAP = 12 mg/day) or placebo (PL), and both groups were assigned to resistance training. Body composition, leptin and adiponectin concentrations, subjective ratings of appetite, energy intake, and exercise performance were assessed at before and after 10 weeks of progressive resistance training. There was a significant increase in body mass (P < .001), fat-free mass (CAP: 58.0 ± 7.1 vs. post, 59.7 ± 7.1 kg; PL: pre, 58.4 ± 7.3 vs. post, 59.8 ± 7.1 kg; P < .001), resting metabolic rate (CAP: pre, 1782.9 ± 160.6 vs. post, 1796.3 ± 162.0 kcal; PL: pre, 1733.0 ± 148.9 vs. post, 1750.5 ± 149.8 kcal; P < .001), maximal strength at 45 leg press (P < .001) and bench press (P < .001) in both groups, but no significant (P > .05) supplementation by training period interaction nor fat mass was observed. For subjective ratings of appetite, energy intake, leptin, and adiponectin, no significant effect of supplementation by training period interaction was observed (P > .05). In conclusion, 10 weeks of resistance training increased total body weight, muscle mass, and maximum strength in healthy untrained men; however, CAP supplementation (12 mg, 7 days per week) failed to change adipose tissue-derived hormones, appetite, body composition and muscle strength in this population. Registered under Brazilian Registry of Clinical Trials (RBR-8cz9kfq).
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Capsaicina/análogos & derivados , Capsicum , Entrenamiento de Fuerza , Masculino , Humanos , Adulto Joven , Adulto , Leptina/metabolismo , Suplementos Dietéticos , Apetito , Adiponectina , Tejido Adiposo/metabolismo , Composición Corporal , Fuerza Muscular , Método Doble Ciego , Alcanfor/metabolismo , Alcanfor/farmacología , Mentol/metabolismo , Mentol/farmacología , Extractos Vegetales/farmacología , Músculo EsqueléticoRESUMEN
Aureobasidium pullulans LB83 is a versatile biocatalyst that produces a plethora of bioactive products thriving on a variety of feedstocks under the varying culture conditions. In our last study using this microorganism, we found cellulase activity (FPase, 2.27 U/ml; CMCase, 7.42 U/ml) and other plant cell wall degrading enzyme activities grown on sugarcane bagasse and soybean meal as carbon source and nitrogen, respectively. In the present study, we provide insights on the secretome analysis of this enzymatic cocktail. The secretome analysis of A. pullulans LB83 by Liquid Chromatography coupled to Mass Spectroscopy (LC-MS/MS) revealed 38 classes of Carbohydrate Active enZymes (CAZymes) of a total of 464 identified proteins. These CAZymes consisted of 21 glycoside hydrolases (55.26%), 12 glycoside hydrolases harboring carbohydrate-binding module (31.58%), 4 carbohydrate esterases (10.53%) and one glycosyl transferase (2.63%). To the best of our knowledge, this is the first report on the secretome analysis of A. pullulans LB83.
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OBJECTIVE: Few population-based studies for Takayasu arteritis (TAK) have been performed, and Latin America prevalence/incidence data are unavailable. We aimed to understand TAK epidemiology in Rio de Janeiro City in 2020 (i.e., 6,747,815 inhabitants). METHODS: This was a cross-sectional fieldwork study where physicians who regularly followed TAK patients in public or private practices from Rio de Janeiro were invited to complete a REDCap survey. Patients should fulfill internationally accepted criteria for TAK and be living in the city. The 2020 prevalence was calculated as cases per 1,000,000 inhabitants (10 6 ). National government databases were analyzed for comparative prevalence assessment. The incidence rate was estimated using retrospective sections of cases diagnosed between 2010 and 2019; relative incidence risk was assessed by Poisson regression models with robust variance. RESULTS: Between May 2020 and May 2021, 114 patients were analyzed. Ninety-seven (85.1%) were female, and the most frequent races were White (44.7%), Mestizo (33.3%), and Black (16.7%). Takayasu arteritis 2020 prevalence was 16.9 cases/10 6 (95% confidence interval [CI], 14.1-20.3 cases/10 6 ); female patients and Black Brazilians had higher prevalence rates at 27.0 (95% CI, 22.2-33.3) and 25.1 cases/10 6 (95% CI, 16.1-39.3 cases/10 6 ), respectively. Government databases' analyses generated a lower prevalence (7.26 cases/10 6 ; 95% CI, 5.49-9.60 cases/10 6 ). The 2010-2019 mean incidence rate was 0.94 cases/10 6 per year (95% CI, 0.73-1.21 cases/10 6 ). Female patients had a higher risk than male patients of having TAK between 2010 and 2019 (relative risk, 2.70; 95% CI, 1.59-4.55; p < 0.0001). CONCLUSION: In the largest population-based fieldwork to date and the first Latin American study on TAK prevalence, Rio de Janeiro City in 2020 showed an intermediate prevalence between Europe and Asia. Female patients and Black Brazilians were more affected than the general population.
