[Latest developments in the non-pharmacological treatment of depression - A more integrative approach]. / Nouveautés dans les traitements non pharmacologiques de la dépression - Place à une approche plus intégrative.

Non-pharmacological treatments of depression have become more widespread recently, especially for mild to moderate forms of depression. These complementary approaches are particularly interesting for patients who are reluctant to start an antidepressant. Novel approaches are found in psychotherapy, alternative treatments, plant-based treatments as well as the prevention of relapse through the use of digital tools. Some are even reimbursed by health insurance. However, these approaches are currently only applicable in combination with usual treatment, pharmacological or psychotherapy, as studies have shown that their efficiency in monotherapy is still limited.

L'intérêt pour les approches non pharmacologiques a augmenté ces dernières années dans la prise en charge des dépressions légères à modérées. Ces nouvelles approches sont intéressantes, notamment pour les patients qui peuvent être réticents à la prise d'un antidépresseur seul. Les nouveautés se trouvent dans les méthodes de psychothérapie, les traitements alternatifs, la phytothérapie ainsi que dans la prévention des rechutes par des outils digitaux. Certaines de ces approches sont remboursées par l'assurance-maladie obligatoire ou complémentaire. Néanmoins, elles restent des traitements complémentaires aux thérapies usuelles, soit pharmacologique et psychothérapeutique, car les preuves de leur efficacité en monothérapie sont encore limitées dans les études.

Dynamic balancing of isoprene carbon sources reflects photosynthetic and photorespiratory responses to temperature stress.

The volatile gas isoprene is emitted in teragrams per annum quantities from the terrestrial biosphere and exerts a large effect on atmospheric chemistry. Isoprene is made primarily from recently fixed photosynthate; however, alternate carbon sources play an important role, particularly when photosynthate is limiting. We examined the relative contribution of these alternate carbon sources under changes in light and temperature, the two environmental conditions that have the strongest influence over isoprene emission. Using a novel real-time analytical approach that allowed us to examine dynamic changes in carbon sources, we observed that relative contributions do not change as a function of light intensity. We found that the classical uncoupling of isoprene emission from net photosynthesis at elevated leaf temperatures is associated with an increased contribution of alternate carbon. We also observed a rapid compensatory response where alternate carbon sources compensated for transient decreases in recently fixed carbon during thermal ramping, thereby maintaining overall increases in isoprene production rates at high temperatures. Photorespiration is known to contribute to the decline in net photosynthesis at high leaf temperatures. A reduction in the temperature at which the contribution of alternate carbon sources increased was observed under photorespiratory conditions, while photosynthetic conditions increased this temperature. Feeding [2-(13)C]glycine (a photorespiratory intermediate) stimulated emissions of [(13)C1-5]isoprene and (13)CO2, supporting the possibility that photorespiration can provide an alternate source of carbon for isoprene synthesis. Our observations have important implications for establishing improved mechanistic predictions of isoprene emissions and primary carbon metabolism, particularly under the predicted increases in future global temperatures.

Electric hand warmer versus observation to avoid discomfort during scalp cooling for chemotherapy-induced alopecia prevention: a randomized study.

Chemotherapy-induced alopecia (CIA) is a challenge in the management of cancer patients. Scalp cooling (SC) leads to reduction in CIA, however it is associated with significant adverse events, leading to 3-13% discontinuation rates. This pilot study evaluated the role of Electric Hand Warmers (EHW) on thermal (TC), sensorial (SCo) and general comfort (GC) in patients with breast cancer (BC) undergoing chemotherapy and SC to reduce CIA. Patients were randomly assigned to EHW use or observation. TC, SCo and GC were evaluated after each chemotherapy infusion. Favorable outcomes in both TC and SCo defined a positive result on GC. We analysed the impact of age, alopecia, chemotherapy regimen and EHW use in the different comfort scales using a Logistic Regression (LR) model. Forty women with early breast cancer were randomly assigned to EHW (n = 20) or observation (n = 20) during neo(adjuvant) chemotherapy. Median age was 53 years. In the EHW arm, favorable thermal response was reported by 79% versus 50% in the control arm (odds ratio [OR] 3.79, p < 0.001). SCo was satisfactory in 82% in the EHW arm versus 74% in the control arm (OR 1.62, p = 0.1). Overall, 73% in the EHW arm had favorable GC versus 44% in the control arm (OR 3.4, p < 0.001). Age, alopecia, and chemotherapy regimen did not impact on comfort measures. Conclusion: Our study suggests that the use of an EHW has a consistent favorable impact on TC and GC of BC patients under SC technology to prevent CIA.

