RESUMO
PURPOSE: Pulmonary arterial hypertension (PAH) is a progressive disease with a poor prognosis, and its management should be grounded in well-developed clinical practice guidelines (CPG). Thus, we critically assess the methodological quality of the available CPG for pharmacological treatments for PAH. METHODS: A systematic review (CRD42023387168) was performed in PubMed, Cochrane, Embase, and Tripdatabase (Jan-2023). Eligible records were appraised by four reviewers using the Appraisal of Guidelines, Research, and Evaluation Collaboration tool (AGREE II) and the complementary tool for assessing recommendations' quality and certainty, AGREE REX. Descriptive statistics were used to summarize the data. RESULTS: Overall, 31 guidelines, mainly authored by professional societies (90%), targeting only physicians as primary users (84%), were identified. Guidelines presented a moderate overall quality (scores of 63% and 51% in AGREE II and AGREE REX, respectively), with a few domains showing slight improvements over the years. AGREE II "Scope and Purpose" (94%) and "Presentation Clarity" (99%) domains obtained the highest scores. The items related to "Stakeholder involvement," "Editorial independence," and "Clinical applicability" (AGREE REX) were fairly reported. Conversely, CPG lacks rigor in development (32% score, AGREE II), scarcely discusses the role of stakeholders, and provides deficient data on the implementation of recommendations (scores of 35% and 46% in AGREE II and AGREE REX, respectively). No differences in the quality of guidelines published by different developers or countries were observed (p > 0.05). CONCLUSION: Methodological weaknesses are common among guidelines addressing PAH treatment, especially regarding scientific rigor, stakeholders' values and preferences, and facilitators and barriers to implementability. Particular attention should be given to developing future guidelines.
RESUMO
Psychotria carthagenensis is a shrubby plant, often consumed by traditional populations in religious rituals. Previous studies have shown that this plant's infusion can inhibit the activity of Acetylcholinesterase (AChE) in rats. Despite the therapeutic potential, there is a lack of research regarding its possible toxicological and genotoxic effects. Hence, this study aimed to analyze the chemical profile of the ethanol extract from P. carthagenensis leaves by LC-DAD-MS and assess its possible toxicity and genotoxicity in zebrafish (Danio rerio). Adult zebrafish (N = 9/group) were exposed at different concentrations and the LC50 was calculated. Frequencies of micronucleus (MN) and nuclear abnormalities (NA) were estimated for genotoxic effects, and degree of tissue changes (DTC) was used to assess the liver and gill histopathology. From the LC-DAD-MS analyses, the identified compounds included N-fructosyl valine, ethyl hexoside, 5-O-E-caffeoylquinic acid, N-feruloylagmatime, roseoside, di-O-deoxyhexoyl-hexosyl quercetin, loiolide, and oleamide. The calculated values of LC50 did not vary significantly during the time of exposure. At the concentrations of 1.25, 2.5, 3.75, 5, 7.5, 10 and 15 mg/L, there was no genotoxicity, and only low to moderate toxicity for the tissues was observed, despite mortality of 100% at doses of 20-100 mg/L of P. carthagenensis ethanolic leaf extract. There were changes in cytoplasm of hepatocytes at 1.25 mg/L, and karyorrhexis, karyolysis and megalocytosis at 10 mg/L. In the gills, the alterations were primary lamellar hyperplasia in all concentrations, and at 10 mg/L, secondary lamellar edema and vascular hyperemia were common. Additionally, the chemical composition of P. carthagenensis was expanded.
