Spatial dynamics of synergistic coinfection in rock-paper-scissors models.

We investigate the spatial dynamics of two-disease epidemics reaching a three-species cyclic model. Regardless of their species, all individuals are susceptible to being infected with two different pathogens, which spread through person-to-person contact. We consider that the simultaneous presence of multiple infections leads to a synergistic amplification in the probability of host mortality due to complications arising from any of the co-occurring diseases. Employing stochastic simulations, we explore the ramifications of this synergistic coinfection on spatial configurations that emerge from stochastic initial conditions. Under conditions of pronounced synergistic coinfection, we identify the emergence of zones inhabited solely by hosts affected by a singular pathogen. At the boundaries of spatial domains dominated by a single disease, interfaces of coinfected hosts appear. The dynamics of these interfaces are shaped by curvature-driven processes and display a scaling behavior reflective of the topological attributes of the underlying two-dimensional space. As the lethality linked to coinfection diminishes, the evolution of the interface network's spatial dynamics is influenced by fluctuations stemming from waves of coinfection that infiltrate territories predominantly occupied by a single disease. Our analysis extends to quantifying the implications of synergistic coinfection at both the individual and population levels Our outcomes show that organisms' infection risk is maximized if the coinfection increases the death due to disease by 30% and minimized as the network dynamics reach the scaling regime, with species populations being maximum. Our conclusions may help ecologists understand the dynamics of epidemics and their impact on the stability of ecosystems.

Phylogenetic position of Diplostomum spp. from New World herons based on complete mitogenomes, rDNA operons, and DNA barcodes, including a new species with partially elucidated life cycle.

Diplostomum ardeae Dubois, 1969 has seldom been reported since its description from the great blue heron (Ardea herodias L., 1758) in the USA. Sequences obtained in this study from the barcode region of cytochrome c oxidase 1 (CO1) in diplostomids from black-crowned night heron (Nycticorax nycticorax (L., 1758)) in Puerto Rico matched data from D. ardeae from A. herodias in the type region. We also obtained DNA barcodes from morphologically similar diplostomids from a rufescent tiger heron (Tigrisoma lineatum (Boddaert, 1783)) and from metacercariae from eye lenses of Trachelyopterus galeatus (Linnaeus, 1766) from the Paraná River basin in Argentina and Brazil, respectively. Barcodes matched (97-100% identity) in these South American adult and larval specimens as well as in recently published sequences from metacercariae from 11 other siluriform fishes from the same region. Barcodes from the South American species, which we describe as Diplostomum lunaschiae n. sp., differed from those of D. ardeae by 7.2-9.8%, and the new species differs from D. ardeae in its size, pharynx:oral sucker length ratio, egg:body length ratio, and distribution of vitellaria. As in prior phylogenetic analysis of CO1 sequences, both D. ardeae and D. lunaschiae n. sp. were not associated with Diplostomum. In more character-rich analyses of nuclear rDNA and of mitochondrial genomes, D. ardeae was an early divergent member of clades of species of Diplostomum. Consequently, we continue to consider D. ardeae and D. lunaschiae n. sp. members of Diplostomum, in contrast to recent suggestions that these species may belong to a different genus.

Cementum protein 1 transfection does not lead to ultrastructural changes in nucleolar organization of human gingival fibroblasts.

