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BACKGROUND AND AIMS: Lianas have higher relative abundance and biomass in drier seasonal forests than in rainforests, but whether this difference is associated with their hydraulic strategies is unclear. Here, we investigate whether lianas of seasonally dry forests are safer and more efficient in water transport than rainforest lianas, explaining patterns of liana abundance. METHODS: We measured hydraulic traits on five pairs of congeneric lianas of the tribe Bignonieae in two contrasting forest sites: the wet 'Dense Ombrophilous Forest' in Central Amazonia (~2 dry months) and the drier 'Semideciduous Seasonal Forest' in the inland Atlantic Forest (~6 dry months). We also gathered a broader database, including 197 trees and 58 liana species from different tropical forests, to compare hydraulic safety between habits and forest types. KEY RESULTS: Bignonieae lianas from both forests had high and similar hydraulic efficiency but exhibited variability in resistance to embolism across forest types when phylogenetic relationships were taken into account. Three genera had higher hydraulic safety in the seasonal forest than in the rainforest, but species across both forests had similar positive hydraulic safety margins despite lower predawn water potential values of seasonal forest lianas. We did not find the safety-efficiency trade-off. Merging our results with previously published data revealed a high variability of resistance to embolism in both trees and lianas, independent of forest types. CONCLUSIONS: The high hydraulic efficiency of lianas detected here probably favours their rapid growth across tropical forests, but differences in hydraulic safety highlight that some species are highly vulnerable and may rely on other mechanisms to cope with drought. Future research on the lethal dehydration threshold and the connection between hydraulic resistance strategies and liana abundance could offer further insights into tropical forest dynamics under climatic threats.
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Bosque Lluvioso , Estaciones del Año , Clima Tropical , Bosques , Agua/fisiología , Bignoniaceae/fisiología , Árboles/fisiología , BrasilRESUMEN
Bilateral acute depigmentation of the iris and bilateral acute iris transillumination (BAIT) are similar clinical entities. The former causes acute-onset depigmentation of the iris stroma without transillumination, whereas the latter causes depigmentation of the iris pigment epithelium with transillumination. The etiopathogenesis of these conditions is not yet fully understood, but the proposed causes include the use of systemic antibiotics (especially moxifloxacin) and viral triggers. We present a case series of five female patients with a mean age of 41 (32-45) years, all of whom suffered acute onset of bilateral pain and redness of the eyes after moxifloxacin use (oral or topical). It is important for ophthalmologists to be aware of the two forms of iris depigmentation since this case series suggests that SARS-CoV-2 or its empirical treatment with moxifloxacin may trigger iris depigmentation. If this is the case, clinicians will likely see increased incidences of bilateral acute depigmentation of the iris and bilateral acute iris transillumination during and after the COVID-19 pandemic.
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COVID-19 , Enfermedades del Iris , Humanos , Femenino , Adulto , Enfermedades del Iris/inducido químicamente , Persona de Mediana Edad , COVID-19/complicaciones , Brasil , Enfermedad Aguda , Moxifloxacino/efectos adversos , Moxifloxacino/uso terapéutico , Transiluminación , SARS-CoV-2 , Trastornos de la Pigmentación/inducido químicamente , Iris/patología , Antibacterianos/efectos adversos , Epitelio Pigmentado Ocular/patología , Epitelio Pigmentado Ocular/efectos de los fármacosRESUMEN
Tumor necrosis factor (TNF) and interferon-gamma (IFNγ) are important inflammatory mediators in the development of cytokine storm syndrome (CSS). Single nucleotide polymorphisms (SNPs) regulate the expression of these cytokines, making host genetics a key factor in the prognosis of COVID-19. In this study, we investigated the associations of the TNF -308G/A and IFNG +874T/A polymorphisms with COVID-19. We analyzed the frequencies of the two polymorphisms in the control groups (CG: TNF -308G/A, n = 497; IFNG +874T/A, n = 397), a group of patients with COVID-19 (CoV, n = 222) and among the subgroups of patients with nonsevere (n = 150) and severe (n = 72) COVID-19. We found no significant difference between the genotypic and allelic frequencies of TNF -308G/A in the groups analyzed; however, both the frequencies of the high expression genotype (TT) (CoV: 13.51% vs. CG: 6.30%; p = 0.003) and the *T allele (CoV: 33.56% vs. CG: 24. 81%; p = 0.001) of the IFNG +874T/A polymorphism were higher in the COVID-19 group than in the control group, with no differences between the subgroups of patients with nonsevere and severe COVID-19. The *T allele of IFNG +874T/A (rs2430561) is associated with susceptibility to symptomatic COVID-19. These SNPs provided valuables clues about the potential mechanism involved in the susceptibility to developing symptomatic COVID-19.