RESUMO
BACKGROUND: Clinical practice guidelines (CPGs) are statements to assist practitioners and stakeholders in decisions about healthcare. Low methodological quality guidelines may prejudice decision-making and negatively affect clinical outcomes in non-communicable diseases, such as cardiovascular diseases worsted by poor lipid management. We appraised the quality of CPGs on dyslipidemia management and synthesized the most updated pharmacological recommendations. METHODS: A systematic review following international recommendations was performed. Searches to retrieve CPG on pharmacological treatments in adults with dyslipidaemia were conducted in PubMed, Scopus, and Trip databases. Eligible articles were assessed using AGREE II (methodological quality) and AGREE-REX (recommendation excellence) tools. Descriptive statistics were used to summarize data. The most updated guidelines (published after 2019) had their recommendations qualitatively synthesized in an exploratory analysis. RESULTS: Overall, 66 guidelines authored by professional societies (75%) and targeting clinicians as primary users were selected. The AGREE II domains Scope and Purpose (89%) and Clarity of Presentation (97%), and the AGREE-REX item Clinical Applicability (77.0%) obtained the highest values. Conversely, guidelines were methodologically poorly performed/documented (46%) and scarcely provided data on the implementability of practical recommendations (38%). Recommendations on pharmacological treatments are overall similar, with slight differences concerning the use of supplements and the availability of drugs. CONCLUSION: High-quality dyslipidaemia CPG, especially outside North America and Europe, and strictly addressing evidence synthesis, appraisal, and recommendations are needed, especially to guide primary care decisions. CPG developers should consider stakeholders' values and preferences and adapt existing statements to individual populations and healthcare systems to ensure successful implementation interventions.
RESUMO
BACKGROUND: Pancreatic fluid collections (PFCs) may recur after resolution with endoscopic transmural drainage (ETD) and standard stent removal (SSR). Herein, we compared the efficacy and safety of leaving long-term indwelling plastic stents (LTIS) vs. standard stent removal after PFC resolution with ETD. METHODS: We performed a systematic review of MEDLINE, EMBASE, CINAHL, Scopus, and Cochrane databases from inception to September 2022. Full-text articles comparing long-term (> 6 months) outcomes of LTIS and SSR were eligible, as well as single-arm studies with ≥ 10 patients with LTIS. Two independent reviewers selected studies, extracted data, and assessed the risk of bias using the Newcastle-Ottawa Scale. Measured outcomes included the following: (A) PFC recurrence; (B) interventions for PFC recurrence; (C) technical success; and (D) adverse events (AEs). Meta-analysis was carried out using random-effects models. RESULTS: We included 16 studies, encompassing 1285 patients. Compared to SSR after PFC resolution with ETD, LTIS was associated with significantly lower risk of PFC recurrence (3% vs. 23%; OR 0.22 [95%CI 0.09-0.52]; I2 = 45%) and need for interventions (2% vs. 14%; OR 0.35 [95%CI 0.16-0.78]; I2 = 0%). The superiority of LTIS on reducing PFC recurrence was found with walled-off necrosis, with or without disconnected pancreatic duct, and with placement of ≥ 2 LTIS. When using LTIS, the pooled proportion of AEs was 8% (95%CI 4-11%) and technical success was 93% (95%CI 86-99%). CONCLUSIONS: Our results show that LTIS after PFC resolution with ETD is feasible, safe, and superior to SSR in reducing the risk of PFC recurrence and need for interventions.
Assuntos
Remoção de Dispositivo , Drenagem , Suco Pancreático , Stents , Humanos , Remoção de Dispositivo/métodos , Drenagem/métodos , Plásticos , Recidiva , Resultado do Tratamento , Suco Pancreático/metabolismoRESUMO
BACKGROUND & AIMS: Understanding the burden of pancreatic cystic lesions (PCLs) in the general population is important for clinicians and policymakers. In this systematic review, we sought to estimate the global prevalence of PCLs using magnetic resonance imaging (MRI) and to investigate factors that contribute to its variation. METHODS: We searched MEDLINE, EMBASE, and Cochrane Central, from database inception through February 2023. We included full-text articles that reported the prevalence of PCLs using MRI in the general population. A proportional meta-analysis was performed, and the prevalence of PCLs was pooled using a random-effects model. RESULTS: Fifteen studies with 65,607 subjects were identified. The pooled prevalence of PCLs was 16% (95% confidence interval [CI], 13%-18%; I2 = 99%), most of which were under 10 mm. Age-specific prevalence of PCLs increased from 9% (95% CI, 7%-12%) at 50 to 59 years, to 18% (95% CI, 14%-22%) at 60 to 69 years, 26% (95% CI, 20%-33%) at 70 to 79 years, and 38% at 80 years and above (95% CI, 25%-52%). There was no difference in prevalence between sexes. Subgroup analysis showed higher PCL prevalence when imaging findings were confirmed by independent radiologist(s) (25%; 95% CI, 16%-33%) than when chart review alone was used (5%; 95% CI, 4%-7%; P < .01). There was no independent association of PCL prevalence with geographic location (Europe, North America, or Asia), MRI indication (screening vs evaluation of non-pancreatic pathology), enrollment period, sample size, magnet strength (1.5 vs 3 tesla), and MRI sequence (magnetic resonance cholangiopancreatography vs no magnetic resonance cholangiopancreatography). CONCLUSION: In this systematic review, the global prevalence of PCLs using a highly sensitive noninvasive imaging modality ranged between 13% and 18%.
