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Objective: To assess the effect of a rapid training intervention on the knowledge of health providers and the provision of preconception care in primary health care services. Methods: Randomized community trial in eight primary health care facilities (four were randomly allocated to the intervention group and four to the control group) in 2020 in Brazil. The intervention consisted of rapid training in preconception health for all health providers in the intervention group. Health providers who had medicine and nursing backgrounds answered structured questionnaires about their knowledge and practices of preconception health-related topics, and reproductive-age women attending the services completed a questionnaire about their experience with preconception care in pre- and postintervention (three months after the intervention) periods. Findings: The level of knowledge among health providers increased after the intervention, but providing information about preconception care and prescribing folic acid showed no significant change, with the exception of screening for future pregnancy intention. Key conclusions and implications for practice: Although the knowledge of health providers on preconception care is a fundamental requirement for its provision in primary health care settings, rapid training focused on preconception health topics was not sufficient to change their practices, with the exception of pregnancy intention screening, which experienced a slight increase after the training. It appears that additional elements, such as the reorganization of primary health care services to prioritize non-pregnant women, the development and implementation of specific guidelines, along with strategies for the dissemination of preconception care awareness, may also play crucial roles for full preconception care implementation in addition to health providers' knowledge of such issues.
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Potentially toxic cyanobacterial blooms (cyanoHABs) have become a problem in public water supply reservoirs. Temperature rise caused by climate change can increase the frequency and intensity of blooms, which may influence the cyanotoxins concentration in the environment. This study aimed to evaluate the effect of the temperature on the responses of a Neotropical catfish exposed to a neurotoxin-rich cyanobacterial crude extract (Raphidiopsis raciborskii T3). Juveniles of Rhamdia quelen were exposed to four treatments, based on study data: control at 25 °C (C25), control at 30 °C (C30), crude extract equivalent to 105 cells.mL-l of R. raciborskii at 25 °C (CE25) and 30 °C (CE30). After 96 h of exposure, the fish were anesthetized and blood was taken. After euthanasia, the gill, posterior kidney, brain, muscle, liver and gonad were sampled for hematological, biochemical, genotoxic and histopathological biomarker analysis. Liver was sampled for proteomic analysis for identification of proteins related to energy production. Water samples were collected at the beginning and the end of the experiment for neurotoxins quantification. Different parameters in both males and females were altered at CE25, evidencing the effects of neurotoxins in freshwater fish. At CE30, a water warming scenario, more effects were observed in females than at 25 °C, such as activation of saxitoxin metabolism pathway and genotoxicity. More damage to macromolecules was observed in females at the higher temperature, demonstrating that the increase in temperature can aggravate the toxicity of neurotoxins produced by R. raciborskii T3.
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Peixes-Gato , Cianobactérias , Animais , Peixes-Gato/fisiologia , Temperatura , Microcistinas/toxicidade , Feminino , Masculino , Toxinas de Cianobactérias , Mudança Climática , Neurotoxinas/toxicidade , Toxinas Bacterianas/toxicidade , Toxinas Marinhas/toxicidadeRESUMO
Skin is the ultimate barrier between body and environment and prevents water loss and penetration of pathogens and toxins. Internal and external stressors, such as ultraviolet radiation (UVR), can damage skin integrity and lead to disorders. Therefore, skin health and skin ageing are important concerns and increased research from cosmetic and pharmaceutical sectors aims to improve skin conditions and provide new anti-ageing treatments. Biomolecules, compared to low molecular weight drugs and cosmetic ingredients, can offer high levels of specificity. Topically applied enzymes have been investigated to treat the adverse effects of sunlight, pollution and other external agents. Enzymes, with a diverse range of targets, present potential for dermatological use such as antioxidant enzymes, proteases and repairing enzymes. In this review, we discuss enzymes for dermatological applications and the challenges associated in this growing field.
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Cosméticos , Dermatopatias , Humanos , Raios Ultravioleta/efeitos adversos , Pele , Dermatopatias/terapia , Luz Solar/efeitos adversos , Cosméticos/farmacologiaRESUMO
Climate change has been one of the most discussed topics in the world. Global warming is characterized by an increase in global temperature, also in aquatic environments. The increased temperature can affect aquatic organisms with lethal and sublethal effects. Thus, it is necessary to understand how different species respond to temperature. This study aimed to evaluate how the Neotropical catfish species Rhamdia quelen responds to temperature increases. The fish were exposed to temperatures of 25 °C (control) and 30 °C after gradual temperature increase for 7 days. After 96 h in each temperature, the fish were anesthetized, blood was collected, and after euthanasia, brain, liver, posterior kidney, gills, muscle, and gonads were collected. The gonads were used for sexing, while other tissues were used for the hematological, biochemical, genotoxic, and histopathological biomarkers analysis. Hepatic proteomic analysis with a focus on energy production was also carried out. Blood parameter changes in both sexes, including an increase in glucose in males, leukopenia in females, and genotoxicity in both sexes. Hepatic proteins related to energy production were altered in both sexes, but mainly in males. Others biomarker alterations, such as histopathological, were not observed in other tissues; however, the antioxidant system was affected differently between sexes. These showed that R. quelen juveniles, at temperatures higher than its optimum temperature such as 30 °C, has several sublethal changes, such as hematological alterations, antioxidant system activation, and energetic metabolism alteration, especially in males. Thus, short-term temperature rise can affect females and males of R. quelen differently.
