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ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis.

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença.

https://doi.org/10.1590/1984-0462/2024/42/2022184

Alterations in deglutition in children with congenital Zika virus syndrome
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Rios, Débora

; Rios, Mino

; Nóbrega, Ana Caline

; Oliveira, Lia Bernadeth de

; Vaz, Daniel

; Sales, Henrique

; Almeida, Breno Lima de

; Lopes, Leticia Serra

; Siqueira, Isadora Cristina de

; Lucena, Rita

CoDAS

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2023, Volume 35 N. 1 elocation e20210270

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

RESUMO Objetivo Caracterizar a deglutição das crianças com síndrome congênita do Zika vírus e comparar com crianças típicas. Método Estudo de delineamento transversal, com 45 crianças diagnosticadas com síndrome congênita do Zika vírus e 45 típicas. A deglutição foi avaliada por meio de avaliações clínicas da alimentação através do Protocolo de Avaliação Clínica da Disfagia Pediátrica e dos parâmetros acústicos da deglutição (sonar Doppler). Resultados A idade média das crianças com síndrome congênita do vírus Zika foi de 26,69 ± 4,46 meses e o perímetro cefálico médio foi de 29,20 ± 1,98 cm. Disfagia orofaríngea de moderada a grave foi observada em 32(71,1%) das crianças com síndrome congênita do Zika vírus, ao contrário do grupo comparação que não revelou alterações na deglutição. Nas crianças com síndrome congênita do Zika vírus foram verificados lábios entreabertos 42(93,3%) e tônus alterado em língua 35(77,8%) e bochechas 34(75,6%). Nas crianças do grupo comparação apenas 6(13,3%) apresentaram fechamento labial insuficiente e 1(2,2%) postura de língua inadequada. Alterações durante a deglutição com líquido e alimento pastoso não foram observadas no grupo comparação. Durante a oferta do alimento ocorreram dificuldades no movimento de sorver 14(77,8%), na captação da colher 35(75%), resíduo em cavidade oral 38(86,4%) e sinais clínicos indicativos de penetração/aspiração laringotraqueal como tosse, engasgo e respiração com esforço. Não foram encontradas diferenças nos parâmetros acústicos da avaliação instrumental. Conclusão as crianças com síndrome congênita do Zika vírus têm alterações nas fases oral e faríngea da deglutição, com sinais clínicos indicativos de penetração/aspiração laringotraqueal quando comparadas a crianças típicas.

ABSTRACT Purpose To characterize swallowing in children with congenital Zika virus syndrome in comparison to typical children. Methods This cross-sectional study enrolled 45 children diagnosed with congenital Zika virus syndrome and 45 others with typical development. Swallowing was evaluated through clinical feeding evaluations Protocolo de Avaliação Clínica da Disfagia Pediátrica and using acoustic swallowing parameters (Doppler sonar). Results The mean age of children with congenital Zika virus syndrome was 26.69 ± 4.46 months and the mean head circumference was 29.20 ± 1.98 cm. Moderate/severe oropharyngeal dysphagia was found in 32(71.1%) of the children with congenital Zika virus syndrome. Significant differences were found between the groups on clinical evaluation: Children with congenital Zika virus syndrome presented insufficient lip closure 42(93.3%) and altered tonus of the tongue 35(77.8%) and cheeks 34(75.6%). In the children in the comparison group, only 6(13.3%) presented insufficient lip closure and 1(2.2%) had inadequate tongue posture. Changes during swallowing with liquid and spoonable food were not observed in the comparison group. When liquid/food was offered, affected children presented difficulties in sipping movements 14(77.8%) and lip/spoon contact 35(75%). The presence of residual food in the oral cavity after swallowing 38(86.4%) and clinical signs indicative of laryngotracheal penetration/aspiration, such as coughing, gagging and/or labored breathing, were also notable. No differences were found between the groups with regard to the acoustic parameters evaluated instrumentally. Conclusion Children with congenital Zika virus syndrome present alterations in the oral phase of swallowing, as well as clinical signs indicative of pharyngeal phase impairment.

https://doi.org/10.1590/2317-1782/20212021270

Percepções de estudantes de Medicina sobre o estresse acadêmico e a mentoria no seu enfrentamento: um estudo qualitativo
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Rios, Izabel Cristina