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COVID-19 , Predisposición Genética a la Enfermedad , Genotipo , Interferón gamma , SARS-CoV-2 , Femenino , Humanos , Masculino , Alelos , COVID-19/genética , COVID-19/virología , Síndrome de Liberación de Citoquinas/genética , Frecuencia de los Genes , Interferón gamma/genética , Polimorfismo de Nucleótido Simple , SARS-CoV-2/patogenicidad , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
OBJECTIVE: To assess FEES findings in defining oral feeding safety in children with suspected dysphagia, comparing them with clinical feeding evaluation results. METHODS: This study comprised a case series involving children with suspected dysphagia, referred for evaluation by otolaryngologists and speech-language pathologists (SLPs) at a Brazilian quaternary public university hospital. These children underwent both clinical evaluations and fiberoptic endoscopic evaluation of swallowing (FEES), with a comprehensive collection of demographic and clinical data. Subsequently, the authors performed a comparative analysis of findings from both assessments. RESULTS: Most patients successfully completed the FEES procedure (93.7%), resulting in a final number of 60 cases included in the study. The prevalence of dysphagia was confirmed in a significant 88% of these cases. Suspected aspiration on clinical SLP evaluation was present in 34 patients. Of these, FEES confirmed aspiration or penetration in 28 patients. Among the 35 patients with aspiration or penetration on FEES, 7 (20%) had no suspicion on SLP clinical assessment. All seven patients in whom clinical SLP evaluation failed to predict penetration/aspiration had neurological disorders. The median age of the children was 2.8 years, and 49 (81.6%) had neurological disorders, while 35 (58.3%) had chronic pulmonary disease. The most prevalent complaints were choking (41.6%) and sialorrhea (23.3%). CONCLUSION: FEES can diagnose structural anomalies of the upper aerodigestive tract and significantly contribute to the detection of aspiration and penetration in this group of patients with suspected dysphagia, identifying moderate and severe dysphagia even in cases where clinical assessment had no suspicion.
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Trastornos de Deglución , Tecnología de Fibra Óptica , Humanos , Trastornos de Deglución/diagnóstico , Femenino , Masculino , Preescolar , Niño , Lactante , Deglución/fisiología , Adolescente , Endoscopía/métodos , Brasil/epidemiología , Aspiración Respiratoria/diagnóstico , Aspiración Respiratoria/etiologíaRESUMEN
Staphylococcus aureus is a Gram-positive pathogen responsible for the majority of skin and soft tissue infections (SSTIs). S. aureus colonizes the anterior nares of approximately 20%-30% of the population and transiently colonizes the skin, thereby increasing the risk of developing SSTIs and more serious infections. Current laboratory models that mimic the skin surface environment are expensive, require substantial infrastructure, and limit the scope of bacterial physiology studies under human skin conditions. To overcome these limitations, we developed a cost-effective, open-source, chemically defined media recipe termed skin-like medium (SLM) that incorporates key aspects of the human skin surface environment and supports growth of several staphylococcal species. We utilized SLM to investigate the transcriptional response of methicillin-resistant Staphylococcus aureus (MRSA) following growth in SLM compared to a commonly used laboratory media. Through RNA-seq analysis, we observed the upregulation of several virulence factors, including genes encoding functions involved in adhesion, proteolysis, and cytotoxicity. To further explore these findings, we conducted quantitative reverse transcription-PCR (qRT-PCR) experiments to determine the influence of media composition, pH, and temperature on the transcriptional response of key factors involved in adhesion and virulence. We also demonstrated that MRSA primed in SLM adhered better to human corneocytes and demonstrated adhesin-specific phenotypes that previously required genetic manipulation. This improved adherence to corneocytes was dependent on both acidic pH and growth in SLM. These results support the potential utility of SLM as an in vitro model for assessing staphylococcal physiology and metabolism on human skin. IMPORTANCE: Staphylococcus aureus is the major cause of skin diseases, and its increased prevalence in skin colonization and infections present a need to understand its physiology in this environment. The work presented here outlines S. aureus upregulation of colonization and virulence factors using a newly developed medium that strives to replicate the human skin surface environment and demonstrates roles for adhesins clumping factor A (ClfA), serine-rich repeat glycoprotein adhesin (SraP), and the fibronectin binding proteins (Fnbps) in human corneocyte adherence.