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Peixes-Gato , Poluentes Químicos da Água , Masculino , Feminino , Animais , Peixes-Gato/fisiologia , Temperatura , Antioxidantes/metabolismo , Biodiversidade , Proteômica , Eutanásia Animal , Fígado/metabolismoRESUMO
The aim of this study was to compare the effects of two anesthetic induction protocols for long procedures carried out in the field in Tapiridae. Sixteen tapirs were divided into two groups (n=8) receiving either detomidine (DET) or dexmedetomidine (DEX) for anesthetic induction. All animals were anesthetized by intramuscular administration of a combination of ketamine (1.5 mg/kg), midazolam (0.2 mg/kg), plus either DET (0.04 mg/kg) or DEX (0.007 mg/kg). Anesthetic maintenance was by continuous infusion of ketamine, midazolam, and glyceryl guaiacol ether at 2 mg/kg per hour, 0.1 mg/kg per hour, and 100 mg/kg per hour, respectively). The animals were kept anesthetized for a total of 50 min to allow physical examination and collection of biological material as part of a research program, and physiological variables (heart rate [HR], respiratory rate, oxyhemoglobin saturation [SpO2], rectal temperature [RT], mean arterial pressure [MAP], blood glucose [GLI], and cortisol) and electrocardiogram were recorded during anesthesia. Anesthetic recovery was monitored by two researchers who were not informed of the induction protocol group. The recorded results were statistically evaluated. In both groups there was an initial increase in MAP, which subsequently decreased; RT gradually decreased during anesthesia; HR and GLI increased throughout the procedure; SpO2 was below normal throughout the procedure. Cortisol levels were significantly higher in the DEX group than in the DET group. Also, the animals in the DEX group had a longer recovery time than those in the DET group. On the basis of the results, we conclude that the combination of alpha-2 agonists and midazolam, ketamine, and glyceryl guaicol ether is an appropriate protocol for the anesthesia of tapirs in the field. However, in moderately extended procedures oxygen supplementation is recommended. Additionally, DEX resulted in fewer cardiovascular effects and longer-lasting sedation than DET.
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Anestésicos , Dexmedetomidina , Ketamina , Animais , Midazolam/farmacologia , Ketamina/farmacologia , Dexmedetomidina/farmacologia , Hidrocortisona , Anestésicos/farmacologia , Éteres , Hipnóticos e Sedativos/farmacologiaRESUMO
Familial hypercholesterolemia (FH) is caused by mutations in the gene that encodes the low-density lipoprotein (LDL) receptor, which leads to an excessive increase in plasma LDL cholesterol levels. Previous studies have shown that FH is associated with gliosis, blood-brain barrier dysfunction, and memory impairment, but the mechanisms associated with these events are still not fully understood. Therefore, we aimed to investigate the role of microgliosis in the neurochemical and behavioral changes associated with FH using LDL receptor knockout (LDLr-/- ) mice. We noticed that microgliosis was more severe in the hippocampus of middle-aged LDLr-/- mice, which was accompanied by microglial morphological changes and alterations in the immunocontent of synaptic protein markers. At three months of age, the LDLr-/- mice already showed increased microgliosis and decreased immunocontent of claudin-5 in the prefrontal cortex (PFC). Subsequently, 6-month-old male C57BL/6 wild-type and LDLr-/- mice were treated once daily for 30 days with minocycline (a pharmacological inhibitor of microglial cell reactivity) or vehicle (saline). Adult LDLr-/- mice displayed significant hippocampal memory impairment, which was ameliorated by minocycline treatment. Non-treated LDLr-/- mice showed increased microglial density in all hippocampal regions analyzed, a process that was not altered by minocycline treatment. Region-specific microglial morphological analysis revealed different effects of genotype or minocycline treatment on microglial morphology, depending on the hippocampal subregion analyzed. Moreover, 6-month-old LDLr-/- mice exhibited a slight but not significant increase in IBA-1 immunoreactivity in the PFC, which was reduced by minocycline treatment without altering microglial morphology. Minocycline treatment also reduced the presence of microglia within the perivascular area in both the PFC and hippocampus of LDLr-/- mice. However, no significant effects of either genotype or minocycline treatment were observed regarding the phagocytic activity of microglia in the PFC and hippocampus. Our results demonstrate that hippocampal microgliosis, microglial morphological changes, and the presence of these glial cells in the perivascular area, but not increased microglial phagocytic activity, are associated with cognitive deficits in a mouse model of FH.
