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au:MAURA, ANTONIO

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Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance
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Freire, Maristela Pinheiro

; Assis, Denise Brandão de

; Tavares, Bruno de Melo

; Brito, Valquiria O.C.

; Marinho, Igor

; Lapchik, Milton

; Guedes, Ana Rubia

; Madalosso, Geraldine

; Oliveira, Maura Salaroli

; Lima, Antonio Carlos Pedroso de

; Levin, Anna S.

Clinics

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2023, Volume 78 elocation 100231

Abstract: En | Text: En | PDF: En

Abstract Background This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in São Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. Methods This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection ‒ CLABSI and Ventilator-Associated Pneumonia ‒ VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 ‒ December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. Results 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (≤ 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. Conclusions HAI increased during COVID-19. The microorganisms’ susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use.

https://doi.org/10.1016/j.clinsp.2023.100231

Asociación de Phlebopus sp. con especies forestales del arbolado urbano de Asunción, Paraguay
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Moreira-Rivas, Esteban Isrrael

; Díaz-Lezcano, Maura Isabel

Revista Cubana de Ciencias Forestales

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aug 2022, Volume 10 N. 2 Pages 197 - 214

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Os ecossistemas paraguaios abrigam uma grande diversidade de organismos em árvores urbanas que incluem interações fungo-planta, comumente chamadas de micorrizas. Estas micorrizas apresentam uma série de hifas subterrâneas de difícil apreciação visual e basidiocarpos que crescem junto com certas espécies florestais. Portanto, o objetivo desta pesquisa foi identificar associações micorrízicas entre macrofungos e espécies florestais que interagem entre si nas árvores urbanas de Assunção, Paraguai. Para isso, duas praças (De las Américas e Infante Rivarola) e o Parque Carlos Antonio López foram selecionados como pontos de referência. Foi realizado um passeio para identificar a composição florística da arborização urbana nos referidos espaços verdes, e a observação da existência de fungos microrrizais. Os corpos de frutificação dos macrofungos encontrados foram coletados e levados ao Laboratório de Biologia da Faculdade de Ciências Agrárias da Universidade Nacional de Assunção, onde foram secos para observação microscópica e identificação. As espécies florestais foram identificadas por meio de chaves taxonômicas, levando em consideração o tamanho da árvore, o caule, a madeira, a casca e as folhas. Três espécimes de macrofungos do gênero Phlebopus foram encontrados associados às árvores das famílias Bignoniaceae e Fabaceae em espaços verdes de Assunção. Duas espécies florestais nativas Handroanthus heptaphyllus (Vell.) Mattos, Jacaranda mimosifolia D. Don e uma exótica Bauhinia variegata L. com associação do fungo Phlebopus sp.

ABSTRACT Paraguay ecosystems are home to a great diversity of organisms in urban trees that include fungus-plant interactions, commonly called mycorrhizae. These mycorrhizaes present a number of subterranean hyphae that are difficult to visually appreciate and basidiocarps that grow together with certain forest species. Therefore, the objective of this research was to identify mycorrhizal associations between macrofungi and forest species that interact with each other in the urban trees of Asunción, Paraguay. For this, two squares (De las Américas and Infante Rivarola) and the Carlos Antonio López Park were selected as reference points. A tour was carried out to identify the floristic composition of urban trees in the aforementioned green spaces, and the observation of the existence of microrhizal fungi. The fruiting bodies of the macrofungi found were collected and taken to the Biology Laboratory of the Faculty of Agrarian Sciences of the National University of Asunción, they were dried for microscopic observation and identification. The forest species were identified using taxonomic keys, taking into account the size of the tree, the stem, the wood, the bark and the leaves. Three specimens of macrofungi of the genus Phlebopus were found associated with the trees of the Bignoniaceae and Fabaceae families in Asuncion green spaces. Two native forest species Handroanthus heptaphyllus (Vell.) Mattos, Jacaranda mimosifolia D. Don and one exotic Bauhinia variegata L. associated with the fungus Phlebopus sp.

RESUMEN Los ecosistemas paraguayos albergan una gran diversidad de organismos en el arbolado urbano que incluyen las interacciones hongo-planta, comúnmente llamadas micorrizas. Estas micorrizas presentan una cantidad de hifas subterráneas de difícil apreciación visual y basidiocarpos que crecen junto a ciertas especies forestales. Por ello, el objetivo de esta investigación fue identificar asociaciones micorrízicas entre macrohongos y especies forestales que interactúan entre de sí en el arbolado urbano de Asunción, Paraguay. Para ello, fueron seleccionados como puntos de referencia dos plazas (De las Américas e Infante Rivarola) y el Parque Carlos Antonio López. Se realizó un recorrido para la identificación de la composición florística del arbolado urbano en los mencionados espacios verdes, y la observación de la existencia de hongos microrrízicos. Los cuerpos fructíferos de los macrohongos encontrados fueron recolectados y llevados al Laboratorio de Biología de la Facultad de Ciencias Agrarias de la Universidad Nacional de Asunción, se procedió al secado de estos para su observación microscópica e identificación. Las especies forestales fueron identificadas mediante las claves taxonómicas teniendo en cuenta el porte del árbol, el fuste, la madera, la corteza y las hojas. Tres ejemplares de macrohongos del género Phlebopus fueron encontrados asociados a los árboles de las familias Bignoniaceae y Fabaceae en los espacios verdes asuncenos. Se identificaron dos especies forestales nativas Handroanthus heptaphyllus (Vell.) Mattos, Jacaranda mimosifolia D. Don y una exótica Bauhinia variegata L. con asociación del hongo Phlebopus sp.