; Santos, Renata Silva

; Vital Junior, Pedro Felix

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e230199

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

A formação médica é considerada estressante devido a fatores como: extensa carga horária, atividades práticas complexas, muito conteúdo e alta exigência de dedicação. Programas de mentoria podem amenizar esse estresse acadêmico. Com o objetivo de investigar a percepção dos estudantes de um programa de mentoria sobre o estresse da formação médica e a mentoria como recurso de enfrentamento, desenhou-se um estudo do tipo transversal com metodologia qualitativa. Selecionaram-se 12 alunos e realizaram-se sessões de grupo focal. Os dados produzidos foram submetidos à análise temática, resultando em duas categorias de estressores – 1. ser estudante e 2. ambiente acadêmico – e em duas categorias de elementos protetores – 1. autocuidado e 2. mentoria. A mentoria foi considerada recurso de enfrentamento por ser um espaço de reflexão e desenvolvimento de habilidades e comportamentos que aumentam competências relacionais, além de propiciar acolhimento, alívio psicológico, pertencimento e efeito tranquilizador.

La formación médica se considera estresante debido a factores tales como: extensa carga horaria, actividades prácticas complejas, mucho contenido, alta exigencia de dedicación. Programas de tutoría pueden amenizar ese estrés académico. Con el objetivo de investigar la percepción de los estudiantes de un programa de tutoría sobre el estrés de la formación médica y la tutoría como recursos de enfrentamiento, se diseñó un estudio del tipo transversal con metodología cualitativa. Se seleccionaron 12 alumnos y se realizaron sesiones de grupo focal. Los datos producidos se sometieron a análisis temático, resultando en dos categorías de factores de estrés: 1. ser estudiante, y 2. ambiente académico; y dos categorías de elementos protectores: 1. autocuidado, y 2. tutoría. La tutoría se consideró recurso de enfrentamiento por ser espacio de reflexión y desarrollo de habilidades y comportamientos que aumentan competencias relacionales además de propiciar amparo, alivio psicológico, pertenencia y efecto tranquilizador.

Medical training is considered stressful due to factors such as heavy course load, complex practical activities, the large volume of content and high expectations in terms of dedication. Mentoring programs can alleviate academic stress. The aim of this qualitative cross-sectional study was to investigate medical students’ perceptions of a mentoring program designed to reduce stress and mentoring as a tool for coping. We selected 12 students and held focus group sessions. We performed a thematic analysis, which resulted in the identification of two categories of stressors and protectors: being a student and the academic environment and self-care and mentoring, respectively. Mentoring was considered a coping resource because it provided a space for reflection and helped students develop skills and behavior that enhance relational skills, in addition to providing a welcoming environment, psychological relief, a feeling of belonging and a tranquilizing effect.

https://doi.org/10.1590/interface.230199

Ecologia da comunidade arbórea de Cerrado stricto sensu às margens de rodovias
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Rios, Jovan Martins

; Santos, Lilian Cristina da Silva

; Costa, João Paulo

; Pereira, Ismael Martins

; Gusson, André Eduardo

; Vale, Vagner Santiago do

Ciência Florestal

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2023, Volume 33 N. 2 elocation e62683

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

ABSTRACT The construction of highways is a major threat to biodiversity the Cerrado. From the phytosociological analyzes in the non aedificandi ranges, this work evaluated its conservation status of cerrado vegetation near highways. The study was carried out in four regions of Cerrado: northwest (NO-GO), south (S-GO) and southeast of Goiás State (SE-GO), and in the Triângulo Mineiro and Alto do Paranaíba in Minas Gerais (TRI). All tree individuals with C30cm (circunference measuredat 30 cm of soil height) > 15 cm, present in 100 plots (50 m x 10 m) independently arranged. The survey showed 1663 individuals distributed in 163 species and 44 families. The density for the regions was 504.44, 395, 307.69 and 151.03 ha-1. The highest similarity on the basis of the Jaccard and Morisita-Horn indices occurred between the TRI and SE-GO areas (0.340 and 0.550), while the lowest values were between the northwest (NO-GO) and south (S-GO) of Goiás State (0.086 and 0.159). Of the species found on the roadsides, 76.3% were also found in conserved areas. The vegetated strips along the highways form small habitats capable of sustaining a diversity similar to that found in natural areas, yet these environments suffer from anthropic disturbances favoring the occurrence of unusual species of that native community.

