Oceanic seabirds chase tropical cyclones.

In late summer and autumn, the passage of intense tropical cyclones can profoundly perturb oceanic and coastal ecosystems. Direct negative effects on individuals and marine communities can be dramatic, especially in the coastal zone,1,2,3,4 but cyclones can also enhance pelagic primary and secondary production.5,6,7,8,9 However, cyclone impacts on open ocean marine life remain poorly understood. Here, we investigate their effects on the foraging movements of a wide-ranging higher predator, the Desertas petrel (Pterodroma deserta), in the mid-latitude North Atlantic during hurricane season. Contrary to previously studied pelagic seabirds in tropical and mid-latitude regions,10,11 Desertas petrels did not avoid cyclones by altering course, nor did they seek calmer conditions within the cyclone eye. Approximately one-third of petrels tracked from their breeding colony interacted with approaching cyclones. Upon encountering strong winds, the birds reduced ground speed, likely by spending less time in flight. A quarter of birds followed cyclone wakes for days and over thousands of kilometers, a behavior documented here for the first time. Within these wakes, tailwind support was higher than along alternative routes. Furthermore, at the mesoscale (hours-weeks and hundreds of kilometers), sea surface temperature dropped and surface chlorophyll sharply increased, suggesting direct effects on ocean stratification, primary production, and therefore presumably prey abundance and accessibility for surface-feeding petrels. We therefore hypothesize that cyclone wakes provide both predictably favorable wind conditions and foraging opportunities. As such, cyclones may have positive net effects on the demography of many mid-latitude pelagic seabirds and, likely, other marine top-predators.

Evidence of acrylamide-induced behavioral deficit, mitochondrial dysfunction and cell death in Drosophila melanogaster.

Acrylamide (ACR), a ubiquitous compound with diverse route of exposure, has been demonstrated to have detrimental effects on human and animal health. The mechanisms underlying its toxicity is multifaceted and not fully elucidated. This study aims to provide further insight into novel pathways underlying ACR toxicity by leveraging on Drosophila melanogaster as a model organism. The concentrations of acrylamide (25, 50 and 100 mg/kg) and period of exposure (7-days) used in this study was established through a concentration response curve. ACR exposure demonstrably reduced organismal viability, evidenced by decline in survival rate, offspring emergence and deficits in activity, sleep and locomotory behaviors. Using a high-resolution respirometry assay, the role of mitochondria respiratory system in ACR-mediated toxicity in the flies was investigated. Acrylamide caused dysregulation in mitochondrial bioenergetics and respiratory capacity leading to an impaired OXPHOS activity and electron transport, ultimately contributing to the pathological process of ACR-toxicity. Furthermore, ACR exacerbated apoptosis and induced oxidative stress in D. melanogaster. The up-regulation of mRNA transcription of Reaper, Debcl and Dark genes and down-regulation of DIAP1, an ubiquitylation catalyzing enzyme, suggests that ACR promotes apoptosis through disruption of caspase and pro-apoptotic protein ubiquitination and a mitochondria-dependent pathway in Drosophila melanogaster. Conclusively, this study provides valuable insights into the cellular mechanism underlying ACR-mediated toxicity. Additionally, our study reinforces the utility of D. melanogaster as a translational tool for elucidating the complex mechanisms of ACR toxicity.

Exploring Heavy Metal and Metalloid Exposure in Children: A Pilot Biomonitoring Study near a Sugarcane Mill.

Sugarcane production has been linked to the release of heavy metals and metalloids (HM/MTs) into the environment, raising concerns about potential health risks. This study aimed to assess the levels of 19 HM/MTs in children living near a sugarcane mill through a pilot biomonitoring investigation. We investigated sex-related differences in these element levels and their correlations. A cross-sectional study was conducted, analyzing data from 20 children in the latter part of 2023. Spearman correlation coefficients with 95% confidence intervals (CIs) were used to assess the relationships between urinary HM/MT levels. Detectable levels of 17 out of the 19 HM/MTs were found across the entire study sample, with arsenic and copper detectable in 95% of the children. Titanium exhibited higher levels in boys compared to girls (p = 0.017). We identified 56 statistically significant correlations, with 51 of them being positive, while the remaining coefficients indicated negative relationships. This study characterized HM/MT levels in school-aged children residing near a sugarcane mill through a pilot biomonitoring investigation. Further research employing larger sample sizes and longitudinal assessments would enhance our understanding of the dynamics and health impacts of HM/MT exposure in this vulnerable population.