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Inflammatory bowel diseases (IBD) cause increased inflammatory signalling and oxidative damage. IBDs are correlated with an increased incidence of brain-related disorders suggesting that the gut-brain-axis exerts a pivotal role in IBD. Butyrate is one of the main microbial metabolites in the colon, and it can cross the blood-brain barrier, directly affecting the brain. We induced ulcerative colitis (UC) in mice utilizing dextran sodium sulfate (DSS) in the drinking water for 7 days. Animals were divided into four groups, receiving water or DSS and treated with saline or 0,066 g/kg of Sodium Butyrate for 7 days. We also used an integrative approach, combining bioinformatics functional network and experimental strategies to understand how butyrate may affect UC. Butyrate was able to attenuate colitis severity and intestinal inflammation. Butyrate protected the colon against oxidative damage in UC and protected the prefrontal cortex from neuroinflammation observed in DSS group. Immunocontent of tight junction proteins Claudin-5 and Occludin were reduced in colon of DSS group mice and butyrate was able to restore to control levels. Occludin and Claudin-5 decrease in DSS group indicate that an intestinal barrier disruption may lead to the increased influx of gut-derived molecules, causing neuroinflammation in the prefrontal cortex, observed by increased IBA-1 marker. The probable protection mechanism of butyrate treatment occurs through NRF2 through Nrf2 and HIF-1α activation and consequent activation of catalase and superoxide dismutase. Our data suggest that systemic inflammation associated with intestinal barrier disruption in UC leads to neuroinflammation in the prefrontal cortex, which was atenuated by butyrate.
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Colite Ulcerativa , Doenças Inflamatórias Intestinais , Animais , Camundongos , Ácido Butírico/uso terapêutico , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/tratamento farmacológico , Doenças Neuroinflamatórias , Claudina-5 , Fator 2 Relacionado a NF-E2 , Ocludina , Córtex Pré-Frontal , Inflamação/tratamento farmacológico , Modelos Animais de DoençasRESUMO
Acute lymphoblastic leukemia (ALL) can be classified into different subgroups based on recurrent genetic alterations. Here, targeted RNA sequencing was used to identify the novel subgroups of ALL in 144 B-other and 40 "classical" ALL samples. The classical TCF3-PBX1, ETV6-RUNX1, KMT2A-rearranged, and BCR-ABL1, and novel P2RY8-CRLF2, ABL-, JAK2-, ZNF384-, MEF2D-, and NUTM1-fusions were easily identified by fusion transcript analysis. IGH-CRLF2 and IGH-EPOR were found by abnormally high levels of expression of CRLF2 or EPOR. DUX4-rearranged was identified by the unusual expression of DUX4 genes and an alternative exon of ERG, or by clustering analysis of gene expression. PAX5-driven ALL, including fusions, intragenic amplifications, and mutations were identified by single-nucleotide variant analysis and manual inspection using the IGV software. Exon junction analysis allowed detection of some intragenic ERG and IKZF1 deletions. CRLF2-high associated with initial white blood cell (WBC) counts of ≥50 × 103/µL and GATA3 risk alleles (rs3781093 and rs3824662), whereas ABL/JAK2/EPOR-fusions associated with high WBC counts, National Cancer Institute's high-risk classification, and IKZF1del. ZNF384-fusions associated with CALLA-negativity and NUTM1-fusions in infants. In conclusion, targeted RNA sequencing further classified 66.7% (96 of 144) B-other ALL cases. All BCP-ALL subgroups, except for iAMP21, hyperdiploid and hypodiploid cases, were identified. Curiously, we observed higher frequencies of females within B-rest ALLs and males in PAX5-driven cases.
