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1.
BMC Infect Dis ; 24(1): 974, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39272020

RESUMO

INTRODUCTION: The greater predisposition to infections, as well as the possibility of a worse response to treatment, can lead to the excessive use of antimicrobials among cancer patients. C-reactive protein (CRP) has gained prominence as a tool for monitoring therapeutic responses and reducing the duration of antibiotic therapy; however, few studies have analyzed this protein in cancer patient populations. We hypothesize that cancer patients with a good response to antibiotic therapy show a faster decline in serum CRP levels, which would allow us to identify candidates for short-course treatments. OBJECTIVE: To evaluate the behavior of serum CRP levels among adult cancer patients using antibiotic therapy, and its association with the duration of this treatment, therapeutic response, and clinical recurrence. METHODS: This work consisted of a retrospective study with cancer patients admitted to a university hospital between September 2018 and December 2019. Adults (age ≥ 18 years) who underwent at least one course of antibiotic therapy were included. CRP behavior over the first 7 days of treatment was classified as: i) good response: when the CRP value on the fifth day of therapy reached 50% or less of the peak value detected in the first 48 h of treatment, and ii) poor response: Maintenance, within the same interval, of a CRP value > 50% of the peak value in the first 48 h. The duration of antibiotic therapy was categorized as up to seven full days or more. Outcomes were assessed by events that occurred during the 30 days of hospitalization or until hospital discharge. PRIMARY OUTCOME: Clinical recurrence of the index infection. SECONDARY OUTCOMES: i) Death from any cause; ii) microbiological recurrence; iii) therapeutic response; iv) colitis associated with Clostridioides difficile; and v) isolation of multi-resistant bacteria, whether in clinical or surveillance samples. RESULTS: The final analysis consisted of 212 patients, with a median age (IQ) of 59.2 (48 - 67) years old and a predominance of females (65%), who were hypertensive (35%), smokers (21%), and diabetics (17.8%). There was no difference in clinical recurrence between the two groups (8.1% vs. 12.2%; p = 0.364), with a lower 30-day mortality in the good CRP response group (32.2% vs. 14.5%; p = 0.002). Despite the tendency towards a lower occurrence of other secondary outcomes in the good response group, these differences were not statistically significant. In the poor CRP response group, outcomes like clinical recurrence, mortality, and therapeutic response were significantly worse, regardless of the duration of antibiotic treatment. CONCLUSION: In this study, cancer patients with a good CRP response during antibiotic therapy presented lower mortality and a higher proportion of satisfactory therapeutic responses. CRP can be a useful tool when combined with other clinical information in optimizing the duration of antimicrobial treatment in a hospitalized cancer population.


Assuntos
Antibacterianos , Infecções Bacterianas , Proteína C-Reativa , Neoplasias , Humanos , Proteína C-Reativa/análise , Masculino , Feminino , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Estudos Retrospectivos , Neoplasias/tratamento farmacológico , Neoplasias/complicações , Pessoa de Meia-Idade , Idoso , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/mortalidade , Infecções Bacterianas/sangue , Prognóstico , Adulto , Resultado do Tratamento
2.
Oncology ; 2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-37989120

RESUMO

INTRODUCTION: Hepatocellular carcinoma (HCC) carcinogenesis is not yet fully known. Insulin-like Growth Factor-1 Receptor (IGF-1R) can translocate to the nucleus and modulate cellular growth, possibly participating in HCC development and aggressiveness. This study aims to evaluate the immunoexpression of IGF-1R in HCC, the cellular compartment involved, and its association with clinicopathological parameters and clinical outcomes. METHODS: Liver specimens from 111 HCC patients who underwent liver transplantation or partial surgical resections at a Brazilian referral hospital center were studied. IGF-1R expression was determined by immunohistochemistry, clinical data were collected from medical records, and pathological parameters were obtained from path review. RESULTS: IGF-1R nuclear expression was higher in the tumor than in the adjacent cirrhosis (p < 0.001). The odds of IGF-1R expression in the nucleus compared to the membrane are lower in the cirrhosis condition than in the tumor, suggesting an increase in the prevalence of nucleus expression relative to the membrane from cirrhosis to tumor. There was an association between IGF-1R nuclear expression in HCC and the moderate/poor grade of histologic differentiation (p < 0.001). However, long-term clinical outcomes were not associated with IGF-1R nuclear expression. CONCLUSION: The data presented here suggest the role of IGF-1R in HCC progression and carcinogenesis as its expression increases in the nucleus relative to the membrane, from cirrhosis to tumor, and it was associated with a poorer differentiated tumor grade. Further research is awaited to fully understand the mechanisms underlying this association.

