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OBJECTIVE: In this study, we have synthesized 19 Thiazolidine (TZD) derivatives to investigate their potential anti-ZIKV effects. METHODS: Nineteen thiazolidine derivatives were synthesized and evaluated for their cytotoxicity and antiviral activity against the ZIKA virus. RESULTS: Among them, six demonstrated remarkable selectivity against the ZIKV virus, exhibiting IC50 values of <5µM, and the other compounds did not demonstrate selectivity for the virus. Interestingly, several derivatives effectively suppressed the replication of ZIKV RNA copies, with derivatives significantly reducing ZIKV mRNA levels at 24 hours post-infection (hpi). Notably, two derivatives (ZKC-4 and -9) stood out by demonstrating a protective effect against ZIKV cell entry. Informed by computational analysis of binding affinity and intermolecular interactions within the NS5 domain's N-7 and O'2 positions, ZKC-4 and FT-39 displayed the highest predicted affinities. Intriguingly, ZKC-4 and ZKC-9 derivatives exhibited the most favorable predicted binding affinities for the ZIKV-E binding site. CONCLUSION: The significance of TZDs as potent antiviral agents is underscored by these findings, suggesting that exploring TZD derivatives holds promise for advancing antiviral therapeutic strategies.

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The aim of this study was to explore the effect of replacing protein pellets with soybean grain in high-concentrate diets with or without the addition of silage, on the intake, digestibility, and rumen and blood parameters of feedlot cattle in tropical regions. Four cannulated, crossbred steers were used, 4.5 ± 0.5 years old, with an average weight of 685.55 ± 111.78 kg. The steers were distributed in a 4 × 4 Latin square, in a 2 × 2 factorial scheme (two sources of protein: protein pellets or whole soybean grain, with or without added dietary bulk). There was no effect (P ≥ 0.109) from the interaction between the source of protein and the addition of silage to the diet on dry matter (DM) and nutrient intake, or the digestibility (P ≥ 0.625) of DM or crude protein (CP). However, both factors affected (P ≤ 0.052) the intake of DM, neutral detergent fiber (NDF), and non-fiber carbohydrates (NFC), as well as the independent digestibility (P ≤ 0.099) of fat, NFC, total carbohydrates (TC), and total cholesterol concentration. There was an effect (P ≤ 0.053) from the interaction between the source of protein and the addition of silage to the diet on the digestibility of NDF and total digestible nutrients (TDN), as well as on the glycose concentration (P = 0.003). Blood parameters (i.e. protein, albumin, creatinine, triglycerides, aspartate aminotransferase (AST), and alanine aminotransferase (ALT)) were not affected (P ≥ 0.139) by the source of protein, the addition of silage, or their interaction. Lastly, including 150 g/kg silage DM in a high-grain diet, and using soybean grain as a source of protein in substitution of protein pellet could be a suitable nutritional strategy to ensure adequate DM and nutrient intake and digestibility, with no detrimental effects on rumen and blood parameters of feedlot cattle in the tropics.

Assuntos

Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Dieta , Digestão , Glycine max , Rúmen , Clima Tropical , Animais , Bovinos/sangue , Bovinos/fisiologia , Bovinos/metabolismo , Rúmen/metabolismo , Masculino , Ração Animal/análise , Digestão/fisiologia , Dieta/veterinária , Silagem/análise , Proteínas Alimentares/metabolismo , Proteínas Alimentares/administração & dosagem , Nutrientes/metabolismo

