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As doenças crônicas não transmissíveis (DCNT) são as principais causas de morbimortalidade no mundo, causando 738.371 óbitos em 2019 no Brasil. Entre elas, há a diabetes mellitus (DM), uma doença que acarreta a hiperglicemia, resultante da deficiência na secreção e/ou ação da insulina. Além das complicações, pacientes com DM apresentam elevado sofrimento emocional, incidindo sobre o autocuidado com o tratamento, a alimentação, a atividade física, entre outros aspectos que afetam sua qualidade de vida. Nessa perspectiva, este estudo objetiva avaliar a aderência ao autocuidado nos pacientes com DM cadastrados em dois Centros de Saúde no município de Campinas, em São Paulo. Estudo de caráter exploratório descritivo, a coleta de dados foi realizada a partir do Questionário de Atividades do Autocuidado com o Diabetes (QAD), adaptado e validado para a cultura brasileira a partir do The Summary of Diabetes Self-Care Activities Measure (SDSCA). Os dados foram analisados mediante tabulação no programa EPI INFO versão 3.5.1. A partir dos achados, os centros de saúde poderão fortalecer a linha de cuidado de indivíduos com diagnóstico de DM, direcionando as ações educativas na prevenção de complicações, permitindo maior independência e autonomia do paciente e aprimorando a adesão ao tratamento.
Chronic Non-Communicable Diseases (NCDs) are the main causes of morbidity and mortality worldwide. In 2019, 738,371 deaths were reported due to NCDs in Brazil. Among them is Diabetes Mellitus (DM), a disease that causes hyperglycemia from a deficiency in insulin secretion and/or action. In addition to complications, DM patients experience high emotional suffering which affects self-care treatment, nutrition, physical activity and other aspects that impact their quality of life. In this perspective, this study evaluates adherence to self-care treatment in DM patients registered in two health centers in Campinas, São Paulo. An exploratory, descriptive study was conducted using data collected by the Diabetes Self-Care Activities Questionnaire (QAD), adapted and validated for Brazil using the Summary of Diabetes Self-Care Activities Measure (SDSCA). Data were analyzed using tabulation in the EPI INFO program version 3.5.1. Based on the findings, health centers may strengthen their line of care for individuals diagnosed with DM, directing educational actions towards preventing complications, allowing greater patient independence and autonomy, thus improving treatment adherence.
Las enfermedades crónicas no transmisibles (ENT) están entre las principales causas de morbimortalidad en el mundo; en 2019 se reportaron en Brasil 738.371 muertes por ENT. Entre las ENT, se encuentra la diabetes mellitus (DM), una afección que causa hiperglucemia y que resulta de una deficiencia en la secreción y/o acción de la insulina. Además de sus complicaciones, los pacientes con DM experimentan un alto sufrimiento emocional, lo que afecta el autocuidado con el tratamiento, la nutrición, la actividad física y otros aspectos relacionados a la calidad de vida. Desde esta perspectiva, este estudio tiene como objetivo evaluar la adherencia al autocuidado en pacientes con DM registrados en dos centros de salud de la ciudad de Campinas, en São Paulo (Brasil). Se trata de un estudio exploratorio, descriptivo, en el cual la recolección de datos se realizó mediante el Cuestionario de Actividades de Autocuidado de la Diabetes (QAD), adaptado y validado para la cultura brasileña mediante el Resumen de las Actividades de Autocuidado de la Diabetes (SDSCA). Los datos se analizaron mediante tabulación en el programa EPI INFO, versión 3.5.1. Los hallazgos apuntan a que los centros de salud podrán fortalecer la línea de atención a las personas diagnosticadas con DM desde acciones educativas sobre la prevención de complicaciones, permitiendo mayor independencia y autonomía del paciente y mejorando así la adherencia al tratamiento.
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In 2018 there was a large yellow fever outbreak in São Paulo, Brazil, with a high fatality rate. Yellow fever virus can cause, among other symptoms, hemorrhage and disseminated intravascular coagulation, indicating a role for endothelial cells in disease pathogenesis. Here, we conducted a case-control study and measured markers related to endothelial damage in plasma and its association with mortality. We found that angiopoietin 2 is strongly associated with a fatal outcome and could serve as a predictive marker for mortality. This could be used to monitor severe cases and provide care to improve disease outcome.
