RESUMO
OBJECTIVES: This study aimed to spatiotemporally analyze the profile of influenza-like illness (ILI) outbreaks in the state of São Paulo, Brazil, between 2020 and 2022. STUDY DESIGN: This was a cross-sectional retrospective study. METHODS: Outbreaks of ILI with final diagnoses of COVID-19, influenza, or other respiratory viruses (ORVs) recorded between January 2020 and November 2022, obtained from the Notifiable Diseases Information System (SINAN NET) Outbreak module, were analyzed. Kernel density estimates and Getis-Ord Gi∗ statistics were performed to identify spatial clusters. RESULTS: A total of 13,314 ILI outbreaks were identified, involving 130,568 cases and 2649 deaths. Of these, 104,399 (80%) were confirmed as COVID-19, 15,861 (12%) were confirmed as ORV, and 10,308 (8%) were confirmed as influenza. The year 2021 had the highest number of outbreaks and cases. Schools recorded the most outbreaks and cases, followed by long-term care facilities for older adults (LTCs). The highest average number of cases per outbreak and the highest attack rates occurred at social gatherings and prisons. Prisoners were three times more likely to contract COVID-19 during outbreaks than people in other institutions. The highest hospitalization and mortality rates for all virus types occurred in the LTC group. The occurrence and intensity of outbreaks were highly heterogeneous among the different institutions after the introduction of new SARS-CoV-2 variants in the state. CONCLUSIONS: ILI outbreaks were not randomly distributed; they clustered in specific areas. Transmissibility varied among different institutions with different responses to the COVID-19 pandemic. These results can be used as a basis for prioritizing actions and allocating resources during future pandemics.
Assuntos
COVID-19 , Influenza Humana , Viroses , Humanos , Idoso , COVID-19/epidemiologia , Influenza Humana/epidemiologia , Pandemias , SARS-CoV-2 , Estudos Retrospectivos , Estudos Transversais , Brasil/epidemiologia , Surtos de DoençasRESUMO
Resumen Los quistes laríngeos, y en particular los quistes de vallécula, son una entidad infrecuente en la práctica clínica habitual. Sin embargo, su localización y aparición en neonatos y lactantes, pueden suponer una causa reconocida de estridor y obstrucción de vía aérea superior que, si no es diagnosticada y tratada de forma precoz, puede tener consecuencias fatales. Presentamos el caso de un lactante que presenta estridor inspiratorio. Se realiza una nasofibrolaringoscopía observándose una formación quística en la vallécula, y una ecografía cervical que muestra dicha formación quística sugerente de un quiste del conducto tirogloso como primera posibilidad etiológica. Ante estos hallazgos, se solicitan pruebas tiroideas y una gammagrafía que son normales, por lo que se decide intervenir al paciente bajo laringoscopia en suspensión, realizando una marsupialización del quiste, sin complicaciones posteriores. El análisis histopatológico posterior confirmó el diagnóstico de un quiste de vallécula. Se debe considerar esta patología en los casos de estridor inspiratorio en lactantes ya que, aunque es infrecuente, su diagnóstico precoz y tratamiento adecuado son determinantes.
Abstract Laryngeal cysts, and especially vallecular cysts, are a rare entity in everyday clinical practice. Nevertheless, their location and the fact that they appear in newborns and infants, must be recognized as a cause of stridor and upper airway obstruction, since their misdiagnosis and late treatment can have fatal consequences. We present the case of an infant with inspiratory stridor. We performed a nasofibrolaryngoscopy where a vallecular cystic lesion was observed, and a neck ultrasound showed a cyst, described as a thyroglossal duct cyst, as the main etiology. Thyroid function tests and a gammagraphy, were both normal, hence the patient underwent a suspension microlaryngoscopy and marsupialization of the cyst, without further complications. The histopathology confirmed the diagnosis of a vallecular cyst. This entity must be considered in infants with inspiratory stridor. Although it is a rare lesion, its early diagnosis and adequate management is crucial.
