RESUMO
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented challenges to global health systems, particularly among vulnerable populations such as the elderly. Understanding the interplay between anthropometric markers, molecular profiles, and disease severity is crucial for effective clinical management and intervention strategies. We conducted a cohort study comprising 43 elderly COVID-19 patients admitted to São Lucas Hospital, PUCRS, Brazil. Anthropometric measurements, including calf circumference (CC) and abdominal circumference (AC), were assessed alongside molecular analyses of peripheral blood samples obtained within 48 h of hospital admission. Sociodemographic data were collected from electronic medical records for comprehensive analysis. Our findings revealed a possible relationship between overweight status, increased abdominal adiposity, and prolonged hospitalization duration, alongside heightened disease severity. We also found no significant correlations between BMI, vitamin D levels, and clinical outcomes. Elevated oxygen requirements were observed in both normal and overweight individuals, with the latter necessitating prolonged oxygen therapy. Molecular analyses revealed changes in the inflammatory profile regarding the outcome of the patients. Our study highlights the critical importance of both anthropometric and molecular markers in predicting disease severity and clinical outcomes in elderly individuals with COVID-19.
Assuntos
Biomarcadores , COVID-19 , SARS-CoV-2 , Humanos , COVID-19/sangue , Idoso , Masculino , Feminino , Biomarcadores/sangue , Idoso de 80 Anos ou mais , Índice de Gravidade de Doença , Inflamação/sangue , Estado Nutricional , Brasil/epidemiologia , Estudos de Coortes , Índice de Massa Corporal , Sobrepeso/sangueRESUMO
ABSTRACT Objective: The optimal time for a neck ultrasound (US) in the follow-up of papillary thyroid cancer (PTC) after the first year is undetermined. We aimed to verify the utility of routine neck US in the surveillance of patients diagnosed with low- and intermediate-risk PTC with no evidence of disease at the one-year assessment. Materials and methods: We conducted a retrospective longitudinal study of patients with low- and intermediate-risk PTC with normal neck US, unstimulated serum thyroglobulin (Tg) < 1 ng/mL and negative anti-Tg antibodies at the one-year follow-up. Patients were divided into group 1 [undetectable Tg (<0.20 ng/mL)] and group 2 [detectable Tg but < 1 ng/mL]. The negative predictive value (NPV) of the one-year unstimulated Tg at the five-year and last follow-up visits was calculated. Results: We included n = 88 patients in group 1 and n = 8 patients in group 2. No patient from group 1 presented suspicious US findings at the five-year evaluation [NPV: 100.0% (95% confidence interval (CI): 95.5%-100.0%)], and at the last visit, only one patient had developed a lymph node classified as suspicious [NPV: 98.8% (95% CI: 93.2%-100.0%); mean follow-up: 6.7 years]. In group 2, two patients' USs presented suspicious findings at the five-year evaluation [NPV: 75.0% (95% CI: 34.9%-96.8%)]. At the last visit, only one patient persisted with suspicious findings in the US [NPV: 87.5% (95% CI: 47.4%-99.7%); mean follow-up: 6.5 years]. Conclusion: Low- and intermediate-risk PTC with an excellent response to treatment at the one-year assessment can be safely monitored with regular unstimulated Tg assessments. Conclusions should not be drawn for Tg levels between 0.20-0.99 ng/mL.
RESUMO
Introduction: The optimal time for a neck ultrasound (US) in the follow-up of papillary thyroid cancer (PTC) after the first year is undetermined. We aimed to verify the utility of routine neck US in the surveillance of patients diagnosed with low- and intermediate-risk PTC with no evidence of disease at the one-year assessment. Subjects and methods: We conducted a retrospective longitudinal study of patients with low- and intermediate-risk PTC with normal neck US, unstimulated serum thyroglobulin (Tg) < 1 ng/mL and negative anti-Tg antibodies at the one-year follow-up. Patients were divided into group 1 [undetectable Tg (<0.20 ng/mL)] and group 2 [detectable Tg but < 1 ng/mL]. The negative predictive value (NPV) of the one-year unstimulated Tg at the five-year and last follow-up visits was calculated. Results: We included n = 88 patients in group 1 and n = 8 patients in group 2. No patient from group 1 presented suspicious US findings at the five-year evaluation [NPV: 100.0% (95% confidence interval (CI): 95.5%-100.0%)], and at the last visit, only one patient had developed a lymph node classified as suspicious [NPV: 98.8% (95% CI: 93.2%-100.0%); mean follow-up: 6.7 years]. In group 2, two patients' USs presented suspicious findings at the five-year evaluation [NPV: 75.0% (95% CI: 34.9%-96.8%)]. At the last visit, only one patient persisted with suspicious findings in the US [NPV: 87.5% (95% CI: 47.4%-99.7%); mean follow-up: 6.5 years]. Conclusion: Low- and intermediaterisk PTC with an excellent response to treatment at the one-year assessment can be safely monitored with regular unstimulated Tg assessments. Conclusions should not be drawn for Tg levels between 0.20-0.99 ng/mL.
Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Carcinoma Papilar/diagnóstico por imagem , Seguimentos , Humanos , Estudos Longitudinais , Pescoço/diagnóstico por imagem , Pescoço/patologia , Estudos Retrospectivos , Tireoglobulina , Câncer Papilífero da Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , UltrassonografiaRESUMO
OBJECTIVES: The aim of this study was to evaluate the interexaminer reliability for tomographic findings in degenerative temporomandibular joint disease and its agreement with clinical diagnosis. METHODS: Women aged 18 and 60 years were invited to participate in this research. All participants were evaluated by a single experienced examiner according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Group 1 was comprised of TMJs with Degenerative Joint Disease (DJD). Group 2 was comprised of healthy TMJs, without any signs and/or symptoms of TMD. All CBCT images were evaluated by 2 calibrated examiners for the image evaluation criteria but blinded for the clinical diagnosis. RESULTS: From the 194 women evaluated, 41 were included, with a mean age of 35.23 (± 14.06) years. Group 1 was comprised of 26 TMJs with DJD and group 2 of 36 asymptomatic TMJs. The interexaminer reliability was κ = 0.706 (p < 0.000), while agreement between clinical and tomographic findings were κ = 0.301 (p = 0.01) and κ = 0.273 (p = 0.02) for each examiner. The use of CBCT as a diagnostic test had shown sensitivity and specificity values of 61.5% and 75%, respectively. CONCLUSIONS: The interexaminer reliability for tomographic findings was strong. However, the agreement between clinical and tomographic findings was reasonable, for both examiners.
Assuntos
Transtornos da Articulação Temporomandibular , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The present study addresses the microbiome of the first whale fall (YOKO 16) that has been described in the deep sea in the southern Atlantic Ocean (São Paulo Plateau; 4204â¯m depth), in terms of its metabolic uniqueness. Sets of ten thousand protein sequences from YOKO 16 and 29 public domain metagenomes (SRA and GenBank databases) that represent various marine, terrestrial and gut-associated microbial communities were analyzed. The determination of protein functionality, based on the KAAS server, indicated that the YOKO 16 microbiome has industrially-relevant proteins, such as proteases and lipases, that have low similarity (~50%) with previously-described enzymes. The amino acid usage in the YOKO 16 protein sequences (based on blastp and Clustal analysis) revealed a pattern of preference similar to that of extremophiles, with an increased usage of polar, charged and acidic amino acids and a decreased usage of nonpolar residues. We concluded that the targeted microbiome is of potential biotechnological use, which justifies the allocation of resources for the discovery of enzymes in deep-sea whale fall communities.
Assuntos
Proteínas de Bactérias/genética , Metagenoma , Microbiota , Seleção Genética , Baleias/microbiologia , Animais , Oceano Atlântico , Proteínas de Bactérias/metabolismoRESUMO
A epidemia de HIV/Aids é considerada um dos maiores problemas de saúde pública nas últimas décadas. Os fenômenos da pauperização e feminização atingem a população que vive em bolsões de alta vulnerabilidade e exclusão social, favorecendo o avanço da epidemia. A 3ª Conferência Municipal de DST/AIDS, ressalta a importância de construção de parcerias, do trabalho em redes e capacitação dos profissionais de saúde. A Supervisão de Saúde de Santo Amaro/ Cidade Ademar, abraça este desafio, e desde novembro de 2009, vem implantando a Estratégia de Apoio Matricial às Unidades Básicas de Saúde UBS, pelos serviços de DST/AIDS(AU)
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Organização e Administração , Saúde Pública , Saúde da FamíliaRESUMO
A epidemia de HIV/Aids é considerada um dos maiores problemas de saúde pública nas últimas décadas. Os fenômenos da pauperização e feminização atingem a população que vive em bolsões de alta vulnerabilidade e exclusão social, favorecendo o avanço da epidemia. A 3ª Conferência Municipal de DST/AIDS, ressalta a importância de construção de parcerias, do trabalho em redes e capacitação dos profissionais de saúde. A Supervisão de Saúde de Santo Amaro/ Cidade Ademar, abraça este desafio, e desde novembro de 2009, vem implantando a Estratégia de Apoio Matricial às Unidades Básicas de Saúde UBS, pelos serviços de DST/AIDS
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Organização e Administração , Saúde Pública , Saúde da FamíliaRESUMO
Madelung's disease, or multiple symmetric lipomatosis, is a rare disease, characterized by accumulation of unencapsulated fat, generally located symmetrically around the neck and shoulders. Here, we present the case of a patient with diffuse lipomatosis accompanied by obstructive sleep apnea due to cervical involvement and facial deformity, which made it necessary to use nasal pillows for ventilation. The patient was hospitalized with a diagnosis of pneumonia and required noninvasive ventilation due to severe hypercapnia. A brief review of the literature was made, and we describe and discuss the investigation of this rare clinical case.
Assuntos
Lipomatose Simétrica Múltipla/complicações , Apneia Obstrutiva do Sono/etiologia , Traumatismos Faciais/etiologia , Humanos , Lipomatose Simétrica Múltipla/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Madelung's disease, or multiple symmetric lipomatosis, is a rare disease, characterized by accumulation of unencapsulated fat, generally located symmetrically around the neck and shoulders. Here, we present the case of a patient with diffuse lipomatosis accompanied by obstructive sleep apnea due to cervical involvement and facial deformity, which made it necessary to use nasal pillows for ventilation. The patient was hospitalized with a diagnosis of pneumonia and required noninvasive ventilation due to severe hypercapnia. A brief review of the literature was made, and we describe and discuss the investigation of this rare clinical case.
A doença de Madelung ou lipomatose simétrica múltipla é uma doença rara, caracterizada pelo acúmulo de tecido adiposo não-encapsulado, localizado simetricamente ao redor do pescoço e na região escapular. Os autores apresentam um caso de associação entre lipomatose difusa e apneia obstrutiva do sono, devido ao envolvimento cervical e à deformação facial que exigiu a utilização de almofadas nasais para a ventilação. O doente foi admitido com o diagnóstico de pneumonia com necessidade de ventilação não-invasiva devido à hipercapnia grave. É apresentada uma breve revisão da literatura, e descrevemos e discutimos a investigação clínica deste raro caso clínico.