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Angiopoietina-2 , Biomarcadores , Febre Amarela , Vírus da Febre Amarela , Humanos , Estudos de Casos e Controles , Febre Amarela/mortalidade , Febre Amarela/sangue , Febre Amarela/virologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Angiopoietina-2/sangue , Biomarcadores/sangue , Brasil/epidemiologia , Idoso , Adulto JovemRESUMO
INTRODUCTION: Genetic mutations or inflammatory, degenerative, or neoplastic conditions can trigger amyloidosis. Hereditary gelsolin amyloidosis is a genetic disorder primarily marked by amyloid fibrils composed of misfolded gelsolin fragments. CASE REPORT: We present three sisters with AGel amyloidosis, illustrating its clinical diversity. Patient 1, a 51-year-old, had bilateral ptosis, ocular discomfort, and dry eye syndrome due to cranial nerve involvement. Patient 2, a 53-year-old, experienced progressive bilateral visual impairment. Patient 3, a 50-year-old, exhibited right eye ectropion. Genetic analysis, with the identical mutation, heterozygous c.640G > A (p.Asp214Asn) mutation, confirmed AGel amyloidosis diagnoses, with common findings including lattice corneal amyloidosis, reduced corneal sensitivity, and recurrent corneal erosions. Neurological manifestations included ataxia and peripheral neuropathy, with skin abnormalities observed in patient 1. Ocular involvement severity and distribution varied among patients. DISCUSSION: Common ocular and neurological manifestations validated AGel amyloidosis diagnoses, reinforcing its hereditary basis. Neurological symptoms highlighted the disorder's impact on various organ systems, while skin abnormalities contributed to ocular discomfort. Variable ocular involvement emphasized the disorder's heterogeneity. These patients emphasize hereditary gelsolin amyloidosis's clinical diversity and suggest potential environmental influences on disease expression. Genetic confirmation and confocal microscopy findings reaffirm the genetic basis while raising questions about assessing systemic disease severity, necessitating further investigation in larger cohorts. Ophthalmologists' specialized care is crucial for managing ocular symptoms, given the absence of a universal cure.
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Amiloidose Familiar , Gelsolina , Microscopia Confocal , Humanos , Feminino , Pessoa de Meia-Idade , Gelsolina/genética , Amiloidose Familiar/genética , Amiloidose Familiar/diagnóstico , Linhagem , Brasil , Mutação , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/genéticaRESUMO
A positive feedback loop where climate warming enhances eutrophication and its manifestations (e.g., cyanobacterial blooms) has been recently highlighted, but its consequences for biodiversity and ecosystem functioning are not fully understood. We conducted a highly replicated indoor experiment with a species-rich subtropical freshwater phytoplankton community. The experiment tested the effects of three constant temperature scenarios (17, 20, and 23 °C) under high-nutrient supply conditions on community composition and proxies of ecosystem functioning, namely resource use efficiency (RUE) and CO2 fluxes. After 32 days, warming reduced species richness and promoted different community trajectories leading to a dominance by green algae in the intermediate temperature and by cyanobacteria in the highest temperature treatments. Warming promoted primary production, with a 10-fold increase in the mean biomass of green algae and cyanobacteria. The maximum RUE occurred under the warmest treatment. All treatments showed net CO2 influx, but the magnitude of influx decreased with warming. We experimentally demonstrated direct effects of warming on phytoplankton species sorting, with negative effects on diversity and direct positive effects on cyanobacteria, which could lead to potential changes in ecosystem functioning. Our results suggest potential positive feedback between the phytoplankton blooms and warming, via lower net CO2 sequestration in cyanobacteria-dominated, warmer systems, and add empirical evidence to the need for decreasing the likelihood of cyanobacterial dominance.
