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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Publication date: 2024-04-08

Abstract: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

https://doi.org/10.1590/SciELOPreprints.8394

Ploidy estimation and pre-selection of banana autotetraploids after in vitro polyploidy induction
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Borges, Viviane P.

; Silveira, Daniela G.

; Costa, Maria A. P. de C.

; Santos-Serejo, Janay A. dos

; Silva, Sebastião de O.

Revista Caatinga

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sep 2023, Volume 36 N. 3 Pages 494 - 501

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

ABSTRACT This study aimed to evaluate the efficiency of the parameters fresh leaf mass and stomatal density in the estimation of ploidy and pre-selection of putative banana autotetraploids. Young plants of the diploid cultivar Ouro (AA), previously subjected to in vitro polyploidization with the antimitotic amiprofos-methyl - APM (0, 10, 20, 30, 40, and 60 µM L-1) and colchicine (2.5 mM L-1) were evaluated for survival, height, number of leaves, pseudostem diameter, leaf disc fresh mass, and stomatal density. Ploidy was determined by flow cytometry in a random sample of 200 plants to find the relationship between the genomic content and the analyzed variables. Spearman’s correlation analysis showed a strong correlation (0.84**) between leaf disc fresh mass and tetraploid plants, as well as an absence of significant correlation between stomatal density and ploidy levels. Thus, the pre-selection of plants was carried out using a reference value of leaf disc fresh mass and resulted in 688 plants pre-selected as putative tetraploids. Among them, 318 were confirmed as tetraploids, 291 as diploids, and 79 as mixoploids after flow cytometry analysis. The pre-selection efficiency was 46.2% of tetraploid plants from the total pre-selected. The results indicate that the use of leaf disc fresh mass is a simple, practical, and promising method to estimate ploidy when a high number of plants is obtained in in vitro banana polyploidization studies, reducing the total number of plants to have confirmed ploidy.

RESUMO Este estudo objetivou avaliar a eficiência dos parâmetros massa fresca foliar e densidade estomática na estimativa da ploidia e pré-seleção de autotetraploides putativos de bananeira. Plantas jovens da cultivar diploide Ouro (AA), previamente submetidas à poliploidização in vitro com os antimitóticos amiprofos-metil - APM (0, 10, 20, 30, 40 e 60 µM L-1) e colchicina (2,5 mM L-1) foram avaliadas quanto à sobrevivência, altura, número de folhas, diâmetro do pseudocaule, massa fresca de disco foliar e densidade estomática. Determinou-se a ploidia, via citometria de fluxo, numa amostra aleatória de 200 plantas, a fim de encontrar relação entre o conteúdo genômico e as variáveis analisadas. Por meio da análise de correlação de Spearman, verificou-se forte correlação (0,84**) entre a massa fresca de disco foliar e as plantas tetraploides, bem como ausência de correlação significativa entre a densidade estomática e os níveis de ploidia. Assim, a pré-seleção das plantas foi feita mediante um valor de referência de massa fresca de disco foliar e resultou em 688 plantas pré-selecionadas como tetraploides putativos. Destas, 318 foram confirmadas como tetraploides, 291 como diploides e 79 mixoploides, após análise de citometria de fluxo. A eficiência de pré-seleção foi de 46,2% de plantas tetraploides do total pré-selecionado. Os resultados indicam que o uso da massa fresca de disco foliar é um método simples, prático e promissor para estimar a ploidia quando é obtido um elevado número de plantas em trabalhos de poliploidização in vitro da bananeira, reduzindo o total de plantas a ter a ploidia confirmada.

https://doi.org/10.1590/1983-21252023v36n302rc

Ectoparasitic diversity, gill alterations in Hoplerythrinus unitaeniatus (Characiformes: Erythrinidae) and Cichlasoma bimaculatum (Perciformes: Cichlidae) and quality of fishing water in the Quilombola zone in Maranhão State, Brazil
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Rodrigues Silva, Ladilson

; Silva Mendes, Juliany

; Alves Paiva, Izabela

; Mendes da Silva Monteiro, Vitorya

; Santos de Jesus, Greiciene dos

; Santos, Hamilton Pereira

; Correa Silva Coimbra, Viviane

; Cutrim Bezerra, Danilo

; Pinto Chaves Bezerra, Nancyleni

Latin american journal of aquatic research

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mar 2023, Volume 51 N. 1 Pages 98 - 108

Abstract: En | Text: En | PDF: En

ABSTRACT The current study aimed to investigate the ectoparasitic diversity and gill alterations in Hoplerythrinus unitaeniatus (Characiformes: Erythrinidae) and Cichlasoma bimaculatum (Perciformes: Cichlidae) and evaluate the microbiological and physicochemical quality of water samples deriving from a Quilombola zone in Maranhão State, Brazil. Water samples and 42 fish specimens, 21 H. unitaeniatus and 21 C. bimaculatum, were collected from a floodable environment. Water samples were subjected to physicochemical and microbiological analyses in the laboratory environment. Fish specimens were euthanized to collect and identify ectoparasites in animals’ mucus, body surface, and gills, as well as to enable the histological analysis of the second right gill arch. The herein-identified ectoparasites have shown 30.95% prevalence and comprised three phyla: Platyhelminthes, Trematoda and Arthropoda. The herein-identified main histological changes comprised incomplete and complete fusion of several lamellae, lifting of respiratory epithelium, lamellar disorganization, lamellar epithelial hyperplasia, and blood sinus dilation. The herein calculated histological alteration index has shown that 23.80% of specimens presented mild-to-moderate tissue damage, 4.77% presented moderate-to-severe tissue changes, and 9.52% presented irreparable tissue damage. It was possible concluding that histological gill lesions identified in fish specimens analyzed may be adaptive responses to the affected environment and the incidence of ectoparasites.