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Leucemia-Linfoma Linfoblástico de Células Precursoras , Masculino , Lactente , Feminino , Humanos , Criança , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Mutação , Aberrações Cromossômicas , Sequência de Bases , Análise de Sequência de RNARESUMO
OBJECTIVE: To assess the quality of antenatal care and its covariates among postpartum women in Mozambique. DESIGN: Cross-sectional study. SETTING: The study was undertaken either at the maternity hospital or at home, in Mozambique, in 2019. PARTICIPANTS: A total of 393 women aged 18 to 49 years were interviewed immediately after giving birth. MEASUREMENTS: The quality of antenatal care was analysed based on the guidelines of the Ministry of Health of Mozambique: antenatal appointment in the first 16 weeks of gestation, 4 or more antenatal appointments, at least one laboratory test, at least 4 or more clinical-obstetric procedures, 3 doses of the prophylactic intermittent treatment for malaria, 2 doses of the tetanus vaccine, and counselling related to general health care. Women who reported all of these situations were classified as having had quality antenatal care. FINDINGS: All women reported at least one antenatal care visit, but only 13.0% were classified as having had quality antenatal care. Women who underwent antenatal care in previous pregnancies (aOR=4,28; 95% CI=1,45-12,62) and whose current pregnancy was planned (aOR=2,51; 95% CI=1,11-5,68) were more likely to have quality antenatal care than those who had never had access to antenatal care in previous pregnancies and those who currently had an unplanned pregnancy. It was observed that the criteria recommended by the Ministry of Health were not followed during antenatal care, especially regarding the gestational age at the beginning of antenatal care, the minimum number of consultations, performing blood tests (complete blood count, blood glucose, blood typing and Rh factor) and guidance on signs of risk in pregnancy and childbirth. KEY CONCLUSIONS: In general, the criteria recommended for quality antenatal care are not incorporated into clinical practice in Mozambique. IMPLICATIONS FOR PRACTICE: While quality antenatal care is essential to reduce maternal morbidity and mortality, many sub-Saharan countries still have low-quality antenatal care services, which is one of the reasons why these countries have the highest maternal mortality rates worldwide.
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Parto , Cuidado Pré-Natal , Gravidez , Feminino , Humanos , Cuidado Pré-Natal/métodos , Moçambique , Estudos Transversais , Período Pós-PartoRESUMO
Vitamin D3 deficiency is associated with an increased risk of dementia. An association between vitamin D3 deficiency and subjective cognitive complaints in geriatric patients has been previously reported. This study aimed to evaluate the effects of two doses of vitamin D3 on spatial memory (using the Radial Maze) and cytokine levels [tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and interleukin-10 (IL-10)] on 2-, 6-, 13-, 22-, and 31-month-old male Wistar rats. Animals were supplemented with vitamin D3 at doses of 42 IU/kg and 420 IU/kg for 21 days. A radial maze test was performed to evaluate spatial memory. After the behavioral test, the frontal cortex and hippocampus were dissected for enzyme immunoassay analyses to measure the cytokine levels (TNFα, IL-1ß, IL-6, and IL-10). Our results showed that vitamin D3 supplementation reversed spatial memory impairment at the supplemented doses (42 and 420 IU/kg) in 6-, 13-, and 22-month-old animals and at a dose of 420 IU/kg in 31-month-old animals. The lower dose (42 IU/kg) regulates both pro- and anti-inflammatory cytokines mainly in the frontal cortex. Our results suggest that vitamin D3 has a modulatory action on pro- and anti-inflammatory cytokines, since older animals showed increased cytokine levels compared to 2-month-old animals, and that vitamin D3 may exert an immunomodulatory effect on aging.
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Colecalciferol , Deficiência de Vitamina D , Ratos , Masculino , Animais , Colecalciferol/farmacologia , Colecalciferol/uso terapêutico , Citocinas , Interleucina-10 , Ratos Wistar , Interleucina-6 , Memória Espacial , Fator de Necrose Tumoral alfa , Anti-InflamatóriosRESUMO
Women older than 60 have a higher risk of dementia, aging-related cognitive decline, and Alzheimer's Disease (AD) than the rest of the population. The main reason is hormonal senescence after menopause, a period characterized by a decline in estrogen levels. Since the effectiveness of drugs currently approved for the treatment of AD is limited, it is necessary to seek the development of new therapeutic strategies. Vitamin D deficiency is prevalent in AD patients and individuals with dementia in general. The supplementation of this vitamin in dementia patients might be an interesting approach for increasing the effectiveness of pre-existing medications for dementia treatment. Thus, the present study aims to investigate the effect of vitamin D treatment associated with memantine and donepezil in female mice submitted to ovariectomy (OVX) for five months and subjected to a dementia animal model induced by intracerebroventricular injection of aggregated amyloid ßeta (Aß1-42). For this purpose, Balb/c mice were divided into five experimental groups, which received 17 days of combined therapy with vitamin D, donepezil, and memantine. Then, animals were subjected to behavioral tests. OVX groups exhibited reduced levels of estradiol (E2) in serum, which was not altered by the combined therapy. Higher levels of vitamin D3 were found in the OVX animals submitted to the triple-association treatment. Mice exposed to both OVX and the dementia animal model presented impairment in short and long-term spatial and habituation memories. Also, female mice exposed to Aß and OVX exhibited a reduction in brain-derived neurotrophic factor (BDNF) and interleukin-4 (IL-4) levels, and an increase in tumor necrose factor-α (TNFα) levels in the hippocampus. Besides, increased levels of IL-1ß in the hippocampus and cerebral cortex were observed, as well as a significant increase in immunoreactivity for glial fibrillary acidic protein (GFAP), an astrocytes marker, in the hippocampus. Notably, triple-association treatment reversed the effects of the exposition of mice to Aß and OVX in the long-term spatial and habituation memories impairment, as well as reversed changes in TNFα, IL-1ß, IL-4, and GFAP immunoreactivity levels in the hippocampus of treated animals. Our results indicate that the therapeutic association of vitamin D, memantine, and donepezil has beneficial effects on memory performance and attenuated the neuroinflammatory response in female mice subjected to OVX associated with a dementia animal model.
