RESUMO

The prompt and accurate identification of the etiological agents of viral respiratory infections is a critical measure in mitigating outbreaks. In this study, we developed and clinically evaluated a novel melting-curve-based multiplex real-time PCR (M-m-qPCR) assay targeting the RNA-dependent RNA polymerase (RdRp) and nucleocapsid phosphoprotein N of SARS-CoV-2, the Matrix protein 2 of the Influenza A virus, the RdRp domain of the L protein from the Human Respiratory Syncytial Virus, and the polyprotein from Rhinovirus B genes. The analytical performance of the M-m-qPCR underwent assessment using in silico analysis and a panel of reference and clinical strains, encompassing viral, bacterial, and fungal pathogens, exhibiting 100% specificity. Moreover, the assay showed a detection limit of 10 copies per reaction for all targeted pathogens using the positive controls. To validate its applicability, the assay was further tested in simulated nasal fluid spiked with the viruses mentioned above, followed by validation on nasopharyngeal swabs collected from 811 individuals. Among them, 13.4% (109/811) tested positive for SARS-CoV-2, and 1.1% (9/811) tested positive for Influenza A. Notably, these results showed 100% concordance with those obtained using a commercial kit. Therefore, the M-m-qPCR exhibits great potential for the routine screening of these respiratory viral pathogens.

RESUMO

BACKGROUND: Conservation projects in zoos may involve translocation of captive animals, which may lead to pathogen spread. Neotropical mammals are important hosts of Trypanosoma cruzi and Leishmania spp. the etiological agents of Chagas disease and Leishmaniasis respectively. Studies of trypanosomatid-infected mammals and vectors (triatomines and sandflies) in zoos are important for the establishment of surveillance and control measures. OBJECTIVES: We investigated trypanosomatid infections in captive wild mammals, triatomines and sandflies at the Brasília Zoo. METHODS: We collected triatomines during active bimonthly surveys, sampled sandflies using light-traps and obtained blood samples from 74 mammals between 2016 and 2017. We used quantitative PCR to detect trypanosomatids in vectors and mammals. RESULTS: We found a colony of 19 Panstrongylus megistus in the porcupine unit and detected T. cruzi infections in five bugs. We captured 17 sandflies of four species including Nyssomyia whitmani and Lutzomyia longipalpis, but no Leishmania infection was detected. qPCR detected 50 T. cruzi-infected mammals belonging to 24 species and five groups of mammals (Carnivora, Cetartiodactyla, Perissodactyla, Pilosa and Primates); Leishmania DNA was detected in 23 mammals from 15 species, mainly carnivores. We detected trypanosomatid infections in 11 mammals born at the Brasília Zoo. CONCLUSIONS: Our results suggest vector-borne transmission of T. cruzi among maned wolves; measures to reduce the risk of new infections should therefore be taken. We also report sandfly presence and Leishmania-infected mammals at the Brasília Zoo. Translocation of wild mammals in and out of the Brasília Zoo should consider the risk of T. cruzi and Leishmania spread.

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Dexamethasone has been widly used in oral and maxillofacial surgery for controlling of postoperative surgical inflammation. Despite its clinical effectiveness, several studies have demonstrated the negative impact of this drug on the healing of soft and hard tissues. This study aimed to assess the effects of different pre-operative doses of dexamethasone on alveolar repair. Sixty rats were divided into four groups of 15 animals each. Single pre-operative doses of dexamethasone equivalent to human doses of 4 mg (Group 4 mg), 8 mg (Group 8 mg), and 12 mg (Group 12 mg), calculated by allometric dose extrapolation, were administered; and rats in the Control Group were injected with saline solution. The animals were anesthetized, and their left mandibular first molars (M1) were removed. After three, seven, and 40 days, 5 animals from each group were euthanized, and bone samples of M1 alveolus were collected for radipgraphic, histomorphological and histometric evaluation of the early and late phases of alveolar healing. At three days, Group 12 mg presented reduced radiographic density, percentage of collagen, and connective matrix compared with the Control Group. At 7 days, the percentage of bone was increased in the Control Group compared to Groups 8 mg and 12 mg (P < 0.05). It can be concluded that a single pre-operative dose of 12 mg of dexamethasone affected the early stages of alveolar repair in rats.