https://doi.org/10.3856/vol51-issue1-fulltext-2936

Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH
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Cardoso, Viviane Cunha

; Grandi, Carlos

; Silveira, Rita C.

; Duarte, José Luiz Bandeira

; Viana, Maria Cândida Ferrarez Bouzada

; Ferreira, Daniela Marques de Lima Mota

; Alves Junior, José Mariano Sales

; Embrizi, Laís Furlan

; Gimenes, Carolina Boschi

; Mello e Silva, Nathalia Moura de

; Melo, Fernanda Pegoraro de Godoi

; Venzon, Paulyne Stadler

; Gomez, Dafne Barcala

; Vale, Marynéa Silva do

; Bentlin, Maria Regina

; Barros, Marina Carvalho de Moraes

; Bigélli, Laura Emilia Monteiro

; Diniz, Edna Maria de Albuquerque

; Luz, Jorge Hecker

; Marba, Sérgio Tadeu Martins

; Almeida, João Henrique Carvalho Leme de

; Aragon, Davi Casale

; Carmona, Fabio

Jornal de Pediatria

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jan 2023, Volume 99 N. 1 Pages 86 - 93

Abstract: En | Text: En | PDF: En

Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.

https://doi.org/10.1016/j.jped.2022.07.007

Influence of Neuropeptide Y and Neuropeptide Y 2 Receptor Variants in Acute Coronary Syndrome
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Soares, Fábia C. S.

; Araújo, Romário M.

; Werkhauser, Roberto P.

; Diniz, George T.

; Bhaskar, Lakkakula V.K.S

; Carvalho, Viviane D. C. V.

; Tashiro, Tetsuo

; Amorim, Ester A. S.

; Silva, Lilian C. A.

; Montenegro, Sergio Tavares

; Neco, Heytor V. P. C.

; Moraes, Clarice N. L.

; Martins, Danyelly B. G.

; Montenegro, Silvia M. L.

International Journal of Cardiovascular Sciences

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aug 2022, Volume 35 N. 4 Pages 444 - 456

Abstract: En | Text: En | PDF: En

Abstract Background The neuropeptide Y (NPY) is one of the most abundant neurotransmitters in the nervous system. NPY acts as a potent stimulator of angiogenesis, inflammation, and adipogenesis, through the NPY 2 receptor (NPY2R). Changes in the NPY signaling pathway have been linked to Acute Coronary Syndrome (ACS). Objectives The purpose of this study is to determine the association between variants in the NPY and NPY2R genes, as well as the severity of acute coronary syndrome (ACS). Methods Approximately 221 ACS patients and 278 healthy controls were selected for this study. Four variants in NPY and two variants in NPY2R genes were genotyped using Taqman allelic discrimination and sequencing. The Chi-square and Fisher's exact tests were used to verify the genotype frequencies. The logistic regression analyses were used for the evaluation of the studied variables. Haplotype analysis was used to evaluate the linkage disequilibrium (LD) between the variants (p<0.05). Results An association of NPY c.20T>C variant was found with the ACS group when compared to the healthy group. In the analysis between variants and risk factors in the ACS group, NPY c.84G>A was associated with hypertension. The analysis between TIMI risk showed a significance for NPY c.20T>C between the low and intermediate/high TIMI risk groups. In the haplotype analysis, strong linkage disequilibrium (LD) was found between the variants NPY c.150G>A and NPY c.-485T>C. Conclusion The NPY c.20T>C variant appears to contribute to the development of ACS. The NPY2R c.-1116A>G variant may contribute to the early development of ACS and the NPY c.84G>A variant appears to contribute to the development of hypertension. In addition, the NPY c.20T>C is associated with a protective effect in ACS severity.

https://doi.org/10.36660/ijcs.20210053

Sociodemographic and clinical profile of crack cocaine treatment-seeking individuals living in “Crackland”, Brazil
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Miguel, André Q. C.

; Simões, Viviane

; Yamauchi, Rodolfo

; Madruga, Clarice S.

; da Silva, Claudio J.

; Laranjeira, Ronaldo R.

; Roll, John M.

; Smith, Crystal L.

; McPherson, Sterling M.

; Mari, Jair J.