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Doença de Alzheimer , Fármacos Neuroprotetores , Camundongos , Feminino , Animais , Memantina/farmacologia , Memantina/uso terapêutico , Donepezila/metabolismo , Donepezila/farmacologia , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Vitamina D/farmacologia , Interleucina-4/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/metabolismo , Vitaminas , Hipocampo/metabolismo , Peptídeos beta-Amiloides/metabolismoRESUMO
INTRODUCTION: The consumption of soft drinks has increased considerably in recent decades, mainly cola soft drinks. Excessive consumption of cola-based soft drinks is associated with several diseases and cognitive decline, particularly memory impairment. Furthermore, diets with high sugar can promote insulin resistance, metabolic syndrome, and dyslipidemia. AIM: Thus, the present study aimed to evaluate the effect of cola soft drink intake on behavioral alterations and oxidative damage in 2-, 8- and 14- month-old male Wistar rats. METHODS: The soft drink groups drank soft drink and/or water ad libitum during 67 days, the control groups ingested only water. Radial-arm maze and Y-maze were used to evaluate spatial memory, open-field to evaluate the habituation memory, and inhibitory avoidance to evaluate aversive memory. The behavioral tests started at the day 57 and finished at day 67 of treatment. At 68th day, the rats were killed; frontal cortex and hippocampus were dissected to the analysis of antioxidants enzymes catalase (CAT) and superoxide dismutase (SOD); and the oxidative markers thiobarbituric acid reactive substances (TBARS) and dichloro-dihydro-fluorescein diacetate (DCFH) were measured in the hippocampus. RESULTS AND DISCUSSION: The cola-based soft drink intake caused memory impairment in the radial-arm maze, Y-maze task, and open-field in the 2- and 8-month-old rat, but not in the 14-month-old. There were no difference among groups in the inhibitory avoidance test. In the frontal cortex, soft drink intake reduced CAT activity in the 8-month-old rats and SOD activity in the 8- and 14-month-old rats. In the hippocampus, the soft drink increased CAT activity in 2- and 8-month-old rats, increased DCFH levels at all ages, and increased TBARS levels in 2-month-rats. Therefore, the results show that long-term soft drink intake leads to memory impairment and oxidative stress. The younger seems to be more susceptible to the soft drink alterations on behavior; however, soft drink caused alterations in the oxidative system at all ages evaluated.
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Transtornos da Memória , Estresse Oxidativo , Animais , Antioxidantes/farmacologia , Bebidas Gaseificadas/efeitos adversos , Hipocampo/metabolismo , Masculino , Aprendizagem em Labirinto , Transtornos da Memória/induzido quimicamente , Transtornos da Memória/metabolismo , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo , Água/metabolismo , Água/farmacologiaRESUMO
Vaccinium ashei Reade, popularly known as Rabbiteye blueberry, has several therapeutic properties attributed to the phenolic compounds present in its leaves and fruits. Here, we sought to evaluate the effects of the hydroalcoholic extract from V. ashei leaves (Bluegem cultivar, VAB) in T-cell Acute lymphoblastic leukemia (T-ALL). The VAB extract was toxic to T-ALL cells at the â¼60 µg/ml concentration. T-ALL cell death occurred through apoptosis. VAB extract was found to induce micronuclei formation, p53 pathway activation, and cell cycle arrest. Those mutagenic effects were evidenced through microscopy analysis and molecular p53 pathway activation. A series of phenolic compounds were identified in VAB extract by mass spectrometry, such as vanillic acid, catechin, caffeic acid, chlorogenic acid, rutin, coumaric acid, taxifolin, quercetin and naringenin, some of which are presumed to induce DNA damage. In conclusion, the V. ashei leaves extract may have important secondary metabolites with antileukemic properties.