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Necrophagous insects such as blow flies (Diptera: Calliphoridae) are considered crucial in forensic entomology. Identification at species level and determination of larval stage are the basis for estimation of postmortem interval (PMI). Insect evidence can also be used in the determination of crime scenes, since body displacement is common. The aim of this study was to determine the chemotaxonomic profile and intraspecific variability of the forensically important blow fly Chrysomya megacephala (F. 1794). Adults were collected in the municipalities of Dourados-MS (Brazil) and Rio Claro-SP (Brazil), and then transferred to the laboratory for oviposition and development of the immature stages. Chemical analysis of cuticular compounds was performed by gas chromatography. Cuticular chemical profiles varied significantly between the two populations, as well as between developmental stages, supporting the use of these compounds as a complementary tool to help identify the species and its stages, along with geographical variability. This could greatly accelerate forensic investigations, eliminating the need to allow the fly larvae to develop until adult stage in order to confirm the species identity and sample origin.

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Síndrome do trefinado é atualmente uma complicação comum na neurotraumatologia, sendo descrita como uma síndrome na qual ocorre deterioração neurológica acompanhada de sinais e sintomas após a remoção de uma parte considerável de osso do crânio, assim como ocorre na hemicraniectomia. Neste artigo, juntamente com a revisão de literatura, será relatado o caso de um paciente adulto, vítima de acidente automobilístico, com história de traumatismo cranioencefálico (TCE) grave que foi submetido à craniectomia terapêutica, cursando com a síndrome do trefinado.

"Syndrome of the Trephined" or "Sinking Skin Flap Syndrome" is an usual syndrome in which neurological deterioration occurs following removal of a large skull bone flap (for example, in descompressive craniectomy). In this article, we will report the case of a 24 years old male, victim of an automobile accident with severe traumatic brain injury (TBI), which developed the Syndrome of the Trephined.

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RESUMO

Life expectancy in Brazil has increased markedly over the last 30 years. Hence, age-related disorders, such as Alzheimer's disease (AD), warrant special attention due to their high prevalence in the elderly. Pharmacologic treatment of AD is based on cholinesterase inhibitors (ChEI) and memantine, leading to modest clinical benefits both in the short and long-term. However, clinical response is heterogeneous and needs further investigation. OBJECTIVE: To investigate the rate of response to ChEI in AD after three months of treatment. METHODS: Patients with mild or moderate dementia due to probable AD or to AD associated with cerebrovascular disease were included in the study. The subjects were assessed at baseline and again after three months of ChEI treatment. Subjects were submitted to the Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, Katz Basic Activities of Daily Living, Pfeffer Functional Activities Questionnaire, Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Good response was defined by a gain of ≥2 points on the MMSE after three months of treatment in relation to baseline. RESULTS: Seventy-one patients, 66 (93%) with probable AD and five (7%) with AD associated with cerebrovascular disease, were evaluated. The good response rate at three months was 31.0%, being 37.2% and 21.4% in mild and moderate dementia, respectively. There were no significant differences on most tests, except for improvement in hallucinations, agitation and dysphoria in moderate dementia patients. CONCLUSION: The rate of good clinical response to ChEI was higher than usually reported. Specific behavioral features significantly improved in the subgroup of moderate dementia.

A expectativa de vida no Brasil aumentou significativamente nos últimos 30 anos. Desse modo, transtornos relacionados à idade, como a doença de Alzheimer (DA), merecem especial atenção, devido à elevada prevalência. O tratamento farmacológico da DA se baseia nos inibidores da colinesterase (IChE) e na memantina, com melhora modesta em curto e longo prazo. Entretanto, a resposta clínica é heterogênea e necessita maior investigação. OBJETIVO: Investigar a taxa de resposta aos IChE em pacientes com DA após três meses de tratamento. MÉTODOS: Pacientes com demência leve ou moderada devida à DA ou DA com doença cerebrovascular foram avaliados antes e após três meses de uso de IChE. Todos foram submetidos ao Mini-Exame do Estado Mental (MEEM), Escala de Demência Mattis, avaliação das atividades básicas de vida diária de Katz, Questionário de Pfeffer, Inventário Neuropsiquiátrico e Escala de Depressão de Cornell. Boa resposta foi definida pelo ganho de ≥2 pontos no MEEM em relação à primeira consulta, após três meses. RESULTADOS: Setenta e um pacientes, 66 (93%) com DA provável e cinco (7%) com DA associada à doença cerebrovascular, foram avaliados. A taxa de boa resposta clínica em três meses foi de 31.0%, sendo 37,2% e 21,4% na demência leve e moderada, respectivamente. Não houve diferença significativa na maioria dos testes, exceto para melhora de alucinação, agitação e depressão em pacientes com demência moderada. CONCLUSÃO: A taxa de boa resposta clínica aos IChE foi superior à encontrada na literatura. Observou-se melhora de alguns sintomas comportamentais em pacientes com DA moderada.