Jornal Brasileiro de Psiquiatria

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mar 2022, Volume 71 N. 1 Pages 50 - 55

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

RESUMO Objetivo: Localizada em São Paulo, a Cracolândia é o maior e mais antigo cenário aberto de uso de drogas do Brasil. Ainda assim, pouco se sabe sobre o perfil dos indivíduos que vivem nessa região e buscam tratamento para crack . O objetivo deste estudo transversal foi descrever características demográficas e clínicas de usuários de crack vivendo na região da Cracolândia que estão em busca de tratamento. Métodos: Noventa e oito indivíduos foram avaliados para transtornos por uso de substâncias do DSM-V, padrão de uso de substâncias, impulsividade e sintomatologia psiquiátrica. O uso recente de crack também foi determinado por meio de coleta de amostras toxicológicas. Resultados: Os resultados indicaram grave vulnerabilidade social, com significativas prevalências de falta de moradia (46,9%), moradia instável (50%), desemprego (60,4%) e abandono escolar precoce (27,5%). A idade média de início do uso de crack foi de 20 anos (DP = 6,9) e a duração média do uso contínuo do crack foi de 15 anos (DP = 9,7). A maioria dos participantes apresentou alguma comorbidade psiquiátrica, particularmente transtorno por uso de álcool (87,8%), bem como altas taxas de sintomatologia psiquiátrica e impulsividade. Mais da metade da amostra relatou pelo menos uma tentativa anterior de tratamento por internação (73,5%) e ambulatorial (65,3%). Conclusão: Os achados desse estudo permitem um maior entendimento do perfil e das necessidades de usuários de crack vivendo na região da Cracolândia e podem ajudar serviços de saúde especializados em dependência química a promoverem uma assistência mais direcionada às demandas específicas dessa população.

ABSTRACT Objective: São Paulo‘s Crackland is the biggest and oldest open drug use scene in Brazil, yet little is known about the profile of crack cocaine treatment-seeking individuals living in this region. The aim of this crossectional study was to describe the demographics and clinical characteristics of treatment-seeking crack users living in the Crackland region. Methods: A sample of nighty eight individuals were screened for DSM-V substance use disorders, including substance use, impulsiveness, and psychiatric symptoms. Recent crack cocaine use was also tested using biologic specimens. Results: Results indicated severe social vulnerability, as participants experienced high rates of homelessness (46.9%), unstable housing (50%), unemployment (60.4%) and early school drop-out (27.5%). The average age of crack use onset was 20 years (SD = 6.9) and the mean duration of continuous crack use was 15 years (SD = 9.7). Most participants presented with concomitant mental health disorders, particularly alcohol use disorder (87.8%), as well high rates of psychiatric symptomatology and impulsiveness. More than half of the sample reported at least one previous inpatient (73.5%) and outpatient (65.3%) addiction treatment attempt. Conclusion: This population profile should inform mental healthcare services, promoting the provision of tailored assistance by targeting specific demands at all levels of treatment.

https://doi.org/10.1590/0047-2085000000362

Endoparasite diversity and liver alterations in Hoplerythrinus unitaeniatus and Cichlasoma bimaculatum in a quilombola area in Maranhão, Brazil
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Silva, Ladilson Rodrigues

; Monteiro, Vitorya Mendes da Silva

; Paiva, Izabela Alves

; Mendes, Juliany Silva

; Jesus, Greiciene dos Santos de

; Silva, Marcelo Victor Rodrigues da

; Bezerra, Danilo Cutrim

; Carreiro, Carlos Riedel Porto

; Ribeiro, Larissa Sarmento dos Santos

; Coimbra, Viviane Correa Silva

; Bezerra, Nancyleni Pinto Chaves

Revista Brasileira de Parasitologia Veterinária

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2022, Volume 31 N. 2 elocation e000922

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

Resumo Objetivou-se avaliar a diversidade de endoparasitos e alterações hepáticas em Hoplerythrinus unitaeniatus (jeju) e Cichlasoma bimaculatum (acará preto) de área quilombola maranhense, Brasil. Assim, 21 H. unitaeniatus e 21 C. bimaculatum foram capturados de ambiente alagável e transportados vivos ao laboratório. Após a eutanásia, procedeu-se à coleta, identificação de endoparasitos e avaliação de alterações hepáticas por meio de análise histológica, baseada na severidade das lesões: (i) alterações de estágio I, não comprometem o funcionamento dos órgãos; (ii) estágio II, lesões mais severas que prejudicam o funcionamento normal dos órgãos; (iii) estágio III, lesões muito severas e irreversíveis. Dos peixes avaliados, 71,43% H. unitaeniatus e 61,90% C. bimaculatum estavam parasitados. Contracaecum sp. foi encontrado nas duas espécies e acantocéfalos apenas em H. unitaeniatus. As alterações hepáticas foram vacuolização, núcleo na periferia das células, deformação do contorno celular, centro de melanomacrófagos, hiperemia, degeneração citoplasmática e vacuolização nuclear. Com o cálculo do índice das alterações, constatou-se que 26,19% dos exemplares apresentaram alterações de estágio I; 38,09% de estágio II e 9,52% de estágio III com a constatação de larvas de Contracaecum sp. encistadas no fígado. Conclui-se que existe alta prevalência de Contracaecum sp., e lesões hepáticas podem ser respostas adaptativas dos peixes à infecção endoparasitária.