RESUMO
BACKGROUND: There are no large reported series determining the Covid-19 cancer patient's characteristics. We determine whether differences exist in cumulative incidence and mortality of Covid-19 infection between cancer patients and general population in Madrid. MATERIAL AND METHODS: We reviewed 1069 medical records of all cancer patients admitted at Oncology department between Feb 1 and April 7, 2020. We described Covid-19 cumulative incidence, treatment outcome, mortality, and associated risk factors. RESULTS: We detected 45/1069 Covid-19 diagnoses in cancer patients vs 42,450/6,662,000 in total population (p < 0.00001). Mortality rate: 19/45 cancer patients vs 5586/42,450 (p = 0.0001). Mortality was associated with older median age, adjusted by staging and histology (74 vs 63.5 years old, OR 1.06, p = 0.03). Patients who combined hydroxychloroquine and azithromycin presented 3/18 deaths, regardless of age, staging, histology, cancer treatment and comorbidities (OR 0.02, p = 0.03). CONCLUSION: Cancer patients are vulnerable to Covid-19 with an increase in complications. Combined hydroxychloroquine and azithromycin is presented as a good treatment option.
Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Neoplasias/complicações , Neoplasias/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Idoso , Azitromicina/uso terapêutico , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Combinação de Medicamentos , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Fatores de Risco , SARS-CoV-2 , Espanha/epidemiologia , Resultado do TratamentoRESUMO
OBJECTIVE: To study the prevalence of risk factors for coronary heart disease (CHD) in university students between 17 an 19 years of age. METHODS: A sample of 289 first year students, 144 females and 145 males, of the University of Costa Rica were included for anthropometric, biochemical and physical studies. RESULTS: One in six (17% N = 48) had total cholesterol > 200 mg/dL and it was more frequent in females. High LDL-C > 130 mg/dL was found in 26% (N = 74) whereas low HDL-C was present in only 42% (N = 121). Nearly 10% (N = 28) smoked and 38% (N = 111) did not exercise. Obesity was seen in 7% (N = 20) when the Body Mass Index was used as a criterium but only 1.4% (N = 4) by body fat. The distribution of risk factors was: one factor in 36% (N = 105), two factors in 27% (N = 77) and three or more in 13% (N = 37). The most common were sedentarism, dislipedemias and smoking. CONCLUSIONS: CHD risk factors were present in many of our adolescents. Our finding suggests the need to promote healthier lifestyles to minimize the potential of these factors to cause CHD in adulthood.
Assuntos
Doença das Coronárias/etiologia , Adolescente , Adulto , Índice de Massa Corporal , Doença das Coronárias/epidemiologia , Exercício Físico , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Fumar , EstudantesRESUMO
The intraperitoneal administration of different extracts of Pimenta dioica (L.) Merrill (Myrtaceae) to conscious normotensive and hypertensive rats caused a depression of the central nervous system (CNS). The intensity of this depression depends on the dose. Analgesic and hypothermic effects were also observed. The total aqueous extract was more effective than the ethanolic extract and the final aqueous fraction was the most effective. The peritoneal irritation caused by the extract explains only partially the depressive effect over the CNS. When the final aqueous fraction was given orally to SDN and SHR rats during 14 days there was no observed change on the sistolic blood pressure, heart rate and weight of the animals.
Assuntos
Extratos Vegetais/farmacologia , Animais , Depressores do Sistema Nervoso Central/administração & dosagem , Feminino , Injeções Intraperitoneais , Masculino , Ratos , Ratos Endogâmicos SHR , Ratos Sprague-DawleyRESUMO
Methylprednisolone (glucocorticoid hormone, MPS), etoposide (epipodophyllotoxin inhibitor of a topoisomerase II), and thapsigargin (inhibitor of the endoplasmic reticular Ca2+-ATPase) were used as apoptosis-inducing agents in rat thymocytes. Early redox changes were determined during the early phase of induced apoptosis. The three agents induced apoptosis as assessed by DNA laddering after agarose gel electrophoresis and by quantitative DNA fragmentation. Intracellular H2O2 steadystate concentrations after 30 min of incubation were 40, 48, 25, and 75 nM for control and MPS-, etoposide-, and thapsigargin-treated thymocytes, respectively. After 30 min of MPS and thapsigargin exposure, increased DCFH oxidation was clear compared with control cells, but no increase in dichlorofluorescein (DCF) was observed in etoposide-treated thymocytes. DCF fluorescence correlated linearly with the intracellular H2O2 concentration after 30 min of incubation. The amounts of thiobarbituric acid-reactive substances produced after 3 h of incubation and expressed as pmol/mg protein were 105+/-23, 120+/-18, 350+/-17, and 98+/-24 pmol/mg protein for untreated and MPS-, thapsigargin-, and etoposide-treated thymocytes, respectively. Common and marked reductions in intracellular glutathione of 46, 73, 58, and 39% were observed after 2 h of incubation with MPS-, thapsigargin-, and etoposide-treated cells and in untreated cells, respectively. A simultaneous increase in oxidized glutathione, compared with untreated cells, was evident in MPS (66%) and was stronger in thapsigargin-exposed cells (250%). A 55% decrease in GSSG in etoposide-treated cells was found. It is concluded that redox changes occur during the early phase of induced apoptosis in rat thymocytes and are not always associated with an oxidative stress. Rather, this situation is closely related with the type of stimuli.