Sympatric and phenotypic variation between two representative species of the Atlantic Forest: an analysis of the hydraulic system
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Castelar, João Victor

; Mangabeira, Pedro Antônio

; Campbell, Glaziele

; Callado, Cátia Henriques

; Cunha, Maura Da

Acta Botanica Brasilica

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2022, Volume 36 elocation e2021abb0195

Abstract: En | Text: En | PDF: En

ABSTRACT Tropical forests are the most diverse on the planet, and it is essential to understand how plant species adapt to the environmental differences inherent in this environment. This study describes the wood anatomy and hydraulic architecture of Bathysa cuspidata and Bathysa nicholsonii in two remnants of the Atlantic Forest through a paired analysis of the hydraulic system related to taxonomic and environmental aspects. Samples were collected non-destructively, processed following techniques of wood anatomy. Sympatric species differ taxonomically in Bathysa cuspidata showed vessels either solitary or radial multiples of 2 to 4 elements, septate fibre-tracheids with thick walls, and larger rays with sheath cells. At the same time, B. nicholsonii has a higher vessel frequency, septate fibre-tracheids with thin walls, narrower rays, vessels with smaller diameters. Although each species’ hydraulic system shows acclimatization variations to different sites of occurrence, the structural differences in wood ensure the segregation between the species in each site. Our results corroborate the relevance of the anatomical wood anatomy studies as a subsidy for a better definition of morphologically similar taxa and show structural aspects aimed at survival in the Atlantic Forest. This data combination has often been neglected in understanding biodiversity in the tropics.

https://doi.org/10.1590/0102-33062021abb0195

Micropropagación de Handroanthus heptaphyllus (VELL.) Mattos a partir de segmentos nodales
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Lezcano, Maura Isabel Díaz

; Arza, Digno Milciades Vera

; Espínola, Diego Dionisio González

; Talavera, Carlos Antonio López

Revista de la Sociedad Científica del Paraguay

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jun 2021, Volume 26 N. 1 Pages 49 - 63

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: The lapacho negro is a forest species of great importance, it is timber and ornamental, so the establishment of a protocol for micropropagation of Handroanthus heptaphyllus could become an alternative for the mass production of this species. The experimentation was carried out in the Biotechnology Laboratory of the Biology Area of the Facultad de Ciencias Agrarias de la Universidad Nacional de Asunción, with the general objective of establishing a protocol for the in vitro micropropagation of Handroanthus heptaphyllus from nodal segments. For the population of variables and units, 1620 explants were planted, each experimental unit consisted of 1 nodal segment. The experimentation had 12 treatments sown in two culture media (Agar/Water and MS), which were based on variations in immersion times of ethanol and sodium hypochlorite for contamination control, for oxidation control the treatment was applied of oxidation prevention 2 g/l of activated carbon, and phytoregulators (AIB and BAP) were added. The mother plants were treated with Copper Oxychloride (OxiCob®) and Dithiocarbamate (Mancozeb®) in a proportion of 3 and 2 g/l respectively. The variables studied were the control of leaf spots in mother plants, contamination of explants, oxidation, survival, sprouting, callus formation and the length of the shoots. Statistical analysis consisted of Kolmogorov-Smirnov normality tests for all variables. 45.8% leaf spot control was achieved, 50% contamination control, oxidation was 100% controlled. 60% of living explants were obtained up to 50 days with leaf differentiation of 1.5 mm of average elongation. Based on these results, it is concluded that the applied treatments affected the variables studied.

Resumen: El lapacho negro es una especie forestal de gran importancia, es maderable y ornamental, por lo que el establecimiento de un protocolo de micropropagación de Handroanthus heptaphyllus podría constituirse en una alternativa para la producción masiva de esta especie. La experimentación se llevó a cabo en el Laboratorio de Biotecnología del Área de Biología de la Facultad de Ciencias Agrarias de la Universidad Nacional de Asunción, teniendo como objetivo establecer un protocolo para la micropropagación in vitro de Handroanthus heptaphyllus a partir de segmentos nodales. Para la población de variables y unidades fueron sembrados 1620 explantes, cada unidad experimental estuvo constituida por 1 segmento nodal. La experimentación tuvo 12 tratamientos sembrados en dos medios de cultivo (Agar/Agua y MS), los cuales se basaron en variaciones en tiempos de inmersión de etanol e hipoclorito de sodio para el control de contaminación, para el control de oxidación se aplicó el tratamiento de prevención de oxidación 2 g/l de carbón activado, y fueron adicionados fitorreguladores (AIB y BAP). Las plantas madre fueron tratadas con Oxicloruro de cobre (OxiCob®) y Ditiocarbamato (Mancozeb®) en proporción de 3 y 2 g/l respectivamente. Las variables estudiadas fueron el control de manchas foliares en plantas madre, la contaminación de explantes, la oxidación, la sobrevivencia, la brotación, la formación de callos y la longitud de los brotes. El análisis estadístico consistió en pruebas de normalidad de Kolmogorov-Smirnov para todas las variables. Se logró un 45,8% de control de manchas foliares, un 50% de control de la contaminación y la oxidación fue controlada al 100%. Se obtuvo un 60% de explantes vivos hasta los 50 días con diferenciación foliar de 1,5 mm de elongación promedio. Con base en estos resultados se concluye que los tratamientos aplicados incidieron en las variables estudiadas.