3.
BMC Pulm Med ; 21(1): 43, 2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509141

RESUMO

BACKGROUND: Besides the clinical benefit of crizotinib in ALK-rearranged metastatic non-small cell lung cancer (NSCLC), concerns about its hepatotoxicity have arisen. It is not clear whether this is a drug class side effect or if the use of other selective ALKs inhibitors is safe after this serious adverse event. While evidence from clinical trials is scarce, reports of treatment after crizotinib-induces hepatitis may add to clinical decision. CASE PRESENTATION: Herein, we report a case of acute hepatitis induced by crizotinib in a 32-years-old female diagnosed with metastatic NSCLC, harboring the ALK-rearrangement. After 60 days of crizotinib therapy, the patient presented with acute hepatitis, diagnosed after investigation of non-specific symptoms, such as nausea and fatigue. Serum aspartate aminotransferase and alanine aminotransferase levels had increased from baseline to 3010 IU/L and 9145 IU/L, respectively. Total bilirubin increased up to 7.91 mg/dL, but she did not develop liver failure. After crizotinib discontinuation, a gradual hepatic function recovery occurred. Unfortunately, during the period without specific oncology treatment, her disease showed an unequivocal progression. Therefore, she started on alectinib with great response, and no liver function alteration recurred. CONCLUSIONS: This case suggests that alectinib, even belonging to the same drug class, could be used as an alternative agent when crizotinib is the etiology of liver damage, but more robust evidence has awaited.


Assuntos
Carbazóis/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Crizotinibe/efeitos adversos , Hepatite/etiologia , Neoplasias Pulmonares/tratamento farmacológico , Piperidinas/uso terapêutico , Adulto , Bilirrubina/sangue , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Hepatite/tratamento farmacológico , Humanos , Fígado/efeitos dos fármacos , Fígado/fisiopatologia , Neoplasias Pulmonares/patologia , Inibidores de Proteínas Quinases/uso terapêutico , Resultado do Tratamento
4.
J Environ Sci Health B ; 56(4): 357-369, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34011245

RESUMO

The determination of some pesticides in surface sediments can provide important information about their distribution in the water column. This work aimed to determine the distribution of the classes of pesticides along the Ondas River's hydrographic basin (ORHB), in eighteen different points, during the dry and rainy periods. The pesticides were extracted from the sediment samples by solid-liquid extraction and then analyzed using a gas chromatograph coupled to mass spectrometry. After the development and validation of the method, nineteen pesticides from the group of organochlorine, organophosphates, carbamate and thiocarbamate, pyrethroids, and strobilurins were quantified in at least one point in the two collection periods, with accuracy varying between 86 and 126%. The average concentrations were 0.020 ng g-1 (carbofuran) to 249.123 ng g-1 (dimethoate) and 0.029 ng g-1 (carbofuran and sulfotep) to 533.522 ng g-1 in the dry and rainy periods, respectively. The results showed a wide distribution of pesticide residues in the ORHB, with higher levels for dimethoate, phenitrothion, and malathion, which may be related to their agricultural use in the region. In Brazil, it does not have specific legislation for maximum permitted values of pesticides in sediment, allowing for inappropriate or prohibited use and, consequently, affecting water quality.