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Increases in hydrological extremes, including drought, are expected for Amazon forests. A fundamental challenge for predicting forest responses lies in identifying ecological strategies which underlie such responses. Characterization of species-specific hydraulic strategies for regulating water-use, thought to be arrayed along an 'isohydric-anisohydric' spectrum, is a widely used approach. However, recent studies have questioned the usefulness of this classification scheme, because its metrics are strongly influenced by environments, and hence can lead to divergent classifications even within the same species. Here, we propose an alternative approach positing that individual hydraulic regulation strategies emerge from the interaction of environments with traits. Specifically, we hypothesize that the vertical forest profile represents a key gradient in drought-related environments (atmospheric vapor pressure deficit, soil water availability) that drives divergent tree water-use strategies for coordinated regulation of stomatal conductance (gs) and leaf water potentials (ΨL) with tree rooting depth, a proxy for water availability. Testing this hypothesis in a seasonal eastern Amazon forest in Brazil, we found that hydraulic strategies indeed depend on height-associated environments. Upper canopy trees, experiencing high vapor pressure deficit (VPD), but stable soil water access through deep rooting, exhibited isohydric strategies, defined by little seasonal change in the diurnal pattern of gs and steady seasonal minimum ΨL. In contrast, understory trees, exposed to less variable VPD but highly variable soil water availability, exhibited anisohydric strategies, with fluctuations in diurnal gs that increased in the dry season along with increasing variation in ΨL. Our finding that canopy height structures the coordination between drought-related environmental stressors and hydraulic traits provides a basis for preserving the applicability of the isohydric-to-anisohydric spectrum, which we show here may consistently emerge from environmental context. Our work highlights the importance of understanding how environmental heterogeneity structures forest responses to climate change, providing a mechanistic basis for improving models of tropical ecosystems.

Assuntos

Florestas , Árvores , Água , Água/metabolismo , Água/fisiologia , Árvores/fisiologia , Brasil , Secas , Transpiração Vegetal/fisiologia , Solo/química , Folhas de Planta/fisiologia

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Seasonal floodplains in the Amazon basin are important sources of methane (CH4), while upland forests are known for their sink capacity. Climate change effects, including shifts in rainfall patterns and rising temperatures, may alter the functionality of soil microbial communities, leading to uncertain changes in CH4 cycling dynamics. To investigate the microbial feedback under climate change scenarios, we performed a microcosm experiment using soils from two floodplains (i.e., Amazonas and Tapajós rivers) and one upland forest. We employed a two-factorial experimental design comprising flooding (with non-flooded control) and temperature (at 27 °C and 30 °C, representing a 3 °C increase) as variables. We assessed prokaryotic community dynamics over 30 days using 16S rRNA gene sequencing and qPCR. These data were integrated with chemical properties, CH4 fluxes, and isotopic values and signatures. In the floodplains, temperature changes did not significantly affect the overall microbial composition and CH4 fluxes. CH4 emissions and uptake in response to flooding and non-flooding conditions, respectively, were observed in the floodplain soils. By contrast, in the upland forest, the higher temperature caused a sink-to-source shift under flooding conditions and reduced CH4 sink capability under dry conditions. The upland soil microbial communities also changed in response to increased temperature, with a higher percentage of specialist microbes observed. Floodplains showed higher total and relative abundances of methanogenic and methanotrophic microbes compared to forest soils. Isotopic data from some flooded samples from the Amazonas river floodplain indicated CH4 oxidation metabolism. This floodplain also showed a high relative abundance of aerobic and anaerobic CH4 oxidizing Bacteria and Archaea. Taken together, our data indicate that CH4 cycle dynamics and microbial communities in Amazonian floodplain and upland forest soils may respond differently to climate change effects. We also highlight the potential role of CH4 oxidation pathways in mitigating CH4 emissions in Amazonian floodplains.