https://doi.org/10.32480/rscp.2021.26.1.49 157 downloads

Timing of nitrogen application and cover crops on upland rice economic viability
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Pascoaloto, Isabô Melina

; Crusciol, Carlos Alexandre Costa

; Nascimento, Carlos Antônio Costa do

; Ferreira, Carlos Magri

; Silva, Mellissa Ananias Soler da

; Souza, Luiz Gustavo Moretti de

; Esperancini, Maura Seiko Tsutsui

Pesquisa Agropecuária Brasileira

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2021, Volume 56 elocation e01924

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: O objetivo deste trabalho foi avaliar a viabilidade econômica e a competitividade do arroz (Oryza sativa) de terras altas, em comparação ao arroz inundado, em sistema com diferentes épocas de fertilização nitrogenada e plantas de cobertura, no Sudeste do Brasil. Os tratamentos consistiram de arroz de terras altas cultivado sob palha de Urochloa brizantha ou Urochloa ruziziensis, com a seguinte fertilização: T, 30 kg ha-1 de N na semeadura do arroz + sem N extra (0 kg ha-1); C, 30 kg ha-1 de N na semeadura do arroz + 90 kg ha-1 de N no perfilhamento do arroz; A2, 30 kg ha-1 de N na semeadura do arroz + 90 kg ha-1 de N um dia antes da semeadura do arroz; e A1, 30 kg ha-1 de N na semeadura do arroz + 90 kg ha-1 de N nos plantios das plantas de cobertura. Foram determinados custo operacional total, receita bruta, lucro operacional, índice de lucratividade e preço de equilíbrio. O arroz de terras altas resulta em ganho monetário para o produtor similar ao do arroz inundado quando se adiciona nitrogênio, independentemente da época de adubação. Em condições de deficit hídrico, o arroz semeado na palhada de U. brizantha apresenta maior índice de lucratividade que o semeado na de U. ruziziensis. Quando há a possibilidade de deficit hídrico, U. brizantha, como planta de cobertura, resulta em maior segurança econômica para os produtores de arroz de terras altas.

Abstract: The objective of this work was to evaluate the economic viability and competitiveness of upland rice (Oryza sativa), compared with flooded rice, in a system with different nitrogen fertilization timing and cover crops in Southeastern Brazil. The treatments consisted of upland rice grown under Urochloa brizantha or Urochloa ruziziensis straw, with the following fertilization: T, 30 kg ha-1 N at rice sowing + no extra N supply (0 kg ha-1); C, 30 kg ha-1 N at rice sowing + 90 kg ha-1 N at rice tillering; A2, 30 kg ha-1 N at rice sowing + 90 kg ha-1 N one day before rice sowing; and A1, 30 kg ha-1 N at rice sowing + 90 kg ha-1 N in the living cover crops. Total operating cost, gross revenue, operating profit, profitability index, and equilibrium price were determined. Upland rice results in a monetary gain for the farmer similar to that of flooded rice when nitrogen is added, regardless of fertilization timing. Under rainfall deficit conditions, upland rice sown on U. brizantha straw shows higher profitability rates than when sown on U. ruziziensis. When there is a possibility of rainfall deficit, U. brizantha, as a cover plant, results in a greater economic security for upland rice producers.

https://doi.org/10.1590/s1678-3921.pab2021.v56.01924 251 downloads

Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study
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Gonçalves, Fabio Augusto Rodrigues

; Besen, Bruno Adler Maccagnan Pinheiro

; Lima, Clarice Antunes de

; Corá, Aline Pivetta

; Pereira, Antônio José Rodrigues

; Perazzio, Sandro Félix

; Gouvea, Christiane Pereira

; Fonseca, Luiz Augusto Marcondes

; Trindade, Evelinda Marramon

; Sumita, Nairo Massakazu

; Duarte, Alberto José da Silva

; Lichtenstein, Arnaldo

; Bonfa, Eloisa

; Utiyama, Edivaldo M.

; Segurado, Aluisio C.

; Perondi, Beatriz

; Miethke-Morais, Anna

; Montal, Amanda C.

; Harima, Leila

; Fusco, Solange R. G.

; Silva, Marjorie F.

