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A bacterial strain was isolated from a brackish water sample of Tagus river, Alcochete, Portugal and was designated TO1_6T. It forms light pink colonies on M13 medium supplemented with N-acetylglucosamine. Cells are pear-shaped to spherical, form rosettes and divide by budding. Strain TO1_6T presents a mesophilic and neutrophilic profile, with optimum growth at 20 to 25 °C and pH 7.0 to 7.5, and vitamin supplementation is not required to promote its growth. The genome of the novel isolate is 7.77 Mbp in size and has a DNA G + C content of 56.3%. Based on its 16S rRNA gene sequence, this strain is affiliated with the phylum Planctomycetota. Further taxonomic characterization using additional phylogenetic markers, namely rpoB gene sequence (encoding the ß-subunit of the DNA-dependent RNA polymerase), as well as Percentage of conserved proteins, average nucleotide identity and average amino acid identity, suggest the affiliation of strain TO1_6T to the genus Stieleria, a recently described taxon in the family Pirellulaceae, order Pirellulales and class Planctomycetia. Based on the genotypic, phylogenetic and physiological characterization, we here describe a new species represented by the type strain TO1_6T (= CECT 30432T, = LMG 32465T), for which the name Stieleria tagensis sp. nov. is proposed.
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Ácidos Graxos , Rios , Rios/microbiologia , Ácidos Graxos/análise , Fosfolipídeos/análise , Planctomicetos , Análise de Sequência de DNA , Filogenia , RNA Ribossômico 16S/genética , Portugal , DNA Bacteriano/genética , DNA Bacteriano/química , Técnicas de Tipagem BacterianaRESUMO
Salterns are extreme environments, where the high salt concentration is the main limitation to microbial growth, along with solar radiation, temperature and pH. These selective pressures might lead to the acquisition of unique genetic adaptations that can manifest in the production of interesting natural products. The present study aimed at obtaining the culturable microbial diversity from two Portuguese salterns located in different geographic regions. A total of 190 isolates were retrieved and identified as belonging to 30 genera distributed among 4 phyla-Firmicutes, Proteobacteria, Actinobacteria and Bacteroidetes. Specifically, members of the genus Bacillus were the most frequently isolated from both salterns and all actinobacterial isolates belong to the rare members of this group. The molecular screening of NRPS and PKS-I genes allowed the detection of 38 isolates presenting PKS-I, 25 isolates presenting NRPS and 23 isolates presenting both types of biosynthetic genes. Sequencing of randomly selected amplicons revealed similarity with known PKS-I and NRPS genes or non-annotated hypothetical proteins. This study is the first contribution on the culturable bacterial diversity of Portuguese salterns and on their bioactive potential. Ultimately, these findings provide a novel contribution to improve the understanding on the microbial diversity of salterns.
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Bactérias/classificação , Bactérias/isolamento & purificação , Ecossistema , Microbiologia Ambiental , Técnicas Bacteriológicas , Portugal , Especificidade da EspécieRESUMO
The increase of many deadly diseases like infections by multidrug-resistant bacteria implies re-inventing the wheel on drug discovery. A better comprehension of the metabolisms and regulation of diseases, the increase in knowledge based on the study of disease-born microorganisms' genomes, the development of more representative disease models and improvement of techniques, technologies, and computation applied to biology are advances that will foster drug discovery in upcoming years. In this paper, several aspects of current methodologies for drug discovery of antibacterial and antifungals, anti-tropical diseases, antibiofilm and antiquorum sensing, anticancer and neuroprotectors are considered. For drug discovery, two different complementary approaches can be applied: classical pharmacology, also known as phenotypic drug discovery, which is the historical basis of drug discovery, and reverse pharmacology, also designated target-based drug discovery. Screening methods based on phenotypic drug discovery have been used to discover new natural products mainly from terrestrial origin. Examples of the discovery of marine natural products are provided. A section on future trends provides a comprehensive overview on recent advances that will foster the pharmaceutical industry.