RESUMO A construção de rodovias representa uma das principais ameaças à biodiversidade do Cerrado. A partir de análises fitossociológicas nas faixas non aedificandi (sem edificação), avaliou-se o estado de conservação da vegetação de cerrado localizadas nas margens de rodovias. O estudo foi realizado em quatro regiões do Cerrado brasileiro: noroeste (NO-GO), sul (S-GO) e sudeste de Goiás (SE-GO), e no Triângulo Mineiro e Alto do Paranaíba em Minas Gerais (TRI). Foram inventariados todos os indivíduos arbóreos com C30cm (circunferência mensurada a 30 cm de altura do solo) > 15 cm presentes em 100 parcelas (50 m x 10 m) dispostas de maneira independente. O levantamento amostrou 1663 indivíduos distribuídos em 163 espécies e 44 famílias. A densidade para as regiões foi de 504,44, 395, 307,69 e 151,03 ha-1. A maior similaridade, com base nos índices de Jaccard e Morisita-Horn, ocorreu entre as áreas TRI e SE-GO (0,340 e 0,550), enquanto o menor valor entre as áreas a noroeste (NO-GO) e sul (S-GO) de Goiás (0,086 e 0,159). Das espécies encontradas nas margens de rodovias, 76,3% foram encontradas também em áreas conservadas. As faixas vegetadas nas margens das rodovias formam pequenos habitats capazes de sustentar uma diversidade semelhante à encontrada em áreas naturais, no entanto, esses ambientes sofrem com perturbações antrópicas, favorecendo a ocorrência de espécies incomuns daquela comunidade nativa.

https://doi.org/10.5902/1980509862683

Percepções de estudantes de Medicina sobre o estresse acadêmico e a mentoria no seu enfrentamento: um estudo qualitativo
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Rios, Izabel Cristina

; Santos, Renata Silva

; Vital Junior, Pedro Felix

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e230199

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

https://doi.org/10.1590/interface.230199

Efficacy and safety of preemptive therapy for cytomegalovirus end-organ disease in people living with HIV: a systematic review and meta-analysis
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Díaz-Brochero, Candida

; Nocua-Báez, Laura Cristina

; Valderrama-Rios, Martha Carolina

; Cortés, Jorge Alberto

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 5 elocation 102805

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Cytomegalovirus end-organ-disease (CMV EOD) is still a major cause of debilitating illness in people living with HIV, especially in developing countries. Objective: To evaluate the efficacy and safety of preemptive therapy against CMV EOD in HIV-positive adults with CMV viremia. Methods: Systematic review of clinical trials by searching electronic databases and clinical trial registries, screening and selection of references, data extraction and assessment of risk of bias. The results were presented in a narrative synthesis. Aggregated analyzes for dichotomous outcomes were reported as odds ratios with 95 % Confidence Intervals. Results: Four RTC were included. A reduction in the risk of CMV EOD with preemptive therapy was found OR=0.49 (95 % CI 0.31-0.76). We did not identify significant differences for all-cause mortality, adverse events, and withdrawal of the therapy secondary to adverse events. Conclusions: Preemptive therapy could be a potential option for preventing CMV EOD in people living with HIV.

https://doi.org/10.1016/j.bjid.2023.102805

Traços funcionais de espécies arbóreas de cerrado sensu stricto e sua importância para a manutenção de comunidades nativas
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Costa, João Paulo

; Dias Neto, Olavo Custódio

; Santos, Lilian Cristina da Silva

; Rodrigues, Amanda Wolberg

; Rios, Jovan Martins

; Prado Júnior, Jamir Afonso do

; Vale, Vagner Santiago do

Ciência Florestal

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dec 2022, Volume 32 N. 4 Pages 1807 - 1829

