The Healthy and Diseased Retina Seen through Neuron-Glia Interactions.

The retina is the sensory tissue responsible for the first stages of visual processing, with a conserved anatomy and functional architecture among vertebrates. To date, retinal eye diseases, such as diabetic retinopathy, age-related macular degeneration, retinitis pigmentosa, glaucoma, and others, affect nearly 170 million people worldwide, resulting in vision loss and blindness. To tackle retinal disorders, the developing retina has been explored as a versatile model to study intercellular signaling, as it presents a broad neurochemical repertoire that has been approached in the last decades in terms of signaling and diseases. Retina, dissociated and arranged as typical cultures, as mixed or neuron- and glia-enriched, and/or organized as neurospheres and/or as organoids, are valuable to understand both neuronal and glial compartments, which have contributed to revealing roles and mechanisms between transmitter systems as well as antioxidants, trophic factors, and extracellular matrix proteins. Overall, contributions in understanding neurogenesis, tissue development, differentiation, connectivity, plasticity, and cell death are widely described. A complete access to the genome of several vertebrates, as well as the recent transcriptome at the single cell level at different stages of development, also anticipates future advances in providing cues to target blinding diseases or retinal dysfunctions.

Detection of cytokines in cervicovaginal lavage in HIV-infected women and its association with high-risk human papillomavirus.

Background: Women living with HIV/AIDS (WLHA) have an increased prevalence of high-risk HPV infection (HR-HPV) and cervical intraepithelial neoplasia (CIN) and a greater risk of cervical cancer despite access to a new generation of antiretroviral therapy. The aim of this study is to evaluate the concentrations of different cytokines involved in the local immune response in WLHA, which is fundamental for understanding the pathogenesis of HPV-related cancer in this population. Methods: IL-1ß, IL-2, IL-4, IL-6, IL-10, IFN-γ, TNF-α, IP-10, GM-CSF, and MIP-1α were investigated in the cervicovaginal lavage (CVL) of 106 WLHA attending at Hospital Universitario Professor Edgard Santos in Salvador, Bahia, Brazil, during the period December 2019 to April 2023 by Luminex®. All participants were also tested for Chlamydia trachomatis and Neisseria gonorrhoeae and underwent colposcopy, Pap smear, and Nugent score. HIV plasma viral load (VL) and CD4 cell count were performed for all WLHA. Results: In this study, 22.6% (24/106) of WLHA were infected with HR-HPV. A higher proportion of patients with HR-HPV (66.7%) had detectable levels of IL-10 than those negative ones (40.2%, p = 0.02). More premenopausal women had either IL-6 (51.4%) or IP-10 (58.3%) than those in menopausal status (26.5% for IL-6 and 32.4% for IP-10, p = 0.013 and p = 0.011, respectively). Vaginosis was negatively associated with detection of IP-10 (24.2% vs. 61.4%, p < 0.001) and INF-γ (39.4% vs. 68.6%, p = 0.005). A positive association was detected for IL-1ß (66.7 vs. 37.1%, p = 0.005) and IL-10 (63.6% vs. 37.1%, p = 0.01). VL and CD4 were not associated with the studied cytokines. Conclusion: We demonstrated a positive association between IL-10 and HPV infection in CVL, suggesting the predominance of the Th2 response in HIV/HPV co-infected patients. However, further studies with longer follow-up will be needed to evaluate the association of IL-10 with HPV infection, CIN, and cervical cancer in WLHA.

Gut microbiome signature and nasal lavage inflammatory markers in young people with asthma.

Background: Asthma is a complex disease and a severe global public health problem resulting from interactions between genetic background and environmental exposures. It has been suggested that gut microbiota may be related to asthma development; however, such relationships needs further investigation. Objective: This study aimed to characterize the gut microbiota as well as the nasal lavage cytokine profile of asthmatic and nonasthmatic individuals. Methods: Stool and nasal lavage samples were collected from 29 children and adolescents with type 2 asthma and 28 children without asthma in Brazil. Amplicon sequencing of the stool bacterial V4 region of the 16S rRNA gene was performed using Illumina MiSeq. Microbiota analysis was performed by QIIME 2 and PICRUSt2. Type 2 asthma phenotype was characterized by high sputum eosinophil counts and positive skin prick tests for house dust mite, cockroach, and/or cat or dog dander. The nasal immune marker profile was assessed using a customized multiplex panel. Results: Stool microbiota differed significantly between asthmatic and nonasthmatic participants (P = .001). Bacteroides was more abundant in participants with asthma (P < .05), while Prevotella was more abundant in nonasthmatic individuals (P < .05). In people with asthma, the relative abundance of Bacteroides correlated with IL-4 concentration in nasal lavage samples. Inference of microbiota functional capacity identified differential fatty acid biosynthesis in asthmatic compared to nonasthmatic subjects. Conclusion: The stool microbiota differed between asthmatic and nonasthmatic young people in Brazil. Asthma was associated with higher Bacteroides levels, which correlated with nasal IL-4 concentration.

Mother's smoking habits affects IL10 methylation but not asthma in Ecuadorian children.

There is no evidence evaluating the IL10 epigenetic upregulation among mestizo children in a high-altitude Andean city in Latin America. OBJECTIVE: To identify polymorphisms and methylation profiles in the IL10 gene associated with asthma in children aged 5 to 11. METHODS: A case-control study was conducted with asthmatic and non-asthmatic children aged 5 to 11 years in Cuenca-Ecuador. Data on allergic diseases and risk factors were collected through a questionnaire for parents. Atopy was measured by skin prick test (SPT) to relevant aeroallergens. Three IL10 single nucleotide polymorphisms were evaluated in all participants, and methylation analysis was performed in 54 participants. Association between risk factors, allergic diseases and genetic factors were estimated using multivariate logistic regression. RESULTS: The results of polymorphisms showed no differences between cases and controls when comparing the SNPs rs3024495, rs3024496, rs1800896 allelic and genotypic frequencies. In the methylation analysis, no differences in the IL10 methylation profile were found between cases and controls; however, the multivariate analysis showed an association between the mother's smoking habits and the IL10 methylation profile. CONCLUSION: Smoking habit could be essential as an environmental exposure factor in regulating gene expression in children with asthma.