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Arteritis de Takayasu , Humanos , Masculino , Femenino , Estudios Retrospectivos , Brasil/epidemiología , Arteritis de Takayasu/diagnóstico , Arteritis de Takayasu/epidemiología , Estudios Transversales , IncidenciaRESUMEN
ABSTRACT Purpose: To translate and validate the Contact Lens Dry Eyes Questionnaire (CLDEQ-8) to Portuguese language and to describe the impact of soft contact lenses on the ocular surface. Methods: We conducted a descriptive transversal study with the aim to: (1) translate and validate the CLDEQ-8 questionnaire to Portuguese language and (2) apply the CLDEQ-8 to a group of contact lens wearers along with a broad evaluation of the impact of soft contact lens on the ocular surface. The evaluation of the impact of soft contact lens was performed for a study population of 81 subjects, categorized in two groups: Group A: 61 contact lens wearers and Group B (control): 20 noncontact lens wearers. The study exclusion criteria were rigid contact lens wear, systemic or ocular diseases, the use of medications predisposing to ocular surface damage, and previous ocular surgeries. Results: For the CLDEQ-8 questionnaire translation and validation, Kappa agreement values were ³0.7 in all questions, implying a good agreement between the Portuguese and English language versions. Considering the ocular surface evaluation of the subjects, all parameters differed in Soft contact lens wearers when compared with the controls (p<0.05), except in those related to tear volume, such as the tear meniscus height and Schirmer test. Conclusions: This study provided a translated and validated Portuguese version of CLDEQ-8 questionnaire, which represents an important tool for the evolution of contact lens wearers. The broad evaluation of the ocular surface revealed an association between soft contact lens wearing and ocular surface disturbances.
RESUMO Objetivo: Traduzir e validar o questionário de olho seco e lentes de contato (CLDEQ-8) para o português e descrever o impacto das lentes de contato gelatinosas na superfície ocular. Métodos: Estudo transversal e descritivo com o objetivo de (1) traduzir e validar o CLDEQ-8 para o português e (2) aplicar o CLDEQ-8 em um grupo de usuários de lentes de contato, juntamente com uma ampla avaliação do impacto das lentes gelatinosas na superfície ocular. A avaliação do impacto das lentes gelatinosas foi realizada em uma amostra composta por 81 indivíduos, divididos em dois grupos: 61 usuários de lente de contato (Grupo A) e um grupo controle de 20 não usuários (Grupo B). Como critério de exclusão: usuário de lentes de contato rígidas, doenças sistêmicas ou oculares prévias, uso de medicamentos que podem causar danos a superfície ocular e cirurgias oculares prévias. Resultados: Para a tradução e validação do questionário CLDEQ-8, os valores de concordância Kappa foram iguais ou superiores a 0,7 em todas as perguntas, o que implica em uma boa concordância entre as versões em português e inglês. Considerando a avaliação da superfície ocular dos sujeitos, todos os parâmetros diferiram nos usuários de lente de contato em comparação com os controles (com p<0,05), exceto naqueles relacionados ao volume lacrimal, como altura do menisco lacrimal e teste de Schirmer. Conclusões: Este estudo forneceu uma versão traduzida para o português e validada do questionário CLDEQ-8, que representa uma importante ferramenta na avaliação de usuários de lente de contato. A avaliação da superfície ocular realizada demonstra a relação entre o uso de lentes de contato gelatinosas e os distúrbios da superfície ocular.