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Background: To evaluate the influence of chemotherapy on the prevalence of trismus in irradiated head and neck cancer patients. Material and Methods: This systematic review guided by PRISMA-2020 and registered in PROSPERO (CRD42021255377) screened 963 articles in 7 scientific-databases (PubMed, Lilacs, Livivo, Scopus, Embase, Web of Science, EBSCO) and 3 grey-literature databases (Open Grey, Google Scholar, ProQuest) and eight articles were included for qualitative synthesis, meta-analysis (combined odds ratio, inverse variance method plus random effects), heterogeneity analysis (I² and Tau²), one-of-out evaluation and publication bias analysis (Eggs' and Begg's tests) (RevMan®, p<0.05). The Newcastle-Ottawa Quality Assessment Scale Cohort Studies was used to assess the risk of bias (RoB). The classification assessment, development, and recommendations (GRADE) approach was used to assess the certainty of evidence. Results: The eight articles evaluated 1474 patients treated with chemoradiotherapy and 858 patients treated with radiotherapy. Five articles had low RoB, and three had high RoB. Chemoradiotherapy significantly (p=0.0003) increased the prevalence of trismus (OR=2.55, 95% CI = 1.53-4.23) compared to radiotherapy, with significant (p=0.010) but low heterogeneity (I²=59%;Tau²=0.29). There was no significant risk of publication bias, one-out analysis showed no significant difference between studies, and GRADE showed a moderate level of evidence. Trismus was directly associated to worse quality of life. Conclusions: The incidence of trismus increases when chemotherapy is combined with radiotherapy for head and neck cancer, which negatively impacts the quality of life. Key words:Radiotherapy, Chemoradiotherapy, Head and Neck Neoplasms, Trismus, Quality of Life.

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INTRODUÇÃO: A substituição valvar é um procedimento cirúrgico que terá impacto na vida do paciente, conforme a seleção entre prótese biológica ou mecânica. Nesse contexto, o analfabetismo e a diminuição do Letramento em Saúde (LS) do paciente valvopata são fatores que impactam na educação em saúde, sendo necessárias estratégias para LSa essa população. Então, identificou-se na literatura a existência de estudos relacionados ao LS de cardiopatas. No entanto, nenhum abordou doenças valvares em pacientes analfabetos funcionais ou estratégias de ensino para seu LS. Este estudo objetivou descrever sobre a construção de uma animação 2D educativa como recurso audiovisual para letramento em saúde da população com valvopatias e analfabetismo funcional, em fila cirúrgica, atrelada a uma estratégia educacional. MÉTODOS: Trata-se de uma pesquisa metodológica de construção de uma animação 2D educativa sobre as diferenças das próteses valvares e suas características pós troca valvar. Utilizou-se a metodologia GEDOVA para automatizar a construção dessa animação, utilizou-se a ferramenta Adobe Express para criação dos personagens e diálogos e Canva, para acréscimo de imagens e detalhes na animação. Por fim, foi adicionada legendas à animação, utilizando a ferramenta Blink. O objeto final foi inserido na plataforma institucional de vídeo (Vimeo) com acesso via Qrcode que ficará disponível no ambulatório de valvopatias, sendo estimulado o acesso pelos profissionais de saúde, para o uso pessoal do paciente e/ou acompanhante. RESULTADOS: O produto de animação 2D nominado de "Troca Valvar: Uma Jornada Educativa". Caracteriza-se por ser ferramenta digital com personagens dialogando utilizando linguagem de fácil compreensão sobre as diferenças entre as próteses biológicas e mecânicas, em formato MP4 disponibilizado via Qr Code hospedado na plataforma digital da instituição atrelada a uma estratégia de ensino que pode ser aplicada às consultas médicas e de enfermagem. CONCLUSÕES: A criação de uma animação 2D possibilitouentender como uma ferramenta com linguagem de fácil compreensão, combinada a uma estratégia de ensino inclusiva, pode ser empregada para o letramento em saúde de pacientes valvopatas analfabetos funcionais. Essa abordagem permite orientá-los sobre as diferenças entre as próteses valvares e os cuidados necessários após a troca, contribuindo para uma melhor adesão terapêutica após o tratamento cirúrgico.