Assuntos
Sedimentos Geológicos/análise , Organofosfatos/análise , Praguicidas/análise , Poluentes Químicos da Água/análise , Agricultura , Brasil , Carbamatos/análise , Fracionamento Químico/métodos , Monitoramento Ambiental/métodos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Hidrocarbonetos Clorados/análise , Resíduos de Praguicidas/análise , Piretrinas/análise , Chuva , Estrobilurinas/análise , Tiocarbamatos/análise
5.
Anal Bioanal Chem ; 406(24): 5989-95, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25023972

RESUMO

In this work, a new approach is proposed to verify the differentiating characteristics of five bacteria (Escherichia coli, Enterococcus faecalis, Streptococcus salivarius, Streptococcus oralis, and Staphylococcus aureus) by using digital images obtained with a simple webcam and variable selection by the Successive Projections Algorithm associated with Linear Discriminant Analysis (SPA-LDA). In this sense, color histograms in the red-green-blue (RGB), hue-saturation-value (HSV), and grayscale channels and their combinations were used as input data, and statistically evaluated by using different multivariate classifiers (Soft Independent Modeling by Class Analogy (SIMCA), Principal Component Analysis-Linear Discriminant Analysis (PCA-LDA), Partial Least Squares Discriminant Analysis (PLS-DA) and Successive Projections Algorithm-Linear Discriminant Analysis (SPA-LDA)). The bacteria strains were cultivated in a nutritive blood agar base layer for 24 h by following the Brazilian Pharmacopoeia, maintaining the status of cell growth and the nature of nutrient solutions under the same conditions. The best result in classification was obtained by using RGB and SPA-LDA, which reached 94 and 100 % of classification accuracy in the training and test sets, respectively. This result is extremely positive from the viewpoint of routine clinical analyses, because it avoids bacterial identification based on phenotypic identification of the causative organism using Gram staining, culture, and biochemical proofs. Therefore, the proposed method presents inherent advantages, promoting a simpler, faster, and low-cost alternative for bacterial identification.


Assuntos
Bactérias/química , Bactérias/classificação , Técnicas de Tipagem Bacteriana/métodos , Fotografação/métodos , Bactérias/isolamento & purificação , Técnicas de Tipagem Bacteriana/instrumentação , Análise Discriminante , Análise dos Mínimos Quadrados , Fotografação/instrumentação
6.
Chemosphere ; 354: 141659, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38490616

RESUMO

This study investigated the occurrence and seasonal distribution of different classes of pesticides in surface waters of the Ondas River Watershed, as well as potential risks to the aquatic health and human water consumption in the western region of Bahia state, Brazil. Two gas chromatography-mass spectrometry analytical methods were applied to monitor 34 pesticides in water samples collected during both the dry and rainy seasons at 17 sites. Upon individual analysis, only γ-HCH, methoxychlor, demeton-S, methyl parathion, fenitrothion, chlorpyrifos, and azoxystrobin exhibited statistically significant differences between seasons. During rainy season, concentration medians of residues were higher for γ-HCH (74.7 ng L-1), methoxychlor (25.1 ng L-1), and azoxystrobin (47.2 ng L-1), potentially linked to historical contamination or illegal use. Conversely, pesticides like methyl parathion, fenitrothion, and chlorpyrifos, belonging to the organophosphate class, showed higher concentration medians in the dry period, measuring 75.1, 5.50, and 10.8 ng L-1, respectively, probably due to region crop activities. The risk quotient (RQ) assessment for aquatic life indicated that 59.0% of the samples in the dry season and 76.0% in the rainy season had RQ values greater than one, signifying a critical scenario for species conservation. Regarding human consumption, elevated risks were observed for heptachlor in both sampling periods and for azoxystrobin during the rainy season, surpassing RQ levels above 1, indicating danger in untreated water ingestion. Additionally, 24.0% and 53.0% of the samples in the dry and rainy seasons, respectively, contained at least one pesticide exceeding the EU resolution limit (100 ng L-1). Therefore, considering this information, implementing mitigation measures to avoid the river's contamination becomes imperative.