The role of IL10 and IL17 gene polymorphisms in treatment response in children and adolescents with severe asthma.

OBJECTIVE: To determine whether polymorphisms of the IL10 and IL17 genes are associated with severe asthma control and bronchodilator reversibility in children and adolescents with severe asthma. METHODS: This was a cross-sectional study, nested within a prospective cohort study of patients with severe asthma. Two outcomes were evaluated: asthma control and bronchodilator reversibility. We extracted DNA from peripheral blood and genotyped three single nucleotide polymorphisms: rs3819024 and rs2275913 in the IL17A gene; and rs3024498 in the IL10 gene. For the association analyses, we performed logistic regression in three genetic models (allelic, additive, and dominant). RESULTS: The rs3024498 C allele in the IL10 gene was associated with failure to achieve asthma control despite regular treatment (p = 0.02). However, the G allele of the IL17A rs3819024 polymorphism was associated with failure to respond to stimulation with a b2 agonist. The rs2275913 polymorphism of the IL17A gene showed no relationship with asthma control or bronchodilator reversibility. CONCLUSIONS: In pediatric patients with severe asthma, the IL10 polymorphism appears to be associated with failure to achieve clinical control, whereas the IL17A polymorphism appears to be associated with a worse bronchodilator response. Knowledge of the involvement of these polymorphisms opens future directions for pharmacogenetic studies and for the implementation of individualized therapeutic management of severe asthma in pediatric patients.

Predictive genetic panel for adult asthma using machine learning methods.

Background: Asthma is a chronic inflammatory disease of the airways that is heterogeneous and multifactorial, making its accurate characterization a complex process. Therefore, identifying the genetic variations associated with asthma and discovering the molecular interactions between the omics that confer risk of developing this disease will help us to unravel the biological pathways involved in its pathogenesis. Objective: We sought to develop a predictive genetic panel for asthma using machine learning methods. Methods: We tested 3 variable selection methods: Boruta's algorithm, the top 200 genome-wide association study markers according to their respective P values, and an elastic net regression. Ten different algorithms were chosen for the classification tests. A predictive panel was built on the basis of joint scores between the classification algorithms. Results: Two variable selection methods, Boruta and genome-wide association studies, were statistically similar in terms of the average accuracies generated, whereas elastic net had the worst overall performance. The predictive genetic panel was completed with 155 single-nucleotide variants, with 91.18% accuracy, 92.75% sensitivity, and 89.55% specificity using the support vector machine algorithm. The markers used range from known single-nucleotide variants to those not previously described in the literature. Our study shows potential in creating genetic prediction panels with tailored penalties per marker, aiding in the identification of optimal machine learning methods for intricate results. Conclusions: This method is able to classify asthma and nonasthma effectively, proving its potential utility in clinical prediction and diagnosis.

The Thr92Ala polymorphism in the type 2 deiodinase gene is linked to depression in patients with COVID-19 after hospital discharge.

Background: The Thr92Ala-DIO2 polymorphism has been associated with clinical outcomes in hospitalized patients with COVID-19 and neuropsychiatric diseases. This study examines the impact of the Thr92Ala-DIO2 polymorphism on neuropsychological symptoms, particularly depressive symptoms, in patients who have had moderate to severe SARS-CoV-2 infection and were later discharged. Methods: Our prospective cohort study, conducted from June to August 2020, collected data from 273 patients hospitalized with COVID-19. This included thyroid function tests, inflammatory markers, hematologic indices, and genotyping of the Thr92Ala-DIO2 polymorphism. Post-discharge, we followed up with 68 patients over 30 to 45 days, dividing them into depressive (29 patients) and non-depressive (39 patients) groups based on their Beck Depression Inventory scores. Results: We categorized 68 patients into three groups based on their genotypes: Thr/Thr (22 patients), Thr/Ala (41 patients), and Ala/Ala (5 patients). Depressive symptoms were less frequent in the Thr/Ala group (29.3%) compared to the Thr/Thr (59.1%) and Ala/Ala (60%) groups (p = 0.048). The Thr/Ala heterozygous genotype correlated with a lower risk of post-COVID-19 depression, as shown by univariate and multivariate logistic regression analyses. These analyses, adjusted for various factors, indicated a 70% to 81% reduction in risk. Conclusion: Our findings appear to be the first to show that heterozygosity for Thr92Ala-DIO2 in patients with COVID-19 may protect against post-COVID-19 depression symptoms up to 2 months after the illness.

Thr92Ala-DIO2 heterozygosity is associated with skeletal muscle mass and myosteatosis in patients with COVID-19.