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Introduction Smell is one of the senses of the human body, and it can be affected by several factors, such as viral infections, traumatic brain injury, iatrogenesis, smoking, and neurodegenerative and systemic diseases. Objectives The main goal of the present study is to describe the epidemiology of olfactory disorders in Rio Grande do Norte (RN). More specifically, to determine the prevalence of olfactory dysfunction and to identify the main risk factors related to these dysfunctions in the state's population. Methods A total of 180 volunteers living in the RN underwent the Connecticut Clinical Research Center (CCCRC) smell test and a clinical and demographic questionnaire. Results A total of 58.89% of the patients presented normosmia and 87.78% were classified as having between normal and mild hyposmia. A statistically significant relationship was found between worse performance in the test and nasal surgery ( p = 0.041) and the subjective feeling of not having an accurate sense of smell ( p = 0.006 on the right nostril). There was no statistical relationship between the olfactory status and the report of coronavirus disease 2019 (COVID-19) infection ( p = 0.254). Conclusion The occurrence of altered sense of smell in our study was different from that reported in other studies that used the same test. The relationship with COVID-19 was not clear.

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Introduction: Stage III NSCLC is a heterogeneous disease, representing approximately one-third of newly diagnosed lung cancers. Brazil lacks detailed information regarding stage distribution, treatment patterns, survival, and prognostic variables in locally advanced NSCLC. Methods: RELANCE/LACOG 0118 is an observational, retrospective cohort study assessing sociodemographic and clinical data of patients diagnosed with having stage III NSCLC from January 2015 to June 2019, regardless of treatment received. The study was conducted across 13 cancer centers in Brazil. Disease status and survival data were collected up to June 2021. Descriptive statistics, survival analyses, and a multivariable Cox regression model were performed. p values less than 0.05 were considered significant. Results: We recruited 403 patients with stage III NSCLC. Most were male (64.0%), White (31.5%), and smokers or former smokers (86.1%). Most patients had public health insurance (67.5%), had stage IIIA disease (63.2%), and were treated with concurrent chemoradiation (53.1%). The median follow-up time was 33.83 months (95% confidence interval [CI]: 30.43-37.50). Median overall survival (OS) was 27.97 months (95% CI: 21.57-31.73), and median progression-free survival was 11.23 months (95% CI: 10.70-12.77). The type of treatment was independently associated with OS and progression-free survival, whereas the types of health insurance and histology were independent predictors of OS only. Conclusions: Brazilian patients with stage III NSCLC with public health insurance are diagnosed later and have poorer OS. Nevertheless, patients with access to adequate treatment have outcomes similar to those reported in the pivotal trials. Health policy should be improved to make lung cancer diagnosis faster and guarantee prompt access to adequate treatment in Brazil.

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BACKGROUND: Inflammation is a series of complex defense-related reactions. The inflammation cascade produces various pro-inflammatory mediators. Unregulated production of these pro-inflammatory mediators can lead to a wide range of diseases, including rheumatoid arthritis, sepsis, and inflammatory bowel disease. In the literature, the anti-inflammatory action of quinoline and thiazolidinedione nuclei are well established, alone, and associated with other nuclei. The synthesis of hybrid molecules is a strategy for obtaining more efficient molecules due to the union of pharmacophoric nuclei known to be related to pharmacological activity. OBJECTIVES: Based on this, this work presents the synthesis of thiazolidinedione-quinoline molecular hybrids and their involvement in the modulation of cytokines involved in the inflammatory reaction cascade. METHODS: After synthesis and characterization, the compounds were submitted to cell viability test (MTT), ELISA IFN-γ and TNF-α, adipogenic differentiation, and molecular docking assay with PPARy and COX-2 targets. RESULTS: LPSF/ZKD2 and LPSF/ZKD7 showed a significant decrease in the concentration of IFN- γ and TNF-α, with a dose-dependent behavior. LPSF/ZKD4 at a concentration of 50 µM significantly reduced IL-6 expression. LPSF/ZKD4 demonstrates lipid accumulation with significant differences between the untreated and negative control groups, indicating a relevant agonist action on the PPARγ receptor. Molecular docking showed that all synthesized compounds have good affinity with PPARγ e COX-2, with binding energy close to -10,000 Kcal/mol. CONCLUSION: These results demonstrate that the synthesis of quinoline-thiazolidinedione hybrids may be a useful strategy for obtaining promising candidates for new anti-inflammatory agents.