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Descoberta de Drogas/métodos , Preparações Farmacêuticas/administração & dosagem , Animais , Produtos Biológicos/farmacologia , Indústria Farmacêutica/métodos , HumanosRESUMO
Probiotics benefits in fish farming have been usually inferred appraising the effects observed on the host and not through the direct assessment of probiotic dynamics in the host gut microbiota. To overcome this gap, quantitative PCR (qPCR) can be a powerful approach to study the bacterial dynamics in fish gut microbiota. The presented work proposes four B. licheniformis-specific DNA markers and details a qPCR method to track putative probiotics B. licheniformis on fish gut. The four B. licheniformis-specific DNA markers - BL5B (hypothetical protein BL00303), BL8A (serA2), BL13C (rfaB) and BL18A (ligD) - were selected and validated by PCR and multiplex-PCR with 20 B. licheniformis isolates and a broad range of non-target bacteria. To assess the dynamics of B. licheniformis in the digesta of farmed fish, a qPCR was validated using markers BL8A and BL18A and calibration curves obtained for both markers with digesta samples spiked with B. licheniformis cells showed a high correlation (R2â¯>â¯0.99) over 6 log units (CFU/reaction), and a limit of detection (LOD) as low as 247â¯CFUs/reaction. Furthermore, the consistent qPCR repeatability and reproducibility underline the specificity and reliability of the qPCR proposed. Ultimately, the possibility to monitor the dynamics of B. licheniformis probiotics in the gut microbiota of farmed fish might be instrumental to optimize best practices in aquaculture.
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Bacillus licheniformis/isolamento & purificação , Peixes/microbiologia , Marcadores Genéticos/genética , Reação em Cadeia da Polimerase Multiplex/métodos , Reação em Cadeia da Polimerase Multiplex/veterinária , Probióticos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Animais , Bacillus licheniformis/genética , Bactérias/genética , Bactérias/isolamento & purificação , Contagem de Colônia Microbiana , DNA Bacteriano/genética , Pesqueiros , Microbioma Gastrointestinal/genética , Genes Bacterianos/genética , Probióticos/análise , RNA Ribossômico 16S/genéticaAssuntos
Actinobacteria/classificação , Filogenia , Águas Salinas , Microbiologia da Água , Actinobacteria/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Portugal , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
Effective patient positioning is a critical factor influencing surgical outcomes, mainly in minimally invasive gynecologic surgery (MIGS) where precise positioning facilitates optimal access to the surgical field. This paper provides a comprehensive exploration of the significance of strategic patient placement in MIGS, emphasizing its role in preventing intraoperative injuries and enhancing overall surgical success. The manuscript addresses potential complications arising from suboptimal positioning and highlights the essential key points for appropriate patient positioning during MIGS, encompassing what the surgical team should or shouldn't do. In this perspective, the risk factors associated with nerve injuries, sliding, compartment syndrome, and pressure ulcers are outlined to guide clinical practice. Overall, this paper underscores the critical role of precise patient positioning in achieving successful MIGS procedures and highlights key principles for the gynecological team to ensure optimal patient outcomes.
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Procedimentos Cirúrgicos em Ginecologia , Procedimentos Cirúrgicos Minimamente Invasivos , Posicionamento do Paciente , Humanos , Procedimentos Cirúrgicos em Ginecologia/métodos , Feminino , Posicionamento do Paciente/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Complicações Intraoperatórias/prevenção & controle , Complicações Pós-Operatórias/prevenção & controleRESUMO
OBJECTIVE: This in situ study aimed to evaluate a new toothpaste formulation containing fluoride (F), casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and sodium trimetaphosphate (TMP) on the process of dental demineralization and biofilm composition. METHODS: This crossover double-blind study consisted of five phases, in which 10 volunteers wore intraoral appliances containing four bovine enamel specimens. The cariogenic challenge was performed using 30 % sucrose solution. Blocks were treated 3 ×/day with the following toothpastes: 1) Placebo (No F-TMP-CPP-ACP), 2) 1100 ppm F (1100F), 3) 1100F + 3 %TMP (1100F-TMP), 4) 1100F + 10 %CPP-ACP (1100F-CPP-ACP) and 5) 1100F-CPP-ACP-TMP. After 7 days, the percentage loss of surface hardness (%SH), integrated loss of subsurface hardness (ΔKHN), F, calcium (Ca) and phosphorus (P) concentration in the enamel was determined. The concentration of F, Ca, P and insoluble extracellular polysaccharide (EPS) in the biofilm were analyzed. RESULTS: The addition of CPP-ACP-TMP to 1100F reduced %SH by 42 % and 39 % when compared to the 1100F and 1100F-CPP-ACP (p < 0.001); in addition, to a reduction in lesion body (ΔKHN) by 36 % for the same treatments. The treatment with 1100F-CPP-ACP-TMP led to a significant increase in the concentration of F, P and Ca in the enamel and biofilm, and reduced the concentration of EPS (p < 0.001). SIGNIFICANCE: Toothpaste formulation containing 1100F-CPP-ACP-TMP prevented the reduction of enamel hardness and significantly influenced the ionic biochemical composition and insoluble extracellular polysaccharide (EPS) in biofilm formed in situ. These results are promising and provide valuable insights for the design of further clinical trials.