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PURPOSE: To translate and validate the Contact Lens Dry Eyes Questionnaire (CLDEQ-8) to Portuguese language and to describe the impact of soft contact lenses on the ocular surface. METHODS: We conducted a descriptive transversal study with the aim to: (1) translate and validate the CLDEQ-8 questionnaire to Portuguese language and (2) apply the CLDEQ-8 to a group of contact lens wearers along with a broad evaluation of the impact of soft contact lens on the ocular surface. The evaluation of the impact of soft contact lens was performed for a study population of 81 subjects, categorized in two groups: Group A: 61 contact lens wearers and Group B (control): 20 noncontact lens wearers. The study exclusion criteria were rigid contact lens wear, systemic or ocular diseases, the use of medications predisposing to ocular surface damage, and previous ocular surgeries. RESULTS: For the CLDEQ-8 questionnaire translation and validation, Kappa agreement values were ³0.7 in all questions, implying a good agreement between the Portuguese and English language versions. Considering the ocular surface evaluation of the subjects, all parameters differed in Soft contact lens wearers when compared with the controls (p<0.05), except in those related to tear volume, such as the tear meniscus height and Schirmer test. CONCLUSIONS: This study provided a translated and validated Portuguese version of CLDEQ-8 questionnaire, which represents an important tool for the evolution of contact lens wearers. The broad evaluation of the ocular surface revealed an association between soft contact lens wearing and ocular surface disturbances.
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Lentes de Contacto Hidrofílicos , Síndromes de Ojo Seco , Lentes de Contacto Hidrofílicos/efectos adversos , Síndromes de Ojo Seco/diagnóstico , Síndromes de Ojo Seco/etiología , Ojo , Humanos , Encuestas y Cuestionarios , LágrimasRESUMEN
To identify and compare keratometric, corneal thickness, and elevation parameters and indices among healthy children, ocular allergy, and keratoconus using the OCULUS Pentacam Scheimpflug topography system. This study included healthy children, children with ocular allergy (OA) without keratoconus, and children with keratoconus (KC). The study design consisted of a prospective evaluation and review of medical records from a Brazilian ophthalmology department. The exclusion criteria were inability to undergo the ocular exam, other ocular diseases, contact lens wear, and topographic corneal ectasia. The effect of each corneal parameter was evaluated using univariate and multivariate logistic regression models adjusted for sex and age, and ROC curves were used to assess the ability each variable to discriminate among groups. A total of 182 subjects were included: healthy children (n = 99), children with OA (n = 32), and children with KC (n = 51). Groups differed in terms of sex, with more males in the OA group (73.2%) and the KC group (67.7%) than in the control group (40.9%). All corneal parameters studied differed significantly between the control and KC groups, and between the OA and KC groups; they also differed significantly between the three groups in terms of astigmatism, q-value, CCT, TP, BAD-D, and ARTmax values. We present the first study to describe and compare corneal tomographic parameters in healthy children, OA, and KC. Keratometry indices, ACD, ARTmax, AETP, and PETP were found to be the most useful for differentiating between healthy and KC children.IBR registry number: CAAE 54921916.9.0000.5404.
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Córnea/fisiología , Topografía de la Córnea/métodos , Hipersensibilidad/diagnóstico , Queratocono/diagnóstico , Área Bajo la Curva , Astigmatismo , Brasil , Niño , Estudios Transversales , Diagnóstico Diferencial , Femenino , Voluntarios Sanos , Humanos , Masculino , Análisis Multivariante , Oportunidad Relativa , Estudios Prospectivos , Curva ROC , Análisis de Regresión , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
A Atenção Primária em Saúde (APS) é um cenário importante para a graduação dos cursos na área da saúde. Objetiva-se descrever e analisar a percepção dos profissionais da saúde de uma Unidade Básica de Saúde (UBS) sobre a atuação dos acadêmicos de enfermagem, medicina e odontologia. Trata-se de um estudo descritivo e exploratório de abordagem qualitativa, por meio da realização de entrevistas semiestruturadas aplicadas a profissionais atuantes na UBS em questão. A UBS apresentou recursos humanos adequados para atender às necessidades dos estudantes, mas uma insuficiência na estrutura física. A atuação dos estudantes traz contribuições para a organização do serviço e atendimento da população, apesar de diminuir a agilidade do serviço e limitar a longitudinalidade nos atendimentos. Conclui-se que a participação de estudantes na UBS agrega valor e é necessária para a formação acadêmica, como meio de ampliar a compreensão do processo saúde-doença e das possibilidades de cuidado.
Primary Health Care (PHC) is an important scenario for undergraduate health courses. The objective is to describe and analyse the perception of health professionals on undergraduate students on nursing, medicine, and dentistry acting in a Basic Health Unit (BHU). It is a descriptive and exploratory study of a qualitative approach with personal semi-structured interviews applied to professionals working in the BHU. The unit presents adequate human resources to attend to the students' needs, despite the physical structure being unsatisfying. The undergraduate students' performance brings contributions to the organization of the service and attendance of the population, although it can reduce and limit the agility and the longitudinality of the service. Through this study, the undergraduate students' participation in the BHU adds value and is essential for academic training as a means to broaden the understanding of the health-disease process and the treatment possibilities.
