RESUMO
BACKGROUND: Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms. METHODS: Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment. RESULTS: 188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores. CONCLUSION: Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.
Assuntos
COVID-19 , Coinfecção , Transtornos do Olfato , Humanos , SARS-CoV-2 , COVID-19/complicações , Anosmia/complicações , Anosmia/epidemiologia , Estudos Prospectivos , Pandemias , Coinfecção/complicações , Coinfecção/epidemiologia , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/etiologia , OlfatoRESUMO
BACKGROUND: Oral manifestations are common in neurofibromatosis 1 (NF1), and include jaws and teeth alterations. Our aim was to investigate the craniomaxillofacial morphology of Brazilian children, adolescents and adults with NF1 using cone beam computed tomography. MATERIAL AND METHODS: This study was conducted with 36 Brazilian individuals with NF1 with ages ranging from 4 to 75. The participants were submitted to anamnesis, extra and intraoral exam and cephalometric analysis using cone beam computed tomography. Height of the NF1 individuals was compared to the length of jaws and skull base. The results of the cephalometric measurements of the NF1 group were compared with a control group paired by age, gender and skin color. RESULTS: Individuals with NF1 had lower maxillary length (p<0.0001), lower mandibular length (p<0.0001), lower skull base length (p<0.0001). In children and adolescents, the mandible was more posteriorly positioned (p=0.01), when compared with the control group. There was no association between jaws and skull base length with the height of the individuals with NF1. CONCLUSIONS: Brazilian children, adolescents and adults with NF1 have short mandible, maxilla and skull base. Moreover, children and adolescents present mandibular retrusion.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Arcada Osseodentária/diagnóstico por imagem , Arcada Osseodentária/patologia , Neurofibromatose 1/complicações , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Adolescente , Adulto , Idoso , Brasil , Estudos de Casos e Controles , Cefalometria , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
INTRODUCTION: Individuals with phenylketonuria (PKU, OMIM 261600) have shown bone disease from childhood. Factors such as non-adherence to treatment, nutritional inadequacy, and high phenylalanine levels are associated with bone disease in several studies. This research aimed to describe the impact of dietary factors (consumption of energy, protein, calcium, phosphorus, and phenylalanine), and the control of plasma phenylalanine levels on bone age (BA) and bone mineral density (BMD). METHODOLOGY: Thirteen patients of both genders, from 8 to 16 years old participated in this study. Control data were collected of phenylalanine levels, food frequency and record, hand and fist X-rays, and spinal bone densitometry. RESULTS: In children group (CG), individuals non-adherent to diet (NAD) consumed lower amounts of calcium (472 ± 100 mg/day) and energy (1743 ± 486 Kcal); they had higher rates of phenylalanine (564 ± 94 µmol/L) in blood, intake phenylalanine (701 ± 334 mg/g), and higher protein intake from free foods (14 ± 6.67 g/day); bone age (BA) values higher than the chronological age (CA) and less BMD values (-0.7 ± 1.6 SD) also were verified. In adolescent group (AG, N = 8) of NAD, values were lower for energy intake (1379 ± 258 Kcal), calcium (801 ± 152 mg/day), phosphorus (657 ± 102 mg/day), food protein (25 ± 7.6 g/day), and intake phenylalanine (1067 ± 382 mg/day) than recommended. Higher levels of plasma phenylalanine (851 ± 244 µmol/L), bone age greater than chronological age and lower BMD values (-2.4 ± -2.5 SD) were observed. CONCLUSION: The results suggest effects on BA and on BMD, in both children and adolescent groups. The bone development is expressed differently in children and adolescents. The non-adherence to the diet verified in both groups and the consequent imbalance in the nutrients intake involved in bone metabolism suggest that these factors influence the failure to thrive in children and reduced bone mineralization in adolescents.
Assuntos
Desenvolvimento Ósseo , Fenilcetonúrias/genética , Adolescente , Densidade Óssea , Osso e Ossos/patologia , Criança , Transtornos da Nutrição Infantil/genética , Ciências da Nutrição Infantil , Densitometria/métodos , Dieta , Ingestão de Energia , Feminino , Humanos , Masculino , Cooperação do Paciente , Fenilalanina/análise , Fenilalanina/sangue , Fenilcetonúrias/fisiopatologia , Raios XRESUMO
The present work describes the fractionation of the crude hexane extract (EBHEX) from Calophyllum brasiliense (Clusiaceae) stem bark. Derivatization of DCM(2-9) fraction with diazomethane afforded the chromanones inophylloidic acid, isobrasiliensic acid, as well as, a mixture containing isobrasiliensic and brasiliensic acids, in the form of their more stable O-methoxy-methyl esters derivatives 1, 2, and 3, respectively. The isolation of 1 from C. brasiliense is described for the first time herein. The use of two-dimensional NMR methods ((1)H-COSY, HMQC, and HMBC) allowed the precise determination of (13)C and (1)H chemical shifts of compounds 1, 2, and 3.
Assuntos
Calophyllum/química , Cromonas/química , Espectroscopia de Ressonância Magnética/métodos , Casca de Planta/química , Extratos Vegetais/química , Ésteres , Estrutura MolecularRESUMO
Gastrointestinal bleeding accounts for 2% of all adult hospital admissions each year. Vascular ectasia is one of the most frequently reported cause of lower gastrointestinal bleeding. In almost 80% of patients with bleeding vascular ectasia will stop spontaneously, but will often recur. Many treatments are proposed like superselective catheterization with infusion of vasoconstrictor by angiography, Laser photocoagulation, heater probe, bipolar electrocoagulation, hot biopsy forceps, have been used in colonoscopy, but some effects are short-lived others are so expensive and without an effective treatment. The authors present one case of bleeding vascular ectasia during colonoscopy submitted to a new, cheap and effective approach with injection a 1:10,000 solution of epinephrine following electrocoagulation by colonoscopy.