Assuntos
Imageamento por Ressonância Magnética , Cisto Pancreático , Humanos , Prevalência , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Cisto Pancreático/epidemiologia , Cisto Pancreático/diagnóstico por imagem , Saúde Global , Masculino , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , FemininoRESUMO
Background: Chloramine-T (CL-T) is a synthetic sodium salt used as a disinfectant in fish farms to combat bacterial infections in fish gills and skin. While its efficacy in pathogen control is well-established, its reactivity with various functional groups has raised concerns. However, limited research exists on the toxicity of disinfection by-products to aquatic organisms. Therefore, this study aims to assess the sublethal effects of CL-T on adult zebrafish by examining biomarkers of nucleus cytotoxicity and genotoxicity, acetylcholinesterase (AChE) inhibition, and histopathological changes. Methods: Male and female adult zebrafish (wildtype AB lineage) specimens were exposed to 70, 140, and 200 mg/L of CL-T and evaluated after 96 h. Cytotoxic and genotoxic effects were evaluated by estimating the frequencies of nuclear abnormalities (NA), micronuclei (MN), and integrated optical density (IOD) of nuclear erythrocytes. Histopathological changes in the gills and liver were assessed using the degree of tissue changes (DTC). AChE activity was measured in brain samples. Results and conclusions: At a concentration of 200 mg/L, NA increased, indicating the cytogenotoxic potential of CL-T in adult zebrafish. Morphological alterations in the nuclei were observed at both 70 and 200 mg/L concentrations. Distinct IOD profiles were identified across the three concentrations. There were no changes in AChE activity in adult zebrafish. The DTC scores were high in all concentrations, and histological alterations suggested low to moderate toxicity of CL-T for adult zebrafish.
Assuntos
Perciformes , Peixe-Zebra , Animais , Masculino , Feminino , Acetilcolinesterase , Cloraminas/toxicidade , Compostos de TosilRESUMO
Genipa americana is a native plant of Brazil with potential applications in folk medicine. Whereas most of the phytochemical and pharmacological studies on this plant have focused on its fruits, the crude extracts of its leaves contain chemical metabolites that may have toxicity to organisms, which have yet to be investigated. This study aimed to determine the main groups of secondary metabolites in the aqueous extract of the leaves of G. americana by phytochemistry and qualitative HPLC, and to evaluate the possible toxicological effects and histopathological changes caused by this extract in zebrafish (Danio rerio) adults, through micronucleus test, nuclear abnormalities and histopathological analyses of gills and liver. While three metabolites of high intensity (phenolic compounds, flavonoids and triterpenes) were found in the phytochemical evaluation, the HPLC showed results compatible with flavonoids and iridoids, all belonging to common classes for this species and the Rubiaceae family. The acute toxicity test did not induce mortality or genotoxicity in zebrafish, but after exposure for 96 h, it was possible to observe injuries to the fish gill tissue, such as lamellar fusion, vasodilation and telangiectasia; in the liver, necrosis was visualized at 40 mg/L, and at higher concentrations (80 and 100 mg/L) induced sinusoidal widening was identified. In conclusion, the results demonstrated the toxic potential of this plant for aquatic species.