Abstract Our aim was to assess endoparasite diversity and liver alterations in Hoplerythrinus unitaeniatus (jeju) and Cichlasoma bimaculatum (acará preto) in a quilombola area in Maranhão, Brazil. For this, 21 H. unitaeniatus and 21 C. bimaculatum were caught in a natural environment and transported to a laboratory. After these had been euthanized, endoparasites were collected and identified. Liver alterations were evaluated histological analysis based on the severity of each lesion: stage I, organ functioning not compromised; stage II, more severe lesions that impair normal functioning of the organs; and stage III, very severe and irreversible lesions. Among the fish evaluated, 71.43% H. unitaeniatus and 61.90% C. bimaculatum were parasitized. Contracaecum sp. was found in both species; while acanthocephalans, only in H. unitaeniatus. The alterations were vacuolization, nucleus in the cell periphery, deformation of the cell outline, melanomacrophage center, hyperemia, cytoplasmic degeneration and nuclear vacuolization. Through calculating a histological alteration index, it was found that 26.19% of the specimens presented lesions in stage I; 38.09% lesions in stage II and 9.52% lesions in stage III. It was concluded that there is high prevalence of Contracaecum sp. and that the liver lesions may be adaptive responses by the fish to endoparasitic infection.

https://doi.org/10.1590/s1984-29612022022

Evaluation of TP53 Gene Expression in Patients with Childhood Cancer in Northeast Santa Catarina, Brazil
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Oliveira, Hugo M.

; Stall, Jaqueline

; Coelho, Karina M.P.A.

; Silva, Viviane C.

; Franca, Paulo H. C.

Jornal Brasileiro de Patologia e Medicina Laboratorial

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2022, Volume 58 elocation e4482022

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction In Brazil, 8,000 new cases of childhood cancer are estimated each year, whose causes are still little known, although some have genetically determined factors. Approximately 70% of human cancers have alterations in the TP53 gene, which encodes the protein responsible for inhibiting the disordered growth of cells exposed to injuries. However, the frequency of alterations in the expression of TP53 in childhood cancers in Brazil remains poorly known. Objective To evaluate the expression of TP53 gene in patients with childhood cancer in northeastern of Santa Catarina, Brazil. Materials and Methods: Retrospectively, 282 patients diagnosed with cancer between 2005 and 2015 in Joinville were included. TP53 expression was evaluated by immunohistochemistry using a score based on the intensity and percentage of stained cells. Results The p53 protein was positive in 25.2% of cases, with no difference between sexes. Considering the five main groups of tumors in the sample, the expression was positive in 31.8%, 27.3%, 20%, 17.2% and 5.9% of lymphomas, nephroblastomas, neuroblastomas, tumors of the Central Nervous System and leukemias, respectively. Conclusion The prevalence of TP53 expression was evaluated in different childhood cancers in the northeastern of Santa Catarina. Positivity was higher among lymphomas and lower in leukemias, but with no significant difference among the five most frequent tumors. Further studies that allow correlation with aggressiveness and disease evolution are required.

https://doi.org/10.1900/jbpml.2022.58.448

Extracellular hydrolytic enzymes produced by yeasts from Antarctic lichens
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DA SILVA, MAYANNE KARLA

; DA SILVA, AVERLANE V.

; FERNANDEZ, PAULA M.

; MONTONE, ROSALINDA C.

; ALVES, RODRIGO P.

; DE QUEIROZ, ALINE C.

; DE OLIVEIRA, VALÉRIA M.

; DOS SANTOS, VIVIANE P.

; PUTZKE, JAIR

; ROSA, LUIZ HENRIQUE

; DUARTE, ALYSSON W.F.

Anais da Academia Brasileira de Ciências

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2022, Volume 94 Suppl. 1 elocation e20210540

Abstract: En | Text: En | PDF: En

Abstract In the Antarctic environment, yeasts are versatile eukaryotes that have shown wide dispersion in different substrates, producing active enzymes in extreme conditions, but their relevance in biotechnological applications is largely unknown. The aim of this study was to evaluate the production of extracellular hydrolases by yeasts isolated from Antarctic lichens and molecularly identify these isolates. From a total of 144 isolates on the screening, 109 (76%) produced at least one of the hydrolases tested, with most activities for proteases 59 (41%), cellulases 58 (40%), esterases 57 (39%), lipases 29 (20%), amylases 23 (16%) and pectinases 20 (14%). Among these isolates, 76 were identified, most belonged to the phylum Basidiomycota (n=73) with the dominance of Vishniacozyma victoriae (n=27), Cystobasidium alpinum (n=3), Mrakia niccombsii (n=3), Cystobasidium laryngis (n=2), Bannozyma yamatoana (n=2), Holtermanniella nyarrowii (n=2), and Glaciozyma martinii (n=2). This study is the first one reporting extracellular enzyme production by yeasts isolated from thallus of the species of Antarctic lichens Lecania brialmontii, Polycauliona candelaria, Usnea capillacea, Cladonia metacorallifera, and Polycauliona regalis. With these data, it’s possible to confirm lichens as a source of hydrolase-producing yeasts, reinforcing the potential of these microorganisms in bioprospecting studies of catalytic molecules from polar regions that may be useful in promising biotechnological applications.

https://doi.org/10.1590/0001-3765202220210540

10.