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Clorófitas , Cianobactérias , Fitoplâncton , Ecossistema , Dióxido de Carbono , Biomassa , Eutrofização , LagosRESUMO
Rotavirus (RV) outbreaks can cause significant economic losses in the livestock and poultry industries. Stool samples were collected from asymptomatic laying and broiler chickens from commercial poultry farms in the states of Rio de Janeiro and Espírito Santo in southeastern Brazil for detection of RV species A and D (RVA and RVD, respectively) by reverse transcription polymerase chain reaction. RV was detected in 10.5% (34/325) of samples: 22 (64.7%) were positive for RVA and nine (26.5%) for RVD, while three (8.8%) exhibited coinfections with both viruses. Sequence analysis of a VP6 fragment from seven RVA-positive samples identified the I11 genotype in all samples. Information regarding avian RV epidemiology is still scanty, despite the high prevalence of RV infections in several bird species and subsequent economic impact. Consequently, monitoring infections caused by avian RVs, especially in commercial birds, is essential not only to provide new and relevant information regarding the biology, epidemiology, and evolution of these viruses, but also to facilitate the implementation of preventive measures.
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Infecções por Rotavirus , Rotavirus , Animais , Rotavirus/genética , Galinhas , Brasil/epidemiologia , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/veterinária , Filogenia , GenótipoRESUMO
In 2018 there was a large yellow fever outbreak in São Paulo, Brazil, with a high fatality rate. Yellow fever virus can cause, among other symptoms, haemorrhage and disseminated intravascular coagulation, indicating a role for endothelial cells in the disease pathogenesis. Here, we conducted a case-control study and measured markers related to endothelial damage in plasma and its association with mortality. We found that angiopoietin-2 is strongly associated with a fatal outcome and could serve as a predictive marker for mortality. This could be used to monitor severe patients and provide care to improve disease outcome.
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Avian rotaviruses (RVs) are important etiologic agents of gastroenteritis in birds. In general, avian RVs are understudied; consequently, there is a paucity of information regarding these viruses. Therefore, the characterization of these viral species is highly relevant because more robust information on genetic, epidemiologic, and evolutionary characteristics can clarify the importance of these infections, and inform efficient prevention and control measures. In this study, we describe partial genome characterizations of two avian RV species, RVF and RVG, detected in asymptomatic poultry flocks in Brazil. Complete or partial sequences of at least one of the genomic segments encoding VP1, VP2, VP4, VP6, VP7, NSP1, NSP4, NSP4, or NSP5 of 23 RVF and 3 RVG strains were obtained, and demonstrated that multiple variants of both RVF and RVG circulate among Brazilian poultry. In this study, new and important information regarding the genomic characteristics of RVF and RVG is described. In addition, the circulation of these viruses in the study region and the genetic variability of the strains detected are demonstrated. Thus, the data generated in this work should help in understanding the genetics and ecology of these viruses. Nonetheless, the availability of a greater number of sequences is necessary to advance the understanding of the evolution and zoonotic potential of these viruses.
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Infecções por Rotavirus , Rotavirus , Animais , Rotavirus/genética , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/veterinária , Infecções por Rotavirus/genética , Brasil/epidemiologia , Aves Domésticas , Galinhas , Filogenia , Genoma Viral , GenótipoRESUMO
BACKGROUND: Yellow fever is a mosquito-borne zoonotic disease caused by yellow fever virus (YFV). Between 2017 and 2019, more than 504 human cases and 176 deaths were confirmed in the outskirts of São Paulo city. Throughout this outbreak, studies suggested a potential association between YFV viremia and mortality. METHODS: Viral ribonucleic acid was measured using reverse-transcription quantitative polymerase chain reaction in plasma samples collected at up to 5 time points, between 3 and 120 days after symptoms onset. RESULTS: Eighty-four patients with confirmed YFV infection were included. Most were males, median age was 42, and 30 (36%) died. Deceased patients were older than survivors (P = .003) and had a higher viremia across all time points (P = .0006). Mean values of viremia had a positive, statistically significant correlation with peak values of neutrophils, indirect bilirubin, aspartate transaminase, international normalized ratio, and creatinine. Finally, a Cox proportional hazards model adjusted for age and laboratory variables showed that viremia is independently associated with death, with a mean 1.84-fold increase (84%) in the hazard of death (P < .001) for each unit increase in mean log10 viremia. CONCLUSIONS: Our results raise the importance of monitoring YFV viremia and suggest a potential benefit of antiviral drugs or neutralizing monoclonal antibodies early in the course of this infection to improve disease outcomes.