; Rocha, Marcelo C.

; Marcilio, Izabel

; Rios, Izabel Cristina

; Kawano, Fabiane Yumi Ogihara

; Jesus, Maria Amélia de

; Kallas, Ésper George

; Carmo, Carolina

; Tanaka, Clarice

; Souza, Heraldo Possolo de

; Marchini, Julio F. M.

; Carvalho, Carlos

; Ferreira, Juliana C.

; Levin, Anna Sara Shafferman

; Oliveira, Maura Salaroli

; Guimarães, Thaís

; Lázari, Carolina dos Santos

; Sabino, Ester

; Magri, Marcello M. C.

; Barros-Filho, Tarcisio E. P.

; Francisco, Maria Cristina Peres Braido

; Costa, Silvia F.

Clinics

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2021, Volume 76 elocation e3547

Abstract: En | Text: En | PDF: En

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.

https://doi.org/10.6061/clinics/2021/e3547

Management of acute stroke and urgent neurointerventional procedures during COVID-19 pandemic: recommendations on the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, Brazilian Society of Cerebrovascular Diseases and Brazilian Society of Neuroradiology
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MONT’ALVERNE, Francisco José Arruda

; LIMA, Fabrício Oliveira

; NOGUEIRA, Raul Gomes

; FREITAS, Carlos Clayton Macedo de

; NETO, Octávio Marques Pontes

; SILVA, Gisele Sampaio

; OLIVEIRA, Maura Salaroli de

; FRUDIT, Michel

; CALDAS, Jose Guilherme Mendes Pereira

; ABUD, Daniel Giansante

; CONFORTO, Adriana Bastos

; CARVALHO, Fernanda Martins Maia

; DIAS, Francisco Antunes

; BAZAN, Rodrigo

; AVELAR, Wagner Mauad

; MORO, Carla Heloísa Cabral

; MAGALHÃES, Pedro Silva Correa de

; MIRANDA, Maramelia

; BARBOSA, Leandro de Assis

; FIOROT JUNIOR, José Antonio

; CARDOSO, Fabrício Buchdid

; REBELLO, Leticia Costa

; PARENTE, Bruno de Sousa Mendes

; FARIA, Mário de Barros

; FREITAS, Gabriel Rodriguez de

; ZÉTOLA, Viviane de Hiroki Flumignan

; OLIVEIRA-FILHO, Jamary

; BEZERRA, Daniel da Cruz

; RODRIGUES, Jorge Luis Nobre

; KUSTER, Gustavo

; MARTINS, Sheila

; CARVALHO, João José Freitas de

Arquivos de Neuro-Psiquiatria

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jul 2020, Volume 78 N. 7 Pages 440 - 449

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: A pandemia causada pelo novo coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2, COVID-19) apresenta novos e importantes desafios à gestão de saúde no Brasil. Além da difícil missão de prestar atendimento aos milhares de pacientes infectados pelo COVID-19, os sistemas de saúde têm que manter a assistência às emergências médicas comuns em períodos sem pandemia, tais como o acidente vascular cerebral (AVC), que continuam ocorrendo e requerem tratamento com presteza e eficiência. A alocação de recursos materiais e humanos para o enfrentamento à pandemia não pode comprometer o atendimento ao AVC agudo, uma emergência cujo tratamento é tempo-dependente e se não realizado implica em importante impacto na mortalidade e incapacitação a longo prazo. Objetivo: Este trabalho resume as recomendações do Departamento Científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia, da Sociedade Brasileira de Doenças Cerebrovasculares e da Sociedade Brasileira de Neurorradiologia para o tratamento do AVC agudo e para a realização de procedimentos de neurointervenção urgentes durante a pandemia de COVID-19, incluindo o uso adequado de ferramentas de triagem e equipamentos de proteção pessoal (para pacientes e profissionais de saúde), além da alocação apropriada de pacientes.

ABSTRACT Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. Objective: This paper summarizes the recommendations from the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Society of Cerebrovascular Diseases and the Brazilian Society of Neuroradiology for management of acute stroke and urgent neuro-interventional procedures during the COVID-19 pandemic, including proper use of screening tools, personal protective equipment (for patients and health professionals), and patient allocation.

https://doi.org/10.1590/0004-282x20200053 2310 downloads

Síndrome hemofagocítico asociado a linfoma de Hodgkin e infección por virus Epstein-Barr. Reporte de caso
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Noyola-García, Maura

; González-Ríos, Ricardo Daniel

; Olascoaga-Lugo, Arturo

; Rodríguez-Florido, Marco Antonio

; Rubio-Anguiano, Brenda Lorena

Revista alergia México

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jun 2020, Volume 67 N. 2 Pages 183 - 188

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Background: Hodgkin lymphoma is a malignant neoplasm of B lymphoid cells whose histologic characteristic is the presence of Reed-Sternberg cells in an inflammatory environment. Case report: A 37-year-old woman with a history of up to 40°C fever for four months, progressive and bilateral decrease in hearing acuity, weight loss of up to 6 kg, cervical lymphadenopathy, hepatosplenomegaly, and pancytopenia. Auditory sensory neuropathy was confirmed. The patient developed hemophagocytic syndrome, therefore, infectious and autoimmune etiologies were ruled out. The CT scan revealed hepatosplenomegaly with thoracic and abdominal cervical nodes, with loss of fatty hilum. The laboratory tests showed evidence that suggested the reactivation of the Epstein-Barr virus. Through a submandibular node biopsy, the diagnostic conclusion was that lymphocyte-rich classical Hodgkin’s lymphoma was present. Conclusion: This is the first report in Latin American literature about a patient with hemophagocytic syndrome that is secondary to classic Hodgkin lymphoma and associated with Epstein-Barr infection.