BACKGROUND AND OBJECTIVE: Transfection of cementum protein 1 (CEMP1) into human gingival fibroblasts (HGFs) notably increases cell metabolism and results in overexpression of molecules related to biomineralization at transcriptional and protein levels. Therefore, HGF-CEMP1 cells are considered as putative cementoblasts. This represents a significant advance in periodontal research because cementum neoformation is a key event in periodontal regeneration. In addition, it is well known that important changes in cell metabolism and protein expression are related to nucleolar structure and the function of this organelle, which is implicated in ribosome biogenesis. The aim of this study was to determine the effect of transfecting CEMP1 gene in human HGF on the ultrastructure of the nucleolus. MATERIAL AND METHODS: Cells were processed using the conventional technique for transmission electron microscopy, fixed with glutaraldehyde, postfixed with osmium tetraoxide, and embedded in epoxy resin. Semi-thin sections were stained with Toluidine blue and observed by light microscopy. Thin sections were stained with uranyl acetate and lead citrate. For ribonucleoprotein detection, the staining method based on the regressive effect of EDTA was used. In addition, the osmium ammine technique was used for specific staining of DNA. RESULTS: The results obtained in this study suggest that transfection of CEMP1 into HGFs does not produce changes in the general nucleolar ultrastructure because the different components of the organelle are present as fibrillary centers, and dense fibrillar and granular components compared with the control. CONCLUSION: The transfection of CEMP1 into HGFs allows these cells to perform cementoblast-like functions without alteration of the ultrastructure of the nucleolus, evaluated by the presence of the different compartments of this organelle involved in ribosomal biogenesis.

Evaluation of the impacts of climate change on disease vectors through ecological niche modelling.

Vector-borne diseases are exceptionally sensitive to climate change. Predicting vector occurrence in specific regions is a challenge that disease control programs must meet in order to plan and execute control interventions and climate change adaptation measures. Recently, an increasing number of scientific articles have applied ecological niche modelling (ENM) to study medically important insects and ticks. With a myriad of available methods, it is challenging to interpret their results. Here we review the future projections of disease vectors produced by ENM, and assess their trends and limitations. Tropical regions are currently occupied by many vector species; but future projections indicate poleward expansions of suitable climates for their occurrence and, therefore, entomological surveillance must be continuously done in areas projected to become suitable. The most commonly applied methods were the maximum entropy algorithm, generalized linear models, the genetic algorithm for rule set prediction, and discriminant analysis. Lack of consideration of the full-known current distribution of the target species on models with future projections has led to questionable predictions. We conclude that there is no ideal 'gold standard' method to model vector distributions; researchers are encouraged to test different methods for the same data. Such practice is becoming common in the field of ENM, but still lags behind in studies of disease vectors.

Study of the interplay between N-graphene defects and small Pd clusters for enhanced hydrogen storage via a spill-over mechanism.

The hydrogen spill-over mechanism was studied by applying Density Functional Theory. We used small palladium clusters to act as the catalyst supported on the substrate (comprised of pyridinic and pyrrolic nitrogen doped graphene), in order to study hydrogen dissociation, migration and diffusion. Charge transfer and strong binding between the catalyst and the substrate lead to dissociated states of H2 and prevent clusters from detaching and coalescing. In dissociated cases of H2 on Pd clusters, energy barriers below 0.6 eV were found. Likewise, concerning hydrogen migration from the catalyst to the substrate, energy barrier values of 0.8 eV (pyridinic defect) and 0.5 eV (pyrrolic defect) were apparent in the case of the Pd4 cluster at full hydrogen saturation. This indicates that hydrogen dissociation and migration may occur spontaneously at room temperature. This result shows that the interaction between the defects and the small metal clusters may explain the role that defects play in hydrogen migration from the catalyst to the substrate. Subsequently, it was found that thermal desorption does not limit chemisorbed hydrogen diffusion on the substrate. This work may thus help to determine experimental strategies with the capacity to enhance hydrogen storage.

Clinical application of 2.7M Cytogenetics array for CNV detection in subjects with idiopathic autism and/or intellectual disability.