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

Abstract Functional traits are morpho-physiological characteristics of species that can significantly influence ecological processes in their natural environment and can be used to form functional groups. Functional groups are species with similar characteristics and functions in communities. The initial objective of the study was to detect patterns in the functional traits of tree species in cerrado sensu stricto. We sought to answer: 1) is it possible to group species into functional groups using leaf and architecture traits, 2) which traits best explained the survival/maintenance of species in their communities. The foliar and architectural functional traits of 32 tree species from cerrado sensu stricto were evaluated. The analyses were able to form four distinct functional groups for cerrado sensu stricto. Group 1 showed trees with higher wood density, dry mass and leaf area and high volume and biomass values. Most species have leaves with low specific leaf area and high leaf area and dry mass. Group 2 had small species with low crown volume and biomass, however, it was the group with the highest specific leaf area and leaf water percentage. Group 3 was formed by species with the lowest contribution of biomass and crown volume in the study, and also showed low values for wood density, leaf area and dry mass, being typically small-sized species. Group 4 showed the highest values for crown volume, biomass and sorghum in the study, configuring the group of species with the largest size of the study, but showed low values for specific leaf area and percentage of water in the leaf.

Resumo Traços funcionais são características morfo-fisiológicas das espécies capazes de influenciar significativamente os processos ecológicos em seu ambiente natural e podem ser utilizadas para formar grupos funcionais. Grupos funcionais são espécies com semelhantes características e funções nas comunidades. O objetivo inicial do estudo foi detectar padrões quanto aos traços funcionais de espécies arbóreas de cerrado sensu stricto. Buscamos responder: 1) é possível agrupar as espécies em grupos funcionais utilizando traços foliares e de arquitetura, 2) quais traços melhor explicaram a sobrevivência/manutenção das espécies em suas comunidades. Foram avaliados os traços funcionais foliares e de arquitetura de 32 espécies arbóreas de cerrado sensu stricto. As análises foram capazes de formar quatro grupos funcionais distintos para cerrado sensu stricto. O grupo 1 apresentou árvores com maior densidade da madeira, massa seca e área foliar e altos valores de volume e biomassa. A maioria das espécies possuem folhas com baixa área foliar específica e alta área foliar e massa seca. O grupo 2 apresentou espécies de pequeno porte, com baixo volume de copa e biomassa, entretanto, foi o grupo com maior área foliar específica e percentual de água na folha. O grupo 3 foi formado por espécies com o menor aporte de biomassa e volume de copa do estudo, e também apresentou valores baixos para densidade de madeira, área foliar e massa seca, sendo espécies tipicamente de pequeno porte. O grupo 4 apresentou os maiores valores de volume de copa, biomassa e súber do estudo, configurando o grupo de espécies com o maior porte do estudo, porém, apresentou baixos valores de área foliar específica e percentual de água na folha.

https://doi.org/10.5902/1980509842472

EXPERIMENTO DIDÁTICO DE QUIMIOMETRIA EMPREGANDO IMAGENS DIGITAIS OBTIDAS POR CELULAR PARA DETERMINAR ADULTERAÇÃO DE AZEITE DE OLIVA COM ÓLEO DE SOJA: UM TUTORIAL, PARTE VI
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Rios, Carlos Alberto

; Souza, André Marcelo de

; Poppi, Ronei Jesus

; Breitkreitz, Márcia Cristina

Química Nova

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sep 2022, Volume 45 N. 9 Pages 1167 - 1176

Abstract: Pt | Text: Pt | PDF: Pt

The aim of this manuscript was to show the concepts involving data treatment of RGB based image analysis by univariate and multivariate approaches - the latter using Partial Least Squares (PLS) - using as a practical example application the determination of extravirgin olive oil adulteration. Digital images were collected using a device made of LEDs, batteries and a smartphone and results are shown in a tutorial format using Matlab computing environment. The experiment can serve as an example for teaching the subject for undergraduate and graduate students.

https://doi.org/10.21577/0100-4042.20170946

Recomendaciones de manejo de los anticoagulantes orales directos (DOACs) anti Xa y anti IIa
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Ceresetto, José M.