Gestational Diabetes Mellitus Changes Human Colostrum Immune Composition.

Breast milk is considered a complete food for babies. Up to 7 days postpartum, it is known as colostrum, rich in immunological compounds, responsible for providing nutrition and ensuring immune protection. However, some maternal factors, such as gestational diabetes mellitus (GDM), can change the concentration of bioactive compounds present in the colostrum and may affect the development of the newborn's immune system. The effect of GDM on colostrum cytokine, chemokine, and growth factors is not well described. Thus, the present study evaluated whether the occurrence of GDM changes the concentration of biomarkers in the colostrum. A cross-sectional study was carried out on postpartum women who had healthy pregnancies and women who had been diagnosed with GDM. A sample of colostrum was collected for Luminex analysis. Our results showed that GDM mothers had higher secretion of cytokines and chemokines in the colostrum, with a higher concentration of IFN-g, IL-6, and IL-15, and a lower concentration of IL-1ra. Among growth factors, we identified a decreased concentration of GM-CSF in the colostrum of GDM mothers. Thus, the data obtained support the idea that the disease leads to immune alterations in the colostrum.

T-Cell Subpopulations Exhibit Distinct Recruitment Potential, Immunoregulatory Profile and Functional Characteristics in Chagas versus Idiopathic Dilated Cardiomyopathies.

Chronic Chagas cardiomyopathy (CCC) is one of the deadliest cardiomyopathies known and the most severe manifestation of Chagas disease, which is caused by infection with the parasite Trypanosoma cruzi. Idiopathic dilated cardiomyopathies (IDC) are a diverse group of inflammatory heart diseases that affect the myocardium and are clinically similar to CCC, often causing heart failure and death. While T-cells are critical for mediating cardiac pathology in CCC and IDC, the mechanisms underlying T-cell function in these cardiomyopathies are not well-defined. In this study, we sought to investigate the phenotypic and functional characteristics of T-cell subpopulations in CCC and IDC, aiming to clarify whether the inflammatory response is similar or distinct in these cardiomyopathies. We evaluated the expression of systemic cytokines, determined the sources of the different cytokines, the expression of their receptors, of cytotoxic molecules, and of molecules associated with recruitment to the heart by circulating CD4+, CD8+, and CD4-CD8- T-cells from CCC and IDC patients, using multiparameter flow cytometry combined with conventional and unsupervised machine-learning strategies. We also used an in silico approach to identify the expression of genes that code for key molecules related to T-cell function in hearts of patient with CCC and IDC. Our data demonstrated that CCC patients displayed a more robust systemic inflammatory cytokine production as compared to IDC. While CD8+ T-cells were highly activated in CCC as compared to IDC, CD4+ T-cells were more activated in IDC. In addition to differential expression of functional molecules, these cells also displayed distinct expression of molecules associated with recruitment to the heart. In silico analysis of gene transcripts in the cardiac tissue demonstrated a significant correlation between CD8 and inflammatory, cytotoxic and cardiotropic molecules in CCC transcripts, while no correlation with CD4 was observed. A positive correlation was observed between CD4 and perforin transcripts in hearts from IDC but not CCC, as compared to normal tissue. These data show a clearly distinct systemic and local cellular response in CCC and IDC, despite their similar cardiac impairment, which may contribute to identifying specific immunotherapeutic targets in these diseases.

Leaf isoprene and monoterpene emission distribution across hyperdominant tree genera in the Amazon basin.