Higher resolution whole-genome arrays facilitate the identification of smaller copy number variations (CNVs) and their integral genes contributing to autism and/or intellectual disability (ASD/ID). Our study describes the use of one of the highest resolution arrays, the Affymetrix(®) Cytogenetics 2.7M array, coupled with quantitative multiplex polymerase chain reaction (PCR) of short fluorescent fragments (QMPSF) for detection and validation of small CNVs. We studied 82 subjects with ASD and ID in total (30 in the validation and 52 in the application cohort) and detected putatively pathogenic CNVs in 6/52 cases from the application cohort. This included a 130-kb maternal duplication spanning exons 64-79 of the DMD gene which was found in a 3-year-old boy manifesting autism and mild neuromotor delays. Other pathogenic CNVs involved 4p14, 12q24.31, 14q32.31, 15q13.2-13.3, and 17p13.3. We established the optimal experimental conditions which, when applied to select small CNVs for QMPSF confirmation, reduced the false positive rate from 60% to 25%. Our work suggests that selection of small CNVs based on the function of integral genes, followed by review of array experimental parameters resulting in highest confirmation rate using multiplex PCR, may enhance the usefulness of higher resolution platforms for ASD and ID gene discovery.

Locally adaptive aggregation of organisms under death risk in rock-paper-scissors models.

We run stochastic simulations of the spatial version of the rock-paper-scissors game, considering that individuals use sensory abilities to scan the environment to detect the presence of enemies. If the local dangerousness level is above a tolerable threshold, individuals aggregate instead of moving randomly on the lattice. We study the impact of the locally adaptive aggregation on the organisms' spatial organisation by measuring the characteristic length scale of the spatial domains occupied by organisms of a single species. Our results reveal that aggregation is beneficial if triggered when the local density of opponents does not exceed 30%; otherwise, the behavioural strategy may harm individuals by increasing the average death risk. We show that if organisms can perceive further distances, they can accurately scan and interpret the signals from the neighbourhood, maximising the effects of the locally adaptive aggregation on the death risk. Finally, we show that the locally adaptive aggregation behaviour promotes biodiversity independently of the organism's mobility. The coexistence probability rises if organisms join conspecifics, even in the presence of a small number of enemies. We verify that our conclusions hold for more complex systems by simulating the generalised rock-paper-scissors models with five and seven species. Our discoveries may be helpful to ecologists in understanding systems where organisms' self-defence behaviour adapts to local environmental cues.

Impact of plasmapheresis on severe COVID-19.

The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and restoring innate and adaptive immune responses. This clinical trial aimed to evaluate the impact of PLEX on the survival of patients with severe SARS-CoV-2 and the effect on the cytokine release syndrome. Hospitalized patients diagnosed with SARS-CoV-2 infection and cytokine storm syndrome were selected to receive 2 sessions of PLEX or standard therapy. Primary outcome was all-cause 60-days mortality; secondary outcome was requirement of mechanical ventilation, SOFA, NEWs-2 scores modification, reduction of pro-inflammatory biomarkers and hospitalization time. Twenty patients received PLEX were compared against 40 patients receiving standard therapy. PLEX reduced 60-days mortality (50% vs 20%; OR 0.25, 95%CI 0.071-0.880; p = 0.029), and this effect was independent from demographic variables and drug therapies used. PLEX significantly decreased SOFA, NEWs-2, pro-inflammatory mediators and increased lymphocyte count, accompanied with a trend to reduce affected lung volume, without effect on SatO2/FiO2 indicator or mechanical ventilation requirement. PLEX therapy provided significant benefits of pro-inflammatory clearance and reduction of 60-days mortality in selected patients with COVID-19, without significant adverse events.

Reproduction of the non-native fish Lepomis gibbosus (Perciformes: Centrarchidae) in Brazil.

