RESUMO

Chagas cardiomyopathy (CC), caused by the protozoan Trypanosoma cruzi, is an important cause of cardiovascular morbidity and mortality in developing countries. It is estimated that 6 to 7 million people worldwide are infected, and it is predicted that it will be responsible for 200,000 deaths by 2025. The World Health Organization (WHO) considers Chagas disease (CD) as a Neglected Tropical Disease (NTD), which must be acknowledged and detected in time, as it remains a clinical and diagnostic challenge in both endemic and non-endemic regions and at different levels of care. The literature on CC was analyzed by searching different databases (Medline, Cochrane Central, EMBASE, PubMed, Google Scholar, EBSCO) from 1968 until October 2022. Multicenter and bioinformatics trials, systematic and bibliographic reviews, international guidelines, and clinical cases were included. The reference lists of the included papers were checked. No linguistic restrictions or study designs were applied. This review is intended to address the current incidence and prevalence of CD and to identify the main pathogenic mechanisms, clinical presentation, and diagnosis of CC.

RESUMO

The present work aims to present ideas about the notion of 'Mystery', based on the contributions of various thinkers from different areas of knowledge. It will focus especially on the experience itself, that is, on the human possibility of generating the mystical experience and conceptualizing the dimension from contact with it. Concepts such as 'Homo Mysticus' (Erich Neumann), 'Numinous' (Rudolf Otto), 'Synchronicity' and 'Self' (Carl G. Jung) will be developed, approaching them from a psychological perspective. A distinction between two different categories of contact is proposed in the article: violent experiences and subtle experiences. The referential framework of analytical psychology enables the possibility of a transcendent and immaterial realm creatively linked to psychic reality, as well as an attempt to understand it. The conceptualization of the symbolic from the Jungian worldview allows us to understand the experience of Mystery from a psychological point of view in relation to the surrounding world. The idea is even raised that the ultimate (and implicit) purpose of the analysis is the manifestation of Mystery, a general name that could encompass the different phenomenological experiences. Is it possible that such experiences occur in the cultural circumstances of the present? What place does Mystery occupy in these times? What forms could it take? By observing dreams, imaginations and synchronicities, experiences of the mysterious will be explored in the context of contemporary Jungian analysis.

Le travail ci-dessous vise à présenter des idées autour de la notion de Mystère, fondées sur l'apport de divers penseurs venant de différents domaines de savoir. L'article se concentre particulièrement sur l'expérience elle-même, à savoir sur la possibilité pour l'être humain de générer cette expérience et de conceptualiser cette dimension à partir du contact avec elle. Des concepts tels « Homo Mysticus ¼ (Erich Neumann), le « Numineux ¼ (Rudolf Otto), « Synchronicité ¼ et « Soi ¼ (Carl G. Jung) seront abordés, du point de vue de la perspective psychologique. L'article propose une distinction entre deux catégories différentes: les expériences violentes et les expériences subtiles. Le cadre de référence de la psychologie analytique permet la possibilité d'un domaine transcendant et immatériel relié de manière créative à la réalité psychique. Ce cadre permet aussi de tenter de comprendre ce domaine. Nous allons jusqu'à envisager l'idée que le but ultime (et implicite) de l'analyse serait la manifestation du Mystère, un nom générique qui peut englober les différentes expériences phénoménologiques. Est-il possible que de telles expériences se produisent actuellement dans les circonstances culturelles? Quelle place le Mystère occupe-t-il dans la période actuelle? Quelles formes peut-il prendre? Par l'étude de rêves, d'imaginations et de synchronicités, des expériences du mystérieux seront examinées dans le contexte de l'analyse Jungienne contemporaine.