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Febre Amarela , Masculino , Animais , Humanos , Feminino , Viremia , Cinética , Brasil/epidemiologia , Vírus da Febre Amarela , Anticorpos Neutralizantes , Anticorpos AntiviraisRESUMO
Resumo Introdução O ambiente alimentar pode influenciar as escolhas alimentares e de bebidas pela população e seu estado nutricional. Objetivo Caracterizar o ambiente alimentar dos campi de universidade federal do Rio de Janeiro. Método Estudo transversal com estabelecimentos que comercializavam alimentos e bebidas dentro dos campi da universidade. A avaliação do ambiente alimentar foi realizada com a aplicação de um instrumento para coleta das informações: tipo de estabelecimento, alimentos/preparações, modalidade, características, cardápio e informações nutricionais, promoções, propagandas, disponibilidade de alimentos/bebidas, variedade e preço. Os alimentos e preparações observados, a presença de estratégias como informação nutricional, propagandas e promoções foram classificados em facilitadores/ barreiras para alimentação saudável, de acordo com o Guia Alimentar para a População Brasileira. Resultados Participaram do estudo cinco estabelecimentos, quatro eram comerciais e um o restaurante universitário (RU). Todos os estabelecimentos aceitavam dinheiro e cartão, havia cardápio e preço na maioria. Nenhum apresentava informação nutricional. A oferta de frutas/hortaliças foi encontrada em quatro estabelecimentos. A disponibilidade de edulcorante artificial foi encontrada em todos os locais. Observou-se grande variedade de balas (8 ± 7,1), refrigerantes (9 ± 3,7), chocolate (8 ± 7,1), biscoito salgado (8 ± 12,3) e doce (7 ± 9,1). Frutas apresentaram preço médio superior, R$ 3,83, quando comparadas aos salgados, R$ 2,85 e biscoitos, R$ 1,50. Conclusão O ambiente alimentar universitário apresentou maior oferta de alimentos não saudáveis, apresentando barreiras na promoção de práticas alimentares mais adequadas.
Abstract Background The food environment can influence food and beverage choice by the population and their nutritional status. Objective To characterize the food environment of campuses at the Federal University of Rio de Janeiro. Method A cross-sectional study of food and beverage establishments within the university was carried out. The assessment of the food environment was performed with the application of an instrument to collect information: type, food or preparations, mode, characteristics, menu and nutritional information, promotions, advertisements, availability of food or drinks, variety, and price. The observed foods and preparations, the presence of an approach such as nutritional information, advertisements, and promotions were classified as facilitators/barriers for healthy eating, according to the Food Guide for the Brazilian Population. Results Of the 5 establishments that participated, 4 were commercial and 1 was a university restaurant (RU). All establishments accepted cash and cards, and most had a menu and price. None had nutritional information. The supply of fruits and vegetables was found in 4 establishments. The availability of artificial sweetener was found in all locations. A wide variety of candies (8 ± 7.1), soft drinks (9 ± 3.7), chocolate (8 ± 7.1), salted biscuits (8 ± 12.3), and sweets (7 ± 9.1) were observed. Fruits had a higher average price, R$3.83, when compared to savory foods, R$ 2.85, and biscuits, R$ 1.50. Conclusion The university food environment presented a greater offer of unhealthy foods, presenting barriers to the promotion of more appropriate eating practices.