Minas Gerais is the fourth largest Brazilian state, and has an estimate of 354 native fish species. However, these fish species may be threatened, as this state has the highest rank of fish introductions reported for Brazil and South America. As one from the total of 85 non-native species detected, Lepomis gibbosus was introduced in the 60s to serve both as foragefish and to improve sport fishing. In this study, we evaluated the establishment of L. gibbosus in a shallow lake in the city ofOuro Preto, Doce River basin, state of Minas Gerais, Southeastern Brazil. We collected fish with fishing rods every two months from March 2002-February 2003. Fragments of gonads from a total of 226 females and 226 males were obtained and processed following standard histological techniques; then 5-7 microm thickness sections were taken and stained in hematoxylin-eosin. Besides, for each specimen, the biometric measurements included the standard length (SL) and body weight (BW); and the sex ratio was obtained. The reproductive cycle stages were confirmed by the distribution of oocytes and spermatogenic cells. The type of spawning was determined by the frequency distribution of the reproductive cycle stages and ovarian histology. Based on the microscopic characteristics of the gonads, the following stages of the reproductive cycle were determined: one=Rest, two=Mature, three=Spawned for females or Spent for males; males and females in reproduction were found throughout the study period. Post-spawned ovaries containing oocytes in stages one (initial perinucleolar), two (advanced perinucleolar), three (pre-vitellogenic), four (vitellogenic) and post-ovulatory follicles indicated fractionated-type spawning in this species. The smallest breeding male and female measured were 4.6 and 4.9cm standard length, respectively, suggesting stunting. The sex ratio did not vary between males and females along the year and bimonthly, being 1:1. Moreover, L. gibbosus appears to be at stage three of biological invasion: establishment through reproduction. We suggest to deliver information about "non-native species" through lectures in schools, colleges/universities, NGOs, government and environmental agencies in the cities and villages, in order to try to prevent environmental degradation by the introduction of non-native fish such as L. gibbosus in the region. We also recommend high fines for red-handed, and the import ban of non-native fish species to the region.

Combination of survival movement strategies in cyclic game systems during an epidemic.

Disease outbreaks affect many ecosystems threatening species that also fight against other natural enemies. We investigate a cyclic game system with 5 species, whose organisms outcompete according to the rules of a generalised spatial rock-paper-scissors game, during an epidemic. We study the effects of behavioural movement strategies that allow individuals of one out of the species to move towards areas with a low density of disease vectors and a high concentration of enemies of their enemies. We perform a series of stochastic simulations to discover the impact of self-preservation strategies in pattern formation, calculating the species' spatial autocorrelation functions. Considering organisms with different physical and cognitive abilities, we compute the benefits of each movement tactic to reduce selection and infection risks. Our findings show that the maximum profit in terms of territorial dominance in the cyclic game is achieved if both survival movement strategies are combined, with individuals prioritising social distancing. In the case of an epidemic causing symptomatic illness, the drop in infection risk when organisms identify and avoid disease vectors does not render a rise in the species population because many refuges are disregarded, limiting the benefits of safeguarding against natural enemies. Our results may be helpful to the understanding of the behavioural strategies in ecosystems where organisms adapt to face living conditions changes.

Spatial organisation plasticity reduces disease infection risk in rock-paper-scissors models.

We study a three-species cyclic game system where organisms face a contagious disease whose virulence may change by a pathogen mutation. As a responsive defence strategy, organisms' mobility is restricted to reduce disease dissemination in the system. The impact of the collective self-preservation strategy on the disease infection risk is investigated by performing stochastic simulations of the spatial version of the rock-paper-scissors game. Our outcomes show that the mobility control strategy induces plasticity in the spatial patterns with groups of organisms of the same species inhabiting spatial domains whose characteristic length scales depend on the level of dispersal restrictions. The spatial organisation plasticity allows the ecosystems to adapt to minimise the individuals' disease contamination risk if an eventual pathogen alters the disease virulence. We discover that if a pathogen mutation makes the disease more transmissible or less lethal, the organisms benefit more if the mobility is not strongly restricted, thus forming large spatial domains. Conversely, the benefits of protecting against a pathogen causing a less contagious or deadlier disease are maximised if the average size of groups of individuals of the same species is significantly limited, reducing the dimensions of groups of organisms significantly. Our findings may help biologists understand the effects of dispersal control as a conservation strategy in ecosystems affected by epidemic outbreaks.

RF generation using a compact bench gyromagnetic line.

