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RESUMEN La eritrodermia es un síndrome inflamatorio cutáneo grave que se caracteriza por eritema y descamación generalizada en más del 90 % del cuerpo. Este síndrome puede ser la etapa final de diversas enfermedades dermatológicas o el inicio de ciertas patologías como la psoriasis, que es la causa más común. Las enfermedades febriles son causa de exacerbaciones de psoriasis. Se cree que el virus actúa como un superantígeno y activa la inmunidad celular causando cambios inmunológicos con clínica variada en individuos predispuestos. Presentamos el caso de un paciente de sexo masculino que debuta con una forma grave de psoriasis posterior a infección por chikungunya.
ABSTRACT Exfoliative dermatitis is a severe cutaneous inflammatory syndrome characterized by generalized erythema and scaling over more than 90 % of the body. This syndrome can be the final stage of various dermatological diseases or the beginning of certain pathologies such as psoriasis, which is the most common cause. Febrile illnesses are cause of psoriasis exacerbations. It is believed that the virus acts as a superantigen and activates cellular immunity causing immunological changes with varied symptoms in predisposed individuals. We present the case of a male patient who presented with a severe form of psoriasis after chikungunya infection.
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RESUMEN Divulgamos el caso de una paciente con psoriasis vulgar que presento empeoramiento de la misma luego de infección por Chikungunya, sin mejoría del brote con el tratamiento habitual de la psoriasis, en quien posteriormente se realiza el diagnóstico de Linfoma Hodgkin tipo clásico. Se inició tratamiento quimioterápico y se observó una mejoría completa de las lesiones cutáneas de la psoriasis.
ABSTRACT We report the case of a patient with psoriasis vulgaris who presented worsening of the disease after infection with Chikungunya, with no improvement of the outbreak with the usual treatment for psoriasis, in whom a diagnosis of classic Hodgkin lymphoma was subsequently made. Chemotherapy treatment was started and a complete improvement of the skin lesions of psoriasis was observed.
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Acute pulmonary embolism (APE) is one of the leading causes of cardiovascular emergencies and the third leading cause of death. Although efforts focus on treating the acute event, patients who survive APE may develop long-term sequelae. Research reveals that approximately half of patients who have suffered an APE do not regain their previous level of function and experience a reduction in their quality of life for several years after the episode. Acute pulmonary embolism can be classified according to the risk of short-term mortality, with most mortality and morbidity concentrated in high-risk and intermediate-risk cases. The first-line treatment for APE is systemic anticoagulation. However, identifying and more aggressively treating people with intermediate to high risk, who have a more favorable risk profile for reperfusion treatments, could reduce short-term mortality and mitigate post-pulmonary embolism syndrome (PPES). Post-pulmonary embolism syndrome refers to a variety of persistent symptoms and functional limitations that occur after an APE. The presence of persistent dyspnea, functional limitations, and/or decreased quality of life after an APE has been recently termed "PPES," although this entity encompasses different manifestations. The most severe cause of persistent dyspnea is chronic thromboembolic pulmonary hypertension, where increased pulmonary artery pressure is due to the fibrotic organization of unresolved APE. Post-PE Syndrome is not always systematically addressed in management guidelines, and its prevalence may be underestimated. More research is needed to fully understand its causes and risk factors. Interventions such as cardiopulmonary rehabilitation have been suggested to improve the quality of life of patients with PPES. A comprehensive, evidence-based approach is essential to effectively prevent and manage PPES and improve the long-term outcomes and well-being of affected patients.