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Universidades , Estado Nutricional , Alimentos e Bebidas , Ingestão de Alimentos , Meio Ambiente , Comportamento Alimentar , Vigilância Alimentar e Nutricional , Guias Alimentares , Informação Nutricional , Dieta SaudávelRESUMO
PURPOSE: The aim of this work was to evaluate the SunCHECK PerFRACTION, the software for in vivo monitoring using EPID images. MATERIALS/METHODS: First, the PerFRACTION ability to detect errors was investigated simulating two situations: (1) variation of LINAC output and (2) variation of the phantom thickness. An ionization chamber was used as reference to measure the introduced dose variations. Both tests used EPID in integrated mode (absolute dose). Second, EPID measurements in integrated mode were carried out during an independent Brazilian governmental audit that provided four phantoms and TLDs. PerFRACTION calculated the absolute dose on EPID plane, and it compared with predicted calculated dose for every delivered plan. The dose deviations reported using PerFRACTION were compared with dose deviations reported by the independent audit. Third, an end-to-end test using a heterogeneous phantom was performed. A VMAT plan with EPID in cine mode was delivered. PerFRACTION calculated the mean dose on CBCT using EPID information and log files. The calculated doses at four different points were compared with ionization chambers measurements. RESULTS: About the first test, the largest difference found was 1.2%. Considering the audit results, the variations detected by TLD measurements and by PerFRACTION dose calculation on EPID plane were close: 12 points had variations less than 2%, 2 points with variation between 2% and 3%, and 2 points with deviations greater than 3% (max 3.7%). The end-to-end tests using a heterogeneous phantom achieved dose deviation less than 1.0% in the water-equivalent region. In the mimicking lung region, the deviations were higher (max 7.3%), but in accordance with what is expected for complex situations. CONCLUSION: The tests results indicate that PerFRACTION dose calculations in different situations have good agreement with standard measurements. Action levels were suggested for absolute dose on EPID plane as well as 3D dose calculation on CBCT using PerFRACTION.
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Equipamentos e Provisões Elétricas , Radioterapia de Intensidade Modulada , Humanos , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos , Software , Imagens de Fantasmas , Radiometria/métodosRESUMO
Coronavac is a widely used SARS-CoV-2 inactivated vaccine, but its long-term immune response assessment is still lacking. We evaluated SARS-CoV-2-specific immune responses, including T cell activation markers, antigen-specific cytokine production and antibody response following vaccination in 53 adult and elderly individuals participating in a phase 3 clinical trial. Activated follicular helper T (Tfh), non-Tfh and memory CD4+ T cells were detected in almost all subjects early after the first vaccine dose. Activated memory CD4+ T cells were predominantly of central and effector memory T cell phenotypes and were sustained for at least 6 months. We also detected a balanced Th1-, Th2- and Th17/Th22-type cytokine production that was associated with response over time, together with particular cytokine profile linked to poor responses in older vaccinees. SARS-CoV-2-specific IgG levels peaked 14 days after the second dose and were mostly stable over one year. CoronaVac was able to induce a potent and durable antiviral antigen-specific cellular response and the cytokine profiles related to the response over time and impacted by the senescence were defined.
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Vacinas contra COVID-19 , COVID-19 , Humanos , Anticorpos Antivirais , Citocinas , Imunidade Celular , Imunoglobulina G , SARS-CoV-2 , VacinaçãoRESUMO
Fish feeding on the benthos mediate important ecological processes in reef ecosystems that are threatened by several anthropogenic activities, including plastic pollution. The impacts of plastic pollution on reef ecological processes, such as herbivory, is still unclear. We experimentally tested in the field how the presence of plastic on the benthos affects fish feeding by using a blocked design to compare fish feeding within 1m2 plastic-free areas and areas with either clean plastic or plastic colonized with biofilm in reefs of NE Brazil. Each area was videoed for 10 min, through which we identified fish species, estimated sizes and quantified the number of bites and feeding frequency. The presence of plastic reduced fish feeding on the benthos, regardless of the biofilm presence, and fish barely interacted with plastic debris. Our results demonstrate that the impact of plastic goes beyond entanglement and ingestion, affecting species behavior and ecological role.
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Recifes de Corais , Ecossistema , Animais , Peixes , Herbivoria , BrasilRESUMO
Objetivo: Verificar o perfil epidemiológico das gestantes e os fatores associados com o encaminhamento de gestantes para um serviço especializado. Método: Estudo transversal retrospectivo, realizado nos prontuários de gestantes classificadas em alto risco, período de janeiro a dezembro de 2019. Realizou-se análise descritiva, bivariada e multivariada. Resultados: Dos 405 prontuários, a média de idade foi 29 anos, 19% eram hipertensas crônicas,14,2% desenvolveram diabetes gestacional. A diferença média entre a data da primeira consulta e a data do encaminhamento pela atenção primária foi de 4 semanas. A regressão logística mostrou que: gestantes de outros municípios, com baixa renda econômica e diferença no tempo de encaminhamento possuem interferência no início do pré-natal. Conclusão: As análises realizadas poderão contribuir para a elaboração de políticas intersetoriais em busca da promoção da saúdede gestantes.