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Medios de Cultivo , Regulación Bacteriana de la Expresión Génica , Staphylococcus aureus Resistente a Meticilina , Piel , Factores de Virulencia , Humanos , Piel/microbiología , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/fisiología , Factores de Virulencia/genética , Factores de Virulencia/metabolismo , Medios de Cultivo/química , Staphylococcus aureus/genética , Staphylococcus aureus/fisiología , Staphylococcus aureus/crecimiento & desarrollo , Staphylococcus aureus/patogenicidad , Infecciones Estafilocócicas/microbiología , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Adhesión BacterianaRESUMEN
Amazonia's floodplain system is the largest and most biodiverse on Earth. Although forests are crucial to the ecological integrity of floodplains, our understanding of their species composition and how this may differ from surrounding forest types is still far too limited, particularly as changing inundation regimes begin to reshape floodplain tree communities and the critical ecosystem functions they underpin. Here we address this gap by taking a spatially explicit look at Amazonia-wide patterns of tree-species turnover and ecological specialization of the region's floodplain forests. We show that the majority of Amazonian tree species can inhabit floodplains, and about a sixth of Amazonian tree diversity is ecologically specialized on floodplains. The degree of specialization in floodplain communities is driven by regional flood patterns, with the most compositionally differentiated floodplain forests located centrally within the fluvial network and contingent on the most extraordinary flood magnitudes regionally. Our results provide a spatially explicit view of ecological specialization of floodplain forest communities and expose the need for whole-basin hydrological integrity to protect the Amazon's tree diversity and its function.
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Biodiversidad , Inundaciones , Ríos , Árboles , Brasil , BosquesRESUMEN
BACKGROUND: The early identification of risk for dysphagia in patients with Parkinson's disease (PD) is essential for the prevention of nutritional and pulmonary complications. OBJECTIVE: To analyze the sensitivity and specificity of the Swallowing Disturbance Questionnaire (SDQ-PD) and the Eating Assessment Tool (EAT-10) in identifying dysphagia risk in patients with early and intermediate stages of PD. METHODS: Twenty-nine patients with PD participated in the study. EAT-10 and SDQ-PD questionnaires were applied, and a videofluoroscopic swallowing study. Dysphagia Outcome and Severity Scale (DOSS) was used to classify the presence and severity of dysphagia, and the Penetration-Aspiration Scale (PAS) was used to identify the presence of penetration/aspiration. In the statistical analysis, the sensitivity and specificity of the risk questionnaires were calculated, as well as positive predictive value, negative predictive value, and accuracy. RESULTS: EAT-10 to identify the risk of penetration/aspiration revealed a sensitivity of 71.42% and specificity of 45.45%; in the identification of the presence of dysphagia, the sensitivity was 47.61%, and the specificity was 12.5%. The SDQ-PD questionnaire for risk of penetration/aspiration demonstrated a sensitivity of 28.57%, and a specificity of 68.18%. In terms of identifying the presence of dysphagia, the sensitivity was 20%, while the specificity was 44.44%. CONCLUSION: The SDQ-PD revealed low sensitivity and low specificity to identify the presence of dysphagia and/or penetration/aspiration in patients with early and intermediate stages of PD in this sample. Despite its low specificity, the EAT-10 exhibited good sensitivity in indicating the risk of penetration/aspiration.