; Tajer, Carlos

; Duboscq, Cristina

; Bottaro, Federico

; Casais, Patricia

; Korin, Jorge

; Fondevila, Carlos

; Giumelli, Carla

; Scazziota, Alejandra

; Rossi, Andrea

; Botto, Fernando

; Ariscancela, Maria Ester

; Martinuzzo, Marta

; Zaidel, Ezequiel

; Fitz Maurice, Mario

; Bahit, Cecilia

; Vazquez, Fernando

; Molnar, Soledad

; Saizberg, Simón

; Negri Aranguren, Pedro

; Rosa, Claudio

; Fedele, José Luis

; Comignani, Pablo

; Pombo, Gonzalo

; Raña, Pablo

; Adamczuk, Yolanda

; Martí, Alejandra

; Charask, Adrián

; Penchasky, Diana

; Riveros, Dardo

; Mariani, Javier

; Puente, Dolores

; Celebrin, Lucia

; Bosio, Martín

; Brodsky, Andrés

; Sanchez Lucero, Analía

; Castillo Costa, Yanina

; Hirschson, Alfredo

; Arbesú, Guillermo

; Viñuales, Susana

; Kazelian, Lucía

; Maneyro, Alberto

; Gutierrez, Victoria

; Castro Rios, Miguel

; Gagliardi, Juan

; Lescano, Adrián

; Repetto, Fernanda

Medicina (Buenos Aires)

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apr 2022, Volume 82 Suppl. 2 Pages 1 - 55

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

Abstract Direct oral anticoagulants have emerged as the drugs that have changed the man agement of the antithrombotic treatment in the last 15 years. Their advantages, like a more friendly way of anticoagulation and their lower risk of bleeding, especially in the brain, have positioned these new anticoagu lants as the first drug of choice in the two most frequent indications of anticoagulation, atrial fibrillation, and the venous thromboembolic disease. However, not all the patients can receive these agents, not all the direct oral anticoagulants have the same characteristics, and most importantly, not all the diseases with an indication of an anticoagulant drug can be treated with them. Therefore, it is mandatory that all the faculties involved in the management of these drugs must know them in depth, to decide the best treatment for the patient. This position paper, from a group of experts in anticoagulation in Argentina, can help the general practitioner in the daily use of direct oral anticoagulants based on the new evidence and the experience of a wide group of professionals. The way we relate to the anticoagulant treatment has changed in the last years. The doctors who work with them must also do so.

Resumen Los anticoagulantes orales directos han surgido como una de las herramientas que ha cambiado el manejo de la enfermedad trombótica en los últimos 15 años. Sus ventajas, desde el punto de vista de la facilidad de uso y menor riesgo de sangrado, especialmente de sangrado cerebral, han posicionado a estos nuevos anticoagulantes como la primera alternativa de tratamiento en las dos indicaciones más frecuentes en que necesitamos estas drogas, la fibrilación auricular y la enfermedad tromboembólica venosa. Sin embargo, no todos los pacientes pueden recibir estos agentes, no todos los anticoagulantes directos tienen las mismas pro piedades y fundamentalmente, no todas las enfermedades con indicación de un anticoagulante pueden tratarse con ellos;con lo cual es necesario que todos los profesionales que están involucrados en el manejo de estos medicamentos estén obligados a conocerlos en profundidad, para poder decidir el mejor tratamiento en cada caso particular. Este documento de posición de expertos de diferentes especialidades de Argentina, presenta lineamientos para el uso correcto de los anticoagulantes directos en base a nueva evidencia y a la experiencia de uso de un amplio grupo de profesionales. La forma de relacionarnos con el tratamiento anticoagulante ha cambiado. Los médicos que trabajamos con ellos también debemos hacerlo.

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Renin angiotensin system molecules and chemokine (C-C motif) ligand 2 (CCL2) in chronic kidney disease patients
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Schettini, Isabella Viana Gomes

; Faria, Débora Vargas

; Nogueira, Leilismara Sousa

; Otoni, Alba

; Silva, Ana Cristina Simões e

; Rios, Danyelle Romana Alves

Brazilian Journal of Nephrology

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mar 2022, Volume 44 N. 1 Pages 19 - 25