Skeletal myotubes expressing ALS mutant SOD1 induce pathogenic changes, impair mitochondrial axonal transport, and trigger motoneuron death.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the loss of motoneurons (MNs), and despite progress, there is no effective treatment. A large body of evidence shows that astrocytes expressing ALS-linked mutant proteins cause non-cell autonomous toxicity of MNs. Although MNs innervate muscle fibers and ALS is characterized by the early disruption of the neuromuscular junction (NMJ) and axon degeneration, there are controversies about whether muscle contributes to non-cell-autonomous toxicity to MNs. In this study, we generated primary skeletal myotubes from myoblasts derived from ALS mice expressing human mutant SOD1 G93A (termed hereafter mutSOD1). Characterization revealed that mutSOD1 skeletal myotubes display intrinsic phenotypic and functional differences compared to control myotubes generated from non-transgenic (NTg) littermates. Next, we analyzed whether ALS myotubes exert non-cell-autonomous toxicity to MNs. We report that conditioned media from mutSOD1 myotubes (mutSOD1-MCM), but not from control myotubes (NTg-MCM), induced robust death of primary MNs in mixed spinal cord cultures and compartmentalized microfluidic chambers. Our study further revealed that applying mutSOD1-MCM to the MN axonal side in microfluidic devices rapidly reduces mitochondrial axonal transport while increasing Ca2+ transients and reactive oxygen species (i.e., H 2 O 2 ). These results indicate that soluble factor(s) released by mutSOD1 myotubes cause MN axonopathy that leads to lethal pathogenic changes.

Metal concentrations and KIM-1 levels in school-aged children: a cross-sectional study.

Environmental exposure to heavy metals and metalloids, originating from sources such as mining and manufacturing activities, has been linked to adverse renal effects. This cross-sectional study assessed children's exposure to these elements and its association with urinary kidney injury molecule-1 (KIM-1). We analyzed data from 99 school-aged children residing in nine localities within the state of Colima, Mexico, during the latter half of 2023. Levels of 23 metals/metalloids and urinary KIM-1 were measured using inductively coupled plasma mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay, respectively. Detectable levels of these contaminants were found in over 91% of participants, with varied exposure profiles observed across locations ( p = 0.019). After adjusting for confounding factors like gender, age, and locality, higher levels of six metals/metalloids (boron, cadmium, cesium, lithium, selenium, zinc) were significantly associated with increased KIM-1 levels. Tailored mitigation efforts are crucial to protect children from regional pollutant burdens. However, limitations exist, as our study did not capture all potential factors influencing heavy metal/metalloid and KIM-1 levels.

Evidence of plastics contamination and sewage-derived residues in a Brazilian Hope Spot for conservation of marine biodiversity - Cagarras Islands and surrounding waters.

Cagarras Islands Archipelago, a no-take MPA in Southeast Brazil, was designated as Natural Monument (MONA Cagarras) and, more recently, recognized as Hope Spot for biodiversity conservation. This study aimed to assess plastic contamination by analyzing marine litter and microplastics in MONA Cagarras and surrounding waters. Marine litter (34.12 kg) was caught by artisanal fishermen in MONA Cagarras proximities, and plastics represented ∼79 %. Personal hygiene items and strains of hair were found, suggesting sewage-derived contamination from Ipanema SSO. Microplastics were detected in MONA Cagarras surface waters. Fragments and black particle were the most frequently found microplastic shape and color, respectively. µ-FTIR analysis identified, in descending order of occurrence, polystyrene-PS, polyethylene-PE, polyvinyl chloride-PVC, polypropylene-P, and polyamide-PA. Our integrated results of macro and microplastic contamination highlight an issue of effective conservation and health of marine biodiversity in MONA Cagarras and surrounding waters and a concern for better management of Brazilian MPAs.

Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020.

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.

Allochrony is shaped by foraging niche segregation rather than adaptation to the windscape in long-ranging seabirds.

BACKGROUND: Ecological segregation allows populations to reduce competition and coexist in sympatry. Using as model organisms two closely related gadfly petrels endemic to the Madeira archipelago and breeding with a two month allochrony, we investigated how movement and foraging preferences shape ecological segregation in sympatric species. We tested the hypothesis that the breeding allochrony is underpinned by foraging niche segregation. Additionally, we investigated whether our data supported the hypothesis that allochrony is driven by species-specific adaptations to different windscapes. METHODS: We present contemporaneous tracking and stable isotopes datasets for Zino's (Pterodroma madeira) and Desertas (Pterodroma deserta) petrels. We quantified the year-round distribution of the petrels, characterised their isotopic niches and quantified their habitat preferences using machine learning (boosted regression trees). Hidden-Markov-models were used to investigate the effect of wind on the central-place movement speed, and a simulation framework was developed to investigate whether each species breeds at times when the windscape is most favourable to sustain their trips. RESULTS: Despite substantial spatial overlap throughout the year, the petrels exhibited diverging isotopic niches and habitat preferences during breeding. Both species used a vast pelagic region in the North Atlantic, but targeted two different mesopelagic ecoregions and showed a preference for habitats mostly differing in sea surface temperature values. Based on our simulation framework, we found that both species would perform trips of similar speed during the other species' breeding season. CONCLUSIONS: The different breeding schedules between the species are underpinned by differences in foraging habitat preferences and adaptation to the local environment, rather than to the windscape. Nevertheless, the larger Desertas petrels exploited significantly windier conditions, potentially unsustainable for the smaller Zino's petrels. Furthermore, due to larger mass and likely higher fasting endurance, Desertas petrels engaged in central-place-foraging movements that covered more ground and lasted longer than those of Zino's petrels. Ultimately, patterns of ecological segregation in sympatric seabirds are shaped by a complex interplay between foraging and movement ecology, where morphology, foraging trip regulation and fasting endurance have an important- yet poorly understood- role.

Exposure of an endangered seabird species to persistent organic pollutants: Assessing levels in blood and link with reproductive parameters.

Ocean contamination, particularly from persistent organic pollutants (POPs), remains a significant threat to marine predators that occupy high trophic positions. Long-lived procellariform seabirds are apex predators in marine ecosystems and tend to accumulate contaminants. Prolonged exposure to pollutants negatively affects their fitness including reproductive success. Low breeding success may represent a hurdle for the restoration of small and endangered seabird populations, including several highly threatened gadfly petrels. Here we investigated the annual variation (2019 and 2022) in organochlorine pesticide (OCP), polychlorinated biphenyl ether (PCB), polybrominated diphenyl ether (PBDE), and polycyclic aromatic hydrocarbon (PAH) exposure in the endangered Bermuda petrel (Pterodroma cahow), and the relationship between female contaminant burden and breeding parameters. We found that petrels were exposed to a wide range of pollutants (33 out of 55 showed measurable levels) with PCBs dominating the blood contaminant profiles in both years. Only 9 compounds were detected in >50 % of the birds. Specifically, among OCPs, p, p'-DDE and hexaclorobenzene were the most frequently detected while fluorene and acenaphthene were the most common PAH. The concentrations of ∑5PCBs and ∑7POPs were higher in older birds. Furthermore, females with greater contaminant burdens laid eggs with a lower probability of hatching. However, female investment in egg production (size and volume) was unrelated to their blood contaminant load. Overall, this study highlights the presence of a wide range of contaminants in the petrel's food web, and it sheds light on the potential impact of chronic exposure to sub-lethal levels of PCBs on the breeding success of seabirds. We claim that toxicological testing should be a practice integrated in the management of seabirds, particularly of endangered species to monitor how past and present anthropogenic activities impact their conservation status.

Bioenergetic modelling of a marine top predator's responses to changes in prey structure.