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This study assessed the effects of different prepartum supplementation plans on Nellore cows' performance, metabolic responses, and early offspring development. Thirty-nine pregnant Nellore cows (224 ± 2.67 days of pregnancy, 5.3 ± 0.29 years of age, body weight 520 ± 15.2 kg, initial body condition score 6.0 ± 0.07) were assigned to one of four treatments: a control group receiving only mineral mixture ad libitum, and three groups receiving daily protein-energy supplements of 2, 4, or 6 g/kg BW for 60 days prepartum. Weights and body condition scores were evaluated at the start of the experiment, 7 days before calving, and at 45 and 90 days postpartum. Cows supplemented with 4 and 6 g/kg BW showed improved body weight and body condition scores prepartum and postpartum and had a shorter service period (p < 0.05). The highest blood urea nitrogen concentrations were observed in cows receiving 6 g/kg BW (p = 0.0124). There was a reduction in blood urea nitrogen at calving for the 6 g/kg BW group, while the control group showed an increase (p < 0.001). Non-esterified fatty acids concentrations were lower 21 days before calving for the 4 and 6 g/kg BW groups compared to the control (p < 0.05) and decreased postpartum for all treatments (p < 0.001). No significant differences were observed in calf birth weight or performance. Supplementing with 4 g/kg BW of protein-energy is recommended to enhance metabolic health and overall performance.
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[This corrects the article DOI: 10.3389/fmicb.2023.1158441.].
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The deep-sea covers over 70% of the Earth's surface and harbors predominantly uncharacterized bacterial communities. Actinobacteria are the major prokaryotic source of bioactive natural products that find their way into drug discovery programs, and the deep-sea is a promising source of biotechnologically relevant actinobacteria. Previous studies on actinobacteria in deep-sea sediments were either regionally restricted or did not combine a community characterization with the analysis of their bioactive potential. Here we characterized the actinobacterial communities of upper layers of deep-sea sediments from the Arctic and the Atlantic (Azores and Madeira) ocean basins, employing 16S rRNA metabarcoding, and studied the biosynthetic potential of cultivable actinobacteria retrieved from those samples. Metabarcoding analysis showed that the actinobacterial composition varied between the sampled regions, with higher abundance in the Arctic samples but higher diversity in the Atlantic ones. Twenty actinobacterial genera were detected using metabarcoding, as a culture-independent method, while culture-dependent methods only allowed the identification of nine genera. Isolation of actinobacteria resulted on the retrieval of 44 isolates, mainly associated with Brachybacterium, Microbacterium, and Brevibacterium genera. Some of these isolates were only identified on a specific sampled region. Chemical extracts of the actinobacterial isolates were subsequently screened for their antimicrobial, anticancer and anti-inflammatory activities. Extracts from two Streptomyces strains demonstrated activity against Candida albicans. Additionally, eight extracts (obtained from Brachybacterium, Brevibacterium, Microbacterium, Rhodococcus, and Streptomyces isolates) showed significant activity against at least one of the tested cancer cell lines (HepG2 and T-47D). Furthermore, 15 actinobacterial extracts showed anti-inflammatory potential in the RAW 264.4 cell model assay, with no concomitant cytotoxic response. Dereplication and molecular networking analysis of the bioactive actinobacterial extracts showed the presence of some metabolites associated with known natural products, but one of the analyzed clusters did not show any match with the natural products described as responsible for these bioactivities. Overall, we were able to recover taxonomically diverse actinobacteria with different bioactivities from the studied deep-sea samples. The conjugation of culture-dependent and -independent methods allows a better understanding of the actinobacterial diversity of deep-sea environments, which is important for the optimization of approaches to obtain novel chemically-rich isolates.