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Mirtilos Azuis (Planta) , Hidrocarbonetos/farmacologia , Leucemia-Linfoma Linfoblástico de Células T Precursoras , Vaccinium , Apoptose , Mirtilos Azuis (Planta)/química , Pontos de Checagem do Ciclo Celular , Humanos , Hidrocarbonetos/química , Fenóis/análise , Extratos Vegetais/química , Folhas de Planta/química , Linfócitos T , Proteína Supressora de Tumor p53 , Vaccinium/químicaRESUMO
Resumo Objetivo Analisar a vulnerabilidade a vivenciar uma gravidez não intencional entre mulheres usuárias de Unidades Básicas de Saúde e os aspectos associados. Métodos Estudo transversal com 470 mulheres usuárias de Unidades Básicas de Saúde da Coordenadoria Regional de Saúde Leste do município de São Paulo. Os dados foram coletados por meio de entrevistas e utilizou-se regressão logística múltipla para analisar os aspectos associados. Resultados Aproximadamente metade das mulheres mostrou estar vulnerável a vivenciar uma gravidez não intencional (48,3%). Mulheres na faixa etária de 25 a 34 anos tiveram mais chance de estar vulneráveis à gravidez não intencional comparadas às mulheres na faixa etária de 18 a 24 anos (OR=2,0; IC95% 1,2-3,4), tendo sido o mesmo observado em relação às mulheres com 35 anos de idade ou mais (OR=9,7; IC95% 5,3-17,6). As mulheres em união estável tiveram menos chance de estar vulneráveis a uma gravidez não intencional comparadas às mulheres solteiras (OR=0,4; IC95% 0,3-0,7). As mulheres que não planejaram a gravidez anterior tinham mais chance de estar vulnerável a uma gravidez não intencional comparadas às mulheres que planejaram a gravidez anterior (OR=2,5; IC95% 1,2-5,1), diferentemente das mulheres que nunca engravidaram (OR=0,4; IC95% 0,2-0,7). Conclusão Uma parcela significativa de mulheres estava vulnerável a vivenciar uma gravidez não intencional. Os aspectos associados a vivenciar uma gravidez não intencional foram a idade, não estar em união estável e não ter planejado a última gravidez.
Resumen Objetivo Analizar la vulnerabilidad al vivenciar un embarazo no intencional entre mujeres usuarias de Unidades Básicas de Salud y los aspectos asociados. Métodos Estudio transversal con 470 mujeres usuarias de Unidades Básicas de Salud de la Coordinación Regional de Salud Este del municipio de São Paulo. Los datos se recopilaron a través de entrevistas y se utilizó la regresión logística múltiple para el análisis de los aspectos asociados. Resultados Aproximadamente la mitad de las mujeres se mostró vulnerable a vivir un embarazo no intencional (48,3 %). Mujeres en el grupo de edad de los 25 a los 34 años tuvieron más posibilidades de vulnerabilidad a un embarazo no intencional cuando comparadas con las mujeres en el grupo de edad de los 18 a los 24 años (OR=2,0; IC95 % 1,2-3,4). Lo mismo se ha observado en relación con las mujeres de 35 años o más (OR=9,7; IC95 % 5,3-17,6). Las mujeres en unión de hecho tuvieron menos posibilidades de vulnerabilidad a un embarazo no intencional en comparación con las mujeres solteras (OR=0,4; IC95 % 0,3-0,7). Las mujeres que no planificaron el embarazo anterior tuvieron más posibilidades de estar vulnerables a un embarazo no intencional cuando comparadas con las mujeres que planificaron el embarazo anterior (OR=2,5; IC95 % 1,2-5,1), a diferencia de las mujeres que nunca habían quedado embarazadas (OR=0,4; IC95 % 0,2-0,7). Conclusión Una parte significativa de las mujeres estaba vulnerable a vivir un embarazo no intencional. Los aspectos asociados a la vivencia de un embarazo no intencional fueron la edad, no tener una unión de hecho y no haber planificado el último embarazo.
Abstract Objective To analyze the vulnerability to experience an unintentional pregnancy among women users of Primary Care Centers and the associated aspects. Methods A cross-sectional study with a total of 470 women users of Primary Care Centers of the East Health Supervision Department from the city of Sao Paulo. Data were collected through interviews and multiple logistic regression was used to analyze the associated aspects. Results Approximately half of the women were found to be vulnerable to experiencing an unintentional pregnancy (48.3%). Women aged 25 to 34 years old were more likely to be vulnerable to unintentional pregnancy compared to women aged 18 to 24 years old (OR=2.0; 95%CI 1.2-3.4), the same observed for women aged 35 years old or older (OR=9.7; 95%CI 5.3-17.6). Women in a stable relationship were less likely to be vulnerable to an unintentional pregnancy compared to single women (OR=0.4; 95%CI 0.3-0.7). Women who did not plan a previous pregnancy were more likely to be vulnerable to an unintentional pregnancy compared to women who planned a previous pregnancy (OR=2.5; 95%CI 1.2-5.1), unlike women who never got pregnant (OR=0.4; 95%CI 0.2-0.7). Conclusion A significant portion of women was vulnerable to experiencing an unintentional pregnancy. The aspects associated with experiencing this pregnancy were age, not being in a stable relationship and not having planned the last pregnancy.