El presente trabajo tiene por objetivo exponer ciertas ideas acerca de la noción de "Misterio", a partir de las contribuciones de diversos pensadores provenientes de distintas áreas del conocimiento. Se focalizará especialmente en la experiencia misma, es decir, en la posibilidad humana de generar dicha vivencia y conceptualizar esa dimensión a partir del contacto con la misma. Se desarrollarán conceptos tales como el de "Homo Mysticus" (Erich Neumann), "Numinoso" (Rudolf Otto), "Sincronicidad" y "Self" (Carl G. Jung), aproximándose a los mismos desde una perspectiva psicológica. Se propone en el artículo una distinción entre dos categorías diferentes de contacto: las experiencias violentas y las experiencias sutiles. El marco referencial de la psicología analítica habilita la posibilidad de un reino trascendente e inmaterial vinculado creativamente con la realidad psíquica, así como una tentativa de compresión del mismo. Se plantea que la finalidad última (e implícita) del análisis es la manifestación del Misterio, denominación general que podría abarcar las diferentes experiencias fenomenológicas. ¿Es posible que se den dichas vivencias en las circunstancias culturales del presente? ¿Qué lugar ocupa el Misterio en los tiempos que corren? ¿Qué formas podría tomar?, A partir de ejemplos clínicos que involucran sueños, imaginaciones y sincronicidades, se explorarán las vivencias de lo misterioso en el contexto del análisis junguiano en la contemporaneidad.

O presente trabalho tem como objetivo apresentar ideias sobre a noção de "Mistério", com base nas contribuições de vários pensadores de diferentes áreas do conhecimento. Ele se concentrará especialmente na própria experiência, ou seja, na possibilidade humana de gerar essa experiência e conceituar essa dimensão a partir do contato com ela Conceitos como 'Homo Mysticus' (Erich Neumann), 'Numinous' (Rudolf Otto), 'Synchronicity' e 'Self' (Carl G. Jung) serão desenvolvidos, abordando-os de uma perspectiva psicológica. Uma distinção entre duas categorias diferentes de contato é proposta no artigo: experiências violentas e experiências sutis. O referencial da psicologia analítica possibilita a possibilidade de um reino transcendente e imaterial criativamente ligado à realidade psíquica, bem como uma tentativa de compreendê-la. Lança-se até a hipótese de que o propósito final (e implícito) da análise seria a manifestação do Mistério, um nome geral que poderia abranger as diferentes experiências fenomenológicas. É possível que tais experiências ocorram nas circunstâncias culturais do presente? Que lugar o Mistério ocupa nestes tempos? Que formas poderia assumir? Ao observar sonhos, imaginações e sincronicidades, as experiências do mistério serão exploradas no contexto da análise junguiana contemporânea.

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This study analyzed the effects of cadmium (Cd) and lead (Pb) on growth, sexual couples, and histological structures of Artemia franciscana exposed to individual concentrations of these metals and combined. No histological effects were observed at tissue level in digestive, respiratory, nervous, and reproductive systems (i.e., necrosis, loss of regular structure) in individual and mixed applications on A. franciscana for 20 days of exposure. No significant differences (p > 0.05) were determined in final size and growth rate among the organisms exposed to Cd and those of control. For Pb, only the final size (3.59 ± 0.59 mm) of organisms exposed to the highest concentration was significantly lower (p < 0.05) than those of the control (4.53 ± 0.34 mm) group, whereas for the combined experiment, no significant differences (p > 0.05) were observed in final size and growth rate. At all Cd concentrations, mean sexual couples were significantly lower (p < 0.05) than those of the control, as well as for Pb. For the combined experiment (8 µg/L of Cd + 8 µg/L of Pb), sexual couples were not observed, indicating synergism and negative reproduction effects. The results showed that Cd and Pb aquatic environmental regulations (as the Criterion of Continuous Concentration) proposed by the US Environmental Protection Agency (EPA) should include their interactions with other metals.

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The technique of high-speed countercurrent chromatography was applied to the isolation of compounds in essential oil derived from the leaves of Piper mollicomum species. Plant leaves (200.0 g) were submitted to hydrodistillation in a modified Clevenger apparatus. The resulting crude leaf essential oil was analyzed by gas chromatography with flame ionization detector (GC-FID) and gas chromatography-mass spectrometry (GC-MS) to determine the profile of the components. The purified fractions were composed of monoterpenes and sesquiterpenes such as camphor (85.0 mg at 98.5% purity), (E)-nerolidol (100.0 mg at 92.8% purity), and camphene (150.0 mg at 82.0% purity). A minor component of the essential oil, bornyl acetate (16.2 mg at 91.2% purity) was also isolated in the one-step separation protocol in 2 h. The countercurrent chromatography technique proved to be a fast and efficient method for the separation of volatile metabolites that conserved the solvent while delivering various fractions of high purity.