Assuntos
Rubiaceae , Peixe-Zebra , Animais , Necrose , Plantas , Folhas de Planta/química , Rubiaceae/química , Flavonoides , Compostos Fitoquímicos , Extratos Vegetais/farmacologiaRESUMO
PURPOSE: This study aimed to assess the association between dietary patterns and tumor staging and the degree of cell differentiation in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: This cross-sectional study included 136 individuals newly diagnosed with different stages of HNSCC, aged 20- to 80 years-old. Dietary patterns were determined by principal component analysis (PCA), using data collected from a food frequency questionnaire (FFQ). Anthropometric, lifestyle, and clinicopathological data were collected from patients' medical records. Disease staging was categorized as initial stage (stages I and II), intermediary (stage III), and advanced (stage IV). Cell differentiation was categorized as poor, moderate, or well-differentiated. The association of dietary patterns with tumor staging and cell differentiation was evaluated using multinomial logistic regression models and adjusted for potential confounders. RESULTS: Three dietary patterns, "healthy," "processed," and "mixed," were identified. The "processed" dietary pattern was associated with intermediary (odds ratio (OR) 2.47; 95% confidence interval (CI) 1.43-4.26; p = 0.001) and advanced (OR 1.78; 95% CI 1.12-2.84; p = 0.015) staging. No association was found between dietary patterns and cell differentiation. CONCLUSION: A high adherence to dietary patterns based on processed foods is associated with advanced tumor staging in patients newly diagnosed with HNSCC.
RESUMO
Background: Immunocompromised patients have an increased risk of developing severe COVID disease, as well as a tendency to suboptimal responses to vaccines. The objective of this study was to evaluate the specific cellular and humoral adaptive immune responses of a cohort of kidney transplant recipients (KTR) after 3 doses of mRNA-1273 vaccine and to determinate the main factors involved. Methods: Prospective observational study in 221 KTR (149 non infected), 55 healthy volunteers (HV) and 23 dialysis patients (DP). We evaluated anti-spike (by quantitative chemiluminescence immunoassay) and anti-nucleocapsid IgG (ELISA), percentage of TCD4+ and TCD8+ lymphocytes producing IFNγ against S-protein by intracellular flow cytometry after Spike-specific 15-mer peptide stimulation and serum neutralizing activity (competitive ELISA) at baseline and after vaccination. Results: Among COVID-19 naïve KTR, 54.2% developed cellular and humoral response after the third dose (vs 100% in DP and 91.7% in HV), 18% only showed cell-mediated response, 22.2% exclusively antibody response and 5.6% none. A correlation of neutralizing activity with both the IgG titer (r=0.485, p<0.001) and the percentage of S-protein-specific IFNγ-producing CD8-T cells (r=0.198, p=0.049) was observed. Factors related to the humoral response in naïve KTR were: lymphocytes count pre-vaccination >1000/mm3 [4.68 (1.72-12.73, p=0.003], eGFR>30 mL/min [7.34(2.72-19.84), p<0.001], mTOR inhibitors [6.40 (1.37-29.86), p=0.018]. Infected KTR developed a stronger serologic response than naïve patients (96.8 vs 75.2%, p<0.001). Conclusions: KTR presented poor cellular and humoral immune responses following vaccination with mRNA-1273. The immunosuppression degree and kidney function of these patients play an important role, but the only modifiable factor with a high impact on humoral immunogenicity after a booster dose was an immunosuppressive therapy including a mTOR inhibitor. Clinical trials are required to confirm these results.
Assuntos
COVID-19 , Transplante de Rim , Humanos , Imunidade Humoral , Vacina de mRNA-1273 contra 2019-nCoV , Inibidores de MTOR , SARS-CoV-2 , Imunoglobulina G , Serina-Treonina Quinases TORRESUMO
Aedes aegypti and A. albopictus mosquitoes are the main vectors for dengue virus (DENV) and other arboviruses, including Zika virus (ZIKV). Understanding the factors that affect transmission of arboviruses from mosquitoes to humans is a priority because it could inform public health and targeted interventions. Reasoning that interactions among viruses in the vector insect might affect transmission, we analysed the viromes of 815 urban Aedes mosquitoes collected from 12 countries worldwide. Two mosquito-specific viruses, Phasi Charoen-like virus (PCLV) and Humaita Tubiacanga virus (HTV), were the most abundant in A. aegypti worldwide. Spatiotemporal analyses of virus circulation in an endemic urban area revealed a 200% increase in chances of having DENV in wild A. aegypti mosquitoes when both HTV and PCLV were present. Using a mouse model in the laboratory, we showed that the presence of HTV and PCLV increased the ability of mosquitoes to transmit DENV and ZIKV to a vertebrate host. By transcriptomic analysis, we found that in DENV-infected mosquitoes, HTV and PCLV block the downregulation of histone H4, which we identify as an important proviral host factor in vivo.