Assuntos
Clorpirifos , Metil Paration , Praguicidas , Pirimidinas , Estrobilurinas , Poluentes Químicos da Água , Humanos , Praguicidas/análise , Estações do Ano , Rios/química , Brasil , Água/análise , Hexaclorocicloexano/análise , Metoxicloro/análise , Fenitrotion , Poluentes Químicos da Água/análise , Medição de Risco , Monitoramento Ambiental/métodos
7.
Food Res Int ; 194: 114866, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39232507

RESUMO

This review explores the historical, botanical, sensory, and quality aspects of Coffea canephora, with a focus on Brazil's rise as a producer of specialty canephora coffees in the Amazon region, Espírito Santo, and Bahia. Brazil has gained global recognition through the first geographical indications for canephora: Matas de Rondônia for robusta amazônico coffee and Espírito Santo for conilon coffee. Despite this, comprehensive insights into how variety, terroir, environmental conditions, and cultivation practices influence the chemical and sensory attributes of Brazilian canephora remain underdeveloped compared to well-studied arabica coffee. Producers and researchers are working to elevate canephora coffees to higher market levels, despite technological, production, and perception challenges stemming from its historical reputation for poor quality. Ensuring the sustainability of Amazonian canephora coffee without deforestation is particularly challenging due to the need to verify practices across numerous small-scale farms. There is also a critical need for standardized production and tasting protocols for Brazilian canephora, leveraging local expertise and professional cuppers to ensure consistent quality and reliable sustainability claims. Significant opportunities exist in valuing the production chain of geographically unique canephora coffees, which could increase specialty exports, enhance economic prospects for local farmers, and support Amazon preservation. Recognizing and marketing these coffees as premium products with unique flavor profiles can boost their global appeal. Another challenge lies in establishing new specialty standards for soluble coffee from specialty canephora to meet consumer demands for convenience without compromising taste or ethical standards. In such a scenario, several analytical methods have been suggested to identify high-quality variants, combating their stigmatization. The potential of spectroscopy techniques and chemometrics-based data science is highlighted in confirming coffee quality, authenticity, traceability, and geographical origin, enhancing model interpretation and predictive accuracy through synergistic and complementary information. Non-targeted spectroscopic analyses, providing comprehensive spectral fingerprints, are contrasted with targeted analyses. Overall, this review offers valuable insights for the coffee scientific community, exporters, importers, roasters, and consumers in recognizing the potential of Brazilian canephora coffees.


Assuntos
Coffea , Café , Paladar , Coffea/química , Brasil , Café/química , Humanos , Análise Espectral/métodos , Sementes/química
8.
Front Oncol ; 14: 1394116, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38807769

RESUMO

Synopsis: This is a systematic review and meta-analysis comparing surgical excision with percutaneous ultrasound-guided vacuum-assisted excision (US-VAE) for the treatment of benign phyllodes tumor (PT) using local recurrence (LR) as the endpoint. Objective: To determine the frequency of local recurrence (LR) of benign phyllodes tumor (PT) after ultrasound-guided vacuum-assisted excision (US-VAE) compared to the frequency of LR after surgical excision. Method: A systematic review and meta-analysis [following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard] was conducted by comparing LR in women older than 18 years treated for benign PT by US-VAE compared with local surgical excision with at least 12 months of follow-up. Studies were retrieved from PubMed, Scopus, Web of Science, and Embase. The pooled effect measure used was the odds ratio (OR) of recurrence. Results: Five comparative prospective or retrospective observational studies published between January 1, 1992, and January 10, 2022, comparing surgical excision with percutaneous US-VAE for LR of benign PT met the selection criteria. Four were retrospective observational cohorts, and one was a prospective observational cohort. A total of 778 women were followed up. Of them, 439 (56.4%) underwent local surgical excision, and 339 (43.6%) patients had US-VAE. The median age of patients in the five studies ranged from 33.7 to 39 years; the median size ranged from 1.5 cm to 3.0 cm, and the median follow-up ranged from 12 months to 46.6 months. The needle gauge ranged from 7G to 11G. LR rates were not statically significant between US-VAE and surgical excision (41 of 339 versus 34 of 439; OR 1.3; p = 0.29). Conclusion: This meta-analysis suggests that using US-VAE for the removal of benign PT does not increase local regional recurrence and is a safe minimally invasive therapeutic option. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022309782.