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BACKGROUND: The high salt concentration is the major factor limiting microbial growth at salterns, along with solar radiation, temperature, and pH. These environmental factors play key roles in the acquisition of unique genetic adaptations for the survival of microorganisms in salterns, which can result in the production of interesting secondary metabolites. The main goal of the present work was to isolate and compare the culturable microbiota from two geographically distant salterns in Portugal and access their biotechnological potential. METHODS: Culturomics approaches using different culture media were applied for microbial isolation. All isolates were identified either by 16S rRNA or ITS genes sequencing, and their biotechonological potential was assessed by PCR. RESULTS: Overall, 154 microbial isolates were recovered that were phylogenetically assigned to 45 taxa from 9 different phyla. From these, 26 isolates may represent putative new taxa. The predominant genera obtained were Penicillium (41 isolates, 26.6%), Streptomyces (13 isolates, 8.4%) and Sinomicrobium (11 isolates, 7.1%). Moreover, the polyketide synthase I gene was present in 64 isolates, the nonribosomal peptide synthethase gene in 16 isolates, and both genes in 23 isolates. CONCLUSIONS: This study adds up valuable knowledge on the culturable microbiota of Portuguese salterns and on its potential for production of secondary metabolites. In the long run, this study provides a widely diverse microbial collection for future works. Data public repository: All DNA sequences were deposited in the GenBank database at National Centre for Biotechnology Information (NCBI) web platform under accession numbers OK169439-OK169485, OK216020-OK216124, OK287059 and OK326927.
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Microbiota , Biotecnologia , Portugal , RNA Ribossômico 16S/genéticaRESUMO
The ability of the Auditory Verbal Learning Test (AVLT) to lateralize hippocampal sclerosis (HS) in mesial temporal lobe epilepsy (MTLE) was explored in a sample of 50 patients with MTLE-HS (23 right and 27 left). Patients' AVLT scores were adjusted to the demographic characteristics of each individual in accordance with the Portuguese normative data. The laterality of the HS was determined by consensus by two neuroradiologists. ROC curves were used to identify the best AVLT cutoff scores to differentiate right vs. left HS. Diagnostic statistics were applied to different AVLT measures. The study results revealed that four AVLT scores can correctly classify the laterality of HS in the total sample and a sub-group of 39 right-handed patients (Edinburgh Laterality Inventory +100): delayed recall trial (76 and 80%, respectively), delayed recognition trial (64 and 67%, respectively), learning over trials index (64 and 74%, respectively), and long-term percent retention index (68 and 72%, respectively). In right-handed patients, the diagnostic capability of the delayed recall trial was improved by pairing it with the learning over trials index (accuracy of 85%). In sum, AVLT measures of verbal memory differentiate left from right HS in MTLE. The delayed recall trial demonstrated good diagnostic capacity.
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This article analyses the use of facial recognition technology (FRT) in (semi-)public spaces with a focus in the Brazilian context. Therefore, the operation of the FRT processing chain is addressed, as well as the juridical nature of the facial signature, focusing mainly in the Brazilian data protection framework. FRT has been used in everyday life for several purposes, such as security, digital ranking, targeted marketing and health protection. However, the indiscriminate use of FRT poses high risks to privacy and data protection. In this perspective, to avoid harms such as inaccuracy, normalisation of cyber-surveillance and lack of transparency, safeguards were identified to guarantee individual rights, such as soft law, oversight, international standards and regulatory sandboxes.