Resumen Antecedentes: El linfoma de Hodgkin es una neoplasia maligna de células linfoides tipo B cuya característica histológica es la presencia de células de Reed-Sternberg en un medio inflamatorio. Caso clínico: Mujer de 37 años, con fiebre de hasta 40 °C desde cuatro meses atrás, disminución bilateral y progresiva de la agudeza auditiva, pérdida ponderal de 6 kg, linfadenopatía cervical, hepatoesplenomegalia y pancitopenia. Se corroboró neuropatía sensorial auditiva. La paciente desarrolló síndrome hemofagocítico, por lo que se descartaron procesos infecciosos o autoinmunes. La tomografía reveló hepatoesplenomegalia, ganglios cervicales torácicos y abdominales con pérdida del hilio graso; en los estudios de laboratorio se evidenciaron datos sugerentes de reactivación del virus de Epstein-Barr. Mediante biopsia de ganglio submandibular se concluyó que se trataba de linfoma de Hodgkin tipo clásico rico en linfocitos. Conclusión: La paciente descrita con síndrome hemofagocítico secundario a linfoma de Hodgkin clásico asociado a infección por Epstein-Barr constituye el primero caso reportado en la literatura latinoamericana.

https://doi.org/10.29262/ram.v67i2.765 284 downloads

A trama da memória: sobre Ana Miranda, Adriana Varejão e Tatiana Salem Levy
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Maura, Antonio

Estudos de Literatura Brasileira Contemporânea

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apr 2017, N. 50 Pages 19 - 34

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

resumo A arte, às vezes, é uma especial elaboração do passado. Não se trata de um passado real - ainda que adote os modos do romance histórico -, mas dos restos da memória e de seu tratamento plástico ou linguístico. Refiro-me a criadoras como as romancistas Tatiana Salem Levy (Lisboa, 1979) e Ana Miranda (Fortaleza, 1951), e a artista plástica Adriana Varejão (Rio de Janeiro, 1964). Em todas elas a memória recebe um tratamento novo. No caso destas artistas, não se pretende rememorar, mas recriar o tempo passado produzindo novos objetos, novos textos, que sirvam para interpretar a realidade, as lembranças, a possível realidade de uma época arcaica, remota, que unicamente a arte é capaz de desvendar.

abstract Art is, at times, a re-elaboration of the past. It does not constitute a real past - even when it takes the form of the historical novel - but offers instead the vestiges of memory and its artistic or linguistic interpretation. I am referring here to the creative interpreters of memory such as the novelists Tatiana Salem-Levy (Lisbon, 1979) and Ana Miranda (Fortaleza, 1951), and the Brazilian artist Adriana Varejão (Rio de Janeiro, 1964). In all of them memory receives a new interpretation. In the work of these artists, the intention is not to remember but to recreate the past, producing new objects, new texts that may serve to interpret the memories, the possible reality of a remote, archaic time, which only art is capable of revealing.

resumen El arte, a veces, es una elaboración especial del pasado. No se trata de un pasado real - a pesar de que adopte la forma de la novela histórica -, sino de los vestigios de la memoria y de su tratamiento plástico o lingüístico. Me refiero a creadoras como las novelistas Tatiana Salem-Levy (Lisboa, 1979) y Ana Miranda (Fortaleza, 1951), y también a la artista plástica Adriana Varejão (Río de Janeiro, 1964). En todas ellas la memoria recibe un tratamiento nuevo. En el caso de éstas artistas, no se pretende rememorar, sino de recrear el tiempo pasado produciendo nuevos objetos, nuevos textos, que sirvan para interpretar los recuerdos, la posible realidad de una época arcaica, remota, que sólo el arte es capaz de desvelar.

https://doi.org/10.1590/2316-4018502 2773 downloads

10.

Online continuing interprofessional education on hospital-acquired infections for Latin America
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Medina-Presentado, Julio C.

; Margolis, Alvaro

; Teixeira, Lucia

; Lorier, Leticia

; Gales, Ana C.

; Pérez-Sartori, Graciela

; Oliveira, Maura S.

; Seija, Verónica

; Paciel, Daniela

; Vignoli, Rafael

; Guerra, Silvia

; Albornoz, Henry

; Arteta, Zaida

; Lopez-Arredondo, Antonio

; García, Sofía

Brazilian Journal of Infectious Diseases

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mar 2017, Volume 21 N. 2 Pages 140 - 147

Abstract: En | Text: En | PDF: En

Abstract Introduction: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. Methods: Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. Results: There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. Discussion: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a "New Challenges" course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions.

https://doi.org/10.1016/j.bjid.2016.11.003 772 downloads

11.