Introduction: The type 2 deiodinase and its Thr92Ala-DIO2 polymorphism have been linked to clinical outcomes in acute lung injury and coronavirus disease 2019 (COVID-19). Objective: The objective was to identify a potential association between Thr92Ala-DIO2 polymorphism and body composition (appendicular muscle mass, myosteatosis, and fat distribution) and to determine whether they reflect the severity or mortality associated with the disease. Methods: In this prospective cohort study (June-August 2020), 181 patients hospitalized with moderate-to-severe COVID-19 underwent a non-contrast-enhanced computed tomography (CT) of the thorax to assess body composition, laboratory tests, and genotyping for the Thr92Ala-DIO2 polymorphism. Results: In total, 181 consecutive patients were stratified into three subgroups according to the genotype: Thr/Thr (n = 64), Thr/Ala (n = 96), and Ala/Ala (n = 21). The prevalence of low muscle area (MA) (< 92 cm²) was 52.5%. Low MA was less frequent in Ala/Thr patients (44.8%) than in Thr/Thr (60.9%) or Ala/Ala patients (61.9%) (P = 0.027). Multivariate logistic regression analysis confirmed that the Thr/Ala allele was associated with a reduced risk of low MA (41% to 69%) and myosteatosis (62% to 72%) compared with Thr/Thr + Ala/Ala (overdominant model). Kaplan-Meier curves showed that patients with low muscle mass and homozygosity had lower survival rates than the other groups. Notably, the heterozygotes with MA ≥92 cm² exhibited the best survival rate. Conclusion: Thr92Ala-DIO2 heterozygosity is associated with increased skeletal MA and less myosteatosis in patients with COVID-19. The protective effect of Thr92Ala-DIO2 heterozygosity on COVID-19 mortality is restricted to patients with reduced MA.

Multi-omics in nasal epithelium reveals three axes of dysregulation for asthma risk in the African Diaspora populations.

Asthma has striking disparities across ancestral groups, but the molecular underpinning of these differences is poorly understood and minimally studied. A goal of the Consortium on Asthma among African-ancestry Populations in the Americas (CAAPA) is to understand multi-omic signatures of asthma focusing on populations of African ancestry. RNASeq and DNA methylation data are generated from nasal epithelium including cases (current asthma, N = 253) and controls (never-asthma, N = 283) from 7 different geographic sites to identify differentially expressed genes (DEGs) and gene networks. We identify 389 DEGs; the top DEG, FN1, was downregulated in cases (q = 3.26 × 10-9) and encodes fibronectin which plays a role in wound healing. The top three gene expression modules implicate networks related to immune response (CEACAM5; p = 9.62 × 10-16 and CPA3; p = 2.39 × 10-14) and wound healing (FN1; p = 7.63 × 10-9). Multi-omic analysis identifies FKBP5, a co-chaperone of glucocorticoid receptor signaling known to be involved in drug response in asthma, where the association between nasal epithelium gene expression is likely regulated by methylation and is associated with increased use of inhaled corticosteroids. This work reveals molecular dysregulation on three axes - increased Th2 inflammation, decreased capacity for wound healing, and impaired drug response - that may play a critical role in asthma within the African Diaspora.

Genetic variants in the TNF pathway impact TNFi response in a mixed population with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a multifactorial autoimmune inflammatory disease that mainly affects the joints, on reducing functional capacity and impacting quality of life. Cytokines such as tumor necrosis factor (TNF) and interleukin 6 (IL-6) are crucial in the pathogenesis and treatment of this disease. Some patients using TNF inhibitors (TNFi) do not respond or lose their response to these medications. Clinical, sociodemographic, and genetic data were used to evaluate the associations of single nucleotide polymorphisms (SNP) in TNF, TNFRSF1A, and TNFRSF1B genes with the diagnosis of RA, standardized score results, laboratory tests, and response to TNFi. In one subsample, TNF and IL-6 serum levels cytokines were performed. A total of 654 subjects (360 healthy controls and 294 diagnosed with RA) were included in the analysis. Higher levels of TNF have been found in individuals diagnosed with RA. IL-6 levels were higher in individuals who did not respond to TNFi treatment, while responders had levels comparable to those without the disease. No associations were found between the SNPs studied and the diagnosis of RA; however, rs767455-C seems to play a role in the response to golimumab treatment, being related to better therapeutic response and lower mean serum leukocyte levels. In addition, rs1061622-G was associated with poorer functional capacity and rs1800629-A was associated with higher leukocyte values and serum transaminase levels. The rs1061622-G and rs767455-C may play a role in the response to TNFi treatment, especially for patients using golimumab, although they do not seem to be associated with the diagnosis of RA. Polymosphisms in the TNF pathway may impact baseline levels of immune cells and markers of renal and hepatic function in RA patients. Our results highlight the importance of evaluating the impact of these polymorphisms on TNFi response and safety, particularly in larger-scale studies.

Repercussões da COVID-19 na morbidade e mortalidade de crianças indígenas: revisão integrativa / Repercussions of COVID-19 on the morbidity and mortality of indigenous children: integrative review

A doença causada pelo COVID-19 repercutiu na saúde de comunidades indígenas, com taxas de internação e óbitos, principalmente, no segmento infantil. O objetivo do estudo foi identificar evidências científicas acerca das repercussões da COVID-19 na morbidade e mortalidade de crianças indígenas. Trata-se de um estudo de revisão integrativa com a questão de pesquisa: Quais as repercussões da pandemia de COVID-19 nas crianças indígenas? Foram acessadas as fontes de dados PUBMED, WEB OF SCIENCE, LILACS e SCOPUS durante o mês de dezembro de 2023 com as estratégias de busca: "indigenous population" AND "child" AND "coronavirus infections" e "native" AND "child" AND "coronavirus infections" com recorte temporal a partir de 2020. A partir dos critérios de inclusão selecionou-se nove produções científicas. Após a interpretação dos resultados, identificou-se que crianças indígenas apresentam maior risco de mortalidade comparada às crianças não indígenas da mesma idade. Isto pode estar relacionado ao aumento da vulnerabilidade, dificuldade de acesso a alimentos e à prematuridade. Concluiu-se que crianças indígenas apresentaram maiores taxas de mortalidade e outras implicações relacionadas à COVID-19 e repercussões relacionadas às desigualdades sociais já existentes e às vulnerabilidades que aumentaram com a pandemia. Destaca-se a escassa produção científica acerca da população indígena, em especial, às crianças.