Determining how animals allocate energy, and how external factors influence this allocation, is crucial to understand species' life history requirements and response to disturbance. This response is driven in part by individuals' energy balance, prey characteristics, foraging behaviour and energy required for essential functions. We developed a bioenergetic model to estimate minimum foraging success rate (FSR), that is, the lowest possible prey capture rate for individuals to obtain the minimum energy intake needed to meet daily metabolic requirements, for female sperm whale (Physeter macrocephalus). The model was based on whales' theoretical energetic requirements using foraging and prey characteristics from animal-borne tags and stomach contents, respectively. We used this model to simulate two prey structure change scenarios: (1) decrease in mean prey size, thus lower prey energy content and (2) decrease in prey size variability, reducing the variability in prey energy content. We estimate the whales need minimum of ~14% FSR to meet their energetic requirements, and energy intake is more sensitive to energy content changes than a decrease in energy variability. To estimate vulnerability to prey structure changes, we evaluated the compensation level required to meet bioenergetic demands. Considering a minimum 14% FSR, whales would need to increase energy intake by 21% (5-35%) and 49% (27-67%) to compensate for a 15% and 30% decrease in energy content, respectively. For a 30% and 50% decrease in energy variability, whales would need to increase energy intake by 13% (0-23%) and 24% (10-35%) to meet energetic demands, respectively. Our model demonstrates how foraging and prey characteristics can be used to estimate impact of changing prey structure in top predator energetics, which can help inform bottom-up effects on marine ecosystems. We showed the importance of considering different FSR in bioenergetics models, as it can have decisive implications on estimates of energy acquired and affect the conclusions about top predator's vulnerability to possible environmental fluctuations.

Students' reading comprehension level and reading demands in teacher education programs: the elephant in the room?

Introduction: Reading comprehension is considered a key ability for students in teacher education programs. Methods: Data from 72 students enrolled in a Chilean school of education was used to estimate the contribution of reading proficiency in first-semester academic performance using regression analysis. Results: Reading comprehension made a significant, albeit modest contribution to predict students' academic performance, after controlling for their scores in the standardized national admission tests and high-school grades. The students' average reading level was below the level of text complexity required in their first term and, although by their senior year they had made significant progress in reading comprehension, their reading level continued to be lower than text demands. Discussion: A qualitative exploration of students' reading behaviors and attitudes revealed they devoted few hours per week to reading class material and even less time to reading for leisure. Faculty were cognizant of the reading deficits of their students but had few suggestions as to how to address. Future studies in higher education should confirm whether the misfit between reading proficiency and reading demands observed in this school of education is the exception or the rule.

Early choroidal and retinal changes detected by swept-source oct in type 2 diabetes and their association with diabetic kidney disease: a longitudinal prospective study.

BACKGROUND: To evaluate structural changes in retina and choroid in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD). METHODS: T2D patients with mild or no diabetic retinopathy (DR) were followed for 3 years using structural SS-OCT and OCT angiography (OCT-A) taken every 6 months. Parameters were compared longitudinally and according to the DKD status on baseline. RESULTS: One hundred and sixty eyes from 80 patients were followed for 3 years, 72 with no DKD (nDKD) at baseline and 88 with DKD. Trend analysis of T2D showed significant thinning in GCL + and circumpapillary retinal fiber neural layer (cRFNL), choroid, and decreased vascular density (VD) in superficial plexus and central choriocapillaris with foveal avascular zone (FAZ) enlargement. Patients with no DKD on baseline presented more significant declines in retinal center and choroidal thickness, increased FAZ and loss of nasal and temporal choriocapillaris volume. In addition, the nDKD group had worse glycemic control and renal parameters at the end of the study. CONCLUSION: Our data suggests the potential existence of early and progressive neurovascular damage in the retina and choroid of patients with Type 2 Diabetes (T2D) who have either no or mild Diabetic Retinopathy (DR). The progression of neurovascular damage appears to be correlated with parameters related to glycemic control and renal damage.

Fin whale song evolution in the North Atlantic.