ANTECEDENTES: A identificação precoce de risco para disfagia nos pacientes com doença de Parkinson (DP) é fundamental para a prevenção de complicações nutricionais e pulmonares. OBJETIVO: Analisar a sensibilidade e especificidade dos questionários Swallowing Disturbance Questionnaire (SDQ-PD) e Eating Assessment Tool (EAT-10) para a identificação do risco de disfagia em pacientes com DP nos estágios iniciais e intermediários da doença. MéTODOS: Participaram 29 pacientes com DP. Foi realizado a aplicação dos questionários EAT-10 e SDQ-PD e o exame de videofluoroscopia da deglutição. Para a classificação da presença e gravidade da disfagia foi utilizada a escala Dysphagia Outcome and Severity Scale e, para identificação da presença de penetração/aspiração, a escala Penetration-Aspiration Scale (PAS). Na análise estatística, calcularam-se a sensibilidade e a especificidade dos questionários de risco EAT-10 e SDQ-DP e o valor preditivo positivo, o valor preditivo negativo e a acurácia. RESULTADOS: A análise do EAT-10 para identificar o risco de penetração/aspiração revelou sensibilidade de 71.42% e especificidade de 45.45%; para identificar a presença de disfagia, a sensibilidade foi de 47,61% e a especificidade de 12.5%. Em relação ao questionário SDQ-PD, para identificar risco de penetração/aspiração, a sensibilidade foi de 28.57% e a especificidade de 68.18% e, para identificar a presença de disfagia, a sensibilidade foi de 20% e a especificidade de 44.44%. CONCLUSãO: O questionário SDQ-PD revelou baixa sensibilidade e baixa especificidade para identificar presença de disfagia e/ou penetração/aspiração em pacientes com DP em estágios iniciais e intermediários para essa amostra. O EAT-10 revelou boa sensibilidade na indicação de risco de penetração/aspiração, apesar de baixa especificidade.
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Trastornos de Deglución , Enfermedad de Parkinson , Humanos , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Enfermedad de Parkinson/complicaciones , Deglución , Sensibilidad y Especificidad , Encuestas y Cuestionarios , Aspiración Respiratoria/complicacionesRESUMEN
The cGAS-STING pathway appears to contribute to dysregulated inflammation during coronavirus disease 2019 (COVID-19); however, inflammatory factors related to long COVID are still being investigated. In the present study, we evaluated the association of cGAS and STING gene expression levels and plasma IFN-α, TNF-α and IL-6 levels with COVID-19 severity in acute infection and long COVID, based on analysis of blood samples from 148 individuals, 87 with acute COVID-19 and 61 in the post-COVID-19 period. Quantification of gene expression was performed by real-time PCR, and cytokine levels were quantified by ELISA and flow cytometry. In acute COVID-19, cGAS, STING, IFN-α, TNF-α, and IL-6 levels were higher in patients with severe disease than in those with nonsevere manifestations (p < 0.05). Long COVID was associated with elevated cGAS, STING and IFN-α levels (p < 0.05). Activation of the cGAS-STING pathway may contribute to an intense systemic inflammatory state in severe COVID-19 and, after infection resolution, induce an autoinflammatory disease in some tissues, resulting in long COVID.
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COVID-19 , Síndrome Post Agudo de COVID-19 , Humanos , Interferón-alfa , Interleucina-6 , Nucleotidiltransferasas/genética , Nucleotidiltransferasas/metabolismo , Transducción de Señal/genética , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
[This corrects the article DOI: 10.3389/fmed.2023.1130218.].
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Clinical manifestations of dermatological and musculoskeletal conditions can sometimes overlap, leading to confusion in diagnosis. Patients with nail and skin infections may undergo imaging examinations with suspicions of muscle, tendon, or joint injuries. Dermatological infections often involve soft tissues and musculoskeletal structures, and their etiology can range from fungi, bacteria, viruses, to protozoa. Relying solely on physical examination may not be sufficient for accurate diagnosis and treatment planning, necessitating the use of complementary imaging exams. The objective of this paper is to present and discuss imaging findings of the main infectious conditions affecting the nail apparatus and skin. The paper also highlights the importance of imaging in clarifying diagnostic uncertainties and guiding appropriate treatment for dermatological conditions.