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Atención Primaria de Salud , EstudiantesRESUMEN
OBJECTIVE: Hemophagocytic lymphohistiocytosis syndrome (HLHS) is characterized by an immunological hyperactivation of cytotoxic T cells, natural killer cells, and macrophages, leading to the secretion of proinflammatory cytokines. HLHS associated with Visceral Leishmaniasis might be difficult to diagnose once symptoms are similar, resulting in the death of untreated patients. Our aim is to describe a series of cases of Visceral Leishmaniasis with HLHS admitted to a referral hospital for infectious diseases. CASE DESCRIPTION: All 115 cases of Visceral Leishmaniasis referred to a referral center for pediatric infectious diseases were reviewed to identify the cases of HLHS. Five cases (4.5%) were confirmed with HLHS and they presented fever, splenomegaly, cytopenia, hypertriglyceridemia or hypofibrinogenemia, increased ferritin and hemophagocytosis in the bone marrow. COMMENTS: It important to rule out HLHS in children with infectious diseases that do not respond adequately to treatment or in patients with severe symptoms, especially in leishmaniasis endemic areas.
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Anemia , Leishmaniasis Visceral , Linfohistiocitosis Hemofagocítica , Fiebre , Humanos , Leishmaniasis Visceral/complicaciones , Leishmaniasis Visceral/diagnóstico , Linfohistiocitosis Hemofagocítica/diagnóstico , SíndromeRESUMEN
Aureobasidium pullulans LB83 was evaluated for cellulase production under submerged fermentation conditions. Different process variables such as carbon sources (corn cob, sugarcane bagasse, and sugarcane straw), synthetic (urea, ammonium sulfate, and peptone), and non-synthetic (soybean meal, rice, and corn meal) nitrogen sources and inoculum size were evaluated by one parameter at-a-time strategy. Aureobasidium pullulans LB83 showed maximum cellulase activity (FPase, 2.27 U/mL; CMCase, 7.42 U/mL) on sugarcane bagasse. Among the nitrogen sources, soybean meal as a non-synthetic nitrogen sources showed a maximum cellulase activity (FPase 2.45 U/mL; CMCase, 6.86 U/mL) after 60 hr. The inoculum size of 1.6 × 106 CFU/mL had the maximum FPase and CMCase activities of 3.14 and 8.74 U/mL, respectively. For the enzymatic hydrolysis, both the commercial cellulase (10 FPU/g of Cellic CTec 2 (#A) and 10 FPU/g of crude enzyme extract (CEE) (#B), and varying ratio of CTec 2 and CEE in combination #C (5 FPU/g of CTec 2 + 5 FPU/g CEE), combination #D (2.5 FPU/g of CTec 2 + 7.5 FPU/g CEE), and combination #E (7.5 FPU/g of CTec 2 + 2.5 FPU/g CEE) were assessed for enzymatic hydrolysis of delignified sugarcane bagasse. Enzyme combination #C showed maximum hydrolysis yield of 92.40%. The study shows the hydrolytic potential of cellulolytic enzymes from A. pullulans LB83 for lignocellulosic sugars production from delignified sugarcane bagasse.
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Aureobasidium/enzimología , Biotecnología/métodos , Celulosa/química , Nitrógeno/química , Carbono/química , Celulasa/química , Celulasas , Fermentación , Glucanos , Concentración de Iones de Hidrógeno , Hidrólisis , Lignina/química , Saccharum , Glycine max/metabolismo , TemperaturaRESUMEN
The COVID-19 outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global major concern. In this review, we addressed a theoretical model on immunopathogenesis associated with severe COVID-19, based on the current literature of SARS-CoV-2 and other epidemic pathogenic coronaviruses, such as SARS and MERS. Several studies have suggested that immune dysregulation and hyperinflammatory response induced by SARS-CoV-2 are more involved in disease severity than the virus itself.Immune dysregulation due to COVID-19 is characterized by delayed and impaired interferon response, lymphocyte exhaustion and cytokine storm that ultimately lead to diffuse lung tissue damage and posterior thrombotic phenomena.Considering there is a lack of clinical evidence provided by randomized clinical trials, the knowledge about SARS-CoV-2 disease pathogenesis and immune response is a cornerstone to develop rationale-based clinical therapeutic strategies. In this narrative review, the authors aimed to describe the immunopathogenesis of severe forms of COVID-19.