Urgent vs. early-start peritoneal dialysis: patients' profile and outcomes
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Calice-Silva, Viviane

; Tonial, Bruna C.

; Daudt, Pedro Eugênio Deboni

; Ribeiro, Izabel

; Ferreira, Helen C.

; Nerbass, Fabiana B.

Brazilian Journal of Nephrology

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mar 2021, Volume 43 N. 1 Pages 110 - 114

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

RESUMO Introdução: A diálise peritoneal (DP) tem sido considerada uma opção segura de terapia em pacientes com doença renal terminal com necessidade urgente de diálise. Recentemente, foi proposto que a DP de início urgente (US-PD) fosse definida quando a DP iniciar dentro de 72 horas após o implante do cateter, e a DP de "início precoce" (ES-PD) quando a DP iniciar entre 3 e 14 dias após o procedimento. Nosso objetivo foi comparar características demográficas e clínicas entre pacientes em US-PD e ES-PD, bem como complicações em 30 dias, internação por 6 meses e taxa de saída do tratamento. Métodos: Pacientes adultos iniciando DP em até 14 dias após a inserção do cateter (outubro/2016 - fevereiro/2019) foram incluídos e divididos no grupo US-PD ou ES-PD com base no tempo de início da DP. Dados clínicos e demográficos, volume de preenchimento na primeira sessão de DP, complicações em 30 dias, hospitalização por 6 meses e taxa de saída foram avaliados. Resultados: Em nosso estudo, 72 pacientes foram analisados (US-PD = 40, ES-PD = 32) com média de idade de 53,2 ± 15,2 anos. Não foram encontradas diferenças entre US-PD e ES-PD em relação às características demográficas, complicações em 30 dias, hospitalização por 6 meses e saída do tratamento. A complicação de curto prazo mais frequente nos pacientes que iniciaram a DP com urgência foi o extravasamento de líquido peritoneal. A causa mais comum de saída foi a transferência para HD. Conclusão: Mais da metade da nossa amostra iniciou a DP menos de 72 horas após a inserção do cateter. A falta de diferença nos desfechos mensurados em comparação com os pacientes que iniciaram o tratamento após esse período incentiva o uso de US-PD quando necessário.

ABSTRACT Introduction: Peritoneal dialysis (PD) has been considered a safe option of therapy in end-stage renal disease patients with urgent need of dialysis. Recently, it was proposed that Urgent-Start-PD (US-PD) be defined when PD starts within 72 hours after catheter placement and “early start” PD (ES-PD) when PD starts between 3 and 14 days after. We aimed to compare demographic and clinical characteristics between patients in US-PD and ES-PD as well as 30-day complications, 6-month hospitalization, and dropout rate. Methods: Adult patients starting PD within 14 days after catheter insertion (October/2016 - February/2019) were included and divided into US-PD group and ES-PD group based on the their PD initiation time. Clinical and demographic data, fill volume for the first PD session, 30-day complications, 6-month hospitalization, and dropout rate were assessed. Results: In our study, 72 patients were analyzed (US-PD=40, ES-PD=32) with mean age of 53.2±15.2 years old. No differences between US-PD and ES-PD regarding demographic characteristics, 30-day complications, 6-month hospitalization, and dropout events were found. The most frequent short-term complication in patients who started PD urgently was leakage. The most common cause of dropout was transfer to HD. Conclusion: Fifty five percent of our sample started PD less than 72 hours after catheter insertion. The lack of difference in the measured outcomes compared to patients that had therapy initiated after this period encourages the use of urgent PD when needed.

https://doi.org/10.1590/2175-8239-jbn-2020-0011 417 downloads

11.

Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís)
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Carvalho, Carolina Abreu de

; Magalhães, Elma Izze da Silva

; Bettiol, Heloisa

; Barbieri, Marco Antonio

; Cardoso, Viviane Cunha

; Matijasevich, Alicia

; Menezes, Ana Maria Baptista

; Horta, Bernardo Lessa

; Wehrmeister, Fernando C.

; Gonçalves, Helen

; Santos, Iná S.

; Lima, Natália Peixoto

; França, Ana Karina Teixeira da Cunha

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2021, Volume 37 N. 4 elocation e00237020