Assuntos
Aedes , Arbovírus , Vírus da Dengue , Dengue , Vírus de Insetos , Vírus de RNA , Infecção por Zika virus , Zika virus , Animais , Humanos , Zika virus/genética , Vírus de Insetos/fisiologia , Vírus da Dengue/genética , Mosquitos Vetores , Arbovírus/genéticaRESUMO
Abstract Objectives: to evaluate the association of pre-pregnancy and current body mass index and the density of dietary macronutrients on underreporting of energy intake at pregnancy. Methods: cross-sectional analysis of 327 postpartum women from the city of Mesquita, in Rio de Janeiro. A food frequency questionnaire was administered at maternity ward having the last six months of the pregnancy as the time frame. Energy balance was considered as the outcome, and it was calculated as the division of energy intake by basal metabolic rate (underreport <1.35). Multivariate logistic regression was applied to test the associations between body mass index (pre-gestational and postpartum) on energy balance (underreport or not). Dietary density of protein (4th quartile), carbohydrate (1st quartile) and fat intake (1st quartile) were tested. Results: mean energy intake was 2,894 kcal and near of 25% of the women were considered as underreported during pregnancy. Obese women had higher chance (OR=1.90; CI95%=1.09-3.33) of being underreported at pregnancy. Underreported women presented greater chance of report dietary intake with higher contents of protein (OR=2.37; CI95%=1.37-4.09) and lower density of fat (OR= .81; CI95%=1.04-3.15). Conclusion: underreported pregnant women had higher chance of report great and lower amounts of protein and fat dietary densities.
Resumo Objetivos: avaliar a associação entre o índice de massa corporal pré-gestacional e pós-parto e a densidade de macronutrientes da dieta com o sub-relato de energia da dieta na gestação. Métodos: análise transversal com 327 puérperas da cidade de Mesquita, no Rio de Janeiro. Aplicou-se o questionário de frequência alimentar na primeira semana após o parto tendo como base o consumo dos dois últimos trimestres gestacionais. O balanço energético foi calculado a partir da divisão da ingestão de energia pela taxa metabólica basal (sub-relato<1,35). Adotou-se a regressão logística multivariada para analisar as associações entre os índices de massa corporal e a densidade dos macronutrientes da dieta (proteína, carboidratos e lipídios) com o balanço energético (sub-relato ou não). Resultados: a ingestão média de energia foi de 2.894 kcal e 25% das mulheres foram classificadas com sub-relato. Mulheres obesas no pós-parto tiveram maiores chances (OR=1,90; IC95%=1,09-3,33) de sub-relato de energia na gravidez e gestantes com balanço energético <1,35 apresentaram dieta com maior densidade de proteína (OR=2,37; IC95%=1,37-4,09) e menor densidade de gordura (OR=1,81; IC95%=1,04-3,15). Conclusão: a obesidade no pós-parto foi associada ao sub-relato de energia na gravidez e o balanço energético associou-se a densidade dos macronutrientes da dieta
Assuntos
Humanos , Feminino , Gravidez , Ingestão de Energia/fisiologia , Gorduras na Dieta , Índice de Massa Corporal , Comportamento Alimentar , Ganho de Peso na Gestação , Obesidade Materna , BrasilRESUMO
Introduction: Group B Streptococcus (GBS) is a human commensal bacterium that is also associated with infection in pregnant and non-pregnant adults, neonates and elderly people. Gap Statement: The authors hypothesize that knowledge of regional GBS genetic patterns may allow the use of prevention and treatment measures to reduce the burden of streptococcal disease. Aim: The aim was to report the genotypic diversity and antimicrobial sensitivity profiles of invasive, noninvasive urinary and colonizing GBS strains, and evaluate the relationships between these findings. Methodology: The study included consecutive and non-duplicated GBS isolates recovered in southern Brazil from 2015 to 2017. We performed multiple-locus variable-number tandem repeat analysis (MLVA) and PCR analyses to determine capsular serotypes and identify the presence of the resistance genes mefA/E, ermB and ermA/TR, and also antibiotic susceptibility testing. Results: The sample consisted of 348 GBS strains, 42 MLVA types were identified, and 4 of them represented 64â% of isolates. Serotype Ia was the most prevalent (42.2â%) and was found in a higher percentage associated with colonization, followed by serotypes V (24.4â%), II (17.8â%) and III (7.8â%). Serotype V was associated with invasive isolates and serotypes II and III with noninvasive isolates, without significant differences. All isolates were susceptible to penicillin. GBS 2018/ hvgA was observed in 17 isolates, with 11 belonging to serogroup III. The Hunter-Gaston diversity index was calculated as 0.879. The genes mefA/E, erm/B and erm/A/TR were found in 45, 19 and 46 isolates. Conclusion: This report suggests that the circulating GBS belong to a limited number of genetic lineages. The most common genotypes were Ia/MT12 and V/MT18, which are associated with high resistance to macrolides and the presence of the genes mefA/E and ermA/TR. Penicillin remains the antibiotic of choice. Implementation of continuous surveillance of GBS infections will be essential to assess GBS epidemiology and develop accurate GBS prevention, especially strategies associated with vaccination.