Assuntos
Apoptose , Timo/citologia , Animais , Fluoresceínas/metabolismo , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Peróxido de Hidrogênio/metabolismo , Peróxidos Lipídicos/metabolismo , Masculino , Oxirredução , Ratos , Ratos Sprague-Dawley , Ácido Tióctico/análogos & derivados , Ácido Tióctico/farmacologia , Timo/metabolismo , Fatores de TempoRESUMO
The possible diuretic effect of the leaf extract of Cecropia obtusifolia, Bertol; used in Costa Rican traditional medicine, was tested on five Sprague Dawley rats in individual metabolic cages. During the control week, distilled water was administered with an intragastric cannula. During the C.obtusifolia week, the rats were given the aqueous leaf extract in a daily dosage of 500 mg/kg, intragastricly. Although, the urinary flow was increased (p < 0.05) by a 20%, there was no statistically significant difference between the following parameters: excretion in urine of osmoles, sodium and potassium; daily ingestion of food and water. The animal weights decreased when C. obtusifolia was used, but only on the fourth day the decrease was significant (p < 0.05). In conclusion, the aqueous leaf extract of C. obtusifolia has a slight diuretic effect.
Assuntos
Diurese/efeitos dos fármacos , Extratos Vegetais/farmacologia , Animais , Peso Corporal/efeitos dos fármacos , Feminino , Concentração de Íons de Hidrogênio , Concentração Osmolar , Extratos Vegetais/administração & dosagem , Potássio/metabolismo , Ratos , Ratos Sprague-Dawley , Sódio/metabolismoRESUMO
The activity in burrows at four different sites was calculated, and it went from 80 to 98% during pretreatment. For the first time in our country, average values of days/deaths of synanthropic rodents in natural conditions were obtained, and the reached values were between 16.50 and 19.06 after applying the biorodenticide. In the statistical analysis, a significant difference was found in the set of objectives related with days/deaths averages (H = 8.60*; p < 0.05). Moreover, no significant differences were found in percentages of residual activity in burrows (G = 8,27; p < 0.05). Results obtained show that Salmocumarín biorodenticide is much more effective in places where great populations of this species of cosmopolitan rodents exist.
Assuntos
Criação de Animais Domésticos , Bovinos , Cumarínicos , Controle Biológico de Vetores/métodos , Controle de Roedores/métodos , Roedores , Rodenticidas , Salmonella enteritidis , Animais , Cuba , Controle Biológico de Vetores/estatística & dados numéricos , Controle de Roedores/estatística & dados numéricos , Estatísticas não ParamétricasRESUMO
Contiene: 1. Impuesto al valor agregado. 2. Régimen complementario al impuesto al valor agregado. 3. Impuesto a la renta presunta de las empresas. 4. Impuesto a la renta presunta de propietarios de bienes. 5. Impuesto especial a la regularización impositiva. 6. Impuesto a los consumos especificos. 7. Impuestos a los consumos específicos. 8. El código tributario - régimen en actualización intereses resarcitorios.
RESUMO
Hypophysectomized rats showed significant modifications in Ca2+-induced swelling and MgATP-induced contraction of liver mitochondria. Two-three months after operation, maximal swelling (MS), rate of swelling (VS), maximal contraction (MC) and rate of contraction (VC) were decreased by 77 (MS), 83 (VS), 79 (MC) and 62 (VC) % (in all cases P less than 0.05 as compared with normal rat mitochondria). Treatment of hypophysectomized rats with bovine pituitary extract, for two weeks, counteracted the effect of hypophysectomy, whereas treatment with bovine growth hormone was ineffective. Adrenalectomy produced similar though less extensive modification of Ca2+-induced swelling but failed to affect the MgATP-dependent mitochondrial contraction. Substrate oxidation by hypophysectomized or adrenalectomized rat mitochondria showed no modification of the energy-yielding mechanisms, capable of explaining the observed changes in mitochondrial swelling.