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

Resumo Introdução: Estudos têm mostrado que o sistema renina angiotensina aldosterona (SRAA) e a inflamação estão relacionados à progressão da lesão renal. O objetivo deste estudo foi avaliar moléculas do SRAA e o Ligante 2 de Quimiocina com Motivo C-C (CCL2) em 82 pacientes com doença renal crônica (DRC). Métodos: Os pacientes foram divididos em dois grupos: pacientes diagnosticados com DRC e pacientes sem diagnóstico de DRC. Foram determinadas a taxa de filtração glomerular (TFG) e a relação albumina/creatinina (RAC), assim como os níveis plasmáticos de angiotensina-(1-7) [Ang-(1-7)], enzima conversora de angiotensina (ECA)1, ECA2 e níveis plasmáticos e urinários de CCL2. Resultados: Os níveis plasmáticos de CCL2 foram significativamente mais altos em pacientes com DRC em comparação com o grupo controle. Pacientes com TFG mais baixa apresentaram níveis plasmáticos mais elevados de ECA2 e CCL2 e menor relação ECA1/ECA2. Pacientes com valores de RAC mais altos apresentaram níveis plasmáticos de ECA1 mais elevados. Conclusão: Pacientes com DRC mostraram maior atividade de ambos os eixos do SRAA, o clássico e o alternativo, e níveis plasmáticos mais altos de CCL2. Portanto, os níveis plasmáticos de moléculas do SRAA e CCL2 parecem ser marcadores prognósticos promissores e até mesmo alvos terapêuticos para a DRC.

Abstract Introduction: Studies have shown that the renin angiotensin aldosterone system (RAAS) and inflammation are related to kidney injury progression. The aim of this study was to evaluate RAAS molecules and chemokine (C-C motif) ligand 2 (CCL2) in 82 patients with chronic kidney disease (CKD). Methods: Patients were divided into two groups: patients diagnosed with CKD and patients without a CKD diagnosis. Glomerular filtration rate (GFR) and albumin/creatinine ratio (ACR) were determined, as well as plasma levels of angiotensin-(1-7) [Ang-(1-7)], angiotensin-converting enzyme (ACE)1, ACE2, and plasma and urinary levels of CCL2. Results: CCL2 plasma levels were significantly higher in patients with CKD compared to the control group. Patients with lower GFR had higher plasma levels of ACE2 and CCL2 and lower ratio ACE1/ACE2. Patients with higher ACR values had higher ACE1 plasma levels. Conclusion: Patients with CKD showed greater activity of both RAAS axes, the classic and alternative, and higher plasma levels of CCL2. Therefore, plasma levels of RAAS molecules and CCL2 seem to be promising prognostic markers and even therapeutic targets for CKD.

https://doi.org/10.1590/2175-8239-jbn-2021-0030

11.

Evaluation of Strongyloides stercoralis infection in patients with HTLV-1
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Pereira Vieira Barreto, Nilo Manoel

; Brito Farias, Marina Morena

; de Lima Oliveira, Cíntia

; Almeida Costa Araujo, Weslei

; Rios Grassi, Maria Fernanda

; Nascimento de Souza, Joelma

; Soares Jacobina, Beatriz

; Aquino Teixeira, Márcia Cristina

; Galvão-Castro, Bernardo

; Matos Soares, Neci

Biomédica

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mar 2022, Volume 42 N. 1 Pages 31 - 40

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

Resumen Introducción. Los individuos infectados por el virus linfotrópico T humano tipo 1 (HTLV-1) pueden presentar formas graves y diseminadas de infestación por Strongyloides stercoralis con poca mejoría terapéutica. Objetivo. Investigar la infestación por S. stercoralis y la seroprevalencia de IgG anti-S. stercoralis en individuos infectados por HTLV-1 atendidos en el Centro de Referencia para HTLV-1 (CHTLV), en Salvador, Bahía, Brasil. Materiales y métodos. Se hizo un estudio transversal con 178 individuos infectados por HTLV-1 atendidos en el centro especializado de HTLV entre enero de 2014 y diciembre de 2018. El diagnóstico parasitológico de S. stercoralis se hizo mediante los métodos de Hoffman, Pons y Janer, cultivo en placa de agar y Baermann-Morais. Para la detección de IgG anti-S. stercoralis, se utilizó una prueba casera de inmunoabsorción ligada a enzimas (ELISA). La infección por HTLV-1 se diagnosticó usando un ELISA comercial y se confirmó mediante Western blot. Resultados. La frecuencia de infestación por S. stercoralis fue del 3,4 % (6/178). Además, los individuos infestados por S. stercoralis provenientes de la zona rural (50,0 %; 3/6) también mostraron hiperinfestación por S. stercoralis (>3.000 larvas/gramo de heces). La frecuencia de anticuerpos IgG anti-S. stercoralis fue del 20,8 % (37/178). Conclusiones. Las personas infectadas por HTLV-1 que viven en condiciones sanitarias precarias son más propensas a desarrollar formas graves de infestación por S. stercoralis. Teniendo en cuenta la gran vulnerabilidad y el resultado desfavorable de la infección en estos individuos, se debe considerar el diagnóstico serológico de S. stercoralis para administrar el tratamiento.