The search for new technologies aiming to reach radiofrequency (RF) generation in different manners for diverse ends is a constant demand for several applications. The goal is to develop cost-effective and simpler systems compared to those that already exist. Our motivation is to reach an alternative way of generating RF in pulsed transmission systems employing a gyromagnetic nonlinear transmission line (GNLTL). The GNLTL consists of a ferrite-loaded-coaxial transmission line and can produce a large frequency spectrum with RF conversion efficiency above 10% from about 200 MHz up to the frequency of 2-4 GHz (S-band) for potential space-based applications. In a GNLTL, the signal amplitude is related to its propagation velocity since the peak voltage travels faster than its portion of lower amplitudes since the ferrite permeability decreases with the current amplitude. As the pulse crest travels faster than its valley, a time reduction happens in the output rise time, called pulse sharpening. Besides, the magnetic moments of ferrite dipoles initially aligned with the axial magnetic bias are displaced from their original position by the azimuthal field generated around the inner conductor by the current pulse, resulting in a damped precession movement. This movement happens along the line length as the current pulse propagates, inducing high-frequency oscillations. In short, the paper's goal is to present the experimental results using a 60-cm gyromagnetic line to provide RF in the GHz range using a solenoid for magnetic bias on a testing bench. Finally, the paper discusses the influence of the azimuthal and the axial magnetic fields on the output signal with the ferrite rings operating in a saturation state during the current pulse propagation.

Guidelines for the diagnosis of antibody-mediated rejection in pancreas allografts-updated Banff grading schema.

The first Banff proposal for the diagnosis of pancreas rejection (Am J Transplant 2008; 8: 237) dealt primarily with the diagnosis of acute T-cell-mediated rejection (ACMR), while only tentatively addressing issues pertaining to antibody-mediated rejection (AMR). This document presents comprehensive guidelines for the diagnosis of AMR, first proposed at the 10th Banff Conference on Allograft Pathology and refined by a broad-based multidisciplinary panel. Pancreatic AMR is best identified by a combination of serological and immunohistopathological findings consisting of (i) identification of circulating donor-specific antibodies, and histopathological data including (ii) morphological evidence of microvascular tissue injury and (iii) C4d staining in interacinar capillaries. Acute AMR is diagnosed conclusively if these three elements are present, whereas a diagnosis of suspicious for AMR is rendered if only two elements are identified. The identification of only one diagnostic element is not sufficient for the diagnosis of AMR but should prompt heightened clinical vigilance. AMR and ACMR may coexist, and should be recognized and graded independently. This proposal is based on our current knowledge of the pathogenesis of pancreas rejection and currently available tools for diagnosis. A systematized clinicopathological approach to AMR is essential for the development and assessment of much needed therapeutic interventions.

Genetic variability and evolutionary analyses of the coat protein gene of Tomato mosaic virus.

Tomato mosaic virus (ToMV), a member of the genus Tobamovirus, infects several ornamental and horticultural crops worldwide. In this study, the nucleotide sequences of the coat protein gene of worldwide ToMV isolates were analyzed to estimate the genetic structure and diversity of this virus and the involved evolutionary forces. The phylogenetic analysis showed three clades with high bootstrap support: Clade I contained three ToMV isolates from Brazil collected from pepper, Clade II comprised one Brazilian ToMV isolate from pepper, and Clade III was composed of ToMV isolates collected from different plant hosts (pepper, tomato, eggplant, lilac, camellia, dogwood, red spruce, etc.) and water (from melting ice, lakes and streams) from different countries: USA, Brazil, Korea, Germany, Spain, Denmark (Greenland), China, Taiwan, Malaysia, Iran, and Kazakhstan. With the exception of Brazil, nucleotide diversity within and between different geographic regions was very low, although statistical analyses suggested some gene flow between most of these regions. Our analyses also suggested a strong negative selection which could have contributed to the genetic stability of ToMV.

Evaluation of fungal adherence to plasma-modified polymethylmethacrylate.