Animal songs can change within and between populations as the result of different evolutionary processes. When these processes include cultural transmission, the social learning of information or behaviours from conspecifics, songs can undergo rapid evolutions because cultural novelties can emerge more frequently than genetic mutations. Understanding these song variations over large temporal and spatial scales can provide insights into the patterns, drivers and limits of song evolution that can ultimately inform on the species' capacity to adapt to rapidly changing acoustic environments. Here, we analysed changes in fin whale (Balaenoptera physalus) songs recorded over two decades across the central and eastern North Atlantic Ocean. We document a rapid replacement of song INIs (inter-note intervals) over just four singing seasons, that co-occurred with hybrid songs (with both INIs), and a clear geographic gradient in the occurrence of different song INIs during the transition period. We also found gradual changes in INIs and note frequencies over more than a decade with fin whales adopting song changes. These results provide evidence of vocal learning in fin whales and reveal patterns of song evolution that raise questions on the limits of song variation in this species.

A Genetic Lab-on-Phone Test for Point-of-Care Diagnostic of Lactose Intolerance near Patient and in less than 90 Minutes.

BACKGROUND: The -13910 C/T single nucleotide polymorphism located within the MCM6 gene, an enhancer region located upstream of the lactase-phlorizin hydrolase gene, is associated with lactase persistence/non-persistence traits among the Caucasian population. The performance of a new point-of-care CE-IVD (In Vitro Diagnostic) marked isothermal lab-on-phone lactose intolerance assay, using crude samples, was assessed in comparison with Sanger sequencing using purified DNA, as reference method. METHODS: The study was conducted following a non-probability sampling using direct buccal swab (n = 63) and capillary blood (n = 43) clinical samples from a total of 63 volunteers. A 3 × 3 confusion matrix/contingency table was used to evaluate the performance of the isothermal lab-on-phone lactose intolerance assay. RESULTS: The isothermal lab-on-phone lactose intolerance assay successfully detected the -13910 C/T variant with a limit of detection of 5 cells/assay and demonstrated an overall accuracy of 98.41% (95% CI, 91.47%-99.96%) for buccal swab samples and 100% (95% CI, 91.19%-100%) for capillary blood, taking just 90 min from sample to result, with only 2 min hands-on. CONCLUSIONS: The lab-on-phone pocket-sized assay displayed good performance when using direct buccal swab and capillary blood samples, enabling a low-cost, real-time, and accurate genotyping of the -13910 C/T region for the rapid diagnosis of primary lactose intolerance at point-of-care, which enables a prompt implementation of appropriate diet habits and/or intolerance therapies. To our knowledge, this is the first point-of-care genetic test for lactose intolerance to be made available on the market.

Gold nanoparticles for surface-enhanced Raman scattering detection of benzyldimethyldodecylammonium chloride at low concentration.

The oil and gas industry plays a vital role in the global economy. The production process has several critical conditions and can expose metals to corrosion. Surfactants like the quaternary ammonium salt Benzyldimethyldodecylammonium Bromide (BDAC) are currently used to prevent corrosions; classical methods for determining these surfactants have problems in saline samples and usually present high costs. In this context, spectroscopic techniques become an excellent alternative for quaternary ammonium salts detection. Here, a SERS (surface-enhanced Raman scattering) sensor based on gold nanoparticles (AuNPs) synthesized through chemical reduction was used as an alternative method for BDAC detection. We detected BDAC at low concentrations in water solutions: at 5 to 30 ppm (1.47 × 10-5 mol L-1 to 8.82 × 10-5 mol L-1); and had the vibration attempt attribute analyzed. A new study of quaternary ammonium compounds using AuNPs and SERS with a different, easy, and repeatable approach to spectra acquisition is presented and shows to be a promising method applied in quaternary ammonium salt compounds detection for the oil and gas industry.