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Embolia Pulmonar , Qualidade de Vida , Humanos , Embolia Pulmonar/terapia , Embolia Pulmonar/fisiopatologia , Fatores de Risco , Síndrome , Resultado do Tratamento , Anticoagulantes/uso terapêutico , Anticoagulantes/efeitos adversos , Dispneia/etiologia , Dispneia/fisiopatologia , Medição de Risco , Fatores de Tempo , Hipertensão Pulmonar/fisiopatologia , Hipertensão Pulmonar/etiologia , Estado FuncionalRESUMO
The tectofugal pathway is a highly conserved visual pathway in all amniotes. In birds and mammals, retinorecipient neurons located in the midbrain roof (optic tectum/superior colliculus) are the source of ascending projections to thalamic relays (nucleus rotundus/caudal pulvinar), which in turn project to specific pallial regions (visual dorsal ventricular ridge [vDVR]/temporal cortex) organized according to a columnar recurrent arrangement of interlaminar circuits. Whether or to which extent these striking hodological correspondences arise from comparable developmental processes is at present an open question, mainly due to the scarcity of data about the ontogeny of the avian tectofugal system. Most of the previous developmental studies of this system in birds have focused on the establishment of the retino-tecto-thalamic connectivity, overlooking the development of the thalamo-pallial-intrapallial circuit. In this work, we studied the latter in chicken embryos by means of immunohistochemical assays and precise ex vivo crystalline injections of biocytin and DiI. We found that the layered organization of the vDVR as well as the system of homotopic reciprocal connections between vDVR layers were present as early as E8. A highly organized thalamo-vDVR projection was also present at this stage. Our immunohistochemical assays suggest that both systems of projections emerge simultaneously even earlier. Combined with previous findings, these results reveal that, in striking contrast with mammals, the peripheral and central stages of the avian tectofugal pathway develop along different timelines, with a tecto-thalamo-intrapallial organization arising before and possibly independently of the retino-isthmo-tectal circuit.
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Galinhas , Colículos Superiores , Tálamo , Vias Visuais , Animais , Vias Visuais/crescimento & desenvolvimento , Embrião de Galinha , Tálamo/crescimento & desenvolvimento , Colículos Superiores/crescimento & desenvolvimentoRESUMO
Tomato spotted wilt orthotospovirus (TSWV) causes substantial economic loss to tomato production, and the Sw-5b resistance gene is widely deployed for management. Here, we show (i) the emergence of resistance-breaking (RB) TSWV strains in processing and fresh market tomato production in California over the past ten years, and (ii) evolutionary relationships with RB strains from other areas. A specific RT-PCR test was used to show the C118Y RB strain that emerged in Fresno County in 2016 quickly became predominant in the central production area and remained so through this study. In 2021, the C118Y strain was detected in the Northern production area, and was predominant in 2022. However, in 2023, the C118Y strain was unexpectedly detected in fewer spotted wilt samples from resistant varieties. This was due to emergence of the T120N RB strain, previously known to occur in Spain. A specific RT-PCR test was developed and used to show that the T120N RB strain was predominant in Colusa and Sutter counties (detected in 75-80% of samples), and detected in ~50% of samples from Yolo County. Pathogenicity tests confirmed California isolates of the T120N strain infected Sw-5b tomato varieties and induced severe symptoms. Another RB strain, C118F, was associated with spotted wilt samples of Sw-5 varieties from fresh market tomato production in southern California. Phylogenetic analyses with complete NSm sequences revealed that the C118Y and T120N RB strains infecting resistant processing tomato in California emerged locally, whereas those from fresh market production were more closely related to isolates from Mexico. Thus, widespread deployment of this single dominant resistance gene in California has driven the local emergence of multiple RB strains in different tomato production areas and types. These results further emphasize the need for ongoing monitoring for RB strains, and identification of sources of resistance to these strains.
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Resistência à Doença , Doenças das Plantas , Solanum lycopersicum , Tospovirus , Solanum lycopersicum/virologia , Solanum lycopersicum/genética , California , Doenças das Plantas/virologia , Doenças das Plantas/genética , Tospovirus/genética , Tospovirus/patogenicidade , Resistência à Doença/genética , FilogeniaRESUMO
Determinar el nivel de conocimiento sobre cáncer oral (CO) que presentaron los estudiantes de pregrado de estomatología. Estudio observacional transversal aplicado a una muestra poblacional de 184 estudiantes (24±3,09 años y 72,8 % mujeres) de una universidad privada de Lima del sexto a décimo ciclo que estuvieron matriculados en un curso de clínica (14,1 % de clínica V). Un cuestionario virtual y presencial con 24 preguntas sobre CO fue aplicado. El instrumento fue validado por juicio de expertos, tuvo un índice de validez de 0,96 (V de Aiken) y una confiabilidad (KR-20) DE 0,856 y ≥0,837 por ítem. La frecuencia de respuestas correctas del total de preguntas fue de 56,6 % siendo similar por sexo y curso de clínica, pero mayor en los >30 años (60 %). Las preguntas mejor contestadas fueron el tipo más frecuente (epidemiología), el factor relacionado (diagnóstico) y factores pronósticos (prevención). Las dimensiones mejor contestadas fueron en tratamientos y complicaciones (72,2 %) y diagnóstico (70,3 %) sobre CO. El nivel de conocimiento sobre CO fue regular (78,8 %). Ni las dimensiones, niveles o puntajes se asociaron a edad, sexo o clínica (P>0,05). Los estudiantes presentaron un nivel de conocimiento regular sobre cáncer oral, indistintamente del sexo, edad o la clínica que cursan.