Abstract Introduction: Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response. Objective: To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil. Materials and methods: We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot. Results: The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S. stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/ gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178). Conclusions: HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.

https://doi.org/10.7705/biomedica.5888 17 downloads

12.

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes

; Melo, Ana Karla Guedes de

; Cruz, Vítor Alves

; Souza, Viviane Angelina de

; Carvalho, Joana Starling de

; Machado, Ketty Lysie Libardi Lira

; Valadares, Lilian David de Azevedo

; Reis Neto, Edgard Torres dos

; Rezende, Rodrigo Poubel Vieira de

; Guimarães, Maria Fernanda Brandão de Resende

; Ferreira, Gilda Aparecida

; Braz, Alessandra de Sousa

; Vieira, Rejane Maria Rodrigues de Abreu

; Pinheiro, Marcelo de Medeiros

; Ribeiro, Sandra Lúcia Euzébio

; Bica, Blanca Elena Gomes Rios

; Baptista, Kátia Lino

; Costa, Izaias Pereira da

; Marques, Claudia Diniz Lopes

; Lopes, Maria Lúcia Lemos

; Martinez, José Eduardo

; Giorgi, Rina Dalva Neubarth

; Mota, Lícia Maria Henrique da

; Loures, Marcos Antônio Araújo da Rocha

; Paiva, Eduardo dos Santos

; Monticielo, Odirlei André

; Xavier, Ricardo Machado

; Kakehasi, Adriana Maria

; Pileggi, Gecilmara Cristina Salviato

Advances in Rheumatology

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2022, Volume 62 elocation 3

Abstract: En | Text: En | PDF: En

Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

https://doi.org/10.1186/s42358-022-00234-7

13.

Applying colorimetry for wood differentiation of fabaceae species grown in southern Brazil
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Vieira, Helena Cristina

; dos Santos, Joielan Xipaia

; Souza, Deivison Venicio

; Rios, Polliana D’ Angelo

; Bolzon de Muñiz, Graciela Inés

; Ribeiro Morrone, Simone

; Nisgoski, Silvana

Maderas. Ciencia y tecnología

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2022, Volume 24 elocation 16

Abstract: En | Text: En | PDF: En

Abstract: Because of the need for identification of forest species, especially for detection of illegal wood trade, the objective of this study was to evaluate the potential of colorimetry for differentiation of Inga vera Willd., Muellera campestris (Mart. ex Benth.) M.J. Silva & A.M.G. Azevedo and Machaerium paraguariense Hassl., species of the Fabaceae family, native to the Araucaria Forest in the state of Santa Catarina, southern Brazil. Discs at breast height were collected from three trees of each species and the colorimetric parameters (L*, a*, b*, C* and h) and visible spectra were evaluated in different radial position of the trunk (near bark, intermediate and near pith) and three different anatomical sections (transversal, radial and tangential surfaces). Mean values of hue angle (h) among the colorimetric parameters resulted in the highest potential for species discrimination. With respect to radial trunk position and anatomical section, parameters a* (green-red) and h were not statistically different, independent of the wood samples evaluated. For other parameters (L*, b* and C*), each species presented distinct results. Principal component analysis with second derivative of visible spectra discriminated all species. Colorimetry associated with chemometrics allowed to distinguish I. vera, M. campestris and M. paraguariense.

https://doi.org/10.4067/s0718-221x2022000100416 68 downloads

14.