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Ion Transport across the cell membrane is required to maintain cell volume homeostasis. In response to changes in extracellular osmolarity, most cells activate specific metabolic or membrane-transport pathways to respond to cell swelling or shrinkage and return their volume to its normal resting state. This process involves the rapid adjustment of the activities of channels and transporters that mediate flux of K+, Na+, Cl-, and small organic osmolytes. Cation chloride cotransporters (CCCs) NKCCs and KCCs are a family of membrane proteins modulated by changes in cell volume and/or in the intracellular chloride concentration ([Cl-]i). Cell swelling triggers regulatory volume decrease (RVD), promoting solute and water efflux to restore normal cell volume. Swelling-activated KCCs mediate RVD in most cell types. In contrast, cell shrinkage triggers regulatory volume increase (RVI), which involves the activation of the NKCC1 cotransporter of the CCC family. Regulation of the CCCs during RVI and RVD by protein phosphorylation is a well-characterized mechanism, where WNK kinases and their downstream kinase substrates, SPAK and OSR1 constitute the essential phospho-regulators. WNKs-SPAK/OSR1-CCCs complex is required to regulate cell shrinkage-induced RVI or cell swelling-induced RVD via activating or inhibitory phosphorylation of NKCCs or KCCs, respectively. WNK1 and WNK4 kinases have been established as [Cl-]i sensors/regulators, while a role for WNK3 kinase as a cell volume-sensing kinase has emerged and is proposed in this chapter.

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The 9th International Countercurrent Chromatography Conference (CCC 2016) was held at Dominican University near Chicago, IL (USA), from August 1st-3rd, 2016. The biennial CCC 20XX conferences provide an opportunity for countercurrent chromatography and centrifugal partition chromatography (CCC/CPC) manufactures, marketers, theorists, and research scientists to gather together socially, learn from each other, and advance countercurrent separation technology. A synopsis of the conference proceedings as well as a series of short reviews of the special edition articles is included in this document. Many productive discussions and collegial conversation at CCC 2016 attested to the liveliness, connectivity, and productivity of the global countercurrent research community and bodes well for the success of the 10th conference at the University of Braunschweig, Germany on August 1-3, 2018.

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OBJECTIVE: To assess the timing of pediatric asthma rehospitalization, variation in rate of rehospitalization across hospitals, and factors associated with rehospitalization at different intervals. STUDY DESIGN: Retrospective cohort analysis of 44,204 hospitalizations for children with asthma within 42 children's hospitals between July 2008 and June 2011. The main outcome measures were rehospitalization for asthma within 7, 15, 30, 60, 180, and 365 days of an index asthma admission. RESULTS: The rate of asthma rehospitalization ranged from 0.5% (n = 208) at 7 days to 17.2% (n = 7603) at 365 days. Black patients and patients with public insurance had higher odds of rehospitalization at 60 days and beyond (P ≤ .01 for both). Adolescents (12- to 18-year-old), patients with a diagnosis of a complex chronic condition, and patients with a prior year asthma admission had higher odds of rehospitalization at every time interval (P ≤ .001 for all). Significant hospital variation in case-mix adjusted rates of rehospitalization existed at each time interval (P ≤ .01 for all). Rates at 365 days were ≤ 10.9% for the top 10% of hospitals; if all hospitals achieved this rate, 36.6% of rehospitalizations might have been avoided. CONCLUSIONS: Significant variation in asthma rehospitalization rates exists across children's hospitals from 7 to 365 days after an index admission. Racial/ethnic and economic disparities emerge at 60 days. By 1 year, rehospitalizations account for 1 in 6 hospitalizations. Assessing asthma rehospitalizations at longer intervals may augment our current understanding of and approach to post-hospitalization care improvement.

