RESUMO
OBJECTIVE: Cardiovascular (CV) morbidity is a well-established problem in systemic lupus erythematosus (SLE). Antimalarial (AM) therapy has been seen as a potential atheroprotective agent. The aim was to assess the impact of AM therapy on traditional and novel atherosclerosis (AT) biomarkers in patients with SLE. METHODS: A search of MEDLINE, EMbase, and Cochrane library for studies evaluating the impact of AM on AT biomarkers in SLE was conducted. Data extraction included serum, functional and structural traditional and novel biomarkers. A narrative synthesis of the findings and a meta-analysis with random effects was conducted estimating mean differences (MD), OR, HR and 95% CIs. RESULTS: The search strategy produced 148 articles, of which 64 were extracted for analysis. The MD in VLDL-cholesterol (-10.29, 95% CI -15.35, 5.24), triglycerides (-15.68, 95% CI -27.51, -3.86), and diastolic BP (-3.42, 95% CI -5.62, -1.23) differed significantly in patients on AM therapy compared with those without AM therapy. Patients on AM had a lower prevalence and incidence of diabetes mellitus than patients not on AM (HR: 0.39, 95% CI 0.17, 0.88). HCQ use was associated with lower blood pressure (BP) variability. Structural markers like carotid intima-media thickness (IMT), carotid plaque (CP) and coronary artery calcification (CAC) were not influenced by AM. For functional markers like endothelial and arterial stiffness the benefit was unclear. The GRADE approach showed a very low-to-low quality of evidence (QoE) per outcome. CONCLUSIONS: There is some evidence on the associations between AM therapy and some AT markers. However, the data on which this conclusion was based was of low to very low evidence.
Assuntos
Antimaláricos , Aterosclerose , Lúpus Eritematoso Sistêmico , Antimaláricos/uso terapêutico , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Biomarcadores , Espessura Intima-Media Carotídea , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Fatores de RiscoRESUMO
During the southern summer of 2020, large phytoplankton blooms were detected using satellite technology in Chile (western Patagonia), where intensive salmonid aquaculture is carried out. Some harvesting sites recorded massive fish mortalities, which were associated with the presence of the dinoflagellate species Cochlodinium sp. The bloom included other phytoplankton species, as Lepidodinium chlorophorum, which persistently changed the colour of the ocean to green. These blooms coincided with the government-managed emergency lockdown due to the COVID-19 pandemic. Local in situ sampling was slowed down. However, imagery from the Copernicus programme allowed operational monitoring. This study shows the benefits of both Sentinel-3 and Sentinel-2 satellites in terms of their spectral, spatial and temporal capabilities for improved algal bloom monitoring. These novel tools, which can foster optimal decision-making, are available for delivering early alerts in situations of natural catastrophes and blockages, such as those occurred during the global COVID-19 lockdown.
Assuntos
COVID-19 , Dinoflagellida , Animais , Chile , Proliferação Nociva de Algas , Humanos , Pandemias , Fitoplâncton , SARS-CoV-2RESUMO
Systemic lupus erythematosus (SLE) is associated with a high burden of cardiovascular disease (CVD), which is in part imputed to classical vascular risk factors such as hypertension. Hypertension is frequent among patients with SLE and studies show it is more prevalent in SLE patients than in people without SLE. Despite the high frequency of hypertension in SLE patients, the pathophysiological mechanisms underlying the development of hypertension remain poorly understood. 24-h ambulatory blood pressure monitoring has emerged as a valuable tool in determining blood pressure (BP) in SLE patients in whom hypertension has been associated with damage accrual, stroke and cognitive dysfunction. Although prevalent, current guidelines neglect the specific management of hypertension in SLE patients in their recommendations. This review discusses the mechanisms that may lead to hypertension and the literature evaluating hypertension screening and management in SLE patients.