Assuntos
Glândulas Suprarrenais/fisiologia , Cálcio/farmacologia , Mitocôndrias Hepáticas/efeitos dos fármacos , Dilatação Mitocondrial/efeitos dos fármacos , Hipófise/fisiologia , Adrenalectomia , Animais , Hipofisectomia , Consumo de Oxigênio/efeitos dos fármacos , Ratos , Extratos de Tecidos/farmacologiaRESUMO
Single and combined effects of intracerebroventricular bolus injection of Ang. II (200 ng), ACh (6 micrograms) and met-enkephalin (50 micrograms) on mean arterial pressure (MAP), was tested in Sprague-Dawley albino rats. A metallic cannula was implanted in the third ventricle according to standard stereotaxic procedures under pentobarbital anesthesia (35 mg/kg). On the third day, the animal was anesthetized again, a carotid artery was cannulated and connected to a pressure transducer for recording of MAP. Ang. II increased MAP; ACh produced a significant increase in the initial 5 minutes after injection and met-enkephalin did not induce any significant changes in MAP. The combined effect showed interesting results. Instead of a potentiation of the rise in MAP, Ang. II and ACh, when given together, did not show any significant changes. Also, met-enkephalin blocked the hypertensive response due to Ang. II, if given combined. This is compatible with an inhibitory action of met-enkephalin on an angiotensinergic neuronal system. A simplified hypothetical model that explains the findings described above is proposed as a working hypothesis.
Assuntos
Acetilcolina/farmacologia , Angiotensina II/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Encefalina Metionina/farmacologia , Acetilcolina/administração & dosagem , Angiotensina II/administração & dosagem , Animais , Combinação de Medicamentos , Encefalina Metionina/administração & dosagem , Injeções Intraventriculares , Masculino , Ratos , Ratos EndogâmicosRESUMO
Single and combined effects of intracerebroventricular bolus injection of Ang. II (200 ng), ACh (6 micrograms) and met-enkephalin (50 micrograms) on mean arterial pressure (MAP), was tested in Sprague-Dawley albino rats. A metallic cannula was implanted in the third ventricle according to standard stereotaxic procedures under pentobarbital anesthesia (35 mg/kg). On the third day, the animal was anesthetized again, a carotid artery was cannulated and connected to a pressure transducer for recording of MAP. Ang. II increased MAP; ACh produced a significant increase in the initial 5 minutes after injection and met-enkephalin did not induce any significant changes in MAP. The combined effect showed interesting results. Instead of a potentiation of the rise in MAP, Ang. II and ACh, when given together, did not show any significant changes. Also, met-enkephalin blocked the hypertensive response due to Ang. II, if given combined. This is compatible with an inhibitory action of met-enkephalin on an angiotensinergic neuronal system. A simplified hypothetical model that explains the findings described above is proposed as a working hypothesis.
Assuntos
Hemoglobinopatias/diagnóstico , Hemoglobinas Anormais , Eletroforese das Proteínas Sanguíneas , Criança , Costa Rica , Deficiência de Glucosefosfato Desidrogenase/epidemiologia , Hemoglobina Falciforme/análise , Hemoglobinopatias/epidemiologia , Hemoglobinas Anormais/análise , Humanos , Talassemia/epidemiologiaRESUMO
Se presenta un protocolo analitico de facil aplicacion en el diagnostico de los trastornos hereditarios de la hemoglobina mas frecuentes, y se senalan algunos resultados obtenidos en una poblacion escolar de Costa Rica
Assuntos
Eletroforese , Índices de Eritrócitos , HemoglobinopatiasRESUMO
En una nina mestiza costarricense de 3 anos de edad, con anemia hipocromica refractaria al tratamiento con hierro, de padre nicaraguense con rasgos orientaloides, y madre costarricense (Guanacaste), con abuelo paterno fenotipicamente asiatico, se logro demostrar la presencia de HbH en su hemolizado, y de cuerpos de inclusion eritrociticos de dicha Hb. Los analisis practicados a la familia ponen en evidencia a una madre portadora de alfa-tal, a un padre como posible portador del gene silencioso del trastorno, a una hermana con hemoglobinograma normal y a otro hermano con la misma condicion doble heterocigota de la propositus (enfermedad por HbH)