Assuntos

Simulação de Acoplamento Molecular , Quinolinas , Tiazolidinedionas , Quinolinas/farmacologia , Quinolinas/química , Quinolinas/síntese química , Tiazolidinedionas/farmacologia , Tiazolidinedionas/síntese química , Tiazolidinedionas/química , Estrutura Molecular , Humanos , Sobrevivência Celular/efeitos dos fármacos , Relação Estrutura-Atividade , Animais , PPAR gama/agonistas , PPAR gama/metabolismo , Relação Dose-Resposta a Droga , Camundongos , Anti-Inflamatórios não Esteroides/farmacologia , Anti-Inflamatórios não Esteroides/síntese química , Anti-Inflamatórios não Esteroides/química , Ciclo-Oxigenase 2/metabolismo , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/síntese química , Anti-Inflamatórios/química , Fator de Necrose Tumoral alfa/metabolismo

RESUMO

QUESTIONS: What is the effect of preoperative respiratory muscle training (RMT) on the incidence of postoperative pulmonary complications (PPCs) after open cardiac surgery? What is the effect of RMT on the duration of mechanical ventilation, postoperative length of stay and respiratory muscle strength? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Adults undergoing elective open cardiac surgery. INTERVENTION: The experimental groups received preoperative RMT and the comparison groups received no intervention. OUTCOME MEASURES: The primary outcomes were PPCs, length of hospital stay, respiratory muscle strength, oxygenation and duration of mechanical ventilation. The methodological quality of studies was assessed using the PEDro scale and the overall certainty of the evidence was assessed using the GRADE approach. RESULTS: Eight trials involving 696 participants were included. Compared with the control group, the respiratory training group had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44, 95% CI 0.25 to 0.78), shorter hospital stay (MD -1.7 days, 95% CI -2.4 to -1.1) and higher maximal inspiratory pressure values at the end of the training protocol (MD 12 cmH2O, 95% CI 8 to 16). The mechanical ventilation time was similar in both groups. The quality of evidence was high for pneumonia, length of hospital stay and maximal inspiratory pressure. CONCLUSION: Preoperative RMT reduced the risk of PPCs and pneumonia after cardiac surgery. The training also improved the maximal inspiratory pressure and reduced hospital stay. The effects on PPCs were large enough to warrant use of RMT in this population. REGISTRATION: CRD42021227779.

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Procedimentos Cirúrgicos Cardíacos , Pneumonia , Adulto , Humanos , Tempo de Internação , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Exercícios Respiratórios/métodos , Pneumonia/prevenção & controle , Músculos Respiratórios/fisiologia , Complicações Pós-Operatórias/prevenção & controle

RESUMO

Abstract Introduction Smell is one of the senses of the human body, and it can be affected by several factors, such as viral infections, traumatic brain injury, iatrogenesis, smoking, and neurodegenerative and systemic diseases. Objectives The main goal of the present study is to describe the epidemiology of olfactory disorders in Rio Grande do Norte (RN). More specifically, to determine the prevalence of olfactory dysfunction and to identify the main risk factors related to these dysfunctions in the state's population. Methods A total of 180 volunteers living in the RN underwent the Connecticut Clinical Research Center (CCCRC) smell test and a clinical and demographic questionnaire. Results A total of 58.89% of the patients presented normosmia and 87.78% were classified as having between normal and mild hyposmia. A statistically significant relationship was found between worse performance in the test and nasal surgery (p = 0.041) and the subjective feeling of not having an accurate sense of smell (p = 0.006 on the right nostril). There was no statistical relationship between the olfactory status and the report of coronavirus disease 2019 (COVID-19) infection (p = 0.254). Conclusion The occurrence of altered sense of smell in our study was different from that reported in other studies that used the same test. The relationship with COVID-19 was not clear.