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OBJECTIVE: To determine incidence and clinical characteristics of hospital-associated venous thromboembolism (VTE) in pediatric patients. STUDY DESIGN: A retrospective analysis of patients with hospital-associated VTE at the Johns Hopkins Hospital from 1994 to 2009 was performed. Clinical characteristics of patients aged 21 years and younger who developed VTE symptoms after 2 days of hospitalization or <90 days after hospital discharge were examined. International Classification of Diseases, Ninth Revision codes were used to categorize patients with complex chronic medical conditions and trauma. RESULTS: There were 270 episodes of hospital-associated VTE in 90,485 admissions (rate 30 per 10,000 admissions). Young adults (18-21 years) and adolescents (14-17 years) had significantly increased rates of VTE compared with children (2-9 years) (incidence rate ratio [IRR] 7.7, 95% CI 5.1-12.0; IRR 4.3, 95% CI 2.7-6.8, respectively). A central venous catheter (CVC) was present in 50% of patients, and a surgical procedure was performed in 45% of patients before VTE diagnosis. For patients without a CVC, trauma was the most common admitting diagnosis. CVC-related VTE was diagnosed most frequently in infants (<1 year old) and in patients with malignancy. Renal and cardiac diseases were associated with the highest rates of VTE (51 and 48 per 10,000, respectively). Rates were significantly higher among those with ≥ 4 medical conditions compared with those with 1 medical condition (IRR 4.0, 95% CI 1.4-8.9). CONCLUSION: Older age and multiple medical conditions were associated with increased rates of hospital-associated VTE. These data can contribute to the design of future clinical trials to prevent hospital-associated VTE in high-risk children.

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OBJECTIVE: To describe the off-label use of antithrombin concentrate in tertiary care pediatric hospitals across the US. STUDY DESIGN: This is a retrospective, multicenter, cohort study of 4210 admissions of children younger than 18 years of age who received antithrombin concentrate between 2002 and 2011 within the Pediatric Health Information System administrative database. An on-label admission was defined as an admission with an International Classification of Diseases diagnostic code for a primary hypercoagulable state; admissions without this code were classified as off-label. RESULTS: During the 10-year study period, off-label use of antithrombin concentrate increased 5-fold. Overall, 97% of study subjects received antithrombin off-label. Neonates younger than 30 days of age comprised the largest age group (45.7%) of use; 87% of patients had at least one complex chronic condition, with congenital heart/lung defects being the most prevalent primary diagnosis (36.3%). Extracorporeal membrane oxygenation was the most common procedure associated with antithrombin use (43.7%). CONCLUSIONS: The off-label use of antithrombin concentrate is increasing rapidly, particularly in critically ill children receiving extracorporeal membrane oxygenation, with few parallel studies to substantiate its safety or efficacy. Further preclinical and controlled clinical studies are critical to expanding our knowledge of this drug. In the meantime, antithrombin concentrate should be used judiciously by clinicians and following guidelines instated by hospitals.

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Introduction: Myelodysplastic Syndrome (MDS) in pediatrics is a rare and difficult clinical picture to diagnose. Classifications currently in use do not always help in identifying risk factors for leukemic transformation in children. Objective: To evaluate the value of current classifications by simultaneously determining a) the frequency of MDS in a pediatric population b) applying CCC classification (category, cytopenias, cytogenetic) and Passmore score (risk score), and c) correlating with progression and evolution to leukemia. Methods: Medical records of 56 children with cytopenias who were registered at the Hemato-oncology Unit, Hospital Roberto del Rio, were retrospectively reviewed from July 2000 to December 2007. Results: 13 patients met MDS diagnostic criteria (7.3 percent of the total hematological malignancies population). According to CCC classification, de novo MDS, refractory cytopenias with dysplasia and abnormal karyotype were the most frequent features. All patients with a high Passmore score progressed to leukemia. Conclusions: SMD classification in pediatrics patients remains difficult given the many differences with an adult population. CCC appears to be the most applicable for our pediatric population. High Passmore score correlated with leukemia development.