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Betacoronavirus/inmunología , Infecciones por Coronavirus/inmunología , Síndrome de Liberación de Citoquinas/inmunología , Neumonía Viral/inmunología , Síndrome de Dificultad Respiratoria/inmunología , Factores de Edad , Enzima Convertidora de Angiotensina 2 , Animales , Formación de Anticuerpos , Betacoronavirus/patogenicidad , Trastornos de la Coagulación Sanguínea/etiología , COVID-19 , Comorbilidad , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Humanos , Inmunidad Innata , Inflamación/inmunología , Pulmón/patología , Linfopenia/inmunología , Ratones , Coronavirus del Síndrome Respiratorio de Oriente Medio/inmunología , Pandemias , Peptidil-Dipeptidasa A/fisiología , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Factores de Riesgo , SARS-CoV-2 , Síndrome Respiratorio Agudo Grave/inmunología , Índice de Severidad de la Enfermedad , Factores Sexuales , Internalización del VirusRESUMEN
Concerns about the negative effects of agriculture on soil physical quality and soil organic carbon (SOC) pools have spurred on the adoption of conservation tillage systems in tropical regions. This study aimed to evaluate the long-term impacts (16th year) of conventional (CT), minimum (MT) and no-tillage (NT) practices and different cover crops (sunn hemp and a bean/millet sequence) on soil physical properties and SOC content of a corn cultivated Ultisol in the northeast of Brazil. Soil bulk density (Bd), soil penetration resistance (SPR), soil aggregation, and total aggregate-associated carbon (C) (4-2 mm) were evaluated. Tillage practices exerted strong control on soil physical properties and total aggregate-C content but were influenced by cover crop species. Minimum tillage presented the lowest Bd, irrespective of cover crop, while NT with bean/millet sequence resulted in the lowest SPR. However, as regards soil aggregation and total aggregate-C, the results indicated that there were no differences between MT and NT, with both systems presenting greater mean weight diameter (MWD) and total aggregate-C content than CT. Total aggregate-C content in the 0.00-0.05 m soil layer in conservation tillage was increased by the adoption of a bean/millet sequence. Increased mechanical disturbance through CT practices was harmful to Bd, soil aggregation and SOC accrual. Overall, more conservative tillage practices and the proper choice of cover crops might yield greater soil quality. Low intensity of soil disturbances due to the adoption of MT favors soil aggregation and the accrual of SOC in weakly structured soils through increases in contact between organic and mineral particles while not causing significant destruction of soil aggregates.
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Análisis del Suelo , Características del Suelo , Conservación de Tierras , Agricultura SostenibleRESUMEN
Concerns about the negative effects of agriculture on soil physical quality and soil organic carbon (SOC) pools have spurred on the adoption of conservation tillage systems in tropical regions. This study aimed to evaluate the long-term impacts (16th year) of conventional (CT), minimum (MT) and no-tillage (NT) practices and different cover crops (sunn hemp and a bean/millet sequence) on soil physical properties and SOC content of a corn cultivated Ultisol in the northeast of Brazil. Soil bulk density (Bd), soil penetration resistance (SPR), soil aggregation, and total aggregate-associated carbon (C) (4-2 mm) were evaluated. Tillage practices exerted strong control on soil physical properties and total aggregate-C content but were influenced by cover crop species. Minimum tillage presented the lowest Bd, irrespective of cover crop, while NT with bean/millet sequence resulted in the lowest SPR. However, as regards soil aggregation and total aggregate-C, the results indicated that there were no differences between MT and NT, with both systems presenting greater mean weight diameter (MWD) and total aggregate-C content than CT. Total aggregate-C content in the 0.00-0.05 m soil layer in conservation tillage was increased by the adoption of a bean/millet sequence. Increased mechanical disturbance through CT practices was harmful to Bd, soil aggregation and SOC accrual. Overall, more conservative tillage practices and the proper choice of cover crops might yield greater soil quality. Low intensity of soil disturbances due to the adoption of MT favors soil aggregation and the accrual of SOC in weakly structured soils through increases in contact between organic and mineral particles while not causing significant destruction of soil aggregates.(AU)
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Análisis del Suelo , Características del Suelo , Conservación de Tierras , Agricultura SostenibleRESUMEN
Abstract The COVID-19 outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global major concern. In this review, we addressed a theoretical model on immunopathogenesis associated with severe COVID-19, based on the current literature of SARS-CoV-2 and other epidemic pathogenic coronaviruses, such as SARS and MERS. Several studies have suggested that immune dysregulation and hyperinflammatory response induced by SARS-CoV-2 are more involved in disease severity than the virus itself. Immune dysregulation due to COVID-19 is characterized by delayed and impaired interferon response, lymphocyte exhaustion and cytokine storm that ultimately lead to diffuse lung tissue damage and posterior thrombotic phenomena. Considering there is a lack of clinical evidence provided by randomized clinical trials, the knowledge about SARS- CoV-2 disease pathogenesis and immune response is a cornerstone to develop rationale-based clinical therapeutic strategies. In this narrative review, the authors aimed to describe the immunopathogenesis of severe forms of COVID-19.(AU)
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Humanos , Neumonía Viral/inmunología , Infecciones por Coronavirus/inmunología , Betacoronavirus/efectos de los fármacos , Trombosis/etiología , Citocinas/efectos adversosRESUMEN
Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.