Tropical forests are acknowledged to be the largest global source of isoprene (C5H8) and monoterpenes (C10H16) emissions, with current synthesis studies suggesting few tropical species emit isoprenoids (20-38%) and do so with highly variable emission capacities, including within the same genera. This apparent lack of a clear phylogenetic thread has created difficulties both in linking isoprenoid function with evolution and for the development of accurate biosphere-atmosphere models. Here, we present a systematic emission study of "hyperdominant" tree species in the Amazon Basin. Across 162 individuals, distributed among 25 botanical families and 113 species, isoprenoid emissions were widespread among both early and late successional species (isoprene: 61.9% of the species; monoterpenes: 15.0%; both isoprene and monoterpenes: 9.7%). The hyperdominant species (69) across the top five most abundant genera, which make up about 50% of all individuals in the Basin, had a similar abundance of isoprenoid emitters (isoprene: 63.8%; monoterpenes: 17.4%; both 11.6%). Among the abundant genera, only Pouteria had a low frequency of isoprene emitting species (15.8% of 19 species). In contrast, Protium, Licania, Inga, and Eschweilera were rich in isoprene emitting species (83.3% of 12 species, 61.1% of 18 species, 100% of 8 species, and 100% of 12 species, respectively). Light response curves of individuals in each of the five genera showed light-dependent, photosynthesis-linked emission rates of isoprene and monoterpenes. Importantly, in every genus, we observed species with light-dependent isoprene emissions together with monoterpenes including ß-ocimene. These observations support the emerging view of the evolution of isoprene synthases from ß-ocimene synthases. Our results have important implications for understanding isoprenoid function-evolution relationships and the development of more accurate Earth System Models.

Effect of chocolate and mate tea on the lipid profile of individuals with HIV/AIDS on antiretroviral therapy: A clinical trial.

OBJECTIVE: HIV/AIDS is generally associated with dyslipidemia and oxidative imbalance, which are caused by the infection itself and by antiretroviral therapy (ART). The flavonoids, found in cocoa and yerba mate, have antioxidant and hypolipidemic properties. The aim of this study was to evaluate the effects of the consumption of dark chocolate and mate tea on the lipid profiles of individuals with HIV/AIDS who are undergoing ART. METHODS: A randomized, double-blind, placebo-controlled crossover clinical trial was conducted with 92 patients receiving ART for ≥6 mo and with viral suppression. The participants were randomized to receive either 65 g of chocolate (with 2148 mg polyphenols) or placebo chocolate (without polyphenols) or 3 g of mate tea (with 107 mg total phenols and 84.24 mg chlorogenic acid) or placebo mate (without polyphenols) for 15 d each, separated by a washout period of 15 d. The lipid profile, including determination of electronegative low-density lipoprotein, was determined after each intervention. The data were analyzed by analysis of variance using the pkcross procedure of the Stata 11.0 software. RESULTS: Analysis of variance revealed a significant overall difference in mean high-density lipoprotein cholesterol (HDL-C) between all supplements (P = 0.047). Using the paired t test, the effect was attributed to the consumption of dark chocolate (P = 0.046). The other parameters investigated were not improved. CONCLUSIONS: The consumption of dark chocolate for 15 d improved HDL-C concentrations of individuals with HIV/AIDS undergoing ART, possibly due to the presence of fatty acids (stearic acid), polyphenols, and theobromine. This fact is important for the cardiovascular protection of these individuals.

The impact of dark chocolate intake on arterial elasticity in individuals with HIV/AIDS undergoing ART: a randomized, double-blind, crossover trial.