RESUMO

In the context of recommended foods to reduce the risk of developing diseases and to improve the quality of life, are the fruits and their derivatives. This study aimed to develop a mixed juice of mango, guava and acerola, with acceptability sensory, using experimental blending to determine the optimal proportions of pulps. In each treatment, these proportions have been defined determined according to a design blending simplex increased by 10 treatments. Were performed physicochemical analyses such as: pH, soluble solids (°Brix), acidity, vitamin C content and sensory analysis. Based on the results, it was found that all the formulations derived from mango, guava and acerola were accepted by consumers. The pulp of guava and mango should participate in a greater proportion of the mix, since they promote acceptance. The pulp of acerola, even in a smaller proportion, contributed to the increase in content of vitamin C.

No âmbito dos alimentos recomendados para redução do risco de desenvolver doenças e para melhoria da qualidade de vida, estão as frutas e seus derivados. Este trabalho teve como objetivo desenvolver um suco misto de manga, goiaba e acerola, com aceitação sensorial, utilizando delineamento de mistura para determinar as proporções das polpas. Em cada tratamento, essas proporções, foram definidas segundo um delineamento de mistura simplex aumentado de 10 tratamentos. Foram realizadas análises físico-químicas, tais como: pH, sólidos solúveis (oBrix), acidez titulável, relação de sólidos solúveis (SST)/acidez titulável (ATT), teor de vitamina C e análise sensorial. Com base nos resultados, verificou-se que todas as formulações, obtidas a partir de manga, goiaba e acerola, foram aceitas pelos consumidores. As polpas de goiaba e manga deveriam participar numa maior proporção da mistura, pois favoreceram a aceitação. A polpa de acerola, mesmo em menor proporção, contribuiu para o aumento do teor de vitamina C. As formulações com maior proporção de manga apresentaram maiores valores de pH. Maiores proporções de acerola contribuíram para maiores valores de acidez titulável. As formulações que continham maiores proporções de goiaba geraram maiores valores da relação SST/ATT

RESUMO

In the context of recommended foods to reduce the risk of developing diseases and to improve the quality of life, are the fruits and their derivatives. This study aimed to develop a mixed juice of mango, guava and acerola, with acceptability sensory, using experimental blending to determine the optimal proportions of pulps. In each treatment, these proportions have been defined determined according to a design blending simplex increased by 10 treatments. Were performed physicochemical analyses such as: pH, soluble solids (°Brix), acidity, vitamin C content and sensory analysis. Based on the results, it was found that all the formulations derived from mango, guava and acerola were accepted by consumers. The pulp of guava and mango should participate in a greater proportion of the mix, since they promote acceptance. The pulp of acerola, even in a smaller proportion, contributed to the increase in content of vitamin C.

No âmbito dos alimentos recomendados para redução do risco de desenvolver doenças e para melhoria da qualidade de vida, estão as frutas e seus derivados. Este trabalho teve como objetivo desenvolver um suco misto de manga, goiaba e acerola, com aceitação sensorial, utilizando delineamento de mistura para determinar as proporções das polpas. Em cada tratamento, essas proporções, foram definidas segundo um delineamento de mistura simplex aumentado de 10 tratamentos. Foram realizadas análises físico-químicas, tais como: pH, sólidos solúveis (oBrix), acidez titulável, relação de sólidos solúveis (SST)/acidez titulável (ATT), teor de vitamina C e análise sensorial. Com base nos resultados, verificou-se que todas as formulações, obtidas a partir de manga, goiaba e acerola, foram aceitas pelos consumidores. As polpas de goiaba e manga deveriam participar numa maior proporção da mistura, pois favoreceram a aceitação. A polpa de acerola, mesmo em menor proporção, contribuiu para o aumento do teor de vitamina C. As formulações com maior proporção de manga apresentaram maiores valores de pH. Maiores proporções de acerola contribuíram para maiores valores de acidez titulável. As formulações que continham maiores proporções de goiaba geraram maiores valores da relação SST/ATT

RESUMO

In the context of recommended foods to reduce the risk of developing diseases and to improve the quality of life, are the fruits and their derivatives. This study aimed to develop a mixed juice of mango, guava and acerola, with acceptability sensory, using experimental blending to determine the optimal proportions of pulps. In each treatment, these proportions have been defined determined according to a design blending simplex increased by 10 treatments. Were performed physicochemical analyses such as: pH, soluble solids (°Brix), acidity, vitamin C content and sensory analysis. Based on the results, it was found that all the formulations derived from mango, guava and acerola were accepted by consumers. The pulp of guava and mango should participate in a greater proportion of the mix, since they promote acceptance. The pulp of acerola, even in a smaller proportion, contributed to the increase in content of vitamin C.