Assuntos
Hipertensão/complicações , Lúpus Eritematoso Sistêmico/etiologia , Lúpus Eritematoso Sistêmico/patologia , Humanos , Prognóstico , Fatores de RiscoRESUMO
El primer paso para obtener seguridad en los resultados emitidos por el laboratorio clínico es confirmar que los procedimientos de medida utilizados tienen un desempeño analítico aceptable. Para conseguirlo se verificó el contador hematológico Beckman Coulter LH 750 de acuerdo con las especificaciones del fabricante y con los requisitos de calidad de este laboratorio. Los parámetros de desempeño evaluados, tanto en modo manual como automático, fueron: porcentaje de arrastre, según protocolo CLSI H26-A2, precisión en condiciones de repetibilidad, precisión en condiciones de precisión intermedia y veracidad, según protocolo CLSI EP15-A2 utilizando controles BIO-RAD, intervalo de medición, según protocolo CLSI EP6-A, límite de cuantificación, según protocolo CLSI EP17-A2 e intervalos de referencia, según protocolo CLSI EP28-A3C. Los datos se analizaron mediante LinChecker y GraphPad 5. En los ensayos realizados se cumplió con las especificaciones estipuladas por el fabricante, como así también con el requisito de calidad de este laboratorio que es variabilidad biológica mínima. También se verificaron los intervalos de referencia para individuos adultos. De esta manera, se logró realizar la verificación del contador hematológico, evidenciando que los parámetros analíticos evaluados tienen un desempeño aceptable.
The first step for safety in the results issued by the clinical laboratory is to confirm that all analytical measurement procedures have shown an acceptable analytical performance. A quality performance evaluation of automated hematology analyzer Beckman Coulter LH 750 was performed according to the quality requirements of our laboratory and manufacturer's specifications. The performance parameters evaluated by both manual and automatic mode were: carryover according to CLSI H26-A2 protocol; repeatability, intermediate precision and trueness according to CLSI EP15-A2 protocol and using BIO-RAD controls; linearity according to CLSI EP6-A protocol; quantification limits according to CLSI EP17-A2 protocol; and reference intervals according to CLSI EP28-A3C protocol. Data were analyzed using LinChecker and GraphPad5 programs. The tests performed complied with the requirements stipulated by the manufacturer and the quality requirements of our laboratory like minimal biological variability. Reference intervals for adult individuals were also checked. Consequently, performance evaluation of the automated hematology analyzer showed that the assessed laboratory parameters have acceptable performance.
O primeiro passo para obter segurança nos resultados emitidos pelo laboratório clínico é confirmar que os processos de medição utilizados tenham um desempenho analítico aceitável. Para obtê-los foi verificado o analisador hematológico Beckman Coulter LH 750 de acordo com as especificações do fabricante e os requisitos de qualidade deste laboratório. Os parâmetros de desempenho avaliados, tanto em modo manual quanto automático, foram: percentual de arrastamento, de acordo com o protocolo CLSI H26-A2, em condições de repetitibidade, precisão em condições de precisão intermediária e veracidade, conforme o protocolo CLSI EP15-A2 usando controles Bio-Rad, intervalo de medição segundo o protocolo CLSI EP6-A, limite de quantificação, de acordo com CLSI EP- 17-A2 e intervalos de referência, de acordo com o protocolo CLSI EP28-A3C. Os dados foram analisados através de LinChecker e GraphPad 5. Nos ensaios realizados foram obsevadas as especificações estabelecidas pelo fabricante, bem como a exigência de qualidade deste laboratório que é variabilidade biológica mínima. Os intervalos de referência para indivíduos adultos também foram verificados. Desta forma, foi possível realizar a verificação do analisador hematológico, que demonstra que os parâmetros analíticos avaliados têm um desempenho aceitável.
Assuntos
Testes Hematológicos , Padrões de Referência , Guias como Assunto , Valores de Referência , Lista de Checagem , Estudo de AvaliaçãoRESUMO
We evaluated the distribution and growth of Vibrio parahaemolyticus in the inland sea of southern Chile, where the world's largest foodborne gastroenteritis outbreak by the pandemic strain O3:K6 occurred in 2005. Intertidal samples of Mytilus chilensis and Venus antiqua were collected around port towns between 41°28'S and 43°07'S, during April to May 2011 and January to March 2012. We used most probable number real-time polymerase chain reaction (MPN-PCR) for enumeration of the tlh, tdh, and trh genes in freshly harvested bivalves and after a controlled postharvest temperature abuse. Pathogenic markers (tdh+ or trh+) were not detected. Total V. parahaemolyticus (tlh+) in freshly harvested samples reached up to 0.38 and 3.66 log MPN/g in 2011 and 2012, respectively, with values close to or above 3 log MPN/g only near Puerto Montt (41°28'S, 72°55'W). Enrichments by temperature abuse (>2 log MPN/g) occurred mainly in the same zone, regardless of the year, suggesting that both natural or anthropogenic exposure to high temperatures were more critical. Lower salinity and higher sea surface temperature in Reloncaví Sound and Reloncaví Estuary were consistent with our observations and allowed confirmation of the existence of a high-risk zone near Puerto Montt. Based on the results, a strategy focused on risk management inside this defined hazard zone is recommended.