Representações sociais de enfermeiros acerca do processo de descentralização do atendimento ao HIV: abordagem estrutural / Social representations of nurses about the decentralization process of HIV care: A structural approach / Representaciones sociales de enfermeros sobre el proceso de descentralización de la atención al VIH: un enfoque estructural

Objetivo: analisar a representação social de enfermeiros sobre o atendimento ao HIV na atenção primária à saúde através de uma abordagem estrutural. Método: Trata-se de um estudo descritivo, exploratório, com abordagem qualitativa e caráter estrutural, com 160 enfermeiros, no período entre dezembro de 2019 a março de 2020 nas unidades de saúde da família do município de Recife, Pernambuco, Brasil. Realizou-se entrevistas semiestruturadas, com a Técnica de Associação Livre de Palavras, e questionário sociodemográfico. Os dados foram processados pelo software IRAMUTEQ, sendo ancorados pela Teoria das Representações Sociais. Aprovado pelo Comitê de Ética em Pesquisa. Resultados: O estímulo à pergunta indutora originou 188 palavras diferentes com frequência mínima de 5 evocações e máxima de 64. Observa-se expressivamente termos associados a fatores subjetivos. Considerações finais: Evidenciou-se que as representações sociais são relevantes e diversas, relacionadas com a atuação dos enfermeiros frente ao atendimento prestado às pessoas vivendo com HIV(AU)

Objective: to analyze nurses' social representation of HIV care in primary health care through a structural approach. Method: This is a descriptive, exploratory study, with a qualitative and structural approach, with 160 nurses, between December 2019 and March 2020 in the family health units of the municipality of Recife, Pernambuco, Brazil. Semi-structured interviews were conducted with the Free Word Association Technique and a sociodemographic questionnaire. The data were processed by the IRAMUTEQ software, being anchored by the Theory of Social Representations. Theone proven by the Research Ethics Committee. Results: The stimulus to the inducing question originated 188 different words with a minimum frequency of 5 evocations and a maximum of 64. Terms associated with subjective factors are significantly observed. Final considerations: It was evidenced that social representations are relevant and diverse, related to the performance of nurses in relation to the care provided to people living with HIV(AU)

Objetivo: analizar la representación social de los enfermeros sobre el cuidado del VIH en la atención primaria de salud a través de un enfoque estructural. Método: Se trata de un estudio descriptivo, exploratorio, con enfoque cualitativo y estructural, con 160 enfermeras, entre diciembre de 2019 y marzo de 2020 en las unidades de salud familiar del municipio de Recife, Pernambuco, Brasil. Se realizaron entrevistas semiestructuradas con la Técnica de Asociación de Palabras Libres y un cuestionario sociodemográfico. Los datos fueron procesados por el software IRAMUTEQ, siendo anclados por la Teoría de las Representaciones Sociales. El comprobado por el Comité de Ética en Investigación. Resultados: El estímulo a la pregunta inductora originó 188 palabras diferentes con una frecuencia mínima de 5 evocaciones y un máximo de 64. Los términos asociados con factores subjetivos se observan significativamente. Consideraciones finales: Se evidenció que las representaciones sociales son relevantes y diversas, relacionadas con el desempeño de las enfermeras en relación con la atención brindada a las personas que viven con VIH(AU)

Riesgo de depresión durante el embarazo en la atención prenatal de riesgo habitual / Risk of depression during pregnancy in usual risk antenatal care / Risco de depressão na gravidez na assistência pré-natal de risco habitual

Objetivo: identificar el riesgo de depresión durante el embarazo en gestantes de riesgo habitual incluidas en el control prenatal y los factores asociados. Método: estudio transversal, realizado con 201 gestantes, en el consultorio de prenatal de riesgo habitual de una maternidad universitaria. Para la recolección de datos se utilizó un formulario electrónico que contenía un instrumento de caracterización y la Escala de Riesgo de Depresión del Embarazo. La variable dependiente fue el riesgo de depresión en el embarazo. El análisis estadístico se realizó mediante el cálculo de la razón de posibilidades (Odds Ratio) y utilizando las pruebas de Chi-cuadrado y exacta de Fischer. Resultados: entre las participantes, 68,2% tenían mayor riesgo de depresión durante el embarazo. Hubo asociación estadísticamente significativa entre mayor riesgo de depresión durante el embarazo y la variable ocupación (p=0,04), o sea, la ausencia del trabajo (OR = 2,00) duplicó la probabilidad de ocurrencia. Conclusión: la alta prevalencia de riesgo de depresión durante el embarazo destaca la necesidad de planificación, priorización e integración de la salud mental en los servicios de salud prenatal, especialmente en el ámbito de la Atención Primaria de Salud, por parte de los gestores de salud y de los formuladores de políticas.