An increase in the frequency of cardiovascular diseases has been observed in the HIV/AIDS population. Studies involving healthy subjects or subjects with other diseases have shown benefits of chocolate supplementation on endothelial function and vasodilation. We evaluate the impact of chocolate consumption on arterial elasticity in people living with human immunodeficiency virus - PLHIV. A double-blind, crossover trial including 110 PLHIV (19 to 59 years) on antiretroviral therapy - ART for at least 6 months and with a viral load of <500 copies per mL was conducted. All subjects were randomly assigned to 15-d dietary supplements containing dark chocolate or placebo with a 15-d washout period. Each participant received one of the two sequences: A (dark chocolate, placebo chocolate); B (placebo chocolate, dark chocolate). Arterial elasticity was measured using the HDI/PulseWave™ CR-2000 CardioVascular Profiling System®. Body composition, lipid profile, C-reactive protein, and thiobarbituric acid reactive substances were also assessed. Analysis of variance (ANOVA) for repeated measures using the Stata 11.0® program was used for cross-over analysis. Most subjects were men (59.0%) and Caucasian (46.1%) and the mean age was 44.6 ± 7.1 years. The mean time since diagnosis of HIV infection was 13.7 ± 5.3 years and the mean duration of ART was 12.9 ± 4.2 years. Chocolate consumption resulted in significant alterations in the large artery elasticity index - LAEI (p = 0.049) and the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.045). This is the first study to evaluate the effect of chocolate on arterial elasticity in PLHIV. The results showed that dark chocolate consumption for 15 days improved the elastic properties of the LAEI in PLHIV. These findings, added to the noninvasive method used, may expand the knowledge of CVDs in this population.

Effect of Chocolate and Yerba Mate Phenolic Compounds on Inflammatory and Oxidative Biomarkers in HIV/AIDS Individuals.

Flavonoids in cocoa and yerba mate have a beneficial role on inflammation and oxidative disorders. Their effect on HIV individuals has not been studied yet, despite the high cardiovascular risk of this population. This study investigated the role of cocoa and yerba mate consumption on oxidative and inflammatory biomarkers in HIV+ individuals. A cross-over, placebo-controlled, double-blind, randomized clinical trial was conducted in 92 individuals on antiretroviral therapy for at least six months and at viral suppression. Participants were randomized to receive either 65 g of chocolate or chocolate-placebo or 3 g of yerba mate or mate-placebo for 15 days each, alternating by a washout period of 15 days. At baseline, and at the end of each intervention regimen, data regarding anthropometry, inflammatory, oxidative and immunological parameters were collected. High-sensitivity C-reactive protein, fibrinogen, lipid profile, white blood cell profile and thiobarbituric acid reactive substances were assessed. There was a difference between mean concentrations of HDL-c (ANOVA; p ≤ 0.05) among the different regimens: dark chocolate, chocolate-placebo, yerba mate and mate-placebo. When a paired Student t-test was used for comparisons between mean HDL-c at baseline and after each regimen, the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.008).

Bioactive and yield potential of jelly palms (Butia odorata Barb. Rodr.).

In this descriptive study, Butia odorata genotypes were evaluated for yield, fruit number, pulp yield, bioactive content (including phenolic compounds, carotenoid, anthocyanin, L-ascorbic acid, and fibre content), antioxidant potential, and phenotypic characteristics. Genotype 117 was the highest yielding, with an estimated fruit yield of 22,000 kg ha(-1) and pulp yield of 12,000 kg ha(-1). On the other hand, the lowest yielding genotype, accession 49, showed an estimated fruit yield of 8400 kg ha(-1). Jelly palm fruit were generally rich in phenolic content (280.50-398.50 mg 100(-1)g), carotenoid content (2.80-4.08 mg 100 g(-1)), and L-ascorbic acid content (34.63-63.84 mg 100g(-1)). While the highest yielding genotype was not the richest in bioactive content, the lowest yielding genotype showed the highest l-ascorbic acid content. Although fruit yield and phytochemical composition are desirable attributes in jelly palm fruit, none of the genotypes evaluated showed high levels of both. Therefore, fruit yield and bioactive phytochemical content appear to be inversely proportional.