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ABSTRACT Bilateral acute depigmentation of the iris and bilateral acute iris transillumination (BAIT) are similar clinical entities. The former causes acute-onset depigmentation of the iris stroma without transillumination, whereas the latter causes depigmentation of the iris pigment epithelium with transillumination. The etiopathogenesis of these conditions is not yet fully understood, but the proposed causes include the use of systemic antibiotics (especially moxifloxacin) and viral triggers. We present a case series of five female patients with a mean age of 41 (32-45) years, all of whom suffered acute onset of bilateral pain and redness of the eyes after moxifloxacin use (oral or topical). It is important for ophthalmologists to be aware of the two forms of iris depigmentation since this case series suggests that SARS-CoV-2 or its empirical treatment with moxifloxacin may trigger iris depigmentation. If this is the case, clinicians will likely see increased incidences of bilateral acute depigmentation of the iris and bilateral acute iris transillumination during and after the COVID-19 pandemic.
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Abstract Background The early identification of risk for dysphagia in patients with Parkinson's disease (PD) is essential for the prevention of nutritional and pulmonary complications. Objective To analyze the sensitivity and specificity of the Swallowing Disturbance Questionnaire (SDQ-PD) and the Eating Assessment Tool (EAT-10) in identifying dysphagia risk in patients with early and intermediate stages of PD. Methods Twenty-nine patients with PD participated in the study. EAT-10 and SDQ-PD questionnaires were applied, and a videofluoroscopic swallowing study. Dysphagia Outcome and Severity Scale (DOSS) was used to classify the presence and severity of dysphagia, and the Penetration-Aspiration Scale (PAS) was used to identify the presence of penetration/aspiration. In the statistical analysis, the sensitivity and specificity of the risk questionnaires were calculated, as well as positive predictive value, negative predictive value, and accuracy. Results EAT-10 to identify the risk of penetration/aspiration revealed a sensitivity of 71.42% and specificity of 45.45%; in the identification of the presence of dysphagia, the sensitivity was 47.61%, and the specificity was 12.5%. The SDQ-PD questionnaire for risk of penetration/aspiration demonstrated a sensitivity of 28.57%, and a specificity of 68.18%. In terms of identifying the presence of dysphagia, the sensitivity was 20%, while the specificity was 44.44%. Conclusion The SDQ-PD revealed low sensitivity and low specificity to identify the presence of dysphagia and/or penetration/aspiration in patients with early and intermediate stages of PD in this sample. Despite its low specificity, the EAT-10 exhibited good sensitivity in indicating the risk of penetration/aspiration.
Resumo Antecedentes A identificação precoce de risco para disfagia nos pacientes com doença de Parkinson (DP) é fundamental para a prevenção de complicações nutricionais e pulmonares. Objetivo Analisar a sensibilidade e especificidade dos questionários Swallowing Disturbance Questionnaire (SDQ-PD) e Eating Assessment Tool (EAT-10) para a identificação do risco de disfagia em pacientes com DP nos estágios iniciais e intermediários da doença. Métodos Participaram 29 pacientes com DP. Foi realizado a aplicação dos questionários EAT-10 e SDQ-PD e o exame de videofluoroscopia da deglutição. Para a classificação da presença e gravidade da disfagia foi utilizada a escala Dysphagia Outcome and Severity Scale e, para identificação da presença de penetração/aspiração, a escala Penetration-Aspiration Scale (PAS). Na análise estatística, calcularam-se a sensibilidade e a especificidade dos questionários de risco EAT-10 e SDQ-DP e o valor preditivo positivo, o valor preditivo negativo e a acurácia. Resultados A análise do EAT-10 para identificar o risco de penetração/aspiração revelou sensibilidade de 71.42% e especificidade de 45.45%; para identificar a presença de disfagia, a sensibilidade foi de 47,61% e a especificidade de 12.5%. Em relação ao questionário SDQ-PD, para identificar risco de penetração/aspiração, a sensibilidade foi de 28.57% e a especificidade de 68.18% e, para identificar a presença de disfagia, a sensibilidade foi de 20% e a especificidade de 44.44%. Conclusão O questionário SDQ-PD revelou baixa sensibilidade e baixa especificidade para identificar presença de disfagia e/ou penetração/aspiração em pacientes com DP em estágios iniciais e intermediários para essa amostra. O EAT-10 revelou boa sensibilidade na indicação de risco de penetração/aspiração, apesar de baixa especificidade.