9.
Food Chem ; 421: 136164, 2023 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-37099954

RESUMO

Tea (Camellia sinensis) fraud has been frequently identified and involves tampering with the labelling of inferior products or without geographical origin certification and even mixing them with superior quality teas to mask an adulteration. Consequently, economic losses and health damage to consumers are observed. Thus, a Chemometrics-assisted Color Histogram-based Analytical System (CACHAS) was employed a simple, cost-effective, reliable, and green analytical tool to screen the quality of teas. Data-Driven Soft Independent Modeling of Class Analogy was used to authenticate their geographical origin and category simultaneously, recognizing correctly all Argentinean and Sri Lankan black teas and Argentinean green teas. For the determination of moisture, total polyphenols, and caffeine, Partial Least Squares obtained satisfactory predictive abilities, with values of root mean squared error of prediction (RMSEP) of 0.50, 0.788, and 0.25 mg kg-1, rpred of 0.81, 0.902, and 0.81, and relative error of prediction (REP) of 6.38, 9.031, and 14.58%., respectively. CACHAS proved to be a good alternative tool for environmentally-friendly non-destructive chemical analysis.


Assuntos
Camellia sinensis , Quimiometria , Chá , Cafeína/análise , Polifenóis/análise
10.
Front Oncol ; 13: 1202544, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37388233

RESUMO

Purpose: This study, conducted during the COVID-19 crisis, primarily aimed to compare the acute toxicity between conventional fractionated radiation therapy (CF-RT) with hypofractionated radiation therapy (HF-RT) among patients who underwent breast-conserving surgery or mastectomy in whom breast or chest wall and regional nodal irradiation (RNI) were indicated. The secondary endpoints were both acute and subacute toxicity, cosmesis, quality of life, and lymphedema features. Methods: In this open and non-inferiority randomized trial, patients (n = 86) were randomly allocated 2:1 in the CF-RT arm (n = 33; 50 Gy/25 fractions ± sequential boost [10 Gy/5 fractions]) versus the HF-RT arm (n = 53; 40 Gy/15 fractions ± concomitant boost [8 Gy/15 fractions]). Toxic effects and cosmesis evaluation used the Common Terminology Criteria for Adverse Events, version 4.03 (CTCAE) and the Harvard/National Surgical Adjuvant Breast and Bowel Project (NSABP)/Radiation Therapy Oncology Group (RTOG) scale. For the patient-reported quality of life (QoL), the European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) and the breast cancer-specific supplementary questionnaire (QLQ-BR23) were used. Lymphedema was assessed by comparing volume differences between the affected and contralateral arms using the Casley-Smith formula. Results: Grade 2 and grade 3 dermatitis were lower with HF-RT than with CF-RT (28% vs. 52%, and 0% vs. 6%, respectively; p = 0.022). HF-RT had a lower rate of grade 2 hyperpigmentation (23% vs. 55%; p = 0.005), compared to CF-RT. No other differences in overall rates of physician-assessed grade 2 or higher and grade 3 or higher acute toxicity between HF-RT and CF-RT were registered. There was no statistical difference between groups regarding cosmesis, lymphedema rate (13% vs. 12% HF-RT vs. CF-RT; p = 1.000), and functional and symptom scales, during both the irradiation period and after 6 months of the end of treatment. The results revealed that the subset of patients up to 65 years or older did not show a statistical difference between both arm fractionation schedules (p > 0.05) regarding skin rash, fibrosis, and lymphedema. Conclusion: HF-RT was non-inferior to CF-RT, and moderate hypofractionation showed lower rates of acute toxicity, with no changes in quality-of-life outcomes. Clinical trial registration: ClinicalTrials.gov, identifier NCT40155531.

11.
J Gastrointest Oncol ; 14(3): 1560-1575, 2023 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-37435200

RESUMO

Background and Objective: Immune checkpoint inhibition has shed light on a new era in cancer therapy, and randomized clinical trials have demonstrated that a meaningful portion of the overall population of metastatic gastric cancer (GC) patients may derive clinical benefit from immunotherapy, which raises the relevance in identifying predictive biomarkers. Programmed cell death-ligand 1 (PD-L1) expression has demonstrated a significant association between level of expression and the magnitude of benefit derived from immune checkpoint inhibition in GC. Nevertheless, this biomarker shows several pitfalls that must be considered in the therapeutic decision to incorporate immune checkpoint inhibition as the standard of care of GC, such as spatial and temporal heterogeneity, interobserver variability, immunohistochemistry (IHC) assay, and influence by chemotherapy or radiation therapy. Methods: In the present comprehensive review, we revised the main studies regarding PD-L1 evaluation in GC. Key Content and Findings: Here we describe the molecular characteristics of the tumor microenvironment in GC, the obstacles in the interpretation of PD-L1 expression and present the data of the clinical trials that have evaluated the efficacy and safety of immune checkpoint inhibition and the association with the biomarker expression, both in first-line and later lines of therapy. Conclusions: From the emerging predictive biomarkers for immune checkpoint inhibition, PD-L1 has demonstrated a meaningful association between level of expression in tumor microenvironment and the magnitude of benefit derived from immune checkpoint inhibition in GC.