The disease caused by COVID-19 had an impact on the health of indigenous communities, with hospitalization and death rates, mainly in the children's segment. The objective of the study was to identify scientific evidence about the repercussions of COVID-19 on the morbidity and mortality of indigenous children. This is an integrative review study with the research question: What are the repercussions of the COVID-19 pandemic on indigenous children? The PUBMED, WEB OF SCIENCE, LILACS and SCOPUS data sources were accessed during the month of December 2023 with the search strategies: "indigenous population" AND "child" AND "coronavirus infections" and "native" AND "child" AND "coronavirus infections", taking 2020 as the epidemiological milestone. Based on the inclusion criteria, nine scientific productions were selected. After interpreting the results, it was identified that indigenous children have a higher risk of mortality compared to non-indigenous children of the same age. This may be related to increased vulnerability, difficulty accessing food and prematurity. It was concluded that indigenous children had higher mortality rates and other implications related to COVID-19 and repercussions related to existing social inequalities and vulnerabilities that increased with the pandemic. The scarce scientific production regarding the indigenous population stands out, especially with regard to children.

Relationship between permanent upper anterior teeth and anthropometric facial measures in different populations: a narrative review

Aim: The main purpose of this study was to conduct a narrative review investigating the possible relationship between permanent maxillary anterior teeth and anthropometric facial parameters in different populations. Methods: Searches were performed in the PubMed, BVS (Biblioteca Virtual em Saúde) and SciELO databases to identify relevant scientific articles using the following search terms: "maxillary anterior teeth", "facial measurements" and "anthropometry", in such a way that 218 publications were found. After application of inclusion and exclusion criteria, 13 publications remained for full-text reading. Results: All studies involved male and female samples and it was notorious that male measurements were unanimously higher than those obtained in the opposite sex. The age of the analyzed participants ranged from 17 to 60 years; however, a mean age of 18 to 25 years was the most investigated in literature. In addition, facial measurements including the bizygomatic width, interpupillary distance, intercanthal distance, interalar width and intercommissural width have been proposed to help determine the correct size of anterior teeth. Conclusion: It was concluded that despite the limited number of studies, some factors that influence dental and facial dimensions, such as sex and age, can be identified. However, there is no standardization of the facial or dental parameters used in the studies, a fact that makes it difficult to establish a universal ratio for clinical dental practice

Radiation-Induced Undifferentiated Pleomorphic Sarcoma after Breast Conserving Therapy: Case Report / Sarcoma Pleomórfico de Mama Radioinduzido Pós-Tratamento Conservador de Câncer de Mama Inicial: Relato de Caso / Sarcoma Pleomórfico de Mama Radioinducido tras Tratamiento Conservador de Cáncer de Mama Inicial: Informe de Caso

Introduction: Breast sarcoma is a rare form of malignancy that arises from connective tissue, comprising less than 5% of all sarcomas. Undifferentiated pleomorphic sarcoma (UPS) of the breast is a rare and aggressive subtype of radiation-induced sarcoma that can occur in treated breast cancer patients. The diagnosis is challenging and often missed due to the low incidence, long latency period, unspecific imaging finding, and difficulties in clinical and histological detection. Case report: A 56-year-old woman was diagnosed with early-stage triple-negative breast cancer in 2013 and underwent breast-conserving therapy (BCT). After five years follow-up, she developed mastalgia and breast induration, and after mammography and ultrasound without suspicious lesions, a magnetic resonance imaging (MRI) was performed and showed a highly suggestive malignancy mass measuring 8.0 cm and invading the chest wall. The core biopsy revealed a spindle cells malignant tumor, negative for pan cytokeratin and most of immuno-histochemical markers, suggesting sarcoma, but requiring investigation of surgical specimen to exclude metaplastic carcinoma. She underwent Halsted radical mastectomy, full-thickness left anterior chest wall resection contemplating segments of the 4th and 5th ribs and reconstruction with synthetic mesh. The surgical specimen evidenced a UPS with clear margins. The patient had good postoperative recovery and remains in follow-up with the mastology team. Conclusion: This report shows that radiation-induced sarcomas of the breast can be difficult to diagnose, and how later treatment can demand a major surgery with higher morbidity. Prognosis may improve if detected early

Introdução: O sarcoma de mama é uma forma rara de câncer que surge do tecido conjuntivo, compreendendo menos de 5% de todos os sarcomas. O sarcoma pleomórfico indiferenciado (SPI) da mama é um subtipo raro e agressivo de sarcoma induzido por radiação que pode surgir em pacientes pós-tratamento conservador de câncer de mama. O diagnóstico é desafiador e, muitas vezes, tardio, em virtude da baixa incidência, longo período de latência, achados de imagem inespecíficos e dificuldades na detecção clínica e histológica. Relato do caso: Paciente do sexo feminino, 56 anos, foi diagnosticada com câncer de mama triplo-negativo estadiamento inicial em 2013 e submetida a tratamento conservador de câncer de mama. Após cinco anos de seguimento, evoluiu com mastalgia e endurecimento mamário e, após mamografia e ultrassonografia sem lesões suspeitas, foi realizada ressonância magnética que evidenciou massa altamente sugestiva de malignidade medindo 8,0 cm com invasão da parede torácica. O resultado da core biopsy revelou um tumor maligno de células fusiformes, negativo para pancitoqueratina e para a maioria dos marcadores imuno-histoquímicos, sugerindo sarcoma, mas exigindo estudo de peça cirúrgica para excluir carcinoma metaplásico. A paciente foi submetida à mastectomia radical de Halsted, ressecção da parede torácica anterior esquerda contemplando segmentos das 4ª e 5ª costelas e reconstrução com tela sintética. O laudo histopatológico da peça cirúrgica evidenciou SPI com margens livres. Evoluiu com boa recuperação pós-operatória, permanecendo em acompanhamento com a equipe de mastologia. Conclusão: O relato de caso ilustra como os sarcomas de mama induzidos por radiação podem ser de difícil diagnóstico e como o tratamento postergado pode exigir uma cirurgia de grande porte com maior morbidade. Estar ciente dessa condição pode melhorar o prognóstico do paciente