No âmbito dos alimentos recomendados para redução do risco de desenvolver doenças e para melhoria da qualidade de vida, estão as frutas e seus derivados. Este trabalho teve como objetivo desenvolver um suco misto de manga, goiaba e acerola, com aceitação sensorial, utilizando delineamento de mistura para determinar as proporções das polpas. Em cada tratamento, essas proporções, foram definidas segundo um delineamento de mistura simplex aumentado de 10 tratamentos. Foram realizadas análises físico-químicas, tais como: pH, sólidos solúveis (oBrix), acidez titulável, relação de sólidos solúveis (SST)/acidez titulável (ATT), teor de vitamina C e análise sensorial. Com base nos resultados, verificou-se que todas as formulações, obtidas a partir de manga, goiaba e acerola, foram aceitas pelos consumidores. As polpas de goiaba e manga deveriam participar numa maior proporção da mistura, pois favoreceram a aceitação. A polpa de acerola, mesmo em menor proporção, contribuiu para o aumento do teor de vitamina C. As formulações com maior proporção de manga apresentaram maiores valores de pH. Maiores proporções de acerola contribuíram para maiores valores de acidez titulável. As formulações que continham maiores proporções de goiaba geraram maiores valores da relação SST/ATT

RESUMO

Alzheimer's disease (AD) is characterized by impairment in memory and autonomy, causing excessive pressure on family and an overburdened health care system. Early diagnosis, with the appropriate treatment, is important to reduce the pattern of disease progression. OBJECTIVE: The study sought to identify the most probable causes of delay in diagnosis. METHODS: A cross-sectional study involving AD patients followed at an Outpatient Geriatric Clinic from a tertiary public university hospital was conducted between June 2009 and February 2011. RESULTS: Ninety-four patients were evaluated (66% women), aged 77.76±6.8 years and with median educational level of 3 years (95% CI 2.7-3.80). Regarding severity of dementia, 51.8% of patients were classified as having mild dementia (CDR 1), 40% moderate dementia (CDR 2) and 8.2% severe dementia (CDR 3). Mean educational level of caregivers was 8.3±3.9 years. Among those who believed there was a delay, 36% stated that the "family thought that the changes were normal for the age of the patient" reporting average delay of 1.8 years (95% CI: 1.3-2.5) while 45.3% stated that the "doctor did not reach a diagnosis" reporting a median delay of 1.5 years (95% CI: 1.4-2.3). CONCLUSION: Based on these results, it can be concluded the time between onset of symptoms and diagnosis was excessive. This study may be useful to help increase awareness of issues not sufficiently discussed in the literature, such as diagnostic delay and influence of caregivers' educational level on treatment.

A doença de Alzheimer é caracterizada por comprometimento na memória e na autonomia, causando pressão excessiva em familiares e sobrecarregando o sistema público de saúde. O diagnóstico precoce, com o tratamento adequado, é importante para reduzir o padrão de evolução da doença. OBJETIVO: O estudo pretende identificar as causas mais prováveis de atraso no diagnóstico. MÉTODOS: Trata-se de um estudo transversal envolvendo pacientes com DA acompanhados em Ambulatório de Geriatria de um hospital terciário público entre junho de 2009 e fevereiro de 2011. RESULTADOS: Noventa e quatro pacientes foram avaliados (66% mulheres), com média de idade de 77,8±6,8 anos e com mediana de escolaridade de 3 anos (IC 95%: 2,7-3,8). Quanto à gravidade da doença, 51,8% foram classificados como demência leve (CDR 1), 40% como demência moderada (CDR 2) e 8,2% como demência grave (CDR 3). A escolaridade do cuidador foi de 8,3±3,9 anos. Entre aqueles que acreditavam que havia um atraso no diagnóstico, 36% responderam que "a família achava as alterações como normais para a idade do paciente", com média de 1,8 anos (IC 95%: 1,3-2,5) e 45,3% responderam que "o médico não fez o diagnóstico", com mediana de 1,5 anos (IC 95%: 1,4-2,3). Foi observado que o tempo entre o início dos sintomas e o diagnóstico foi maior do que deveria ser. CONCLUSÃO: Este estudo pode contribuir para aumentar o conhecimento sobre questões ainda pouco discutidas na literatura científica, como atraso no diagnóstico e influência da escolaridade do cuidador no tratamento.