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Gels containing juca seed galactomannan (JSG) were evaluated for their potential to prevent the progression of dentin erosive wear in an in vitro study with four experimental groups (n = 9). The treatments included distilled water (DW), 0.05% stannous fluoride (121 ppm F), and 0.5% or 1% JSG. The specimens underwent a cycle (3 times/day) consisting of immersion in 1% citric acid (5 minutes), treatment (5 minutes), and artificial saliva exposure (2 hours/overnight) for 5 days. Surface changes were assessed using mechanical profilometry (wear), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). The data were analyzed using ANOVA followed by Tukey's post-test (p < 0.05). The negative control group exhibited the highest wear (6.0 µm ± 3.5), significantly differing from the group treated with 0.05% stannous fluoride gel (p = 0.007), which showed less dentin loss. The groups treated with 0.5% and 1% JSG showed results similar to the negative control (p = 0.661; p = 0.212, respectively) and the stannous fluoride group (p = 0.103; p = 0.379, respectively). In the SEM images, the specimen treated with stannous fluoride showed obliterated tubules, while the JSG gels formed crystals on the dentin surface, as confirmed by the presence of oxygen and calcium in the EDS analysis. Although the JSG gels showed similar results to the stannous fluoride, did not exhibit superior efficacy at the tested concentrations.
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Caesalpinia , Erosión de los Dientes , Fluoruros de Estaño , Erosión de los Dientes/prevención & control , Dentina , Geles , Fluoruros , Fluoruro de SodioRESUMEN
Abstract Gels containing juca seed galactomannan (JSG) were evaluated for their potential to prevent the progression of dentin erosive wear in an in vitro study with four experimental groups (n = 9). The treatments included distilled water (DW), 0.05% stannous fluoride (121 ppm F), and 0.5% or 1% JSG. The specimens underwent a cycle (3 times/day) consisting of immersion in 1% citric acid (5 minutes), treatment (5 minutes), and artificial saliva exposure (2 hours/overnight) for 5 days. Surface changes were assessed using mechanical profilometry (wear), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). The data were analyzed using ANOVA followed by Tukey's post-test (p < 0.05). The negative control group exhibited the highest wear (6.0 µm ± 3.5), significantly differing from the group treated with 0.05% stannous fluoride gel (p = 0.007), which showed less dentin loss. The groups treated with 0.5% and 1% JSG showed results similar to the negative control (p = 0.661; p = 0.212, respectively) and the stannous fluoride group (p = 0.103; p = 0.379, respectively). In the SEM images, the specimen treated with stannous fluoride showed obliterated tubules, while the JSG gels formed crystals on the dentin surface, as confirmed by the presence of oxygen and calcium in the EDS analysis. Although the JSG gels showed similar results to the stannous fluoride, did not exhibit superior efficacy at the tested concentrations.
Resumo Géis contendo galactomanana da semente de jucá (GSJ) foram avaliados quanto ao seu potencial na prevenção da progressão do desgaste erosivo dentinário em um estudo in vitro com quatro grupos experimentais (n = 9). Os tratamentos incluíram água destilada (AD), 0,05% de fluoreto de estanho (121 ppm F) e 0,5% ou 1% de GSJ. Os espécimes passaram por um ciclo (3 vezes ao dia) que consistia em imersão em ácido cítrico 1% (5 minutos), tratamento (5 minutos) e exposição a saliva artificial (2 horas/durante a noite) por 5 dias. As alterações de superfície foram avaliadas utilizando perfilometria mecânica (desgaste), microscopia eletrônica de varredura (MEV) e espectroscopia de raios-X por dispersão de energia (EDS). Os dados foram analisados por ANOVA, seguida do pós-teste de Tukey (p < 0,05). O grupo controle negativo apresentou o maior desgaste (6,0 µm ± 3,5), diferindo significativamente do grupo tratado com gel de fluoreto de estanho a 0,05% (p = 0,007), que apresentou menor perda de dentina. Os grupos tratados com 0,5% e 1% de GSJ apresentaram resultados semelhantes ao grupo controle negativo (p = 0,661; p = 0,212, respectivamente) e ao grupo de fluoreto de estanho (p = 0,103; p = 0,379, respectivamente). Nas imagens de MEV, o espécime tratado com fluoreto de estanho mostrou túbulos obliterados, enquanto os géis GSJ formaram cristais na superfície da dentina, como confirmado pela presença de oxigênio e cálcio na análise de EDS. Embora os géis GSJ tenham apresentado resultados semelhantes ao fluoreto de estanho, eles não demonstraram eficácia superior nas concentrações testadas.