The objective of this study was to determine the level of knowledge about oral cancer (OC) presented by undergraduate stomatology students. A cross-sectional observational study applied to a population sample of 184 students (24±3.09 years and 72.8 % women) from a private university in Lima from the sixth to tenth cycle who were enrolled in a clinical course (14.1 % of clinic V). A virtual and in-person questionnaire with 24 questions about OC was applied. The instrument was validated by expert judgment, it had a validity index of 0.96 (Aiken's V) and reliability (KR-20) of 0.856 and ≥0.837 per item. The frequency of correct answers to the total number of questions was 56.6 %, being similar by sex and clinical course, but higher in those >30 years of age (60 %). The best-answered questions were the most frequent type (epidemiology), the related factor (diagnosis), and the prognostic factors (prevention). The dimensions best answered were in treatments and complications (72.2 %) and diagnosis (70.3 %) of CO. The level of knowledge about OC was regular (78.8 %). Neither dimensions, levels, nor scores were associated with age, sex, or clinical features (P>0.05). The students presented a regular level of knowledge about oral cancer, regardless of sex, age or the clinical course they studied.
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Diabetic foot (DF) is a leading cause of nontraumatic lower-extremity amputations, premature death, and a sign of social inequality in diabetes treatment. In Mexico, the incidence of DF is on the rise yet little is known about its impact among indigenous people, a disadvantaged group. Based on ethnographic research conducted in Oaxaca and analysis of institutional health-data, in this article we show the health care delays that rural indigenous people face when dealing with DF. Indigenous people's uncertainty regarding their right to health and the structural barriers to medical care favor DF complications, a phenomenon that should be read as social suffering. Since health data concerning indigenous health care service users is patchy and imprecise, indigenous people's social suffering is invisibilized. This omission or partiality in the official records limits public health decision-making and undermines the human rights of the population.
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Antropologia Médica , Pé Diabético , Humanos , México/etnologia , Pé Diabético/etnologia , Pé Diabético/terapia , Feminino , Masculino , Pessoa de Meia-Idade , Povos Indígenas , Adulto , Acessibilidade aos Serviços de Saúde , População Rural , Idoso , Indígenas Norte-Americanos/etnologiaRESUMO
Introducción: el SARS-CoV-2 desde el 2020 generó innumerables desafíos. El decúbito prono se utilizó para mejorar la oxigenación, y la terapia nutricional se adaptó para cubrir los requerimientos y reducir complicaciones. Objetivos: evaluar la tolerancia de la nutrición enteral y su adecuación energética en pacientes ventilados en decúbito prono con infección por SARS-CoV-2, en sala respiratoria del Departamento de Cuidados Intensivos Adultos del Hospital de Clínicas-Facultad de Ciencias Médicas - Universidad Nacional de Asunción, de marzo a julio 2021. Metodología: estudio observacional, descriptivo, retrospectivo, de corte transversal, de casos consecutivos, con información obtenida de fichas de pacientes de terapia intensiva, que recibieron soporte nutricional en posición prona. Se tomaron datos demográficos, clínicos y nutricionales. Se evaluó la tolerancia nutricional durante la posición prona, definiéndola como la presencia de un volumen de residuo gástrico < 500 mL cada 6 h.. La adecuación energética fue determinada teniendo en cuenta el porcentaje cumplido de la prescripción nutricional. Resultados: se reclutaron 41 pacientes. El 60,9 % eran hombres; la mediana de edad fue 55 años (RIC=23). Las principales comorbilidades fueron obesidad (57,3 %) e hipertensión arterial (43,9 %). El 85,4 % presentó buena tolerancia gástrica en posición prono, con residuo gástrico menor a 500 ml. El porcentaje de adecuación energética fue de 84 %. Conclusión: la terapia nutricional enteral en decúbito prono fue bien tolerada por la mayoría de nuestros pacientes, posibilitando alcanzar los requerimientos nutricionales indicados.