Introducción: El sarcoma de mama es una forma rara de cáncer que surge del tejido conectivo y comprende menos del 5% de todos los sarcomas. El sarcoma pleomórfico indiferenciado (SPI) de la mama es un subtipo raro y agresivo de sarcoma inducido por radiación que puede surgir en pacientes después de un tratamiento conservador del cáncer de mama. El diagnóstico es un desafío y, a menudo, se retrasa debido a la baja incidencia, el largo período de latencia, los hallazgos de imagen inespecíficos y las dificultades en la detección clínica e histológica. Informe del caso: Una paciente de 56 años fue diagnosticada de cáncer de mama triple negativo en estadio inicial en 2013 y se sometió a un tratamiento conservador para el cáncer de mama. A los cinco años de seguimiento desarrolló mastalgia y endurecimiento mamario, y tras mamografía y ecografía sin lesiones sospechosas, se realizó una resonancia magnética, que mostró una masa altamente sugestiva de malignidad de 8,0 cm. con invasión de la pared torácica. El estudio anatomopatológico de la lesión mostró un tumor de células fusiformes maligno, negativo para pancitoqueratina y para la mayoría de los marcadores inmuno-histoquímicos, lo que sugería sarcoma, pero requirió un estudio de la pieza quirúrgica para descartar un carcinoma metaplásico. La paciente fue intervenida de mastectomía radical de Halsted, resección de la pared torácica anterior izquierda cubriendo segmentos de las 4ª y 5ª costillas y reconstrucción con malla sintética. El informe histopatológico de la pieza quirúrgica mostró UPS, con márgenes libres. Evolucionó con buena recuperación postoperatoria, permaneciendo en seguimiento con el equipo de mastología. Conclusión: El relato de caso ilustra cómo los sarcomas de mama inducidos por radiación pueden ser difíciles de diagnosticar y cómo el tratamiento tardío puede requerir una cirugía mayor con mayor morbilidad. Ser consciente de esta condición puede mejorar el pronóstico del paciente.Palabras clave: sarcoma; neoplasias de la mama; neoplasias inducidas por radiación; neoplasias primarias secundarias; informes de casos

Ações de educação permanente em saúde em tempos de pandemia: prioridades nos planos estaduais e nacional de contingência / Permanent health education actions in pandemic times: priorities in state and national contingency plans

Resumo Objetivo: analisar ações de educação permanente em saúde nos Planos Nacional e Estaduais de Contingência para enfrentamento à pandemia de COVID-19 no Brasil. Metodologia: pesquisa documental, com utilização de 54 planos nas versões iniciais e finais, publicados entre janeiro de 2020 e maio de 2021. A análise do conteúdo contemplou identificação e sistematização das propostas voltadas para capacitação e reorganização do processo de trabalho e cuidados à saúde física e mental dos trabalhadores de saúde. Resultados: as ações voltaram-se à capacitação dos trabalhadores com ênfase em síndrome gripal, medidas de controle de riscos de infeção e conhecimento sobre biossegurança. Poucos planos abordaram jornadas e processo de trabalho das equipes, promoção e assistência à saúde mental dos trabalhadores principalmente no âmbito hospitalar. Conclusão: superficialidade nas abordagens das ações de educação permanente nos planos de contingência, necessidade de inclusão de ações na agenda estratégica do Ministério da Saúde e das secretarias estaduais e municipais de saúde com qualificação dos trabalhadores para enfrentar esta e outras epidemias. Propõe adoção de medidas de proteção e promoção da saúde no cotidiano da gestão do trabalho em saúde no âmbito do SUS.

Abstract Objective: to assess permanent health education actions regarding the national and state contingency plans to face the COVID-19 pandemic in Brazil. Method: documentary research, using 54 plans in the initial and final versions, published between January 2020 and May 2021. The content analysis included the identification and systematization of proposals aimed at training and reorganizing the work process, as well as physical and mental health care of health workers. Results: the actions were focused on training workers with an emphasis on flu syndrome, infection risk control measures and knowledge about biosafety. Few plans addressed the teams' working hours and work process, promotion and assistance to the workers' mental health, mainly in the hospital environment. Conclusion: the superficiality regarding the approach to permanent education actions in contingency plans need to include actions in the strategic agenda of the Ministry of Health and State and Municipal Health Secretariats, with the qualification of workers to face this and other epidemics. They propose the adoption of health protection and promotion measures in daily health work management within the scope of the SUS.