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The gastrointestinal microbiota plays a critical role on host health and metabolism. This is particularly important in teleost nutrition, because fish do not possess some of the necessary enzymes to cope with the dietary challenges of aquaculture production. A main difficulty within fish nutrition is its dependence on fish meal, an unsustainable commodity and a source of organic pollutants. The most obvious sustainable alternatives to fish meal are plant feedstuffs, but their nutritive value is limited by the presence of high levels of non-starch polysaccharides (NSP), which are not metabolized by fish. The composition of fish-gut microbial communities have been demonstrated to adapt when the host is fed different ingredients. Thus, we hypothesized that a selective pressure of plant-based diets on fish gut microbiota, could be a beneficial strategy for an enrichment of bacteria with a secretome able to mobilize dietary NSP. By targeting bacterial sporulating isolates with diverse carbohydrase activities from the gut of European sea bass, we have obtained isolates with high probiotic potential. By inferring the adaptive fitness to the fish gut and the amenability to industrial processing, we identified the best two candidates to become industrially valuable probiotics. This potential was confirmed in vivo, since one of the select isolates lead to a better growth and feed utilization efficiency in fish fed probiotic-supplemented plant-based diets, thus contributing for sustainable and more cost-effective aquaculture practices.
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Ração Animal , Bass/microbiologia , Carboidratos/química , Carnivoridade/fisiologia , Microbioma Gastrointestinal , Plantas , Probióticos/isolamento & purificação , Animais , Aquicultura , Biodiversidade , Sobrevivência Celular , DietaRESUMO
This clinical case report aims to describe the development of periradicular and perimplant cystic lesions resulted from the intimate contact of the apical region of osseointegrated implants of dental roots, and discuss the reasons fo r failure of the guided bone regeneration procedure associated with platelet rich fibrin and leukocytes, this process was used to the treatment of the first case. Case Reports. Three cases were reported, two cases described the close contact between the tooth roots and the osseointegrated implants and another with a distance of 1.08 mm. All cases realized a radiographic, and they had not periapical lesions before contact with the apical region of the osseointegrated implants on the roots of the teeth. In the case with the largest cystic extension, the procedure was: removal of the osseointegrated implant with apicectomy of the neighboring teeth, excisional biopsy of the lesion, and grafting using the technique of guided bone regeneration associated with L-PRF. All three cases, endodontic treatment was performed on the neighboring teeth within 2 years of survival of the osseointegrated implants in order to reverse the existing lesion. Results. The diagnostic hypothesis of the three cases was periradicular and peri-implant lesion, arising from a contact of the apical region of the osseointegrated implant with the adja cent tooth. The distance of 1.08 mm between the apices did not ensure normality of the periradicular and peri-implant tissues. The intimate contact caused lesions of different extents and root fractures. Conclusion. Premature contact of the osseointegrated implant with the root region of the neighboring tooth may lead to the development of periradicular and peri-implant lesions, suggesting that it is not possible to control this infectious process with endodontic treatment of the injured tooth.
Este reporte de caso clínico tuvo como objetivo describir el desarrollo de lesiones quísticas perirradiculares y periimplantarias resultantes del contacto íntimo de la región apical de implantes osteointegrados de raíces dentales, y además discutir las razones del fracaso del procedimiento de regeneración ósea guiada asociado a fibrina rica en plaquetas y leucocitos. Este proceso se utilizó para el tratamiento del primer caso. Se reportaron tres casos, en dos casos se describieron el estrecho contacto entre las raíces de los dientes y los implantes osteointegrados y en el otro se determinó una distancia de 1,08 mm. En los tres casos se realizó una radiografía y se determinó que no existían lesiones periapicales, antes del contacto con la región apical de los implantes osteointegrados, en las raíces de los dientes. En el caso de mayor extensión quística, el procedimiento fue: extracción del implante osteointegrado con apicectomía de los dientes vecinos, biopsia excisional de la lesión e injerto mediante la técnica de regeneración ósea guiada asociada a L-PRF. En los tres casos, el tratamiento de endodoncia se realizó en los dientes vecinos dentro de los 2 años de supervivencia de los implantes osteointegrados para revertir la lesión existente. La hipótesis diagnóstica de los tres casos fue lesión perirradicular y periimplantaria, originada por un contacto de la región apical del implante osteointegrado con el diente adyacente. La distancia de 1,08 mm entre los ápices no aseguraba la normalidad de los tejidos perirradiculares y periimplantarios. El contacto íntimo provocó lesiones de diferente extensión y fracturas radiculares. El contacto prematuro del implante osteointegrado con la región radicular del diente vecino puede conducir al desarrollo de lesiones perirradiculares y periimplantarias, lo que sugiere que no es posible controlar este proceso infeccioso con tratamiento endodóntico del diente lesionado.