Introducción: El Síndrome mielodisplásico (SMD) en pediatría constituye una patología hemato-oncológica rara y de difícil diagnóstico. Las clasificaciones en uso, FAB (Franco Américo Británica) y OMS (Organización Mundial de la Salud), no han permitido definir factores de riesgo de transformación leucémica. Objetivo: Conocer la frecuencia del SMD en una población pediátrica, aplicar la clasificación CCC (Categoría, Citopenia, Citogenética) y el Score de Passmore (puntaje de riesgo) y relacionarlos con evolución y progresión a leucemia. Pacientes y Método: Revisión retrospectiva de 56 fichas de pacientes con citopenias atendidos en la Unidad de Hemato-oncología del Hospital Roberto del Río, entre Julio 2000 y Diciembre 2007. Resultados: Trece pacientes reunían criterios de SMD, correspondiendo al 7,3 por ciento de las neoplasias hematológicas. Al aplicar la clasificación CCC, predominaron los SMD de novo, las citopenias refractarias con displasia y el cariotipo anormal. Todos los pacientes con Score de Passmore > 2 progresaron a leucemia (4/9). Conclusiones: La clasificación del SMD en pediatría continúa siendo compleja. La clasificación CCC resultó más aplicable en la población pediátrica que las anteriores clasificaciones. El Score de Passmore mostró una alta correlación entre puntaje elevado y evolución a leucemia.

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Aiming to evaluate effects of doses and timing of Chlormequat chloride (CCC) application in wheat, a field experiment was conducted in a distrophic red yellow podzolic soil located at Federal University of Santa Maria, RS, in 1989. Five doses were used, zero, 100, 200, 300 e 400g/ha of CCC applied at stages 4 (tillering), 7 (second visible node) and 10 (booting) and in parceled doses, using as source the commercial product Tuval (10% i.a). Increasing CCC rates increased harvest index and grain yield. The product was more effective when applied at growth stages 4 and 7. Parceling doses did not significantly affect plant characteristics or grain yield.

Com objetivo de avaliar efeitos de doses e épocas de aplicação de Cloreto de Chlormequat (CCC) em trigo, cv. IAC-5, foi conduzido um experimento, a campo, em solo da unidade de mapeamento São Pedro (Podzólico Vermelho Amarelo distrófico) na Universidade Federal de Santa Maria, RS, no ano de 1989. Foram estudadas as doses zero, 100, 200, 300 e 400g/ha de CCC aplicadas nos estádios 4 (afilhamento completo), 7 (segundo nó visível no colmo da planta) e 10 (emborrachamento) e o fracionamento das doses, tendo como fonte o produto comercial Tuval (10% i.a.). O aumento nas doses de CCC provocou acréscimos no índice de colheita e rendimento de grãos, sendo este efeito mais acentuado quando a aplicação foi efetuada nos estádios 4 e 7. O parcelamento das doses não mostrou efeito significativo sobre as características da planta e rendimento de grãos.

RESUMO

An experiment was conducted aiming to evaluate the effect of Chlormequat Chloride (CCC) doses and application time on the wheat cultivar CEP-19. It was carried out during 1990, at the Federal University of Santa Maria on a Distrophic Read Yellow Podzolic soil. The doses applied were zero, 200, 300, 400 and 500g/ha having as source the product Tuval (10% a. i.) and 1000g/ha of the commercial product Cycocel (50% ai.) applied at growth stage 3 (tillering), 6 (first visible nod) and 8 (booting) and doses fractioning. Grain yield and harvest index increased linearly with CCC applied at tillering stage. Plant height decreased with CCC applied mainly at growth stages 3 and 6. Dose parceling did not affect plant characteristics studied or grain yields.