RESUMO
Rapid identification of existing respiratory viruses in biological samples is of utmost importance in strategies to combat pandemics. Inputting MALDI FT-ICR MS (matrix-assisted laser desorption/ionization Fourier-transform ion cyclotron resonance mass spectrometry) data output into machine learning algorithms could hold promise in classifying positive samples for SARS-CoV-2. This study aimed to develop a fast and effective methodology to perform saliva-based screening of patients with suspected COVID-19, using the MALDI FT-ICR MS technique with a support vector machine (SVM). In the method optimization, the best sample preparation was obtained with the digestion of saliva in 10 µL of trypsin for 2 h and the MALDI analysis, which presented a satisfactory resolution for the analysis with 1 M. SVM models were created with data from the analysis of 97 samples that were designated as SARS-CoV-2 positives versus 52 negatives, confirmed by RT-PCR tests. SVM1 and SVM2 models showed the best results. The calibration group obtained 100% accuracy, and the test group 95.6% (SVM1) and 86.7% (SVM2). SVM1 selected 780 variables and has a false negative rate (FNR) of 0%, while SVM2 selected only two variables with a FNR of 3%. The proposed methodology suggests a promising tool to aid screening for COVID-19.
Assuntos
COVID-19 , COVID-19/diagnóstico , Teste para COVID-19 , Análise de Fourier , Humanos , Aprendizado de Máquina , SARS-CoV-2 , Saliva , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodosRESUMO
BACKGROUND: Few studies have described the clinical impact of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in renal transplant recipients (RTRs) in the context of omicron variant and the third vaccine dose. Antibody titer has been tried to relate to the prediction of outcomes related to SARS-CoV-2, but it results controversially in these populations. METHODS: All patients with positive SARS-CoV-2 polymerase chain reaction followed at a RTRs reference center from March 15, 2020, to March 15, 2022, were considered for analysis. Cases were analyzed by vaccination status. Breakthrough cases were then analyzed by nonantibodies (<20 arbitrary unit [AU]/mL), low (20-100 AU/mL), and high antibody titers (>100 AU/mL) against SARS-CoV-2 spike protein. Outcomes included pneumonia and mortality. We used logistic regression multivariable to assess for confounders. RESULTS: Among 186 RTRs with coronavirus disease 2019, 50.5% (n = 94) were vaccinated versus 49.5% (n = 92) unvaccinated. Of the vaccinated patients, 67.02% developed a high antibody titer (>100 AU/mL) but 14.89% achieved a low antibody titer and 18.08% nonantibodies. Pneumonia-free survival (day 20) was 95% in high antibody titer but 40% in unvaccinated RTRs. Survival in RTRs at day 60 was similar in the unvaccinated group compared with nonantibodies breakthrough cases (82%) but 92% in the low antibody titer group (relative risk, 0.027; 95% confidence interval, 0.002-0.479; P = 0.014). Only patients with >100 AU/mL showed a 100% survival on day 60 postinfection. CONCLUSIONS: Vaccinated RTRs who achieve at least a low antibody titer (>20 AU/mL) had better results in terms of pneumonia and mortality than unvaccinated RTRs. Antibody titer >100 AU/mL associate with even better results than patients with lower antibody titers.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Transplante de Rim , Humanos , Anticorpos Antivirais , COVID-19/prevenção & controle , SARS-CoV-2 , Transplantados , Resultado do Tratamento , VacinaçãoRESUMO
Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.