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Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Gravidez não Desejada , Sistema Único de Saúde , Vulnerabilidade em Saúde , Centros de Saúde , Estudos Transversais , Fatores Etários , Anticoncepção , Saúde Reprodutiva , Fatores SociaisRESUMO
Objetivo: Analisar a vulnerabilidade a vivenciar uma gravidez não intencional entre mulheres usuárias de Unidades Básicas de Saúde e os aspectos associados. Métodos: Estudo transversal com 470 mulheres usuárias de Unidades Básicas de Saúde da Coordenadoria Regional de Saúde Leste do município de São Paulo. Os dados foram coletados por meio de entrevistas e utilizou-se regressão logística múltipla para analisar os aspectos associados. Resultados: Aproximadamente metade das mulheres mostrou estar vulnerável a vivenciar uma gravidez não intencional (48,3%). Mulheres na faixa etária de 25 a 34 anos tiveram mais chance de estar vulneráveis à gravidez não intencional comparadas às mulheres na faixa etária de 18 a 24 anos (OR=2,0; IC95% 1,2-3,4), tendo sido o mesmo observado em relação às mulheres com 35 anos de idade ou mais (OR=9,7; IC95% 5,3-17,6). As mulheres em união estável tiveram menos chance de estar vulneráveis a uma gravidez não intencional comparadas às mulheres solteiras (OR=0,4; IC95% 0,3-0,7). As mulheres que não planejaram a gravidez anterior tinham mais chance de estar vulnerável a uma gravidez não intencional comparadas às mulheres que planejaram a gravidez anterior (OR=2,5; IC95% 1,2-5,1), diferentemente das mulheres que nunca engravidaram (OR=0,4; IC95% 0,2-0,7). Conclusão: Uma parcela significativa de mulheres estava vulnerável a vivenciar uma gravidez não intencional. Os aspectos associados a vivenciar uma gravidez não intencional foram a idade, não estar em união estável e não ter planejado a última gravidez.
Assuntos
Mulheres , Casamento , Modelos Logísticos , Grupos EtáriosRESUMO
Little is known regarding the use of emergency contraception among women from different regions of Brazil. The use of emergency contraception as well as contraceptive methods before and after coitus was analyzed. This cross-sectional study assessed the use of emergency contraception by interviewing 2,051 women aged between 18 and 49 attending 76 basic health units in three capitals: São Paulo-SP, Aracaju-SE and Cuiabá-MT. Aspects associated with the use of emergency contraception were analyzed by means of multiple logistic regression. Over half of the women reported the use of emergency contraception (56.7%). Having a high level of education, being from a more privileged socioeconomic group, having a paid job and having had four or more sexual partners were associated with the use of emergency contraception. Being 35 years of age or older and being in a stable relationship was negatively associated. The last time they used emergency contraception, 53.2% used another method, with the male condom and oral pill being the most frequent. Of those who did not use the method, half adopted the regular method after using it (51.7%). The conclusion drawn is that emergency contraception is widely used and does not appear to affect the use of the regular contraceptive method.
Pouco se sabe sobre o uso da anticoncepção de emergência entre mulheres de diferentes regiões do país. Este estudo analisou o uso da anticoncepção de emergência e os aspectos associados, bem como o uso de métodos contraceptivos antes e após. Trata-se de estudo transversal, conduzido com 2.051 mulheres de 18-49 anos, usuárias de 76 Unidades Básicas de Saúde de São Paulo-SP, Aracaju-SE e Cuiabá-MT. Os aspectos associados ao uso da anticoncepção de emergência foram analisados por meio de regressão logística múltipla. Mais da metade das mulheres relatou já ter usado a anticoncepção de emergência (56,7%). Ter alta escolaridade, ser de grupo socioeconômico mais favorecido, ter trabalho remunerado e ter tido quatro ou mais parceiros sexuais associou-se com uso de anticoncepção de emergência. Ter 35 anos de idade ou mais e estar em união estável associou-se negativamente. Da última vez que usaram a anticoncepção de emergência, 53,2% usavam outro método, sendo preservativo masculino e pílula oral os mais frequentes. Das que não usavam método, metade adotou método regular após o uso (51,7%). Conclui-se que a anticoncepção de emergência é amplamente utilizada e parece não contribuir para interrupção do método contraceptivo de uso regular.