Objective: To verify the epidemiological profile of pregnant women and the factors associated with referring pregnant women to a specialized service. Method: Retrospective cross-sectional study, carried out on the medical records of pregnant women classified as high risk, from January to December 2019. A descriptive, bivariate and multivariate analysis was performed. Results: Of the 405 medical records, mean age was 29 years, 19% were chronic hypertensive patients, 14.2% developed gestational diabetes. The average difference between the date of the first consultation and the date of referral by primary care was 4 weeks. The logistic regression showed that: pregnant women from other cities, withlow economic income and difference in referral time have interference in the beginning of prenatal care. Conclusion: The analyzes carried out may contribute to the development of intersectoral policies in search of health promotion for pregnant women.
Objetivo: Verificar el perfil epidemiológico de la gestante y los factores asociados a la derivación de gestantes a un servicio especializado. Método: Estudio retrospectivo, transversal, realizado sobre las historias clínicas de gestantes clasificadas como de alto riesgo, de enero a diciembre de 2019. Se realizó un análisis descriptivo, bivariado y multivariado. Resultados: De las 405 historias clínicas, la edad promedio fue de 29 años, el 19% eran hipertensos crónicos, el 14,2% desarrolló diabetes gestacional. La diferencia media entre la fecha de la primera consulta y la fecha de derivación por atención primaria fue de 4 semanas. La regresión logística mostró que: mujeres embarazadas de otras ciudades, con bajos ingresos económicos e diferencia en el tiempo de derivación tienen interferencia en el inicio de la atención prenatal. Conclusión: Los análisis realizados pueden contribuir a la elaboración de políticas intersectoriales en busca de promoción de la salud de la gestante.
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Humanos , Feminino , Gravidez , Cuidado Pré-Natal , Qualidade da Assistência à Saúde , Atenção Secundária à Saúde , Enfermagem , Gravidez de Alto RiscoRESUMO
Acquired antibiotic resistance in bacteria has become an important worldwide challenge. Currently, several bacteria, including Escherichia coli, have multidrug resistance profiles. Genes such as bla CTX-M-24 and bla KPC-2 (carbapenemase) are widespread. This research letter reports about a genomic surveillance study where multidrug-resistant E. coli containing CTX-M-24(IncF [F-:A1:B32]) and KPC-2(IncX3/IncU) plasmids were obtained from community- acquired urinary tract infection in Brazil.
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Infecções por Escherichia coli , Escherichia coli , Humanos , Escherichia coli/genética , Brasil , Plasmídeos/genética , beta-Lactamases/genética , Infecções por Escherichia coli/microbiologia , Antibacterianos/farmacologiaRESUMO
Background: The Sinovac SARS-CoV-2 inactivated vaccine (CoronaVac) has been demonstrated to be safe, well tolerated, and efficacious in preventing mild and severe Covid-19. Although different studies have demonstrated its short-term immunogenicity, long-term cellular and humoral response evaluations are still lacking. Methods: Cellular and humoral responses were assessed after enrollment of volunteers in the PROFISCOV phase 3 double-blind, randomized, placebo-controlled clinical trial to evaluate CoronaVac. Assays were performed using flow cytometry to evaluate cellular immune response and an antigen binding electrochemiluminescence assay to detect antigen-specific antibodies to the virus. Results: Fifty-three volunteers were selected for long term assessment of their SARS-CoV-2-specific immune responses. CD4 + T cell responses (including circulating follicular helper (cTfh, CD45RA - CXCR5 + ) expressing CD40L, as well as non-cTfh cells expressing CXCR3) were observed early upon the first vaccine dose, increased after the second dose, remaining stable for 6-months. Memory CD4 + T cells were detected in almost all vaccinees, the majority being central memory T cells. IgG levels against Wuhan/WH04/2020 N, S and receptor binding domain (RBD) antigens and the variants of concern (VOCs, including B.1.1.7/Alpha, B.1.351/Beta and P.1/Gamma) S and RBD antigens peaked 14 days after the second vaccine shot, and were mostly stable for a 1-year period. Conclusions: CoronaVac two-doses regimen is able to induce a potent and durable SARS-CoV-2 specific cellular response. The cellular reaction is part of a coordinated immune response that includes high levels of specific IgG levels against parental and SARS-CoV-2 VOC strains, still detected after one year. Funding: Fundação Butantan, Instituto Butantan and São Paulo Research Foundation (FAPESP) (grants 2020/10127-1 and 2020/06409-1). This work has also been supported by NIH contract 75N93019C00065 (A.S, D.W). PATH facilitated reagent donations for this work with support by the Bill & Melinda Gates Foundation (INV-021239). Under the grant conditions of the foundation, a Creative Commons Attribution 4.0 generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission.