TRIAGEM NEONATAL DE IMUNODEFICIÊNCIAS GRAVES COMBINADAS POR MEIO DE TRECS E KRECS: SEGUNDO ESTUDO PILOTO NO BRASIL
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Kanegae, Marilia Pyles P.

; Barreiros, Lucila Akune

; Sousa, Jusley Lira

; Brito, Marco Antônio S.

; Oliveira Junior, Edgar Borges de

; Soares, Lara Pereira

; Mazzucchelli, Juliana Themudo L.

; Fernandes, Débora Quiorato

; Hadachi, Sonia Marchezi

; Holanda, Silvia Maia

; Guimarães, Flavia Alice T. M.

; Boacnin, Maura Aparecida P. V. V.

; Pereira, Marley Aparecida L.

; Bueno, Joaquina Maria C.

; Grumach, Anete Sevciovic

; Gesu, Regina Sumiko W. Di

; Santos, Amélia Miyashiro N. dos

; Bellesi, Newton

; Costa-Carvalho, Beatriz T.

; Condino-Neto, Antonio

Revista Paulista de Pediatria

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mar 2017, Volume 35 N. 1 Pages 25 - 32

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Validar a quantificação de T-cell receptor excision circles (TRECs) e kappa-deleting recombination circles (KRECs) por reação em cadeia de polimerase (polymerase chain reaction, PCR) em tempo real (qRT-PCR), para triagem neonatal de imunodeficiências primárias que cursam com defeitos nas células T e/ou B no Brasil. Métodos: Amostras de sangue de recém-nascidos (RN) e controles foram coletadas em papel-filtro. O DNA foi extraído e os TRECs e KRECs foram quantificados por reação duplex de qRT-PCR. O valor de corte foi determinado pela análise de Receiver Operating Characteristics Curve, utilizando-se o programa Statistical Package for the Social Sciences (SSPS) (IBM®, Armonk, NY, EUA). Resultados: 6.881 amostras de RN foram analisadas quanto à concentração de TRECs e KRECs. Os valores de TRECs variaram entre 1 e 1.006 TRECs/µL, com média e mediana de 160 e 139 TRECs/µL, respectivamente. Três amostras de pacientes diagnosticados com imunodeficiência grave combinada (severe combined immunodeficiency, SCID) apresentaram valores de TRECs abaixo de 4/µL e um paciente com Síndrome de DiGeorge apresentou TRECs indetectáveis. Os valores de KRECs encontraram-se entre 10 e 1.097 KRECs/µL, com média e mediana de 130 e 108 KRECs/µL, e quatro pacientes com diagnóstico de agamaglobulinemia tiveram resultados abaixo de 4 KRECs/µL. Os valores de corte encontrados foram 15 TRECs/µL e 14 KRECs/µL, e foram estabelecidos de acordo com a análise da Receiver Operating Characteristics Curve, com sensibilidade de 100% para detecção de SCID e agamaglobulinemia, respectivamente. Conclusões: A quantificação de TRECs e KRECs foi capaz de diagnosticar crianças com linfopenias T e/ou B em nosso estudo, validando a técnica e dando o primeiro passo para a implementação da triagem neonatal em grande escala no Brasil.

ABSTRACT Objective: To validate the quantification of T-cell receptor excision circles (TRECs) and kappa-deleting recombination excision circles (KRECs) by real-time polymerase chain reaction (qRT-PCR) for newborn screening of primary immunodeficiencies with defects in T and/or B cells in Brazil. Methods: Blood samples from newborns and controls were collected on filter paper. DNA was extracted and TRECs, and KRECs were quantified by a duplex real-time PCR. The cutoff values were determined by receiver operating characteristic curve analysis using SPSS software (IBM®, Armonk, NY, USA). Results: Around 6,881 samples from newborns were collected and TRECs and KRECs were quantified. The TRECs values ranged between 1 and 1,006 TRECs/µL, with mean and median of 160 and 139 TRECs/µL, respectively. Three samples from patients with severe combined immunodeficiency (SCID) showed TRECs below 4/µL and a patient with DiGeorge syndrome showed undetectable TRECs. KRECs values ranged from 10 to 1,097 KRECs/µL, with mean and median of 130 and 108 KRECs/µL. Four patients with agammaglobulinemia had results below 4 KRECs/µL. The cutoff values were 15 TRECs/µL and 14 KRECs/µL and were established according to the receiver operating characteristic curve analysis, with 100% sensitivity for SCID and agammaglobulinemia detection, respectively. Conclusions: Quantification of TRECs and KRECs was able to diagnose children with T- and/or B-cell lymphopenia in our study, which validated the technique in Brazil and enabled us to implement the newborn screening program for SCID and agammaglobulinemia.

https://doi.org/10.1590/1984-0462/;2017;35;1;00013 6784 downloads

12.