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

O estudo teve como objetivo estimar as prevalências de excesso de peso e de obesidade, de acordo com sexo e renda, no Consórcio RPS (Ribeirão Preto, Pelotas e São Luís) de coorte de nascimentos brasileiros. Os participantes nas coortes de Ribeirão Preto (1978/1979 e 1994), Pelotas (1982, 1993 e 2004) e São Luís (1997/1998) foram incluídos em diferentes seguimentos a partir dos sete anos de idade. O excesso de peso (sobrepeso e obesidade) e a obesidade foram avaliados pelo índice de massa corporal. As maiores prevalências foram observadas em Ribeirão Preto (excesso de peso: 27,7% aos 9-11 e 47,1% aos 22-23 anos; obesidade: 8,6% aos 9-11 e 19,8% aos 22-23 anos) e as menores taxas em São Luís (excesso de peso: 5,4% aos 7-9 e 17,2% aos 18-19 anos; obesidade: 1,8% aos 7-9 e 3,6% aos 18-19 anos). Quanto mais jovem a coorte, maior a prevalência de excesso de peso e de obesidade, na comparação entre grupos etários semelhantes. O aumento na prevalência de obesidade foi maior que na prevalência de excesso de peso. As mulheres tiveram menor prevalência de excesso de peso nas coortes mais velhas e maior prevalência de obesidade nas coortes mais jovens. Maiores prevalências de excesso de peso e de obesidade foram observadas nas crianças e adolescentes com renda familiar mais alta e em adultos de renda mais baixa. As diferenças nas prevalências de excesso de peso e de obesidade evidenciaram que os indivíduos das coortes mais jovens estão mais expostos a essa morbidade, assim como, aqueles nascidos na cidade mais desenvolvida, os adultos de baixa renda e crianças e adolescentes pertencentes a família do tercil de maior renda. Portanto, os resultados indicam a necessidade de priorizar medidas dirigidas aos indivíduos mais jovens.

Our objective was to estimate the prevalence of excess weight and obesity, according to sex and income in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas, and São Luís). Participants in the Ribeirão Preto (1978/1979 and 1994), Pelotas (1982, 1993 and 2004) and São Luís (1997/1998) birth cohorts were included in different follow-ups from 7 years old onwards. Excess weight (overweight and obesity) were assessed by body mass index. The highest prevalences were observed in Ribeirão Preto (excess weight: 27.7% at 9-11 and 47.1% at 22-23 years; obesity: 8.6% at 9-11 and 19.8% at 22-23 years) while the smallest was in São Luís (excess weight: 5.4 to 7-9 and 17.2% at 18-19 years; obesity: 1.8% at 7-9 and 3.6% at 18-19 years). The younger the cohort, the greater the prevalence of excess weight and obesity when comparing similar age groups. Increases in obesity prevalence were greater than in excess weight prevalence. Women had lower excess weight prevalence in older cohorts and higher obesity prevalence in younger cohorts. Higher excess weight and obesity prevalence were observed in higher income children and adolescents, and in poorer adults. Differences in the prevalence of excess weight and obesity evidenced that individuals from younger cohorts are more exposed to this morbidity, as well as those who were born in the most developed city, low-income adults as well as children and adolescents belonging to families of the highest income tertile. Therefore, the results of this study indicate the need to prioritize actions aimed at younger individuals.

El objetivo de este estudio fue estimar la prevalencia de sobrepeso y obesidad, según sexo e ingresos en el Consorcio RPS (Ribeirão Preto, Pelotas and São Luís) cohortes brasileñas de nascimientos. Los participantes en las cohortes de nacimiento de Ribeirão Preto (1978/1979 y 1994), Pelotas (1982, 1993 y 2004) y São Luís (1997/1998) fueron incluidos en diferentes seguimientos desde los 7 años de edad. El exceso de peso (sobrepeso y obesidad) fueron evaluados por el índice de masa corporal. Las prevalencias más altas se observaron en Ribeirão Preto (exceso de peso: 27,7% a los 9-11 y 47,1% a los 22-23 años; obesidad: 8,6% a los 9-11 y 19,8% a los 22-23 años) y los más pequeños en São Luís (exceso de peso: 5,4 a los 7-9 y 17,2% a los 18-19 años; obesidad: 1,8% a los 7-9 y 3,6% a los 18-19 años). Cuanto más joven fuera la cohorte, mayor era la prevalencia de exceso de peso y obesidad, cuando se comparan con grupos de edad similares. El incremento en la prevalencia de obesidad fue mayor que en la prevalencia de exceso de peso. Las mujeres tenían una prevalencia de exceso de peso más baja en las cohortes más viejas y una mayor prevalencia de obesidad en las cohortes más jóvenes. Se observaron prevalencias más altas de exceso de peso y obesidad en los niños y adolescentes con mayores ingresos, y en los adultos más pobres. Las diferencias en las prevalencias de exceso de peso y obesidad evidenciaron que las personas de las cohortes más jóvenes estaban más expuestas a esta morbilidad, al igual que aquellas que habían nacido en las ciudades más desarrolladas, adultos con bajos ingresos, además de niños y adolescentes pertenecientes a las familias del tercil de ingresos más altos. Por eso, los resultados de este estudio indican la necesidad de priorizar acciones dirigidas a las personas más jóvenes.

https://doi.org/10.1590/0102-311x00237020

12.