Introduction: SARS-CoV-2 since 2020 has generated countless challenges. Prone position was used to improve oxygenation, and nutritional therapy was adapted to meet requirements and reduce complications. Objectives: evaluate the tolerance of enteral nutrition and its energetic adequacy in ventilated patients in the prone position with SARS-CoV-2 infection, in the respiratory room of the Adult Intensive Care Department of the Hospital de Clínicas - Facultad de Ciencias Médicas - Universidad Nacional de Asunción, from March to July 2021. Methodology: observational, descriptive, retrospective, cross-sectional study of consecutive cases, with information obtained from records of intensive care patients, who received nutritional support in a prone position. Demographic, clinical and nutritional data were taken. Nutritional tolerance was evaluated during the prone position, defining it as the presence of a volume of gastric residue < 500 mL every 6 h. Energy adequacy was determined taking into account the percentage fulfilled of the nutritional prescription. Results: 41 patients were recruited. 60.9 % were men; the median age was 55 years (IQR=23). The main comorbidities were obesity (57.3 %) and high blood pressure (43.9 %). 85.4 % had good gastric tolerance in the prone position, with gastric residue less than 500 ml. The percentage of energy adequacy was 84 %. Conclusion: enteral nutritional therapy in the prone position was well tolerated by the majority of our patients, making it possible to achieve the indicated nutritional requirements.
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El síndrome de Wells es una afección dérmica que presenta un gran polimorfismo clínico. Es una patología autolimitada, recurrente y su origen es incierto. Reportamos el caso de una paciente de 29 años, procedente del área Central de Paraguay, comerciante, sin patología de base que consultó por edema de manos y piel. El tratamiento indicado fue corticoide vía oral y desparasitación con buena evolución y sin recidivas.
Wells syndrome is a dermal condition with a high clinical polymorphism. It is a self-limited, recurrent pathology and its origin is uncertain. We report the case of a 29-year-old female patient from the central area of Paraguay, a shopkeeper, with no underlying pathology, who consulted for hand and skin edema. The indicated treatment was oral corticosteroid and deworming with good evolution and no recurrences.
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Sepsis is one of the main causes of admission to Intensive Care Units (ICU). The hemodynamic objectives usually sought during the resuscitation of the patient in septic shock correspond to macrohemodynamic parameters (heart rate, blood pressure, central venous pressure). However, persistent alterations in microcirculation, despite the restoration of macrohemodynamic parameters, can cause organ failure. This dissociation between the macrocirculation and microcirculation originates the need to evaluate organ tissue perfusion, the most commonly used being urinary output, lactatemia, central venous oxygen saturation (ScvO2), and veno-arterial pCO2 gap. Because peripheral tissues, such as the skin, are sensitive to disturbances in perfusion, noninvasive monitoring of peripheral circulation, such as skin temperature gradient, capillary refill time, mottling score, and peripheral perfusion index may be helpful as early markers of the existence of systemic hemodynamic alterations. Peripheral circulation monitoring techniques are relatively easy to interpret and can be used directly at the patient's bedside. This approach can be quickly applied in the intra- or extra-ICU setting. The objective of this narrative review is to analyze the various existing tissue perfusion markers and to update the evidence that allows guiding hemodynamic support in a more individualized therapy for each patient.