Fatal Brazilian spotted fever in a healthy military man during field training in Rio de Janeiro city, southeastern Brazil
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Pacheco-Silva, Ana Beatriz

; Martins, Ezequias Batista

; López, Angie Jeannine Rios

; Detepo, Paula João Tomas

; Mamani, Roxana Flores

; Japiassú, André Miguel

; Lupi, Otilia

; Mendes, Tulio Vieira

; Pina-Costa, Anielle de

; Calvet, Guilherme Amaral

; Bressan, Clarisse da Silveira

; Silva, Michele Fernanda Borges da

; Ogino, Liana Lumi

; Assis, Matheus Ribeiro da Silva

; Marques, Amanda Meneleu

; Dias, Cristina Maria Giordano

; Borchert, Juliana Mildward

; Lemos, Elba Regina Sampaio de

; Brasil, Patrícia

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e77

Abstract: En | Text: En | PDF: En

ABSTRACT Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

https://doi.org/10.1590/s1678-9946202264077

15.

Clinical practice guideline for screening of patients at risk of colonization by carbapenemase-producing Enterobacterales and the treatment of infections caused by these bacteria
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Cortés, Jorge Alberto

; Leal, Aura Lucía

; Muñetón-López, Gerardo

; Bravo-Ojeda, Juan Sebastián

; Nocua-Báez, Laura Cristina

; Avila, Vaneza

; Silva, Edwin

; Alvarez-Moreno, Carlos Arturo

; Espitia, Pilar

; Gualtero, Sandra Milena

; Valderrama, Sandra Liliana

; Guevara, Fredy Orlando

; Esparza, Germán

; Saavedra, Carlos Humberto

; Díaz, Jorge Augusto

; Valderrama-Rios, Martha Carolina

Revista de la Facultad de Medicina

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sep 2021, Volume 69 N. 3 elocation e209

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

Abstract Carbapenemase-producing Enterobacterales (CPE) infections have increased in recent years. Colombia has become an endemic country for this group of microorganisms, and the infections they cause have a serious impact in terms of morbidity and mortality. The early identification of CPE carriers who are admitted to health care centers as patients is necessary to implement adequate isolation and infection control measures to limit the spread of this type of microorganisms in hospitals. Furthermore, treating these infections is a challenging task due to the limited therapeutic alternatives available and the fact that there are only a few studies proving their effectiveness in this setting. Therefore, the objective of the present work is to develop a clinical practice guideline (CPG) for the screening of patients at risk of CPE colonization and the treatment of inpatients with suspected or confirmed infections caused by this type of bacteria through a CPG adaptation process based on the ADAPTE methodology. With this purpose in mind, evidence-informed recommendations for the screening and timely identification of CPE carriers admitted to hospitals are made, as well as for the adequate pharmacological treatment of CPE infections in this context.

Resumen Las infecciones por Enterobacterales productores de carbapenemasas (EPC) han aumentado en los últimos años. Colombia se ha convertido en un país endémico para este grupo de microorganismos y las infecciones que causan tienen un impacto importante en términos de morbimortalidad. La identificación temprana de los portadores de EPC que ingresan como pacientes a las instituciones de salud es necesaria para implementar medidas de aislamiento y control de infecciones adecuadas que limiten la diseminación de este tipo de microorganismos en los hospitales. Además, el tratamiento de estas infecciones es difícil debido a las limitadas alternativas terapéuticas disponibles y la escasez de estudios que demuestren su efectividad en este escenario. Por lo anterior, el objetivo del presente trabajo es desarrollar una guía de práctica clínica (GPC) para la tamización de pacientes con riesgo de colonización por EPC y para el manejo de pacientes con infecciones, ya sea sospechadas o confirmadas, causadas por este tipo de bacterias, mediante un proceso de adaptación de GPC basado en la metodología ADAPTE. Con este propósito en mente, se hacen recomendaciones informadas en evidencia para realizar la tamización y oportuna identificación de portadores de EPC admitidos en instituciones hospitalarias, así como para el adecuado manejo farmacológico de las infecciones por CPE en este escenario.

https://doi.org/10.15446/revfacmed.v69n3.90140 60 downloads

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