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Abstract Effective patient positioning is a critical factor influencing surgical outcomes, mainly in minimally invasive gynecologic surgery (MIGS) where precise positioning facilitates optimal access to the surgical field. This paper provides a comprehensive exploration of the significance of strategic patient placement in MIGS, emphasizing its role in preventing intraoperative injuries and enhancing overall surgical success. The manuscript addresses potential complications arising from suboptimal positioning and highlights the essential key points for appropriate patient positioning during MIGS, encompassing what the surgical team should or shouldn't do. In this perspective, the risk factors associated with nerve injuries, sliding, compartment syndrome, and pressure ulcers are outlined to guide clinical practice. Overall, this paper underscores the critical role of precise patient positioning in achieving successful MIGS procedures and highlights key principles for the gynecological team to ensure optimal patient outcomes.
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Humanos , Feminino , Procedimentos Cirúrgicos em Ginecologia , Fatores de Risco , Resultado do Tratamento , Síndromes Compartimentais , Procedimentos Cirúrgicos Minimamente Invasivos , Úlcera por Pressão , Posicionamento do Paciente , Segurança do Paciente , Complicações IntraoperatóriasRESUMO
PURPOSE: We investigated functional reorganization mechanisms of the human medial temporal lobe (MTL) for episodic memory, in patients suffering from medial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS). METHODS: We used functional magnetic resonance imaging (fMRI) to measure brain activity changes during matched episodic encoding tasks of abstract words (Verbal) and line drawings (Visual), in patients with unilateral right MTLE undergoing presurgical evaluation and healthy controls. RESULTS: As expected, a significant interaction between material type and the side of MTL activity was present in the control group, with preferential involvement of the left hippocampus in verbal encoding and the right parahippocampal region in visual encoding. When compared with controls, right MTLE patients with intact performance activated a region in the left hippocampus more during visual encoding, which resulted in an interaction between group and hemisphere. Importantly, an effect of memory performance on visual encoding activity was observed in the patients, with greater engagement of the left MTL being associated with higher recognition scores. Interestingly, activity in the left MTL also depended on the epileptic seizure frequency, suggesting a role for this clinical parameter in the recruitment of contralateral regions. DISCUSSION: Taken together, these results indicate functional reorganization of the MTLs in right HS, through transfer of function from the right to the left hemisphere, and strongly suggest an adaptive role for such reorganization mechanism in supporting preserved visual memory.
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Adaptação Fisiológica , Epilepsia do Lobo Temporal/complicações , Transtornos da Memória/etiologia , Transtornos da Memória/terapia , Percepção Visual , Adulto , Epilepsia do Lobo Temporal/diagnóstico , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Lateralidade Funcional , Hipocampo/fisiopatologia , Humanos , Masculino , Transtornos da Memória/diagnóstico , Testes Neuropsicológicos , Índice de Gravidade de Doença , Comportamento VerbalRESUMO
OBJECTIVE: To investigate the longterm psychological outcome in survivors of critical illness after intensive care unit discharge. METHODS: A prospective cohort of survivors admitted to a mixed intensive care unit between January and September 2010 was evaluated six months and five years after hospital discharge. The Dementia Rating Scale-2, the Hospital Anxiety and Depression Scale, the Posttraumatic stress syndrome 14-questions inventory, the Euro Quality of Life 5 Dimensions (EQ-5-D), and the Visual Analogue Scale (EQ VAS) were assessed at both follow-up periods. RESULTS: Of 267 patients, 25 patients were evaluated at 6 months after discharge (62 ± 16 years); 12 (48%) presented cognitive impairment, 6 (24%) anxiety, 4 (16%) depression, and 4 (16%) post-traumatic stress disorder. Among those re-evaluated five years after discharge (n = 17; 65 ± 15 years), the frequency of cognitive impairment dropped from 8 (47%) to 3 (18%) (p = 0.063), due to improvement in these patients over time, and other patients did not acquire any dysfunction after discharge. At five years after discharge, only two patients (12%) reported anxiety, and none had depression or post-traumatic stress disorder. No differences were found between the six-month and five-year follow-ups regarding EQ-5-D and EQ VAS. CONCLUSION: Survivors do not show a progressive decline in cognitive function or quality of life within five years after intensive care unit discharge. Psychopathological symptoms tend to decrease with time.