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Curraleiro Pé-Duro (CPD) cattle, a Brazilian local breed, are animals that are highly resistant to infectious and parasitic diseases. Strategies for the conservation of the breed and the genetic resistance to diseases should also consider the characteristics of the breed. The objective of this study was to analyze the diversity and population structure of the CPD breed using microsatellite markers and to correlate the serological profiles for causative agents of brucellosis, leptospirosis, neosporosis, leukosis, infectious bovine rhinotracheitis, and bovine viral diarrhea. DNA samples of 608 bovines were amplified and genotyped using 28 microsatellite markers for breed characterization. The genotypes were assigned to three clusters, indicating a substructure population related to the geographic distance. The observed heterozygosity was lower than that expected in most loci, and fixation index (Fst) in the subpopulation values ranged from 0.03073 (ETH3) to 0.402 (INRA63) on cluster 1, from 0.00 (INRA32) to 0.39359 (INRA63) on cluster 2, and from 0.00 (INRA32) to 0.28483 (TGLA53) on cluster 3. The Brucella spp., Neospora caninum, and Bovine Leukemia Virus frequencies were significantly different (p < 0.05) between clusters. The differences between the occurrences of diseases were not sufficient to indicate a genetic subpopulation with increased resistance to infections.
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OBJECTIVE: The objective of this study was to assess interpersonal nonsexual violence against children and adolescents in a tertiary university hospital. METHODS: A cross-sectional study was performed in 240 patients under nonsexual violence situation for 15 consecutive years. Data analyses included demographic data, hospital referral site, type and author of nonsexual violence, legal referral, laboratorial and imaging examinations, and outcomes. RESULTS: Nonsexual violence situation was diagnosed in 240 (0.1%) of 295,993 patients for 15 years: 148 (61.7%) in children and 92 (38.3%) in adolescents. Out of 240, the most frequent types of violence were negligence in 156 (65.0%), physical 62 (25.8%), psychological/emotional aggression 52 (21.7%), Munchausen by proxy syndrome 4 (1.7%), and bullying/cyberbullying in 3 (1.3%). Out of 123, the most common pediatric chronic conditions were chronic kidney disease 24 (19.5%), human immunodeficiency virus 14 (11.4%), prematurity 9 (7.3%), cerebral palsy 8 (6.5%), and asthma 8 (6.5%). Further comparison between children versus adolescent under nonsexual violence situation revealed significant difference between the hospital referral sites. The frequency of patients under violence referred from outpatient clinics was significantly reduced in children versus adolescents (27.7 vs. 62%), whereas emergency department was higher in the former group (57.4 vs. 25.0%; p<0.001). All types of violence situations and pediatric chronic conditions were similar in both groups (p>0.05). CONCLUSIONS: Nonsexual violence against our pediatric population was rarely diagnosed in a tertiary hospital, mainly negligence, physical, and psychological/emotional aggression. Approximately two-thirds of violence diagnosis occurred in children, referred mainly by the emergency department. In contrast, approximately one-third of violence diagnosis occurred in adolescents, referred mostly by outpatient clinics.