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Abstract Objective: To identify clinical and epidemiological characteristics of children evaluated by the pediatric aerodigestive program at the beginning of its activity, describe challenges in followup, and suggest mitigation strategies. Methods: A case series was conducted describing the first 25 patients discussed by the aerodigestive team from a Brazilian quaternary public university hospital between April 2019 and October 2020. The median follow-up was 37 months. Results: During the study period 25 children were seen by the group and the median age at first assessment was 45.7 months old. Eight children had a primary airway abnormality, five had a tracheostomy. Nine children had genetic disorders and one had esophageal atresia. Dysphagia was present in 80% of the patients, 68% had a history of chronic or recurrent lung disease, 64% had a gastroenterological diagnosis and 56% had neurological impairment. Moderate to severe dysphagia was identified in 12 children and 7 of these had an exclusive oral diet at the time. The majority of children (72%) had 3 or more comorbidities. Following team discussion, a change in feeding strategy was suggested in 56% of the children. The most frequently ordered exam was pHmetry (44%) and gastrostomy was the surgical procedure with the longest waiting list. Conclusions: Dysphagia was the most frequent issue encountered in this initial group of aerodigestive patients. Pediatricians caring for these children must be involved in aerodigestive team discussions and hospital policies must be revised to facilitate access to exams and procedures needed for this population.
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Objetivo: caracterizar as teses e dissertações disponíveis no banco de teses da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior que abordem a neoplasia mamária masculina. Método: Realizou-se uma revisão de literatura, de caráter bibliométrico, selecionando 7 estudos, por meio de check list previamente estabelecido. Resultados: Identificou-se que 85,7% dos estudos selecionados eram dissertações de mestrado, publicadas entre 2007 e 2019. A maioria foi produzida na Universidade de São Paulo (42,8%). Quanto à publicação de artigos originados das teses e dissertações, 71,4% dos autores não publicaram. Conclusão: embora os métodos de diagnóstico do câncer de mama tenham avançado, a produção científica sobre o câncer de mama masculino ainda se faz incipiente no Brasil. Esse é um dado importante que pode auxiliar na elaboração de novos trabalhos, objetivando um melhor atendimento e prognóstico nesses pacientes.
Objective: to characterize the theses and dissertations available in the theses bank of the Coordination for the Improvement of Higher Education Personnel that address male breast cancer. Method: A bibliometric literature review was carried out, selecting 7 studies, using a previously established checklist. Results: We identified that 85.7% of the selected studies were master's theses, published between 2007 and 2019. Most were produced at the University of São Paulo (42.8%). As for the publication of articles originating from theses and dissertations, 71.4% of the authors did not publish. Conclusion: although methods for diagnosing breast cancer have advanced, scientific production on male breast cancer is still incipient in Brazil. This is an important fact that can help in the development of new studies, aiming at better care and prognosis for these patients.
Objetivo: caracterizar tesis y disertaciones disponibles en el banco de tesis de la Coordinación de Perfeccionamiento del Personal de Educación Superior que abordan el cáncer de mama masculino. Método: Se realizó una revisión bibliométrica de la literatura, seleccionando 7 estudios a través de un checklist previamente establecido. Resultados: Se identificó que el 85,7% de los estudios seleccionados fueron tesis de maestría, publicadas entre 2007 y 2019. La mayoría fueron producidos en la Universidad de São Paulo (42,8%). Cuanto la publicación de artículos provenientes de tesis y disertaciones, el 71,4% de los autores no publicó. Conclusión: aunque los métodos de diagnóstico del cáncer de mama han avanzado, la producción científica sobre el cáncer de mama masculino es aún incipiente en Brasil. Este es un hecho importante que puede ayudar en el desarrollo de nuevos estudios, con el objetivo de mejorar la atención y el pronóstico de estos pacientes.