Complete denture hygiene solutions: antibiofilm activity and effects on physical and mechanical properties of acrylic resin
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ROCHA, Millena Mangueira

; CARVALHO, Adrianne Moura

; COIMBRA, Flávia Cristina Targa

; ARRUDA, Carolina Noronha Ferraz de

; OLIVEIRA, Viviane de Cássia

; MACEDO, Ana Paula

; SILVA-LOVATO, Cláudia Helena

; PAGNANO, Valéria Oliveira

; PARANHOS, Helena de Freitas Oliveira

Journal of Applied Oral Science

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2021, Volume 29 elocation e20200948

Abstract: En | Text: En | PDF: En

Abstract Appropriated denture hygiene is a predictive factor for longevity of rehabilitation treatment and maintenance of the oral mucosal health. Although, disinfectant solutions are commonly used as denture cleansers, the impact of these solutions on acrylic resin-based dentures remain unclear. Objective To evaluate, in vitro, the antibiofilm activity of complete denture hygiene solutions and their effects on physical and mechanical properties of acrylic resin. Methodology For antibiofilm activity measurement acrylic resin specimens were contaminated with Candida albicans, Candida glabrata and Streptococcus mutans. After biofilm growth, the specimens were assigned to the hygiene solutions: Distilled water (Control); 0.2% Sodium hypochlorite (SH); Efferdent Power Clean Crystals (EPC) and 6.25% Ricinus communis (RC). The viability of microorganisms was evaluated by agar plate counts. In parallel, physical, and mechanical properties of the acrylic resin were evaluated after simulating a 5-year period of daily immersion in the previously mentioned solutions. The changes in surface roughness, color, microhardness, flexural strength, impact strength, sorption and solubility were evaluated. Data were compared by ANOVA followed by the Tukey test or Kruskal-Wallis followed by the Dunn test depending on the distribution (α=0.05). Results Regarding antibiofilm action, SH eliminated all microorganisms while EPC and RC exhibited moderate action against S. mutans (p=0.001) and C. glabrata (p<0.001), respectively. Relative to effects on the physical and mechanical properties of the acrylic resin, RC led to higher values of color change (p=0.030), hardness (p<0.001), surface roughness (p=0.006) and flexural strength (p<0.001). Moreover, RC induced the highest values of changes in solubility (p<0.001). EPC promoted greater changes in surface morphology, whereas immersion in SH retained the initial appearance of the acrylic resin surface. All hygiene solutions reduced the impact strength (p<0.05). Conclusion SH presented the most effective antibiofilm activity. In addition, changes on properties were observed after immersion in RC, which were considered within acceptable limits.

https://doi.org/10.1590/1678-7757-2020-0948 151 downloads

13.

Action of disinfectant solutions on adaptive capacity and virulence factors of the Candida spp. biofilms formed on acrylic resin
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BADARÓ, Mauricio Malheiros

; BUENO, Frank Lucarini

; MAKRAKIS, Lais Ranieri

; ARAÚJO, Camila Borba

; OLIVEIRA, Viviane de Cássia

; MACEDO, Ana Paula

; PARANHOS, Helena de Freitas Oliveira

; WATANABE, Evandro

; SILVA-LOVATO, Cláudia Helena

Journal of Applied Oral Science

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2021, Volume 29 elocation e20210024

Abstract: En | Text: En | PDF: En

Abstract Understanding the behavior of Candida spp. when exposed to denture disinfectants is essential to optimize their effectiveness. Changes in the virulence factors may cause increased resistance of Candida spp. to disinfectant agents. Objective To evaluate the microbial load, cellular metabolism, hydrolytic enzyme production, hyphae formation, live cell and biofilm quantification of Candida albicans, Candida tropicalis and Candida glabrata after exposure to disinfectant solutions. Methodology Simple biofilms were grown on heat-polymerized acrylic resin specimens, and divided into groups according to solutions/strains: distilled water (control); 0.25% sodium hypochlorite (NaOCl 0.25% ); 10% Ricinus communis (RC 10%); and 0.5% Chloramine T (CT 0.5%). The virulence factors were evaluated using the CFU count (microbial load), XTT method (cell metabolism), epifluorescence microscopy (biofilm removal and live or dead cells adhered), protease and phospholipase production and hyphae formation. Data were analyzed (α=0.05) by one-way ANOVA/ Tukey post hoc test, Kruskal-Wallis test and Wilcoxon test. Results NaOCl 0.25% was the most effective solution. CT 0.5% reduced the number of CFUs more than RC 10% and the control. RC 10% was effective only against C. glabrata. RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata. Enzyme production was not affected. Hyphal growth in the RC 10% and CT 0.5% groups was similar to that of the control. CT 0.5% was better than RC 10% against C. albicans and C. tropicalis when measuring the total amount of biofilm and number of living cells. For C. glabrata, CT 0.5% was equal to RC 10% in the maintenance of living cells; RC 10% was superior for biofilm removal. Conclusions The CT 0.5% achieved better results than those of Ricinus communis at 10%, favoring the creation of specific products for dentures. Adjustments in the formulations of RC 10% are necessary due to efficacy against C. glabrata. The NaOCl 0.25% is the most effective and could be suitable for use as a positive control.

https://doi.org/10.1590/1678-7757-2021-0024 117 downloads

14.

Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís)
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Carvalho, Carolina Abreu de

; Magalhães, Elma Izze da Silva

; Bettiol, Heloisa

; Barbieri, Marco Antonio

; Cardoso, Viviane Cunha

; Matijasevich, Alicia

; Menezes, Ana Maria Baptista

; Horta, Bernardo Lessa

; Wehrmeister, Fernando C.

; Gonçalves, Helen

; Santos, Iná S.