O experimento foi conduzido na Universidade Federal de Santa Maria-RS, no ano de 1990, em solo Podzólico Vermelho Amarelo distrófico (Unidade de Mapeamento São Pedro), com o objetivo de avaliar o efeito de doses e épocas de aplicação de Cloreto de Chlormequat (CCC) em trigo, cv CEP-19. Foram estudadas as doses Zero, 200, 300, 400, 500g/ha de CCC, tendo como fonte o produto comercial Tuval (10% i. a.) e 1000g/ha de CCC, do produto comercial Cycocel (50% i. a.), aplicadas nos estádios 3 (afilhamento), 6 (primeiro nó visível no colmo) e 8 (início do emborrachamento) e o fracionamento das doses. O rendimento de grãos e índice de colheita apresentaram acréscimo linear em respostas à aplicação de CCC no afilhamento. A altura de planta decresceu com a aplicação do CCC principalmente nos estádios 3 e 6. O parcelamento das doses não afetou o rendimento de grãos e as demais características da planta estudadas.

RESUMO

An experiment was conducted aiming to evaluate the effect of Chlormequat Chloride (CCC) doses and application time on the wheat cultivar CEP-19. It was carried out during 1990, at the Federal University of Santa Maria on a Distrophic Read Yellow Podzolic soil. The doses applied were zero, 200, 300, 400 and 500g/ha having as source the product Tuval (10% a. i.) and 1000g/ha of the commercial product Cycocel (50% ai.) applied at growth stage 3 (tillering), 6 (first visible nod) and 8 (booting) and doses fractioning. Grain yield and harvest index increased linearly with CCC applied at tillering stage. Plant height decreased with CCC applied mainly at growth stages 3 and 6. Dose parceling did not affect plant characteristics studied or grain yields.

O experimento foi conduzido na Universidade Federal de Santa Maria-RS, no ano de 1990, em solo Podzólico Vermelho Amarelo distrófico (Unidade de Mapeamento São Pedro), com o objetivo de avaliar o efeito de doses e épocas de aplicação de Cloreto de Chlormequat (CCC) em trigo, cv CEP-19. Foram estudadas as doses Zero, 200, 300, 400, 500g/ha de CCC, tendo como fonte o produto comercial Tuval (10% i. a.) e 1000g/ha de CCC, do produto comercial Cycocel (50% i. a.), aplicadas nos estádios 3 (afilhamento), 6 (primeiro nó visível no colmo) e 8 (início do emborrachamento) e o fracionamento das doses. O rendimento de grãos e índice de colheita apresentaram acréscimo linear em respostas à aplicação de CCC no afilhamento. A altura de planta decresceu com a aplicação do CCC principalmente nos estádios 3 e 6. O parcelamento das doses não afetou o rendimento de grãos e as demais características da planta estudadas.

RESUMO

Aiming to evaluate effects of doses and timing of Chlormequat chloride (CCC) application in wheat, a field experiment was conducted in a distrophic red yellow podzolic soil located at Federal University of Santa Maria, RS, in 1989. Five doses were used, zero, 100, 200, 300 e 400g/ha of CCC applied at stages 4 (tillering), 7 (second visible node) and 10 (booting) and in parceled doses, using as source the commercial product Tuval (10% i.a). Increasing CCC rates increased harvest index and grain yield. The product was more effective when applied at growth stages 4 and 7. Parceling doses did not significantly affect plant characteristics or grain yield.

Com objetivo de avaliar efeitos de doses e épocas de aplicação de Cloreto de Chlormequat (CCC) em trigo, cv. IAC-5, foi conduzido um experimento, a campo, em solo da unidade de mapeamento São Pedro (Podzólico Vermelho Amarelo distrófico) na Universidade Federal de Santa Maria, RS, no ano de 1989. Foram estudadas as doses zero, 100, 200, 300 e 400g/ha de CCC aplicadas nos estádios 4 (afilhamento completo), 7 (segundo nó visível no colmo da planta) e 10 (emborrachamento) e o fracionamento das doses, tendo como fonte o produto comercial Tuval (10% i.a.). O aumento nas doses de CCC provocou acréscimos no índice de colheita e rendimento de grãos, sendo este efeito mais acentuado quando a aplicação foi efetuada nos estádios 4 e 7. O parcelamento das doses não mostrou efeito significativo sobre as características da planta e rendimento de grãos.