Asunto(s)
Neoplasias de la Mama , Salud del HombreRESUMEN
INTRODUÇÃO: A dengue é considerada uma das principais arboviroses mundiais, caracterizada no Brasil pelo aumento de casos graves e óbitos. OBJETIVO: realizar análise espacial dos casos prováveis de dengue em São Luís - MA. MÉTODOS: Estudo ecológico de base populacional dos casos prováveis de dengue, notificados no Sistema de Informação de Agravos de Notificação (SINAN) em 2015 e 2016, ocorridos no município de São Luís MA. Foram georreferenciados 4.681 casos prováveis de dengue por setores censitários, calculadas as taxas de incidência e ajustadas através do estimador bayesiano empírico local. Foi utilizado o estimador de densidade de Kernel e Moran Global e Local para a análise espacial. RESULTADOS: Evidenciou-se através do estimador de densidade de Kernel, áreas quentes (alta-densidade) nos setores censitários da região noroeste do município. As taxas de incidência foram ajustadas pela aplicação do método bayesiano empírico local, identificando-se maior quantidade de setores com média e alta incidência. A partir do índice de Moran global foi evidenciada autocorrelação espacial positiva estatisticamente significativa para as taxas de incidência de dengue (I=0,69; p<0,001) e para as taxas de incidência ajustadas pelo método bayesiano (I=0,80; p<0,001). De acordo com o índice de Moran local, identificou-se clusters de setores de alta incidência de dengue em áreas com alta densidade populacional na região nordeste e noroeste do município. CONCLUSÃO: A pesquisa demonstrou que os estimadores bayesianos ajudaram a minimizar os problemas de subnotificação e da influência do tamanho populacional nos setores censitários.
INTRODUCTION: Dengue is considered one of the main arboviruses in the world, characterized in Brazil by the increase in severe cases and deaths. OBJECTIVE: to perform spatial analysis of probable dengue cases in São Luís - MA. METHODS: Population-based ecological study of probable dengue cases, reported in the Notifiable Diseases Information System (SINAN) in 2015 and 2016, which took place in the city of São Luís - MA. 4,681 probable dengue cases were georeferenced by census sectors, incidence rates were calculated and adjusted using the local empirical Bayesian estimator. The Kernel and Moran Global and Local density estimator was used for spatial analysis. RESULTS: Hot areas (high-density) in the census sectors of the northwest region of the municipality were evidenced through the Kernel density estimator. Incidence rates were adjusted by applying the local empirical Bayesian method, identifying a greater number of sectors with medium and high incidence. From the global Moran index, statistically significant positive spatial autocorrelation was evidenced for the dengue incidence rates (I = 0.69; p <0.001) and for the incidence rates adjusted by the Bayesian method (I = 0.80; p <0.001). According to the local Moran index, clusters of sectors with a high incidence of dengue were identified in areas with high population density in the northeast and northwest regions of the municipality. CONCLUSION: The research demonstrated that Bayesian estimators helped to minimize the problems of underreporting and the influence of population size on census tracts.
INTRODUCCIÓN: El dengue es considerado una de las principales arbovirosis a nivel mundial, caracterizada en Brasil por el aumento de casos graves y muertes. OBJETIVO: Realizar un análisis espacial de los casos probables de dengue en São Luís - MA. MÉTODOS: Estudio ecológico de base poblacional de los casos probables de dengue, notificados en el Sistema de Informação de Agravos de Notificação (SINAN) en 2015 y 2016, ocurridos en el municipio de São Luís - MA. Se georreferenciaron 4.681 casos probables de dengue por sectores censales, se calcularon las tasas de incidencia y se ajustaron mediante el estimador empírico bayesiano local. Para el análisis espacial se utilizó el estimador de densidad Kernel y Moran global y local. RESULTADOS: Se evidenció a través del estimador de densidad Kernel, áreas calientes (de alta densidad) en los sectores censales de la región noroeste del municipio. Las tasas de incidencia se ajustaron mediante la aplicación del método bayesiano empírico local, identificándose una mayor cantidad de setores con incidencia media y alta. A partir del índice global de Moran se evidenció una autocorrelación espacial positiva estadísticamente significativa para las tasas de incidencia de dengue (I=0,69; p<0,001) y para las tasas de incidencia ajustadas por el método bayesiano (I=0,80; p<0,001). Según el índice local de Moran, se identificaron clusters de sectores de alta incidencia de dengue en áreas con alta densidad de población en las regiones noreste y noroeste del municipio. CONCLUSIÓN: La investigación demostró que los estimadores bayesianos ayudaron a minimizar los problemas de infradeclaración y la influencia del tamaño de la población en los sectores censales.