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This study evaluated photobiomodulation therapy (PBMT) for treatment of trismus in patients undergoing radiotherapy for head and neck cancer (HNC). Sixteen patients, 10 men and 6 women, who had a mouth opening < 35 mm and underwent RT were included. The patients were evaluated daily before and after the PBMT application, measuring mouth opening and performing pain scores for the masticatory muscles using the visual analog scale (VAS). We used the infrared laser (~ 808 nm) extraorally, 0.1 W power, 3 J energy, 30 s (107 J/cm2) per point, applied to temporalis anterior, masseter muscles, and temporomandibular joints (TMJ). An intraoral point was made in the trigonoretromolar region towards the medial pterygoid muscle. The mean mouth opening of the patients increased by more than 7 mm throughout the treatment. The pain scores on the initial days showed an immediate reduction after PBMT on the ipsilateral side in the muscles and TMJ. Throughout PBMT applications, there was a significant reduction in pain scores in all muscles and the TMJ. The radiation dose of all patients was above 40 Gy, which is the threshold dose for the risk of developing trismus. SPSS software was used and adopted a confidence of 95%. The Kolmogorov-Smirnov normality test, Wilcoxon test, and Spearman correlation were performed. PBMT controls muscular pain and reduced mouth opening limitation in HNC during radiotherapy. Further studies are needed to evaluate the preventive capacity of PBMT protocols for RT trismus-related HNC.

Assuntos

Neoplasias de Cabeça e Pescoço , Terapia com Luz de Baixa Intensidade , Masculino , Humanos , Feminino , Trismo/etiologia , Trismo/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Neoplasias de Cabeça e Pescoço/radioterapia , Músculos da Mastigação , Dor

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OBJECTIVE: The objective of this systematic review was to determine whether oral and dental hygiene protocols (DHPs) reduce the incidence and severity of oral mucositis (OM) during antineoplastic treatment. MATERIALS AND METHODS: This PROSPERO-registered systematic review (CRD42021295322) was based on searches of publicly accessible databases, including PubMed, Scopus, Web of Science, LILACS, EBSCOhost, LIVIVO, Embase, and gray literature (Google Scholar, ProQuest, and Energy) until December 2021. Twenty-five articles from these searches and 14 articles retrieved from the references therein were evaluated in this systematic review and meta-analysis. The risk of bias (RoB) was assessed using RoB-2 and ROBINS-I for randomized (RCT) and non-randomized (n-RCT) clinical trials, respectively. A meta-analysis was performed on RCTs and n-RCTs in two subgroups to evaluate oral mouth rinses or DHP. GRADE-pro was used to assess the degree of certainty of the evidence. RESULTS: Of the 3367 articles retrieved, 25 RCTs and 14 n-RCTs involving 2109 and 754 patients, respectively, were included in the analyses. RoB was low for RCTs and moderate-to-very severe for n-RCTs. High heterogeneity and publication RoB were identified. In RCTs, mouth rinses (p = 0.830) and DHP (p = 0.100) did not reduce the incidence of OM. However, mouth rinses strongly reduced the severity of OM (p < 0.001; Cohen's d = - 1.87, 95% confidence interval [CI] = - 2.49 to - 1.24). In non-RCTs, mouth rinses (p < 0.001) and DHP (p < 0.001) reduced the relative risk of OM 0.38 (95% CI = 0.24 to 0.59) and 0.64 (95% CI = 0.53 to 0.70) times, respectively. In addition, DHP strongly reduced OM severity (Cohen's d = - 0.81, 95% CI = - 1.03 to - 0.59). GRADE-pro showed high certainty of OM severity and incidence in RCTs and non-RCTs, respectively, and low (OM incidence in RCTs) to very low (OM severity in non-RCTs) certainty in other outcomes. CONCLUSION: DHPs strongly reduce the severity and moderately reduce the incidence of OM. However, further studies with low heterogeneity are needed to validate these findings.