The role of IL10 and IL17 gene polymorphisms in treatment response in children and adolescents with severe asthma / O papel de polimorfismos dos genes IL10 e IL17 na resposta ao tratamento em crianças e adolescentes com asma grave

ABSTRACT Objective: To determine whether polymorphisms of the IL10 and IL17 genes are associated with severe asthma control and bronchodilator reversibility in children and adolescents with severe asthma. Methods: This was a cross-sectional study, nested within a prospective cohort study of patients with severe asthma. Two outcomes were evaluated: asthma control and bronchodilator reversibility. We extracted DNA from peripheral blood and genotyped three single nucleotide polymorphisms: rs3819024 and rs2275913 in the IL17A gene; and rs3024498 in the IL10 gene. For the association analyses, we performed logistic regression in three genetic models (allelic, additive, and dominant). Results: The rs3024498 C allele in the IL10 gene was associated with failure to achieve asthma control despite regular treatment (p = 0.02). However, the G allele of the IL17A rs3819024 polymorphism was associated with failure to respond to stimulation with a b2 agonist. The rs2275913 polymorphism of the IL17A gene showed no relationship with asthma control or bronchodilator reversibility. Conclusions: In pediatric patients with severe asthma, the IL10 polymorphism appears to be associated with failure to achieve clinical control, whereas the IL17A polymorphism appears to be associated with a worse bronchodilator response. Knowledge of the involvement of these polymorphisms opens future directions for pharmacogenetic studies and for the implementation of individualized therapeutic management of severe asthma in pediatric patients.

RESUMO Objetivo: Determinar se existe relação entre polimorfismos dos genes IL10 e IL17 e controle da asma grave e reversibilidade com broncodilatador em crianças e adolescentes com asma grave. Métodos: Estudo transversal, aninhado em um estudo prospectivo de coorte com pacientes com asma grave. Foram avaliados dois desfechos: controle da asma e reversibilidade com broncodilatador. Extraímos DNA do sangue periférico e genotipamos três polimorfismos de nucleotídeo único: rs3819024 e rs2275913 no gene IL17A e rs3024498 no gene IL10. Para as análises de associação, realizamos regressão logística em três modelos genéticos (alélico, aditivo e dominante). Resultados: O alelo C do polimorfismo rs3024498 do gene IL10 apresentou relação com asma que permaneceu descontrolada mesmo com tratamento regular (p = 0,02). No entanto, o alelo G do polimorfismo rs3819024 do gene IL17A apresentou relação com ausência de resposta ao estímulo com b2-agonista. O polimorfismo rs2275913 do gene IL17A não apresentou relação com controle da asma ou reversibilidade com broncodilatador. Conclusões: Em pacientes pediátricos com asma grave, o polimorfismo do gene IL10 parece estar relacionado com ausência de controle clínico, ao passo que o polimorfismo do gene IL17A parece estar relacionado com pior resposta ao broncodilatador. O conhecimento a respeito do envolvimento desses polimorfismos abre perspectivas futuras para estudos farmacogenéticos e para a implantação de manejo terapêutico individualizado da asma grave em pacientes pediátricos.

Frequência alélica e potencial regulatório de polimorfismosno gene NELL1 em uma população da Bahia ­ Brasil / Allele frequency and regulatory potential of polimorphisms in NELL1 gene in a population of Bahia ­ Brazil

Introdução: o gene NELL1 codifica a proteína semelhante ao fator de crescimento epidérmico (do inglês Epidermal Growth factor (EGF)-like). GWASs e estudos de associação com genes candidatos têm sido utilizados para estabelecer a conexão entre polimorfismos de nucleotídeo único (SNP) no NELL1 e diversas doenças. Objetivo: descrever a frequência alélica e o potencial regulatório dos polimorfismos do gene NELL1, estudados em uma população de Salvador (Bahia, Brasil) e descrever a frequência desses polimorfismos e a associação com diversas doenças, em populações africana, ameríndia, asiática e europeia. Metodologia: 1094 participantes foram recrutados através do Programa de Controle da Asma e da Rinite Alérgica no Estado da Bahia (ProAR). Os indivíduos tiveram o DNA genômico extraído e genotipado, utilizando-se a plataforma Illumina. Os SNP foram consultados através da plataforma SeattleSec Annotation. As bases de dados NCBI, RegulomeDB e Haploview 4.2 foram utilizadas para as análises. Resultados: foram analisados 346 SNPs do gene NELL1. Desses, 53 SNPs tiveram o MAF variando entre 50% e 40% e função intrônica. Os SNPs rs10833465 (alelo A), rs908944 (alelo C), rs1516766 (alelo A), rs10766739 (alelo G) e rs11025878 (alelo G) apresentam uma pontuação de 3, de acordo com o banco do RegulomeDB. O SNP rs7117671, com pontuação 2b, pode ter impacto regulatório e funcional. 101 SNPs apresentaram o MAF entre 39% e 20%. Dos polimorfismos menos frequentes nessa população, 192 apresentaram um MAF entre 19% e 2%. Discussão: alguns SNPs, com diferentes frequências, apresentaram alta probabilidade de impacto funcional. Foram encontrados, na literatura, estudos de associação dos SNPs e osteoporose, doenças metabólicas, condições inflamatórias, doenças neuropsiquiátricas e tumores malignos. Conclusão: ospolimorfismos do gene NELL1 estudados apresentaram diferentes frequências na população desse estudo e tiveram seus alelos associados a doenças em diferentes populações. Sugere-se que sejam realizados mais estudos.