12.
J Hepatocell Carcinoma ; 10: 91-98, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36711001

RESUMO

Introduction: Hepatocellular carcinoma is the most common primary neoplasia of the liver. Microvascular invasion predicts outcome and defines tumor staging. However, its diagnosis is still a challenge. The present study aims to evaluate inter and intraobserver agreement in identifying the presence of microvascular invasion using conventional and immunohistochemistry histology. Methods: Three pathologists performed the analysis of 76 hepatocellular carcinoma explants to characterize the presence of microvascular invasion using the hematoxylin/eosin stain and immunohistochemistry for CD34. The evaluations were made individually, in two distinct moments. Results were analyzed by the Kappa's coefficient and ROC curves. Results: Our study demonstrated similar agreement for microvascular invasion between hematoxylin/eosin and CD34 methods. However, the intraobserver agreement values for both methods were higher than the interobserver ones. The accuracy of CD34 in relation to hematoxylin/eosin by ROC curves in intraobserver analysis tends to a high specificity, ranging from 82.1 to almost 100%, with sensitivity of 46.9% to 81.1%. In interobserver analysis, CD34 also has a high specificity (84.3% to 85.5%) while its sensitivity is a little shorter (81.2% to 84.3%). Conclusion: Intraobserver higher agreement allows us to suppose that pathologists employed own criteria to evaluate vascular invasion, reinforcing the need of standardization. ROC Curves analysis showed that the CD34 method is more specific than sensitive. Therefore, immunohistochemistry for CD34 should not be used routinely, but it could be useful to help confirming invasion previously seen by conventional histology.

13.
Food Chem ; 370: 131072, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34537434

RESUMO

Food analysis covers aspects of quality and detection of possible frauds to ensure the integrity of the food. The arsenal of analytical instruments available for food analysis is broad and allows the generation of a large volume of information per sample. But this instrumental information may not yet give the desired answer; it must be processed to provide a final answer for decision making. The possibility of discarding non-informative and/or redundant signals can lead to models of better accuracy, robustness, and chemical interpretability, in line with the principle of parsimony. Thus, in this tutorial review, we cover aspects of variable selection in food analysis, including definitions, theoretical aspects of variable selection, and case studies showing the advantages of variable selection-based models concerning the use of a wide range of non-informative and redundant instrumental information in the analysis of food matrices.


Assuntos
Análise de Alimentos , Fraude
14.
Sao Paulo Med J ; 140(2): 290-296, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34932783

RESUMO

BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions ("hospital and outpatient care", "primary care", "prophylactic and therapeutic support" and "epidemiological surveillance"). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare.


Assuntos
COVID-19 , Brasil/epidemiologia , Gastos em Saúde , Hospitalização , Humanos , SARS-CoV-2
15.
Anal Chim Acta ; 1206: 339411, 2022 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-35473880