Assuntos

Antineoplásicos , Higiene Bucal , Estomatite , Humanos , Antineoplásicos/efeitos adversos , Incidência , Antissépticos Bucais/uso terapêutico , Estomatite/induzido quimicamente , Estomatite/epidemiologia , Estomatite/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias/complicações , Neoplasias/tratamento farmacológico

RESUMO

Objective The objective of the present study was to assess the hormonal alterations that occurred in patients with subarachnoid hemorrhage. Methods This is a case series with 21 patients diagnosed with subarachnoid hemorrhage of aneurysmal etiology up to 30 days after the ictus. The following hormonal measurements were performed in these patients: cortisol, GH, testosterone, prolactin, estradiol, FSH, LH, FSH, T3, T4 and free T4. The hormonal results of the cases were compared with the results of twelve volunteers from the control group and correlated with findings in brain tomography, cerebral angiography, Hunt-Hess scale, and vasospasm. Results The main altered hormones were cortisol (52.6%), GH (42.9%) and TSH (28.6%). There was a trend towards more severe cases in the following groups of patients: Hunt-Hess scale > 2, Fisher scale > 1, aneurysmal topography in the anterior communicating artery and those who had vasospasm. Conclusion The present study observed the tendency of pituitary hormonal changes in patients with subarachnoid hemorrhage of aneurysmal etiology, corroborating the need for dosage of hormones from the hypothalamic-pituitary axis in the management of these cases.

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Objetivo O objetivo do presente estudo foi avaliar as alterações hormonais em pacientes com hemorragia subaracnóidea e correlacionar tais alterações com a gravidade da hemorragia. Métodos Trata-se de uma série de casos com 21 pacientes com diagnóstico de hemorragia subaracnóidea de etiologia aneurismática até 30 dias do ictus. Foram realizadas as seguintes dosagens hormonais nesses pacientes: cortisol, GH, testosterona, prolactina, estradiol, FSH, LH, FSH, T3, T4 e T4 livre. Os resultados hormonais dos casos foram comparados com os resultados de 12 voluntários do grupo controle e correlacionados com achados em tomografia de crânio, estudo angiográfico cerebral, escala de Hunt-Hess e vasoespasmo. Resultados Os principais hormônios alterados foram o cortisol (52,6%), GH (42,9%) e o TSH (28,6%). Houve uma tendência de casos mais graves nos seguintes grupos de pacientes: escala de Hunt-Hess > 2, escala de Fisher > 1, topografia aneurismática na artéria comunicante anterior e aqueles que cursaram com o vasoespasmo. Conclusão O presente estudo observou a tendência de alterações hormonais hipofisárias em pacientes com hemorragia subaracnóidea de etiologia aneurismática, corroborando a necessidade de dosagem dos hormônios do eixo hipotálamo-hipofisário no manejo desses casos.

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(1) Background: Maternal syphilis (MS) and congenital syphilis (CS) are serious public health problems worldwide due to their high morbidity and mortality rates. (2) Objective: Evaluating the applicability of Clinical Protocols and Treatment Guidelines on case incidence trends in Brazil and Portugal. (3) Methods: The review was done through bibliographic research in two public databases and government websites from both countries, published between 2007 and 2022. All guidelines that contained CS and MS were selected. (4) Results and discussion: After evaluation, we found that Brazil and Portugal have adequate protocols for screening and treating congenital and maternal syphilis. (5) Conclusion: The results suggest that CS and MS incidence are notably higher in Brazil than in Portugal due to economic, cultural, and social disparities and the differences in territory size. Therefore, these demographic and socioeconomic factors could strongly influence efforts to fight against syphilis and thus control the infection.

Assuntos

Complicações Infecciosas na Gravidez , Sífilis Congênita , Sífilis , Brasil/epidemiologia , Protocolos Clínicos , Feminino , Humanos , Portugal/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Sífilis/epidemiologia , Sífilis/prevenção & controle , Sífilis Congênita/diagnóstico , Sífilis Congênita/epidemiologia , Sífilis Congênita/prevenção & controle