Assuntos
Violência por Parceiro Íntimo , Adulto , Brasil , Estudos de Coortes , Feminino , Humanos , Gravidez , Gestantes , Estudos ProspectivosRESUMO
Abstract Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.
Resumo Pouco se sabe sobre as repercussões da violência por parceiro íntimo (VPI) nos desfechos nutricionais da gravidez, principalmente no que diz respeito à dieta. O objetivo foi investigar se a ocorrência de VPI física na gestação está associada aos padrões alimentares gestacionais. 161 gestantes adultas participaram de um estudo prospectivo no Rio de Janeiro, Brasil. A VPI física geral e grave foi medida para avaliar a VPI a qualquer momento durante a gravidez. Três padrões alimentares gestacionais ("Saudável", "Brasileiro Comum" e "Processado") foram estabelecidos pela análise de componentes principais. O efeito da VPI física foi testado em relação ao escore de adesão a cada um dos padrões alimentares. A ocorrência de VPI física geral e grave em qualquer momento da gestação foi de 20,4% e 6,8%, respectivamente. Mulheres que viviam em relacionamentos íntimos em que ocorreu VPI física geral e grave tiveram um aumento médio de 0,604 unidades (IC95% 0,149-1,058) e 1,347 unidades (IC95% 0,670-2,024), respectivamente, no escore de adesão ao padrão alimentar processado. Não foi observada associação com os padrões alimentares "Saudável" e "Brasileiro Comum". A VPI física foi associada à maior adesão a um padrão alimentar de menor qualidade nutricional na gestação.
RESUMO
O presente artigo consiste em uma reflexão de natureza historiográfica sobre o percurso da Revista Estudos e Pesquisas em Psicologia, do Instituto de Psicologia da Universidade do Estado do Rio de Janeiro (IP-UERJ), por ocasião do 20º aniversário (2001-2021) do periódico. Por meio de análise documental das edições regulares (excetuando os dossiês temáticos) e de entrevistas com três ex-editoras-chefe, são analisados, em especial: o contexto de criação do periódico, no início dos anos 2000; as transformações no processo editorial, decorrentes tanto das injunções das políticas científicas de avaliação de periódicos pela CAPES, quanto da maciça migração das publicações científicas para o meio eletrônico; os impactos da crise sistêmica de financiamento da universidade pública (notadamente, as especificidades do contexto uerjiano) na segunda metade da década de 2010. Deste modo, reflete-se tanto sobre as especificidades da trajetória da Estudos e Pesquisas em Psicologia, quanto sobre os sentidos e desafios envolvidos no fazer editorial no cenário contemporâneo.
The present article consists of a historiographical reflection on the trajectory of the journal Estudos e Pesquisas em Psicologia [Studies and Research in Psychology], of the Institute of Psychology of the State University of Rio de Janeiro [Instituto de Psicologia da Universidade do Estado do Rio de Janeiro] (IP-UERJ), on the occasion of the 20th anniversary (2001-2021) of this journal. Through a documental analysis of the regular editions (except for the thematic dossiers) and interviews with three former editors-in-chief, are analyzed, in particular: the journal's creation context, in the early 2000s; the transformations in the editorial process, resulting both from the injunctions of scientific policies for evaluating journals by CAPES, and from the massive migration of scientific publications to the electronic media; the impacts of the systemic crisis of public university funding (notably, the specificities of the UERJ context) in the second half of the 2010s. In this way, are considered both the specificities of the trajectory of the Estudos e Pesquisas em Psicologia and the meanings and challenges involved in editorial production in the contemporary scenario.
El presente artículo consiste en una reflexión historiográfica acerca de la trayectoria de la Revista Estudos e Pesquisas em Psicologia [Estudios e Investigaciones en Psicología], del Instituto de Psicología de la Universidad del Estado de Río de Janeiro (IP-UERJ), por casualidad del 20° aniversario (2001-2021) de esta revista. Mediante un análisis documental de las ediciones regulares (excepto los dossiers temáticos) y entrevistas con tres ex-editoras-jefes, se analizan, en particular: el contexto de creación de la revista, a principios de la década de 2000; las transformaciones en el proceso editorial, resultados tanto de los mandatos de las políticas científicas de evaluación de revistas por la CAPES, como de la migración masiva de publicaciones científicas hacia el medio electrónico; los impactos de la crisis sistémica de financiación de las universidades públicas (en particular, las especificidades del contexto de la UERJ) en la segunda mitad de la década de 2010. De esta forma, se piensa tanto acerca de las especificidades de la trayectoria de la Estudos e Pesquisas em Psicologia como también sobre los significados y desafíos que implica el hacer editorial en el escenario contemporáneo.