Ants (Hymenoptera: Formicidae) in hospitals of southern Brazil
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LUTINSKI, JUNIR ANTONIO

; AHLERT, CAROLINA CHARLIER

; DE FREITAS, BIANCA RIBEIRO

; TRAUTMANN, MAURA MOREL

; TANCREDO, SIMONE PIROTTA

; MELLO GARCIA, FLÁVIO ROBERTO

Revista Colombiana de Entomología

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dec 2015, Volume 41 N. 2 Pages 235 - 240

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Las hormigas están entre los organismos mejor adaptados a los entornos urbanos. Las que se encuentran en los hospitales han recibido más atención y se han descrito como vectores importantes de organismos patógenos. Este estudio tuvo como objetivo comparar la riqueza y abundancia de hormigas en cuatro hospitales en el sur de Brasil y analizar la asociación de especies en diferentes ambientes hospitalarios. Se tomaron muestras de cuatro tipos de ambientes: unidades de cuidados intensivos (UCI), centros de nutrición, enfermerías y almacenes. La riqueza de muestreo en cada una de las cuatro condiciones se comparó usando un análisis de rarefacción basado en el número de ocurrencias. Para evaluar la asociación entre las especies de hormigas con ambientes hospitalarios, se construyó un Análisis de Componentes Principales (PCA). Se identificaron 20 especies. El sector de la nutrición fue el ambiente con la mayor riqueza (S = 14), seguido de las enfermerías (S = 7), almacenes (S = 7) y las salas de UCI (S = 4). Cinco especies se asociaron con los ambientes evaluados, entre ellos,Nylanderia fulva y Nylanderia fulva. Este resultado puede servir como una advertencia a las autoridades de los hospitales sobre los riesgos de transmisión mecánica de agentes patógenos por hormigas en ambientes hospitalarios.

Ants are among the organisms best adapted to urban environments. Those found in hospital settings have received much attention and have been described as important vectors of pathogenic organisms. This study aimed to compare the richness and abundance of ants in four hospitals in southern Brazil and to analyze the association of species in different hospitals environments. Four types of environments were sampled: wards of intensive care units (iCU's), nutrition centers, infirmaries, and warehouses. The sample richness in each of the four areas was compared using a rarefaction analysis based on number of occurrences. To assess the association between ant species and hospital environments, a Principal Component Analysis (PCA) was constructed. Twenty (20) species were identified. The nutrition sector was the environment with the highest richness (S = 14), followed by infirmaries (S = 7), warehouses (S = 7), and ICU wards (S = 4). Five species were associated with the environments evaluated, among them, Monomorium pharaonis and Nylanderia fulva. These results may serve as a warning to hospital authorities about the risks of mechanical transmission of pathogenic agents by ants in hospital environments.

626 downloads

13.

Culture of mouse peritoneal macrophages with mouse serum induces lipid bodies that associate with the parasitophorous vacuole and decrease their microbicidal capacity against Toxoplasma gondii
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Mota, Laura Azeredo Miranda

; Roberto Neto, João

; Monteiro, Verônica Gomes

; Lobato, Caroliny Samary Silva

; Oliveira, Marco Antonio de

; Cunha, Maura da

; D’Ávila, Heloisa

; Seabra, Sérgio Henrique

; Bozza, Patrícia Torres

; DaMatta, Renato Augusto

Memórias do Instituto Oswaldo Cruz

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sep 2014, Volume 109 N. 6 Pages 767 - 774

Abstract: En | Text: En | PDF: En

Lipid bodies [lipid droplets (LBs)] are lipid-rich organelles involved in lipid metabolism, signalling and inflammation. Recent findings suggest a role for LBs in host response to infection; however, the potential functions of this organelle in Toxoplasma gondii infection and how it alters macrophage microbicidal capacity during infection are not well understood. Here, we investigated the role of host LBs in T. gondii infection in mouse peritoneal macrophages in vitro. Macrophages cultured with mouse serum (MS) had higher numbers of LBs than those cultured in foetal bovine serum and can function as a model to study the role of LBs during intracellular pathogen infection. LBs were found in association with the parasitophorous vacuole, suggesting that T. gondii may benefit from this lipid source. Moreover, increased numbers of macrophage LBs correlated with high prostaglandin E2 (PGE2) production and decreased nitric oxide (NO) synthesis. Accordingly, LB-enriched macrophages cultured with MS were less efficient at controlling T. gondii growth. Treatment of macrophages cultured with MS with indomethacin, an inhibitor of PGE2 production, increased the microbicidal capacity against T. gondii. Collectively, these results suggest that culture with MS caused a decrease in microbicidal activity of macrophages against T. gondii by increasing PGE2 while lowering NO production.

https://doi.org/10.1590/0074-0276140119 2817 downloads

14.