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INTRODUCTION: Brain ischaemic hypoxia can produce severe neurological damage that leads to behavioural disorders. This research analysed the hippocampal and cerebellar histological alterations caused by brain ischaemic hypoxia experimentally induced by sodium nitrite (NaNO2) and possible direct repercussions of this hypoxia on behaviour. METHODOLOGY: An experimental study was carried out by administering 60mg/kg NaNO2 to 10 Wistar rats at 3 months of age for 15 consecutive days. Ten control rats did not receive NaNO2. To assess behavioural repercussions, the animals were evaluated in Open Field, Elevated Plus-Maze (EPM), and Forced Swim tests before and after injury to evaluate locomotion, anxiety, and depression, respectively. Markers of stress were evaluated by measuring the blood levels of cortisol, glucose, cholesterol, and lactate. The presence of hippocampal lesions was verified by histologically studying the CA1-CA4 areas. Sections of the cerebellum were also evaluated because Purkinje cells are highly sensitive to ischaemic hypoxia and may serve as markers for this process. RESULTS: The number of neurons with lesions was significantly higher in animals exposed to NaNO2 in the hippocampus areas CA2, CA3, and CA4. The cerebellum was also very vulnerable to hypoxia, presenting extensive lesion áreas. These results are correlated with the parameters of the anxiety and depression tests. CONCLUSION: NaNO2 promoted brain damage due to ischaemic hypoxia in rats. Intoxicated animals showed decreased brain weights; damage in hippocampus and cerebellum; and anxiogenic and depressive behaviour.
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Isquemia Encefálica/patología , Cerebelo/patología , Hipocampo/patología , Hipoxia Encefálica/patología , Animales , Ansiedad/sangre , Ansiedad/patología , Glucemia/metabolismo , Isquemia Encefálica/sangre , Isquemia Encefálica/psicología , Colesterol/sangre , Depresión/sangre , Depresión/patología , Hidrocortisona/sangre , Hipoxia Encefálica/sangre , Hipoxia Encefálica/psicología , Ácido Láctico/sangre , Actividad Motora , Neuronas/patología , Ratas Wistar , Nitrito de SodioRESUMEN
Procura-se trazer ao debate a contratação da força de trabalho no SUS e o processo de descentralização das ações e serviços de saúde. Os dados demonstram que os municípios são os principais contratadores, o que os tem levado a atingir o limite de gastos com pessoal previsto na Lei de Responsabilidade Fiscal (LRF). A Lei 11.350/2006, que admite a contratação de agentes comunitários e de combate às endemias apenas pela administração pública direta, agravou a situação e poderá causar prejuízos à saúde da população. São relatadas aqui experiências de municípios em difícil situação em decorrência desse quadro e apresentadas possíveis soluções para enfrentar a situação relatada.
This paper debates the hiring of the workforce for the Brazilian Unified Health System and theprocess of decentralizing health care services and actions. The data show that local authorities arethe main employers, which has led them to reach the limit for personnel costs established by theFiscal Responsibility Law (LRF). Law 11.350/2006, that allows for community agents for combatagainst endemic diseases only to be hired directly by the public administration, has aggravatedthe situation and may be detrimental to the populations health. Reports are presented of theexperiences of towns that have found themselves in difficulty due to these circumstances andpossible solutions to the situation are proposed.