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Ansiedade/epidemiologia , Cuidados Críticos/psicologia , Estado Terminal/psicologia , Sobreviventes/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Fatores de TempoRESUMO
RESUMO O estudo propôs a elaboração de um índice de vulnerabilidade à propagação da COVID-19 utilizando análise multivariada associada à análise geoespacial. O método empregado considerou a vulnerabilidade como uma combinação de três fatores: exposição, susceptibilidade e capacidade de resposta. A metodologia foi composta de seis etapas: seleção e agrupamento de variáveis; definição dos indicadores; normalização; atribuição de pesos via análise dos componentes principais; estimativa e normalização do índice; e classificação por meio das técnicas Jenks, Kmeans, quantis e clusterização hierárquica (Hclust). Foi realizada uma caracterização da exposição da cidade de Fortaleza, Brasil, à COVID-19 por meio da densidade populacional, da quantidade de habitações subnormais e precárias, da porcentagem de idosos por residência e da proximidade a terminais de ônibus. O estudo procurou sobrepor fatores socioeconômicos e índices de abastecimento público e de esgotamento sanitário, para a classificação de setores censitários em cinco níveis de vulnerabilidade. Estes apresentaram, em sua maioria, classe de alta (Jenks e quantis) e moderada (K-means e Hclust) vulnerabilidade. As regiões de maior vulnerabilidade estão localizadas no sul e no oeste da cidade, onde há maior concentração de aglomerados subnormais. Os resultados podem auxiliar no desenvolvimento de estratégias de enfrentamento direcionadas para os grupos mais expostos aos riscos associados à COVID-19, assim como na preparação para futuras crises de saúde pública. A metodologia pode ser replicada para outras cidades e serve como ferramenta para os gestores públicos.
ABSTRACT The study proposes an index of vulnerability to the spread of COVID-19 using multivariate and geospatial analyses. Vulnerability was considered as a combination of exposure, susceptibility, and responsiveness of the population. The methodology consisted of six steps: selection and grouping of variables; definition of indicators; normalization of the variables; weight calculation using principal component analysis; index calculation and normalization; and classification using Jenks, Kmeans, Quantile, and Hclust techniques. The exposure of Fortaleza, Brazil, to COVID-19 was assessed by means of population density, number of subnormal and precarious housing, percentage of aged people per residence and proximity to bus terminals. The study integrates factors related to socioeconomic characteristics, public water supply and sanitation for the classification of census tracts in five levels of vulnerability. Most of them present high (Jenks and Quantile) and moderate (K-means and Hclust) vulnerability. The most vulnerable regions are in the South and West Zones of the city, where many subnormal agglomerates are located. The results can assist the development of coping strategies for the groups most exposed to the risks associated with COVID-19, as well as in the preparation for future public health crises. The methodology can be replicated in other cities and can be useful for public managers.
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This study aimed to produce adjusted normative data for the Portuguese version of the Auditory Verbal Learning Test (AVLT). The study included 1,068 community-dwelling individuals (736 women, 332 men) aged 18 to 93 years old (Mage = 56 years, SD = 18) who had educational backgrounds ranging from 0 to 24 years (M = 9.8 years, SD = 5.3). The results showed that sex, age, and education were significantly associated with AVLT performance. These demographic characteristics accounted for 24% to 35% of the variance of direct recall trials and for 8% to 39% of the variance of derived recall scores. The normative data for direct and derived recall scores are presented as regression-based algorithms to adjust for sex, age, and education with subsequent correspondence between adjusted scores and percentile distribution. The norms for the recognition correct score are presented as algorithms to estimate the recognition scores for 5th, 10th, and 18th percentiles for each combination of the variables sex, age, and education.