Relação entre a vegetação e as propriedades do solo em áreas de campo limpo úmido no Parque Nacional de Sete Cidades, Piauí, Brasil
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Mendes, Maura Rejane de Araújo

; Munhoz, Cássia Beatriz Rodrigues

; Silva Júnior, Manoel Cláudio da

; Castro, Antonio Alberto Jorge Farias

Rodriguésia

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dec 2012, Volume 63 N. 4 Pages 971 - 984

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O objetivo desse estudo foi avaliar a estrutura da camada herbáceo-subarbustiva em comunidades de campo limpo no Parque Nacional de Sete Cidades localizado no Piauí, e a sua relação com as variáveis edáficas e espaciais das áreas. A amostragem da vegetação foi realizada no final da estação chuvosa/início da seca, através do método de interseção na linha, para determinar a composição e a cobertura linear das espécies. Dezessete linhas de 10 m, subdivididas em seções de 1 m, foram distribuídas em seis áreas distintas. Amostras de solo (0-20 cm) foram coletadas para análises químicas e texturais. Foram amostrados 71 táxons relacionados a 46 gêneros e 25 famílias. A análise de correspondência canônica (CCA) separou as linhas amostradas em três grupos, associados as propriedades texturais e químicas do solos, que coincidiram com as áreas mais similares. O procedimento de permutação com múltiplas respostas (MRPP) detectou diferenças significativas entre os grupos da CCA. As variáveis ambientais mais fortemente correlacionadas foram Cu, Fe, saturação de alumínio, silte, Zn, saturação de bases e areia, explicando 37,9% da variação dos dados. A distância espacial entre as linhas foi responsável por 16,8% da variação explicada. A distribuição dos campos úmidos no Parque parece estar determinada pelos gradientes de textura e fertilidade dos solos.

Variations in soil proprieties seem to determine the spatial distribution of plant communities in the moist grassland. The aim of this study was to evaluate the relationship between the floristic composition and structure of the herbaceous-subshrub layer and soil and spatial variables in grassland communities in the National Park of Sete Cidades, Piauí, Brazil. The composition and linear coverage of the species were assessed by the line-intercept method. A total of 17 lines of 10 m, subdivided in sections of 1 m, were distributed into six distinct areas. Soil samples were collected for chemical and textural analysis. We sampled 71 taxa in 46 genera and 25 families. Through canonical correspondence analysis (CCA) the lines sampled were separated into three groups, associated with the textural and chemical soil properties, which coincided with the most similar sites. The multi-response permutation procedures (MRPP) found significant differences between groups of the CCA. The environmental variables most strongly correlated were Cu, Fe, aluminum saturation, silt, Zn, base saturation and sand, accounting for 37.9% of data variation. The spatial distance between the lines accounted for 16.8% of the explained variance. The distribution of the wet grasslands in the park seems to be determined by texture and soil fertility gradients.

3810 downloads

15.

Síndrome de Guillain-Barré em associação temporal com a vacina influenza A
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Ferrarini, Maria Aparecida G

; Scattolin, Mônica Ayres A

; Rodrigues, Marcelo Masruha

; Resende, Maura Helena F

; Santos, Isabel Cristina L. dos

; Iazzetti, Antônio Vladir

Revista Paulista de Pediatria

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dec 2011, Volume 29 N. 4 Pages 685 - 688

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Descrever um caso de síndrome de Guillain-Barré em associação temporal com a vacina influenza A (H1N1) 2009. DESCRIÇAO DO CASO: Menino de quatro anos com queixa inicial de dor em coxa direita e perda de força muscular ascendente 15 dias após a segunda dose da vacina influenza A (H1N1) 2009. Ao exame neurológico apresentava tetraparesia e arreflexia, com predomínio em membros inferiores. A eletroneuromiografia evidenciou redução da velocidade e bloqueio de condução neuronal, com discreta perda axonal secundária. Foi tratado com imunoglobulina por via intravenosa, atingiu platô no quarto dia de evolução da doença e, depois, houve melhora progressiva da força muscular. COMENTÁRIOS: Com o emprego em larga escala da vacina influenza A (H1N1) 2009 em nosso meio e os dados preliminares do sistema de vigilância norte-americano mostrando associação temporal significante com a síndrome de Guillain-Barré, recomenda-se a descrição dos casos suspeitos dessa associação. A vacina continua sendo o método mais efetivo para prevenir doença grave e morte por influenza.

OBJECTIVE: To report a case of Guillain-Barré syndrome following influenza A (H1N1) 2009 vaccine. CASE DESCRIPTION: A four-year-old boy presented right thigh pain and ascending muscular weakness 15 days after the second dose of influenza A (H1N1) 2009 vaccine. The neurological examination revealed tetraparesis and areflexia. Electroneuromyography showed lower velocity and conduction blockage with small secondary axonal loss. Treated with intravenous immunoglobulin, the patient reached a plateau in the 4th day, followed by progressive muscular strength improvement. COMMENTS: The employment of large-scale influenza A (H1N1) 2009 vaccination and the preliminary reports from the American Surveillance Program suggest a significant association between Guillain-Barré syndrome and influenza A H1N1 2009 vaccination. All suspected cases of this association should be published for further evaluation. Vaccination remains the most effective method to prevent serious illness and death related to influenza.

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