Introduction: the NELL1 gene encodes the epidermal growth factor (EGF)-like protein. GWASs and association studies with candidate genes have been used to establish the connection between single nucleotide polymorphisms (SNP) in NELL1 and various diseases. Objective: to describe the allele frequency and regulatory potential of NELL1 gene polymorphisms studied in a population from Salvador, Bahia, Brazil; and to describe the frequency of these polymorphisms, and the association with various diseases, in African, Amerindian, Asian and European populations. Methodology: one thousand and ninety-four (1094) participants were recruited through the Program for the Control of Asthma and Allergic Rhinitis in the State of Bahia (ProAR). Individuals had their genomic DNA extracted and genotyped using the Illumina platform. The SNPs were consulted through the SeattleSec Annotation platform. The NCBI, RegulomeDB and Haploview 4.2 databases were used for the analyses. Results: four hundred and seventy-three (346) NELL1 gene SNPs were analyzed. Of these, 53 SNPs had MAF ranging between 50% and 40% and intronic function. The SNPs rs10833465 (A allele), rs908944 (C allele), rs1516766 (A allele), rs10766739 (G allele) and rs11025878 (G allele) showed a score of 3, according to the RegulomeDB database. SNP rs7117671, with score 2b, may have regulatory and functional impact. One hundred and eighteen (101) SNPs presented MAF between 39% and 20%. Of the less frequent polymorphisms in this population, 192 had a MAF between 19% and 2%. Discussion: some SNPs, with different frequencies, presented a high probability of functional impact. Studies on the association of SNPs and osteoporosis, metabolic diseases, inflammatory conditions, neuropsychiatric diseases and malignant tumors were found in the literature. Conclusion: the NELL1 gene polymorphisms studied showed different frequencies in the population of this study and had their alleles associated with diseases in different populations. It is suggested that further studies be carried out.

Caracterização de polimorfismos nos genes OPG, RANK e RANKL em uma população brasileira / Characterization of OPG, RANK and RANKL gene polymorphisms in a Brazilian population

Introdução: o sistema RANKL (receptor-ativador do fator nuclear-ligante κB)/RANK (receptor ativador do NF-kB)/OPG (osteoprotegrina) Introdução: o sistema OPG (osteoprotegrina)/RANK (receptor ativador do NF-kB)/RANKL (receptor-ativador do fator nuclear-ligante κB) regula os processos fisiológicos e patológicos da remodelação óssea. Polimorfismos genéticos nos genes OPG, RANK e RANKL têm sido associados a doenças, em diferentes populações. Objetivo: Descrever a frequência e o potencial regulatório dos polimorfismos do sistema OPG, RANK e RANKL em uma população brasileira; avaliar o seu potencial como marcadores genéticos informativos de ancestralidade; comparar com patologias associadas em outras populações. Metodologia: neste estudo, 506 indivíduos adultos, participantes de uma coorte acometidos de asma e periodontite, tiveram o DNA genômico extraído e genotipado, utilizando-se a plataforma Illumina. As plataformas NCBI, RegulomeDB, Haploview 4.2 e rSNPBase foram consultadas e utilizadas para análises. Resultados e Discussão: os polimorfismos mais frequentes na população estudada foram o rs3102724 no gene OPG, com frequência de menor alelo (MAF) de 46%; o rs4941129 em RANK, MAF 50%; e o rs9525641 em RANKL, MAF 46%. Os rs3134063 (1f) em OPG, rs17069898 (1f) em RANK e rs2200287 (1d) em RANKL apresentaram maior impacto funcional. Em OPG e RANK, nove polimorfismos se caracterizaram como marcadores genéticos informativos de ancestralidade, com predomínio nas populações YRI (africanos) e CEU (europeus). Os nove polimorfismos, com função intrônica, apresentaram MAF entre 2 a 46% na população-alvo e foram associados a patologias do metabolismo ósseo em outras populações. Conclusão: polimorfismos dos genes estudados se mostraram frequentes na população estudada e tiveram seus alelos mais frequentes associados a doenças em populações ancestrais. Sugere-se que sejam realizados mais estudos.

Introduction: The OPG (osteoprotegerin)/ RANK (NF-kB activating receptor)/ RANKL (nuclear-binding factor κB receptor-activating system regulates the physiological and pathological processes of bone remodeling. Genetic polymorphisms (SNPs) in OPG, RANK and RANKL genes have been associated with diseases in different populations. Objective: Describe the regulatory frequency and potential of SNPs in OPG, RANK and RANKL in a Brazilian population; assess their potential as informative genetic markers of ancestry; compare with pathologies associated with these polymorphisms in other populations. Methods: in this study, 506 adult individuals, participating in a cohort involving asthma and periodontitis, had genomic DNA extracted and genotyped using the Illumina platform. The NCBI, RegulomeDB, Haploview 4.2 and rSNPBase platforms were consulted and used for analysis. Results and discussion: the most frequent polymorphisms in the studied population were the rs3102724 in the OPG gene, with the lowest allele frequency (MAF) of 46%; rs4941129 in RANK, MAF 50% and rs9525641 in RANKL, MAF 46%. The rs3134063 (1f) in OPG, rs17069898 (1f) in RANK and rs2200287 (1d) in RANKL, had greater functional impact. In OPG and RANK, 9 SNPs were characterized as informative genetic markers of ancestry, predominantly in YRI (African) and CEU (European) populations. These 9 SNPs, with intronic function, presented MAF between 2 and 46% in our population, and were associated with pathologies in bone metabolism in other populations. Conclusion: SNPs of the studied genes were found to be frequent in the studied population and had their most frequent alleles associated with diseases in ancestral populations. It is suggested that further studies be carried out

Analysis of permanent second molar development in children born with cleft lip and palate

Abstract The study of dental development in individuals born with cleft lip and palate (CLP) serves to determine when orthodontic intervention should start. Objective To evaluate the permanent second molar development in children born with cleft lip and palate according to Demirjian's and Nolla's methods. Methodology Out of a total of 513 digital panoramic radiographs, 113 pairs of children aged 3 to 16 years were selected. The exams were from children born with or without cleft lip and palate, of the same sex, with an age difference of up to 30 days. The images were analyzed by three examiners and reliability was checked through intra-examiner agreement by the Kappa test. The data were analyzed by Wilcoxon's and Mann-Whitney tests according to each dataset. Results The findings indicated delayed development of the permanent second molars in children with CLP (P<0.001). The development of the right permanent second molar was delayed compared to the left molar in children with CLP. Moreover, mandibular teeth showed significantly earlier development than maxillary teeth in both the case and control groups. There was no significant difference in the development of permanent second molars between sexes. Conclusion Children with CLP presented delay in the development of permanent second molars.