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Hemodinâmica , Microcirculação , Humanos , Criança , Microcirculação/fisiologia , Hemodinâmica/fisiologia , Choque Séptico/terapia , Choque Séptico/fisiopatologia , Choque Séptico/diagnóstico , Monitorização Fisiológica/métodos , Monitorização Hemodinâmica/métodos , Doença Aguda , Sepse/diagnóstico , Sepse/terapia , Sepse/fisiopatologia , Biomarcadores/sangueRESUMO
Early vocabulary development is crucial for future cognitive and academic outcomes, and parent-child booksharing has been recognized as a powerful home literacy practice to promote word learning. However, evidence about the link between booksharing and language development in diverse cultural and socioeconomic settings is currently limited, hindering the formulation of a broadly applicable framework to understand the favorable conditions for early vocabulary development. This study explores the relationship between booksharing and early receptive and expressive vocabulary in a sample of 183 mothers and their toddlers in Costa Rica, a context where reading is not a common practice and children have limited access to books. Mothers completed an interview about their booksharing practices and reported children's receptive and expressive vocabulary. Results demonstrated a positive link between maternal booksharing and children's expressive vocabulary. Child gender moderated the link between booksharing and receptive vocabulary, exhibiting a stronger association in girls than in boys. Mothers with lower education levels reported higher expressive vocabulary scores for their children than mothers with higher education levels. These findings underscore the significance of booksharing in the home literacy environment, even in cultural contexts with distinct reading practices. Moreover, they highlight the need to incorporate sociocultural factors into comprehensive accounts concerning the role of booksharing in early word learning.
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Livros , Desenvolvimento da Linguagem , Leitura , Vocabulário , Humanos , Feminino , Costa Rica , Masculino , Pré-Escolar , Adulto , Lactente , Relações Mãe-Filho , Mães/psicologiaRESUMO
PURPOSE: Literature reviews outline minimally invasive approaches for abdominal diastasis in patients without skin excess. However, few surgeons are trained in endoscopic rectus sheath plication, and no simulated training programs exist for this method. This study aimed to develop and validate a synthetic simulation model for the training of skills in this approach under the Messick validity framework. METHODS: A cross-sectional study was carried out to assess the participants' previous level of laparoscopic/endoscopic skills by a questionnaire. Participants performed an endoscopic plication on the model and their performance was evaluated by one blinded observer using the global rating scale OSATS and a procedure specific checklist (PSC) scale. A 5-level Likert survey was applied to 5 experts and 4 plastic surgeons to assess Face and Content validity. RESULTS: Fifteen non-experts and 5 experts in abdominal wall endoscopic surgery were recruited. A median OSATS score [25 (range 24-25) vs 14 (range 5-22); p < 0.05 of maximum 25 points] and a median PSC score [11 (range 10-11) vs 8 (range 3-10); p < 0.05 of maximum 11 points] was significantly higher for experts compared with nonexperts. All experts agreed or strongly agreed that the model simulates a real scenario of endoscopic plication of the rectus sheath. CONCLUSION: Our simulation model met all validation criteria outlined in the Messick framework, demonstrating its ability to differentiate between experts and non-experts based on their baseline endoscopic surgical skills. This model stands as a valuable tool for evaluating skills in endoscopic rectus sheath plication.
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Competência Clínica , Reto do Abdome , Treinamento por Simulação , Humanos , Estudos Transversais , Reto do Abdome/cirurgia , Modelos Anatômicos , Endoscopia/educação , Endoscopia/métodosRESUMO
BACKGROUND: Despite nearly a quarter of Venezuelans remaining unvaccinated against coronavirus disease 2019 (COVID-19), the factors contributing to vaccine hesitancy in the country have not been thoroughly investigated. METHODS: A cross-sectional study was conducted from October 15th to 30th, 2022, using a knowledge, attitudes, and practices (KAP) survey to identify factors associated with COVID-19 vaccine hesitancy. RESULTS: The study analyzed data from 1,930 participants from all 24 states of Venezuela. The majority (93.4%) were vaccinated. The mean age was 40 years, predominantly female (67.3%), and held a university degree (70.6%). The mean KAP score was significantly higher among vaccinated individuals compared to unvaccinated ones (7.79 vs. 3.94 points for knowledge, 40 vs. 24 points for attitudes, and 16 vs. 10 points for practices, all p < 0.001). Increases in the scores for KAP were associated with increased odds of being vaccinated (84.6%, 25.6%, and 33% respectively for each one-point increase, all p < 0.001). Certain demographic factors such as marital status, occupation, religious beliefs, monthly income, and location influence COVID-19 vaccine knowledge. Higher income and certain occupations decrease the odds of low knowledge, while residing in specific states increases it. Attitudes towards the COVID-19 vaccine are influenced by age, health status, vaccination status, and location. Higher income and absence of certain health conditions decrease the odds of negative attitudes. Lastly, age, occupation, monthly income, and location affect vaccine practices. Advanced age and higher income decrease the odds of inappropriate practices, while residing in La Guaira state increases them. CONCLUSION: Factors such as age, education level, occupation, monthly income, and location were found to be associated with knowledge and attitudes towards COVID-19 vaccine among the surveyed Venezuelans.