Objective: to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. Method: a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer's Exact tests. Results: among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. Conclusion: the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.

Objetivo: identificar o risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de risco habitual e os fatores associados. Método: estudo transversal, realizado com 201 gestantes, no ambulatório de pré-natal de risco habitual de uma maternidade universitária. A coleta de dados utilizou um formulário eletrônico contendo um instrumento de caracterização e a Escala de Risco de Depressão na Gravidez. A variável dependente foi o risco de depressão na gravidez. A análise estatística deu-se pelo cálculo da razão de chances (Odds Ratio) e pelos testes Qui-quadrado e Exato de Fischer. Resultados: entre as participantes, 68,2% apresentaram maior risco de depressão na gravidez. Houve associação estatisticamente significativa entre o maior risco de depressão na gravidez e a variável ocupação (p=0,04), ou seja, a ausência de emprego (OR = 2,00) aumentou em duas vezes a chance de ocorrência. Conclusão: a alta prevalência de risco de depressão na gravidez evidencia a necessidade de planejamento, priorização e integração da saúde mental nos serviços de saúde pré-natal, principalmente no ambiente da Atenção Primária à Saúde, por parte de gestores de saúde e formuladores de políticas.

Delayed Diagnosis of Primary Hyperparathyroidism: A Case Report.

Primary hyperparathyroidism (PHPT) is characterized by an elevation in serum calcium levels, sometimes leading to aggravated clinical conditions, namely nephrolithiasis, nephrocalcinosis, and/or fractures. A 55-year-old patient was admitted to the hospital with acute obstructive pyelonephritis in March 2021, having another episode one year later. Initial blood and urine analysis detected inflammatory markers, namely C-reactive protein, and the presence of leucocytes and blood in the urine. The renal computed tomography scan exhibited renal asymmetry, nephrocalcinosis, and multiple kidney stones. The patient was scheduled for a follow-up one year later to perform blood and urine analysis to uncover the cause of nephrocalcinosis, displaying high serum calcium and parathyroid hormone (PTH) levels. The thyroid ultrasound revealed a parathyroid adenoma, which was removed through a right lower parathyroidectomy, improving the symptoms. The clinical condition described here is an atypical manifestation of this disease because PHPT is normally asymptomatic. In the present case study, nephrocalcinosis and nephrolithiasis were strong indicators of the underlying disease. However, the delay in the follow-up consultation resulted in complications for the patient, such as microabscesses in the kidneys, which could lead to reduced renal function in the future. Early detection of key aspects of the disease could avoid further complications and suffering for the patient. For example, the family physician's follow-up of the patient's condition could surpass the waiting time between consultations with different specialties, and promote early treatment.

Association between Vaccination Status for COVID-19 and the Risk of Severe Symptoms during the Endemic Phase of the Disease.

The global health emergency caused by COVID-19 concluded in May 2023, marking the beginning of an endemic phase. This study aimed to evaluate the association between vaccination status and other patient characteristics and the risk of severe disease during this new endemic period. A nationwide cohort study was conducted in Mexico, where we analyzed data from 646 adults who had received positive confirmation of COVID-19 through PCR testing from May to August 2023. The overall risk of severe symptoms in the study sample was 5.3%. The average time elapsed from the last vaccine shot to symptom onset was over six months in all the immunized groups (1, 2 or 3 vaccine doses). Compared to unvaccinated patients, those with three vaccine doses showed an elevated risk of severe symptoms. Advancing age and various chronic comorbidities (specifically cardiovascular, kidney, and obstructive pulmonary conditions) were associated with a heightened risk of severe COVID-19 manifestations. These findings underscore the ongoing seriousness of COVID-19, even in an endemic phase, underscoring the urgent need for tailored interventions aimed at high-risk patients.