; Lima, Natália Peixoto

; França, Ana Karina Teixeira da Cunha

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2021, Volume 37 N. 4 elocation e00237020

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

https://doi.org/10.1590/0102-311x00237020 257 downloads

15.

RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods
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Confortin, Susana Cararo

; Ribeiro, Marizélia Rodrigues Costa

; Barros, Aluísio J. D.

; Menezes, Ana Maria Baptista

; Horta, Bernardo L.

; Victora, Cesar Gomes

; Barros, Fernando C.

; Gonçalves, Helen

; Bettiol, Heloisa

; Santos, Iná Silva dos

; Barbieri, Marco Antonio

; Saraiva, Maria da Conceição Pereira

; Alves, Maria Teresa Seabra Soares de Britto e

; Silveira, Mariângela Freitas da

; Domingues, Marlos Rodrigues

; Lima, Natália Peixoto

; Rocha, Paulo Ricardo Higassiaraguti

; Cavalli, Ricardo Carvalho

; Batista, Rosângela Fernandes Lucena

; Cardoso, Viviane Cunha

; Simões, Vanda Maria Ferreira

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2021, Volume 37 N. 4 elocation e00093320

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

Resumo: O artigo descreve a história, objetivos e métodos utilizados pelas nove coortes do Consórcio RPS de Coortes de Nascimento. São identificados eixos temáticos comuns, com apresentação dos objetivos, anos de linha de base, fases de seguimento e representatividade das populações de estudo. O Consórcio inclui três coortes de nascimento de Ribeirão Preto, Estado de São Paulo (1978/1979, 1994 e 2010), quatro de Pelotas, Estado do Rio Grande do Sul (1982, 1993, 2004 e 2015) e duas de São Luís, Estado do Maranhão (1997 e 2010). As coortes provêm de três regiões do Brasil, de três estados diferentes, com importantes diferenças socioeconômicas, culturais e de infraestrutura. As coortes foram iniciadas ao nascer dos participantes, exceto a mais recente em cada município, onde as mães foram recrutadas durante a gestação. Os instrumentos para a coleta de dados foram refinados para aproximar diferentes exposições na primeira infância e a influência, a longo prazo, no processo saúde-doença. Os investigadores das nove coortes realizaram estudos perinatais e depois examinaram o capital humano, saúde mental, nutrição e sinais percursores de doenças crônicas. Um total de 17.636 nascidos vivos foram recrutados em Ribeirão Preto, 19.669 em Pelotas e 7.659 em São Luís. Nas coortes que foram iniciadas durante a gestação, foram entrevistadas 1.400 gestantes em Ribeirão Preto, 3.199 em Pelotas e 1.447 em São Luís. Foram utilizadas diferentes estratégias para reduzir as perdas de seguimento. A rede de pesquisa do Consórcio permite analisar a incidência de doenças e identificar possíveis relações causais que podem explicar os desfechos de saúde nessas populações e contribuir para o desenvolvimento de medidas públicas e políticas de saúde que estejam mais de acordo com as respectivas realidades.

Abstract: This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.

Resumen: El trabajo describe la historia, objetivos y métodos usados por nueve cohortes brasileñas del RPS Consorcio de Cohortes de Nacimiento. Se identificaron los ejes temáticos comunes y los objetivos, así como los periodos de referencia, la presentación del estadio de seguimiento y representatividad de la población estudiada. El consorcio incluye tres cohortes de nacimiento de Ribeirão Preto, Estado de São Paulo (1978/1979, 1994 y 2010), cuatro de Pelotas, Estado del Rio Grande do Sul (1982, 1993, 2004 y 2015), y dos de São Luís, Estado del Maranhão (1997 y 2010). Las cohortes cubren tres regiones de Brasil, de tres estados distintos, con marcadas diferencias socioeconómicas, culturales y de infraestructura. Las cohortes comenzaron con el nacimiento, excepto para la más reciente en cada municipio, donde las madres fueron reclutadas durante la gestación. Los instrumentos para la recogida de datos han sido depurados, con el fin de realizar una aproximación a diferentes exposiciones durante las fases tempranas de la vida y su influencia a largo plazo en el proceso de salud-enfermedad. Se incluyeron a los investigadores de las nueve cohortes, donde se llevaron a cabo estudios perinatales, así como los recursos humanos analizados posteriormente, al igual que la salud mental, nutrición y signos precursores de enfermedades no comunicables. Un total de 17.636 nacidos vivos fueron reclutados en Ribeirão Preto, 19.669 en Pelotas, y 7.659 en São Luís. En los estudios que comenzaron durante el embarazo, 1.400 mujeres embarazadas fueron entrevistadas en Ribeirão Preto, 3.199 en Pelotas, y 1.447 en São Luís. Se usaron diferentes estrategias para reducir pérdidas, con el fin de realizar el seguimiento. Esta red de investigación permite el análisis de la incidencia de enfermedades y el establecimiento de posibles relaciones causales que podrían explicar los resultados de salud de estas poblaciones, con el fin de contribuir al desarrollo de acciones gubernamentales y políticas de salud más consistentes con la realidad.

https://doi.org/10.1590/0102-311x00093320 419 downloads

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