Assuntos
Psicologia , Atividades Científicas e Tecnológicas , Publicação PeriódicaRESUMO
Dengue virus (DENV) 1-4 is the etiological agent of dengue, the most important viral infection transmitted by Aedes spp mosquitoes to humans. Our goal was to identify the circulating DENV in Aedes aegypti collected in an area of Brazil where all four DENV serotypes had already been detected in humans, understand the epidemiology better, and to test the vector as a virological surveillance tool. Twenty-eight larvae pools and 174 females of Aedes aegypti were screened by reverse transcriptase quantitative polymerase chain reaction and semi-nested PCR assays. PCR products were sequenced, and phylogenetic analyses were performed. Nine larvae pools (32.1%) were positive for DENV, four (44.4%) with DENV-3, and five (55.6%) with more than one serotype. Fifteen females (8.6%) were positive for any DENV serotype. DENV-1 isolates belong to genotype V, DENV-2 to American-Asian genotype, DENV-3 to genotypes I and III, and DENV-4 to genotypes I and II. We demonstrate for the first time the co-circulation of all four DENV serotypes in larvae pools and adult Aedes aegypti in a hyperendemic area. This scenario represents a challenge for disease control and reinforces the importance of virological surveillance in the vector as a tool for predicting circulating DENV serotypes in humans.
Assuntos
Aedes , Vírus da Dengue , Dengue , Aedes/virologia , Animais , Brasil , Dengue/epidemiologia , Vírus da Dengue/genética , Feminino , Larva , Mosquitos Vetores/virologia , Filogenia , SorogrupoRESUMO
BACKGROUND: Most of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID-19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID-19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID-19 patients and their associations with the incidence of adverse COVID-19 outcomes. METHODS: We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID-19 in this prospective observational study. Dental and periodontal status was assessed using in-hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID-19 symptoms, and hospitalization endpoints were tested using chi-square test and incidence rate ratio (IRR) estimation using a generalized linear model with log-Poisson regression. The regression models used a block-wise selection of predictors for oral health-related variables, comorbidities, and patients' ages. RESULTS: Overall, poor oral health conditions were highly prevalent and associated with critical COVID-19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07-1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44-4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12-3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission. CONCLUSION: There was a positive association between deleterious oral health-related conditions, especially periodontitis, and severe COVID-19 outcomes in hospitalized COVID-19 patients.
Assuntos
COVID-19 , Doenças da Boca , Periodontite , Perda de Dente , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Saúde Bucal , Perda de Dente/epidemiologia , Assistência Odontológica , Periodontite/complicações , Periodontite/epidemiologiaRESUMO
Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is used worldwide to test and trace the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). "Extraction-less" or "direct" real time-reverse transcription polymerase chain reaction (RT-PCR) is a transparent and accessible qualitative method for SARS-CoV-2 detection from nasopharyngeal or oral pharyngeal samples with the potential to generate actionable data more quickly, at a lower cost, and with fewer experimental resources than full RT-qPCR. This study engaged 10 global testing sites, including laboratories currently experiencing testing limitations due to reagent or equipment shortages, in an international interlaboratory ring trial. Participating laboratories were provided a common protocol, common reagents, aliquots of identical pooled clinical samples, and purified nucleic acids and used their existing in-house equipment. We observed 100% concordance across laboratories in the correct identification of all positive and negative samples, with highly similar cycle threshold values. The test also performed well when applied to locally collected patient nasopharyngeal samples, provided the viral transport media did not contain charcoal or guanidine, both of which appeared to potently inhibit the RT-PCR reaction. Our results suggest that direct RT-PCR assay methods can be clearly translated across sites utilizing readily available equipment and expertise and are thus a feasible option for more efficient COVID-19 coronavirus disease testing as demanded by the continuing pandemic.