There is a propensity for fungal adherence to the polymethylmethacrylate used for making denture bases. Therefore, this study investigated whether surface modifications with plasma treatments would reduce the adherence of Candida albicans to a denture base resin. Samples (n = 180) with smooth and rough surfaces were made and divided into five groups: control - non-treated; experimental groups - submitted to plasma treatments to obtain surfaces with different hydrophobicities (Ar/50 W; ArO(2) /70 W; AAt/130 W) or with incorporated fluoride (Ar/SF(6) 70 W). Contact angles were measured immediately after treatments and after samples were immersed in water for 48 h. For each group, half the samples were incubated with saliva before the adherence test. The number of adhered C. albicans was evaluated by counting after crystal violet staining. The plasma treatments were effective in modifying the polymethylmethacrylate surface. However, there was a significant alteration in the contact angle measured after immersion in water. No statistically significant difference in the adherence of C. albicans was observed between the experimental and control groups, irrespective of the presence or absence of saliva, and surface roughness.

Extreme subcutaneous, intramuscular and inhaled insulin resistance treated by pancreas transplantation alone.

Diabetes mellitus with resistance to insulin administered subcutaneously or intramuscularly (DRIASM) is a rare syndrome and is usually treated with continuous intravenous insulin infusion. We present here two cases of DRIASM in 16 and 18 years female patients that were submitted to pancreas transplantation alone (PTA). Both were diagnosed with type 1 diabetes as young children and had labile glycemic control with recurrent episodes of diabetic ketoacidosis. They had prolonged periods of hospitalization and complications related to their central venous access. Exocrine and endocrine drainages were in the bladder and systemic, respectively. Both presented immediate graft function. In patient 1, enteric conversion was necessary due to reflux pancreatitis. Patient 2 developed mild postoperative hyperglycemia in spite of having normal pancreas allograft biopsy and that was attributed to her immunosuppressive regimen. Patient 1 died 9 months after PTA from septic shock related to pneumonia. In 8 months of follow-up, Patient 2 presented optimal glycemic control without the use of antidiabetic agents. In conclusion, PTA may be an alternative treatment for DRIASM patients.

Toxicological and phytochemical studies of Aspidosperma subincanum Mart. stem bark (Guatambu).

Aspidosperma subincanum Mart. is widely used in Brazilian folk medicine to treat digestive disorders. In this study, acute and subchronic toxicity and cytotoxicity of stem bark ethanolic extract of Aspidosperma subincanum (EEAs) have been evaluated. In addition, phytochemical analysis was performed. The EEAs had low acute toxicity in mice with LD50 =1129 +/- 154mg/kg p.o. and 397 +/- 15 mg/kg i.p. The LC50 was 1340 +/- 428 microg/mL in the brine shrimp assay. There was no relevance of serious changes in behavioral, hematological and biochemical parameters and no deleterious effect on vital organs of rats that resulted after 30 days daily exposure to 5 and 100 mg/kg of EEAs. Phytochemical analysis of stem bark of A. subincanum revealed the presence of indole alkaloids, saponins, terpenoids, steroids and tannins and resulted in the isolation of oleic acid and guatambuine as major constituents. Using the method of the dose by factor approach, the human safe dose was 210 mg/70 kg/day. The EEAs appears to be safe and non-toxic in low doses in rodents and domestic preparations used by population have relatively security.

Occurrence of larvae of trypanorhynch cestodes in snappers (Lutjanidae) from northeast Brazil.

Three species of snappers from artisanal, small-scale fisheries were examined for the presence of parasites. A total of 139 lutjanid fish were collected: 69 specimens of Lutjanus analis, 47 specimens of Lutjanus vivanus, and 23 specimens of Lutjanus synagris. Encysted plerocercoid of trypanorhynch cestodes found at necropsy in the viscera of snappers were sampled for parasitological analysis. These plerocercoid larvae belong to the genera Floriceps, Pseudogrillotia , and Oncomegas. Although these parasites do not have any zoonotic potential, fish with heavy loads of plerocercoids are rejected during inspection as they compromise meat hygiene. Our findings suggest that light larval cestode infections in lutjanids would not lead to consumer rejection of the food product. The occurrence of Floriceps sp. in L. analis and in L. synagris, of Pseudogrillotia sp. in L. vivanus and in L. synagris , and of Oncomegas sp. in L. synagris are new findings in these fish species. These parasites are new to these fish species and have not been reported in snappers from the northeast coast of Brazil. The results contribute to the existing body of knowledge about the parasitic fauna of fish and its distribution along the coastline of Brazil.