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Vacinas contra COVID-19 , COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Hesitação Vacinal , Humanos , Venezuela , Feminino , Masculino , Adulto , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Estudos Transversais , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , COVID-19/psicologia , Pessoa de Meia-Idade , Adulto Jovem , Inquéritos e Questionários , Adolescente , IdosoRESUMO
BACKGROUND: Deficiencies in the thyroid hormone transporter monocarboxylate 8 (MCT8) due to pathogenic variants in the SLC16A2 gene (OMIM 300095) result in a complex phenotype with main endocrine and neurologic symptoms. This rare disorder, named Allan-Herndon-Dudley syndrome (AHDS) (OMIM 300523), is inherited in an X-linked trait. One of the prominent features of AHDS is the presence of movement disorders (MD), which are complex and carry a significant burden of the disease. CASES: Patient 1: male with hypotonia since birth, developmental delay, dystonic posturing at 4 months and at 15 months, and startle reaction developed with sensory stimuli. Patient 2: male, at 2 months, shows hypotonia and developmental delay, paroxysmal episodes triggered by a stimulus with sudden blush, tonic asymmetric posture, and no epileptiform activity. At 10 months, generalized dystonic posturing. Patient 3: typical neurodevelopmental milestones until 6 months; at 24 months, dystonia, startle reaction, and upper motoneuron signs. CONCLUSIONS: We aim to describe our patients diagnosed with AHDS, focusing on MD phenomenology and strengthening the phenotype-genotype correlations for this rare condition.
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Hipotonia Muscular , Humanos , Masculino , Hipotonia Muscular/genética , Transportadores de Ácidos Monocarboxílicos/genética , Transportadores de Ácidos Monocarboxílicos/deficiência , Atrofia Muscular/genética , Atrofia Muscular/patologia , Lactente , Transtornos dos Movimentos/genética , Deficiência Intelectual Ligada ao Cromossomo X/genética , Deficiência Intelectual Ligada ao Cromossomo X/diagnóstico , Simportadores/genética , Simportadores/deficiência , Colômbia , Pré-Escolar , Fenótipo , Deficiências do Desenvolvimento/genéticaRESUMO
This paper describes and compares the integration of cross-sector actors' participation into the governance of two local health councils, one located in Salvador de Bahia (Brazil) and the other in the Canary Islands (Spain). Based on the cross-national comparative research conducted as part of a doctoral thesis, a qualitative design based on secondary data analysis was proposed on the three stages of the organisational integration process of participation. We used information from individual semi-structured interviews (n = 70), situational observation, focus groups, literature review, and field notes to understand participatory processes of networking between multiple cross-sector actors and to show how such processes might be associated with innovative practices. For these innovations to be successfully implemented, stakeholders need to acquire adequate competencies in cross-sector collaboration, enabling them to learn about new organisational practices and to adapt the network of actors to the often unpredictable influences of contextual factors.
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Grupos Focais , Espanha , Brasil , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Governo Local , Atenção à Saúde/organização & administração , Participação dos InteressadosRESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. METHODS: We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. RESULTS: A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. CONCLUSION: This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.
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COVID-19 , Infecções por HIV , Humanos , Masculino , Feminino , Adolescente , Adulto , HIV , COVID-19/epidemiologia , Pandemias , Estudos Transversais , Vacinas contra COVID-19/uso terapêutico , Venezuela/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologiaRESUMO
StarD7 is a member of the START protein family required for phosphatidylcholine delivery to the mitochondria, thus key to maintain mitochondrial structure. Its deficiency has been associated with an impairment of cellular processes, such as proliferation and migration, and it has also been reported that it is needed in myogenic differentiation. Here, we show that StarD7 deficiency in C2C12 muscle cells results in the accumulation of abnormal mitochondria, a reduced number of mitochondria per cell area and increased glycolysis. In addition, StarD7-deficient cells undergo an increase in mitochondria-ER contact sites, reduced connexin 43 expression, and disturbances in lipid handling, evidenced by lipid droplet accumulation and decreased levels in phosphatidylserine synthase 1 and 2 expression. Interestingly, StarD7-deficient cells showed alterations in mitophagy markers. We observed accumulation of LC3B-II and BNIP3 proteins in mitochondria-enriched fractions and accumulation of autophagolysosomal and lysosomal vesicles in StarD7-deficient cells. Furthermore, live-cell imaging experiments of StarD7 knockdown cells expressing mitochondria-targeted mKeima indicated an enhanced mitochondria delivery into lysosomes. Importantly, StarD7 reconstitution in StarD7-deficient cells restores LC3B-II expression in mitochondria-enriched fractions at similar levels to those observed in control cells. Collectively, these findings suggest that StarD7-deficient C2C12 myoblasts are associated with altered cristae structure, disturbances in neutral lipid accumulation, glucose metabolism, and increased mitophagy flux. The alterations mentioned above allow for the maintenance of mitochondrial function.