RESUMO

The monitoring of total suspended (TSS) and settleable (SetS) solids in wastewater is essential to maintain the quality parameters for aquatic biota because they can transport pollutants and block light penetration. Determining them by their respective reference methods, however, is laborious, expensive, and time consuming. To overcome this, we developed a new analytical instrument called Solids in Wastewater's Machine Vision-based Automatic Analyzer (SWAMVA), which is equiped with an automatic sampler and a software for real-time digital movie capture to quantify sequentially the TSS and SetS contents in wastewater samples. The machine vision algorithm (MVA) coupled with the Red color plane (derived from color histograms in the Red-Green-Blue (RGB) system) showed the best prediction results with R2 of 0.988 and 0.964, and relative error of prediction (REP) of 6.133 and 9.115% for TSS and SetS, respectively. The constructed models were validated by Analysis of Variance (ANOVA), and the accuracy and precision of the predictions by the t- and F-tests, respectively, at a 0.05 significance level. The elliptical joint confidence region (EJCR) test confirmed the accuracy, while the coefficient of variation (CV) of 6.529 and 10.908% confirmed the good precisions, respectively. Compared with the reference method (Standard Methods For the Examination of Water and Wastewater), the proposed method reduced the analysis volume from 1.5 L to just 15 mL and the analysis time from 12 h to 24 s per sample. Therefore, SWAMVA can be considered an important alternative to the determination of TSS and SetS in wastewater as an automatic, fast, and low-cost analytical tool, following the principles of Green Chemistry and exploiting Industry 4.0 features such as intelligent processing, miniaturization, and machine vision.


Assuntos
Águas Residuárias
16.
Cancer Treat Res Commun ; 32: 100616, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35940119

RESUMO

Colorectal cancer (CRC) is the third leading cause of cancer-related mortality in the United States and the second cause worldwide. Its incidence rates have been decreasing in the overall population in the US in the past few decades, but with increasing rates in the population younger than 50 years old. Environmental factors are supposed to be involved in the development of the disease, with strong evidence favoring an influence of the diet and lifestyle. A diet high in red meat and calories, and low in fiber, fruits and vegetables increases the risk of CRC, as well as physical inactivity. The influence of low calcium intake and low levels of vitamin D on the risk of the disease and on the clinical outcomes of CRC patients has also been investigated. Hypovitaminosis D has been highly prevalent worldwide and associated with several chronic diseases, including malignancies. Vitamin D is a steroid hormone with the main function of regulating bone metabolism, but with many other physiological functions, such as anti-inflammatory, immunomodulatory, and antiangiogenic effects, potentially acting as a carcinogenesis inhibitor. In this review, we aim to describe the relation of vitamin D with malignant diseases, mainly CRC, as well as to highlight the results of the studies which addressed the potential role of vitamin D in the development and progression of the disease. In addition, we will present the results of the pivotal randomized clinical trials that evaluated the impact of vitamin D supplementation on the clinical outcomes of patients with CRC.


Assuntos
Neoplasias Colorretais , Vitamina D , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Humanos , Incidência , Pessoa de Meia-Idade , Vitamina D/uso terapêutico
17.
Food Chem ; 368: 130843, 2022 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-34418692

RESUMO

This works proposed a feasibility study on NIR spectroscopy and chemometrics-assisted color histogram-based analytical systems (CACHAS) to determine and authenticate the cassava starch content in wheat flour. Prediction results of partial least squares (PLS) achieved coefficient of correlation (rpred) of 0.977 and root mean square error of prediction (RMSEP) of 1.826 mg kg-1 for the certified additive-free wheat flour, while rpred of 0.995 and RMSEP of 1.004 mg kg-1 were obtained for the commercial wheat flour containing chemical additives. Additionally, Data-Driven Soft Independent Modelling of Class Analogy (dd-SIMCA) presented similar predictive ability using NIR and CACHAS for the certified wheat flour, authenticating all target samples, besides correctly recognizing samples that could represent a fraud. No satisfactory results were obtained for the commercial wheat flour. Therefore, NIR spectroscopy is more useful to offer definitive quantitative and qualitative analysis, while CACHAS can only provide an alternative preliminary analysis.


Assuntos
Farinha , Manihot , Pão , Estudos de Viabilidade , Farinha/análise , Análise dos Mínimos Quadrados , Espectroscopia de Luz Próxima ao Infravermelho , Amido , Triticum
18.
Environ Sci Pollut Res Int ; 29(33): 50376-50391, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35230632