Experiences of violence among students of public schools / Levantamento sobre vivências de violência entre estudantes de escolas públicas

INTRODUCTION: School violence is a problem that involves a lot of bad consequences for the lives of students. So preventing and researching about it is very important OBJECTIVE: The objective of this study was identify the experiences of violence of students from public schools participating in the PSE - School Health Program and SPE - Health and Prevention in the Schools of FlorianópolisMETHODS: Participants were 871 students from the 9th grade of elementary school to the 3rd year of high school with an average age of 15 years and 6 monthsRESULTS: Regarding the experiences of violence, 81.6% stated that they had already witnessed scenes of violence, with 51.1% of these scenes occurring at school. Besides, 28% of the participants reported having already suffered prejudice at school. There was a significant statistical association between violent behavior and gender (being a boy), having a habit of watching movies and playing video games with violent content, skipping classes and having a regular to bad relationship with teachersCONCLUSIONS: Violence is part of student's daily activities, involving a broad context and it is pretty much related to school

INTRODUÇÃO: A violência escolar é um problema que envolve muitas consequências ruins para a vida dos alunos Portanto, prevenir e pesquisar sobre isso é muito importanteOBJETIVO: Identificar as experiências de violência de alunos de escolas públicas participantes do PSE - Programa de Saúde na Escola e SPE - Saúde e Prevenção nas Escolas de FlorianópolisMÉTODO: Participaram 871 alunos da 9ª série do ensino fundamental ao 3º ano do ensino médio, com média de idade de 15 anos e 6 mesesRESULTADOS: Em relação às experiências de violência, 81,6% afirmaram já ter presenciado cenas de violência, sendo 51,1% delas na escola. Além disso, 28% dos participantes relataram já ter sofrido preconceito na escola. Houve associação estatisticamente significante entre comportamento violento e ser menino, com o hábito de assistir filmes e jogar videogame com conteúdo violento, matar aulas e ter um relacionamento regular a ruim com os professoresCONCLUSÃO: A violência faz parte das atividades diárias do aluno, envolvendo um contexto amplo e está praticamente relacionada à escola

Política nacional de práticas integrativas e complementares em saúde: discurso dos enfermeiros da atenção básica / National policy on integrative and complementary health practices: discourse of primary care nursing

Objetivo: Analisar o discurso dos enfermeiros da Atenção Básica em relação à Política Nacional de Práticas Integrativas e Complementares de Saúde. Método: Trata-se de estudo descritivo com abordagem qualitativa, realizado com 14 enfermeiros das Estratégias de Saúde da Família. Para a coleta de dados foi utilizada uma entrevista semiestruturada, após a aprovação do Comitê de Ética e Pesquisa. Resultados: Percebeu-se o desconhecimento dos enfermeiros em relação à Política Nacional de Práticas Integrativas e Complementares de Saúde, em razão das lacunas no processo formativo e falta de educação permanente, porém os profissionais pontuaram as possíveis práticas que podem ser utilizadas no cuidado e evidenciou-se, como destaque, neste estudo, a orientação de plantas medicinais e fitoterápicos e certa confusão na diferenciação entre as mesmas. Conclusão: É necessário que exista o fortalecimento na formação acadêmica dos enfermeiros, diminuindo as lacunas existentes no aprendizado, por meio da inclusão de disciplinas e apoio da gestão, oferecendo ações de educação permanente, referentes a essas formas de cuidado no cenário da Atenção Básica

Objetivo: Analizar el discurso de los enfermeros de la Atención Primaria con respecto a la Política Nacional de Prácticas Integradoras y Complementarias de Salud. Método: Se trata de un estudio descriptivo con enfoque cualitativo conducido con 14 enfermeros de las Estrategias de Salud Familiar. Para la recolección de datos, se utilizó una entrevista semiestructurada, después de la aprobación del Comité de Ética e Investigación. Resultados: Se notó el desconocimiento de los enfermeros acerca de la Política Nacional de Prácticas Integradoras y Complementarias de Salud debido a lagunas en el proceso formativo y falta de educación continua, pero los profesionales señalaron las posibles prácticas que pueden ser utilizadas en la atención, haciendo hincapié en este estudio en la orientación de plantas medicinales y medicaciones fitoterapéuticas, mostrando alguna confusión en la diferenciación entre las mismas. Conclusión: Se hace necesario potenciar la formación académica de los enfermeros, disminuyendo las lagunas existentes en el aprendizaje, a través de la inclusión de asignaturas y apoyo de la gestión ofreciendo acciones de educación continua referentes a esas formas de atención en el escenario de la Atención Primaria.

Objective: To analyze the discourse of Primary Care nursing regarding the National Policy on Integrative and Complementary Health Practices. Method: This is a descriptive study with a qualitative approach, which was performed with 14 nurses of the Family Health Strategies. A semi-structured interview was used to collect data, after the approval of the Research Ethics Committee. Results: Nurses were unaware of the National Policy on Integrative and Complementary Health Practices due to gaps in the training process and lack of continuing education. Nevertheless, the professionals highlighted the possible practices that could be used in care, with an emphasis being placed on the orientation of medicinal plants and herbal medicines, showing some confusion in the differentiation between them. Conclusion: There is a need to strengthen the academic training of nurses, reducing the gaps in learning, through the inclusion of subjects and management support by offering continuing education actions related to these ways of care in the Primary Care setting.