Assuntos
Anticoncepção Pós-Coito , Anticoncepcionais Pós-Coito , Adolescente , Adulto , Brasil , Cidades , Comportamento Contraceptivo , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Adulto JovemRESUMO
Chagas Disease, also known as American trypanosomiasis, is a Neglected Tropical Disease that affects around seven million people, especially in Latin America. Noteworthy, there has been an increase in the numbers of case reports in non-endemic areas, such as North America, Europe, Japan, and Australia. The disease is a vector-borne disease caused by the pathogen Trypanosoma cruzi being transmitted by infected bugs. It is known that about forty percent of infected patients develop cardiac, digestive, or neurological alterations. There are only two drugs currently used for treatment, benznidazole and nifurtimox. However, both therapeutic regimens present several limitations, such as toxicity, mutagenicity and low efficiency during the chronic phase. Some reports in the literature point to the occurrence of parasite resistance. To overcome these limitations, the bioprospection of novel molecules as alternatives is one of the major goals to improve therapeutic success in this chronic disease. Bioprospecting active metabolites from natural resources might bring new hopes for disease control and parasite elimination. Here we summarize the most recent advances to identify and test Algae, Bacteria and Fungi-derived bioactive compounds with trypanocidal activity using experimental models, in vitro testing and in silico approaches.
Assuntos
Doença de Chagas , Nitroimidazóis , Tripanossomicidas , Trypanosoma cruzi , Bactérias , Doença de Chagas/tratamento farmacológico , Fungos , Humanos , Nifurtimox/uso terapêutico , Nitroimidazóis/uso terapêutico , Tripanossomicidas/farmacologia , Tripanossomicidas/uso terapêuticoRESUMO
Mayaro virus (MAYV) has historically been associated with sylvatic transmission; however, urban outbreaks have been reported in Brazil, including cases of co-detection with dengue virus (DENV). Therefore, we performed a molecular survey to investigate MAYV circulation and cocirculation with DENV within Goiania, a major city in Central-West Brazil. Among 375 subjects with arbovirus-like symptoms, 259 were positive for DENV and 26 for MAYV. Of these, 17 were coinfected with DENV-2, suggesting co-transmission of the viruses. The most common complaints at the time of inclusion were myalgia, headache, fever, arthralgia, retro-orbital pain, and skin rash. No specific symptoms were associated with MAYV when either detected alone or co-detected with DENV, compared to that when DENV was detected alone. Most MAYV-infected subjects were women with no recent travel history to rural/sylvatic areas. Phylogenetic reconstruction indicated that the MAYV identified in this study is closely related with a lineage observed in Peru, belonging to genotype D. Our results corroborate the growing circulation of MAYV in urban environments in Brazil and reinforce the need to implement laboratory diagnosis in the Unified Health System, considering that the clinical manifestations of Mayaro fever are similar to those of other arboviruses, particularly dengue. Furthermore, most cases occurred in association with DENV-2. Further phylogenetic studies are needed to evaluate MAYV, which has not been widely examined.
Assuntos
Infecções por Alphavirus/epidemiologia , Alphavirus/fisiologia , Febre/epidemiologia , Adulto , Idoso , Alphavirus/genética , Infecções por Alphavirus/virologia , Brasil/epidemiologia , Feminino , Febre/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Prevalência , Adulto JovemRESUMO
Pouco se sabe sobre o uso da anticoncepção de emergência entre mulheres de diferentes regiões do país. Este estudo analisou o uso da anticoncepção de emergência e os aspectos associados, bem como o uso de métodos contraceptivos antes e após. Trata-se de estudo transversal, conduzido com 2.051 mulheres de 18-49 anos, usuárias de 76 Unidades Básicas de Saúde de São Paulo-SP, Aracaju-SE e Cuiabá-MT. Os aspectos associados ao uso da anticoncepção de emergência foram analisados por meio de regressão logística múltipla. Mais da metade das mulheres relatou já ter usado a anticoncepção de emergência (56,7%). Ter alta escolaridade, ser de grupo socioeconômico mais favorecido, ter trabalho remunerado e ter tido quatro ou mais parceiros sexuais associou-se com uso de anticoncepção de emergência. Ter 35 anos de idade ou mais e estar em união estável associou-se negativamente. Da última vez que usaram a anticoncepção de emergência, 53,2% usavam outro método, sendo preservativo masculino e pílula oral os mais frequentes. Das que não usavam método, metade adotou método regular após o uso (51,7%). Conclui-se que a anticoncepção de emergência é amplamente utilizada e parece não contribuir para interrupção do método contraceptivo de uso regular