RESUMO

Objective: To describe the successful implementation of an enhanced public health surveillance system based on early detection, tracing contacts, and patient follow-up and support. Study design: A prospective observational cohort study conducted in Serrana, São Paulo State, Brazil. Methods: The implementation was based on four axes: increasing the access to SARS-CoV-2 testing; correct swab collection; testing patients with mild symptoms; and patient follow-up. Positivity rate, patient demographic and clinical characteristics, dynamics of disease severity, SARS-CoV-2 genome evolution, and the impact on COVID-19 research were assessed from August 23, 2020 to February 6, 2021 (between epidemiological week 35/2020 and 5/2021, a total of 24 weeks). Results: The number of sites collecting rt-PCR for SARS-CoV-2 was increased from one to seven points and staff was trained in the correct use of personal protective equipment and in the swab collection technique. During the study period, 6728 samples were collected from 6155 participants vs. 2770 collections in a similar period before. SARS-CoV-2 RNA was detected in 1758 (26.1%) swabs vs. 1117 (36.7%) before the implementation of the surveillance system (p < 0.001). Positivity rates varied widely between epidemiological weeks 35/2020 and 5/2021 (IQR, 12.8%-31.3%). Out of COVID-19 patients, 91.1% were adults at a median age of 35 years (IQR, 25-50 years), 42.6% were men and 57.4% were women, with a SARS-CoV-2 positivity rate of 28.6% and 24.4% (p < 0.001), respectively. The most common symptoms were headache (72.6%), myalgia (65.0%), and cough (61.7%). Comorbidities were found in 20.8% of patients, the most common being hypertension and diabetes. According to the World Health Organization clinical progression scale, 93.5% of patients had mild disease, 1.6% were hospitalized with moderate disease, 3.2% were hospitalized with severe disease, and 1.4% died. The enhanced surveillance system led to the development of COVID-19 related research. Conclusions: The enhanced surveillance system in Serrana improved COVID-19 understanding and management. By integrating community and academic institutions, it was possible to monitor SARS-CoV-2 positive cases and variants, follow the epidemic trend, guide patients, and develop relevant research projects.

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The low availability of phosphorus and water in soil can promote the remobilization of carbohydrates in the plant, releasing energy to mitigate stress. In this context, our objective was to analyze the production and allocation of carbohydrates in plants of Carapa guianensis Aubl. submitted to different doses of phosphate fertilization, during the rainy and dry seasons, in the western region of Pará. We used three phosphorus dosages (0, 50, 250 kg ha−1) as treatments. We evaluated the plants during the dry and wet seasons. We quantified dry matter production, phosphorus content, total soluble sugars, reducing sugars, sucrose, and starch. Phosphate fertilization and different evaluation periods influenced carbohydrate concentrations (p < 0.05) in plants. The highest levels of P in the leaves were registered in October and, in the roots the content decreased with the passage of time in all treatments. The control had higher dry matter production in leaves and stems. During the dry season, there was an accumulation of carbohydrates in plants and a low production of dry matter. Soluble sugars and sucrose tended to be allocated to the stem, reducing sugars to the leaves and starch to the roots, in most periods. In general, C. guianensis seedlings were not very responsive to phosphorus addition.

RESUMO

ABSTRACT BACKGROUND: Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance. OBJECTIVES: To assess high school students' knowledge of stroke. DESIGN AND SETTING: Cross-sectional study conducted in high schools in northeastern Brazil. METHODS: A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services. CONCLUSIONS: There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.

RESUMO

Here, we report the metagenomes from two Amazonian floodplain sediments in eastern Brazil. Tropical wetlands are well known for their role in the global carbon cycle. Microbial information on this diversified and dynamic landscape will provide further insights into its significance in regional and global biogeochemical cycles.

RESUMO

BACKGROUND: Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance. OBJECTIVES: To assess high school students' knowledge of stroke. DESIGN AND SETTING: Cross-sectional study conducted in high schools in northeastern Brazil. METHODS: A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services. CONCLUSIONS: There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.

Assuntos

Conhecimentos, Atitudes e Prática em Saúde , Acidente Vascular Cerebral , Brasil/epidemiologia , Estudos Transversais , Humanos , Masculino , Estudantes