RESUMO

The Rio de Ondas Hydrographic Basin (ROHB), Bahia state, Brazil, is located in a region with abundant water resources and is highly impacted by intense agricultural activity. In such a scenario, the use of organochlorine pesticides can represent a potential risk to the aquatic environments, due to their persistence, high bioaccumulation capacity, and high toxicity. Thus, organochlorine pesticide residues in bottom sediment samples from rivers on eighteen sites distributed along the ROHB in the dry and rainy periods were analyzed by gas chromatography coupled with mass spectrometry. The validated method showed no matrix effect, recoveries ranging from 82% (ß-HCB) to 118% (DDD), limits of detection between 0.003 ng g-1 (α-HCH) and 0.011 ng g-1 (DDT), limits of quantification of 0.010 ng g-1 (α-HCH) to 0.036 ng g-1 (DDT), repeatability with the highest relative standard deviation of 0.97% (α-hexachlorocyclohexane at 2.000 ng g-1), and inter-day precision ranging from 10% (aldrin at 0.050 ng g-1 and 0.600 ng g-1 and α-endosulfan at 0.600 ng g-1) to 25% (ß-endosulfan at 0.050 ng g-1). Although most compounds were banned since 1985, it was observed that their residues were widely distributed in the ROHB, with the total concentrations varying from 3.242 ng g-1 (P02) to 12.052 ng g-1 (P17) and from 0.313 ng g-1 (P14) to 30.861 ng g-1 (P13) in the dry and rainy periods, respectively, which may be related to historical contamination and/or prohibited use. Moreover, the spatiotemporal variation showed the highest concentrations of organochlorine pesticide residues in the rainy season, coinciding with the planting period.


Assuntos
Hidrocarbonetos Clorados , Resíduos de Praguicidas , Praguicidas , Poluentes Químicos da Água , Brasil , DDT/análise , Endossulfano/análise , Monitoramento Ambiental/métodos , Cromatografia Gasosa-Espectrometria de Massas , Sedimentos Geológicos/química , Hidrocarbonetos Clorados/análise , Resíduos de Praguicidas/análise , Praguicidas/análise , Poluentes Químicos da Água/análise
19.
Oncol Lett ; 23(1): 32, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34966448

RESUMO

The expression of the inositol 1,4,5-trisphosphate receptor type 3 (ITRP3) in hepatocytes is a common event in the pathogenesis of hepatocellular carcinoma (HCC), regardless of the type of underlying liver disease. However, it is not known whether ITPR3 expression in hepatocytes is involved in tumor maintenance. The aim of the present study was to determine whether there is an association between ITPR3 expression and clinical and morphological parameters using HCC samples obtained from liver explants from patients (n=53) with different etiologies of underlying chronic liver disease (CLD). ITPR3 expression, mitosis and apoptosis were analyzed in human liver samples by immunohistochemistry. Clinical and event-free survival data were combined to assess the relationship between ITPR3 and liver cancer growth in patients. RNA sequencing analysis was performed to identify apoptotic genes altered by ITPR3 expression in a liver tumor cell line. ITPR3 was highly expressed in HCC tumor cells relative to adjacent CLD tissue and healthy livers. There was an inverse correlation between ITPR3 expression and mitotic and apoptotic indices in HCC, suggesting that ITPR3 contributed to the maintenance of HCC by promoting resistance to apoptosis. This was confirmed by the upregulation of CTSB, CHOP and GADD45, genes involved in the apoptotic pathway in HCC. The expression of ITPR3 in the liver may be a promising prognostic marker of HCC.

20.
Food Chem ; 365: 130467, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34243118

RESUMO

This work proposes the use of UV-Vis spectroscopy and one-class classifiers to authenticate honey in terms of their individual and simultaneous adulterations with corn syrup, agave syrup, and sugarcane molasses. Then, spectra of aqueous authentic (n = 73) and adulterated (n = 162) honey samples were recorded. Before the construction of OC-PLS and DD-SIMCA models, different pre-processing techniques were used to removed baseline shifts. The best result obtained by DD-SIMCA using offset correction, correctly classifying all the samples in the test set. Therefore, the proposed methodology can be used as a promising tool to authenticate honey and prevent fraudulent labeling, affording security to consumers and providing an alternative to regulatory agencies. Moreover, it avoids laborious sample preparation and additional operational costs, since the analytical information is acquired using a routine instrumental technique, without the need for any sample preparation step, other than dilution of the samples in water alone.


Assuntos
Mel , Carboidratos , Contaminação de Alimentos/análise , Mel/análise , Análise Espectral , Açúcares
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