Comparison between selective head cooling and whole-body cooling in neonatal therapeutic hypothermia / Comparação entre resfriamento seletivo da cabeça e resfriamento de corpo inteiro na hipotermia terapêutica neonatal

INTRODUCTION: Experimental evidence, as well as improved clinical studies of the reduction of brain injury and, improves the neurological outcome, in newborns with hypoxic-ischemic encephalopathy (HIE) occurring in therapeutic hypothermia (TH). OBJECTIVE: To verify the potential of hypothermic hypoxic-ischemic encephalopathy (HIE) therapy in neonatal asphyxia, based on literature data, comparing the benefits between selective head cooling (SHC) and whole-body cooling (WBC), see that the use of TH as a standard treatment in newborns with moderate or severe HIE has been adopted. METHODS: A search was performed in the PubMed and SciELO databases of human studies, using the keywords "Therapeutic Hypothermia", "Induced Hypothermia", and "Hypoxic-Ischemic Encephalopathy", "Selective cooling of the head", "Total body cooling" and its variables. RESULTS: Eleven articles were selected to compose the review, after detailed reading. There is a consensus, that the reduction of the risk of death or disability at 18 months of life in neonates with moderate to severe HIE, occurs to TH through the techniques of WBC or SHC. It was found in the studies that there is no difference in terms of adverse effects between the two methods. As for radiological changes, such as hypoxic-ischemic injuries and the incidence of seizures after cooling, they are more frequent with SHC. CONCLUSION: Both WBC and SHC demonstrated neuroprotective properties, although WBC provides a broader area of brain protection. However, no significant differences were found between the methods in terms of adverse effects and beneficial short or long-term results.

INTRODUÇÃO: Evidências experimentais, assim como estudos clínicos, sugerem a redução da lesão cerebral e melhora do desfecho neurológico, em recém-nascidos com encefalopatia isquêmica hipóxica (EHI) submetidos à hipotermia terapêutica (HT). OBJETIVO: Verificar a potencialidade da terapia hipotérmica de encefalopatia hipóxico-isquêmica (EHI) na asfixia neonatal, com base em dados da literatura, comparando os benefícios entre o resfriamento seletivo da cabeça (RSC) e o resfriamento de corpo inteiro (RCI), visto que o uso de hipotermia terapêutica (HT) como tratamento padrão em recém-nascidos com EHI moderada ou grave tem sido amplamente adotada. MÉTODOS: Foi realizada uma busca nas bases de dados PubMed e SciELO de estudos em humanos, utilizando-se as palavras-chave "Therapeutic Hypothermia", "Induced Hypothermia", "Hypoxic-Ischemic Encephalopathy", "selective head cooling", "whole body cooling" e suas respectivas variáveis. RESULTADOS: Foram selecionados 11 artigos para compor a revisão, após leitura detalhada. É consenso, a redução do risco de morte ou incapacidade aos 18 meses de vida nos neonatos com EHI moderado a grave, submetidos à HT através das técnicas de RCI ou RSC. Constatou-se diante dos estudos que não há diferença em termos de efeitos adversos entre os dois métodos. Quanto às alterações radiológicas, as lesões hipóxico-isquêmicas e incidência de convulsões após o resfriamento são mais frequentes com o RSC. CONCLUSÃO: Tanto RCI quanto o RSC demonstraram propriedades neuroprotetoras, embora o RCI proporcione uma área de proteção cerebral mais ampla. No entanto, não foram constatadas diferenças significativas entre os métodos quanto a efeitos adversos e a resultados benéficos em curto e longo prazo.