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Proteínas de Transporte , Mitofagia , Proteínas de Transporte/metabolismo , Glicólise/genética , Lipídeos , Mitofagia/genética , Mioblastos/metabolismo , Animais , CamundongosRESUMO
A mandatory tomato-free period (TFP) was implemented in the state of Goiás, Brazil, in 2007 to help manage diseases caused by whitefly-transmitted begomoviruses. The impact of the TFP was examined in five locations across three states in Central Brazil from 2013 to 2016. Surveys revealed significant differences in begomovirus disease incidence among locations, i.e., low in Guaíra-TFP and Patos de Minas-TFP; moderate-high in Itaberaí-TFP and Morrinhos-TFP; and high in the non-TFP (NTFP) control, Cristalina-NTFP. PCR tests and DNA sequencing were used to validate the symptoms and showed that all collected symptomatic plant samples were infected with tomato severe rugose virus (ToSRV), a common indigenous bipartite begomovirus. Early season surveys (20 to 40 days after transplants [DAT]) in Itaberaí-TFP and Morrinhos-TFP revealed significantly less begomovirus disease in fields established sooner after the TFP (0 to 2 months) compared with incidences in (i) equivalent early planted fields in the Cristalina-NTFP control and (ii) fields established longer after the end of the TFP (>2 to 5 months). Whitefly infestation of crops was detected year-round in all locations and years, and all tested adults were classified in the Bemisia tabaci MEAM1 cryptic species. Infestation levels were significantly higher during the summer but did not vary significantly among locations. Results of monthly monitoring of adult whiteflies for general begomovirus and ToSRV were positively correlated and were indicators of disease incidence in the field. Notably, ToSRV was not detected in whiteflies collected from nontomato plants during the TFP, and there was a longer lag period before detection in whiteflies collected from processing tomatoes for Itaberaí-TFP and Morrinhos-TFP compared with Cristalina-NTFP. Taken together with the low levels of ToSRV infection detected in potential nontomato reservoir hosts at all locations, our results revealed low levels of primary inoculum during the TFP. Thus, even in a complex agroecosystem with year-round whitefly infestation of crops, the TFP was beneficial due to delayed and reduced begomovirus disease pressure during a critical stage of plant development (first month) and for favoring low levels of primary inoculum. Thus, we concluded that the TFP should be part of a regional integrated pest management (IPM) program targeting ToSRV in Brazil.
RESUMO
Los fenómenos reaccionales de la lepra son complicaciones inflamatorias que a menudo se presentan como verdaderas emergencias médicas durante el curso del tratamiento o incluso después de culminarlo. A menudo, los síntomas sistémicos como la fiebre pueden aparecer antes que las manifestaciones cutáneas y desconcertar al médico. Se realiza la presentación del caso de un paciente masculino, 39 años, sano, que acude con cuadro de 2 meses de evolución de fiebre, pérdida de peso, con posterior aparición de manchas rojas en todo el cuerpo. Se realizaron biopsia de piel y baciloscopia, con los cuales se pudieron llegar al diagnóstico de lepra.
The reactional phenomena of leprosy are inflammatory complications that often present as true medical emergencies during treatment or even after completion. Often, systemic symptoms such as fever can appear before skin manifestations and baffle the doctor. The case presented is a 39-year male patient, healthy, who consult with a 2-month history of fever, and weight loss, with subsequent appearance of red spots all over the body. A skin biopsy and smear microscopy were performed, with which leprosy was diagnosed.