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Violência , Adolescente , Criança , Doença Crônica , Estudos Transversais , Hospitais Universitários , Humanos , América LatinaRESUMO
E. coli is the main pathogen of UTI. It is important to be aware the local epidemiological data for an appropriate initial treatment. Resistance to antimicrobial agents has increased, especially to first-choice antibiotics in the treatment of cystitis. There are few studies on the sensivity profile of community uropathogen in our region. OBJECTIVE: To characterize antimicrobials the sensitivity profile to E. coli isolated from urocultures of women treated at Basic Health Units and Emergency Care Units of Londrina- Paraná- Brazil during a period of 12 months (June 1, 2016 to June 1, 2017). METHODOLOGY: A cross-sectional study was carried out from June 2016 to June 2017. All urine samples collected in the Basic Health Units and Emergency Departments in the city of Londrina (Paraná State, Brazil) were sent to a Central Laboratory where the identification and antimicrobial susceptibility testing were performed. Clinical Laboratory Standards Institute (CLSI) breakpoints were used for the interpretation of susceptibility testing results. RESULTS: 56,555 urine cultures were performed in the period, of which 8,832 were positive, of which 5,377 were women. Of these samples, 4.7% were enterobacteria producing extended-spectrum beta-lactamases (ESBL) and 15.5% resistant to quinolones. TMP- SMX was resistant in more than 30% of the samples in all age groups. Among quinolone-resistant isolates, resistance to cephalothin, ampicillin and sulfamethoxazole-trimethoprim was greater than 60%. Nitrofurantoin was the only antimicrobial that showed 90% of sensitivity. CONCLUSION: The antimicrobials sensitivity profile was similar to that reported in the literature, with TMP- SMX resistance greater than 30% in the studied samples. Nitrofurantoin maintains high sensitivity rates greater than 90%. Resistance to quinolones increases proportionally with age, as well ESBL.
Assuntos
Anti-Infecciosos , Infecções por Escherichia coli , Quinolonas , Infecções Urinárias , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Brasil , Estudos Transversais , Farmacorresistência Bacteriana , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Nitrofurantoína/uso terapêutico , Quinolonas/uso terapêutico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , beta-LactamasesRESUMO
Objective: Autologous hematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe and progressive systemic sclerosis (SSc). Here, we aimed to investigate how AHSCT affects the vasculopathy of SSc patients. Methods: Twenty-seven SSc patients were retrospectively assessed, before and after AHSCT, for vessel morphology (nailfold capillaroscopy), skin expression of endothelial markers and serum levels of markers of inflammation, angiogenesis and endothelial activation. Skin biopsies were analyzed by immunohistochemistry (IHC) for expression of CD31, VE-cadherin, E-selectin, angiopoietin-1 (Ang1), angiopoietin-2 (Ang2), Tie-2, vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), and endothelin-1 before and 12 months post-AHSCT. Serum samples from SSc patients were assessed before and up to 36 months after AHSCT for IL-6, von Willebrand factor (vWF), CXC Motif Chemokine Ligand 8 (CXCL8), Endothelin-1, epidermal growth factor (EGF), VEGFA, Pentraxin-3, Intercellular Adhesion Molecule 1 (ICAM-1), E-selectin, P-selectin, Thrombomodulin and IL-18 levels, and compared to healthy control samples. Results: On nailfold capillaroscopy, the number of capillaries increased at 1 year, while giant capillaries decreased at 6 months and 1 year after AHSCT. In the skin biopsies, expression of E-selectin notably decreased and Ang1 increased after AHSCT. At baseline, all vascular markers evaluated in the serum were significantly higher in SSc patients when compared to healthy controls, except for ICAM-1. When compared at different time points after AHSCT, Thrombomodulin, Pentraxin-3, vWF, and IL-18 levels remained generally stable at high levels until 36 months after AHSCT. Conclusion: Our results suggest that AHSCT contributes to improvements of the vessel morphology and dermal microvasculopathy, but does not normalize elevated levels of serum vascular markers in SSc patients. Additional vascular therapeutic approaches might contribute to more effectively treat the endothelial injury.