Trombose essencial: uma revisão da literatura / Essential thrombosis: a literature review

Trombose essencial é uma das doenças mieloproliferativas crônicas, rara e de etiologia ainda desconhecida, mas que apresenta risco alto de eventos trombóticos e/ou hemorrágicos, uma vez que acomete as células megacariocíticas e, consequentemente, as plaquetas. O objetivo deste trabalho foi realizar uma revisão das publicações sobre o tema abordado. O estudo caracteriza-se como revisão bibliográfica de artigos das bases de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) e Google acadêmico. Foram incluídos artigos disponíveis e em qualquer idioma de publicação, com a finalidade de aumentar o referencial teórico. Posteriormente à seleção e análise dos artigos, foram encontrados alguns pontos em comum, como a dificuldade em se diagnosticar a doença. De acordo com os estudos, a maioria dos doentes é assintomática, mas pode apresentar desde eventos trombóticos até mesmo embolia pulmonar. Atualmente, o tema vem crescendo, principalmente abordando técnicas moleculares mais específicas para a descoberta da doença em seu estágio inicial. A análise dos artigos demonstrou a dificuldade do diagnóstico da trombose essencial, sendo a sua identificação crucial nos estágios iniciais.

Essential thrombosis is one of the chronic myeloproliferative diseases, rare and of unknown etiology, but which presents a high risk of thrombotic and / or hemorrhagic events. Once it attacks the megakaryocytic cells and consequently the platelets. The objective of this work is to review the publications on the subject. The study is characterized as a bibliographical review of articles from the Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) and Google Acadêmico. Articles were included and in any language of publication, in order to increase the theoretical reference. Subsequent to the selection and analysis of the articles, some common points were found such as the difficulty in diagnosing the disease. According to the studies, the majority of patients are asymptomatic but may present from thrombotic events to even pulmonary embolism. Currently, the topic has been growing, mainly addressing molecular techniques more specific to the discovery of the disease in its initial stage. The analysis of the articles demonstrated the difficulty of diagnosing essential thrombosis, which is crucial in the initial stages.

Princípios analíticos da gasometria arterial / Analytical principles of arterial gasometry

Gasometria arterial (GA) é um exame que permite avaliar a condição respiratória e metabólica do paciente, sendo uma das formas mais comuns de investigação clínica em casos emergenciais e de cuidados críticos. É utilizada para medir as concentrações de oxigênio e também para avaliação do distúrbio do equilíbrio ácido-base, da oxigenação do sangue arterial e da ventilação alveolar. O presente estudo tem como objetivo apontar e avaliar os princípios da técnica de gasometria arterial, fases analíticas, principais doenças em que se utiliza o exame e inovações da técnica ao longo dos anos, baseado em dados de artigos científicos e banco de dados do Scielo (Scientific Eletronic Library Online) e Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde). A coleta de sangue arterial para gasometria ocorre através de um procedimento invasivo realizado por intermédio de uma punção arterial. Tal procedimento é executado pelo profissional enfermeiro e exige qualificações técnicas e científicas. O estudo mostrou que as informações acerca do exame constituem uma importante ferramenta para que se possam compreender a complexidade da técnica bem como os distúrbios ácido-base envolvidos na clínica do paciente.

Arterial blood gas (GA) is an exam that allows the assessment of respiratory and metabolic condition, being one of the most common forms of clinical investigation in emergency cases and critical care. It is used to measure oxygen concentrations, as well as for evaluation of acid-base balance disorder, arterial blood oxygenation and alveolar ventilation. This study aims to point out and evaluate the principles of arterial blood gas technique, analytical phases, main diseases in which the examination is used and innovations of the technique over the years, based on data from scientific articles and SciELO database (Scientific Electronic Library Online) and Lilacs (Latin American and Caribbean Health Sciences Literature). The collection of arterial blood for blood gas analysis occurs through an invasive procedure in which an arterial puncture is performed. Such procedure is performed by the professional nurse and requires technical and scientific qualifications. The study showed that the information about the exam is an important tool to understand the complexity of the technique, as well as the acid-base disorders involved in the patient's clinic.

A severe manifestation of primary HIV-1 infection in an adolescent.

Primary HIV infection (PHI) is symptomatic in 50-90% of patients with symptoms resembling infectious mononucleosis. The diagnosis, however, is seldom made at first presentation. Clinically severe presentations during primary HIV type 1 infection are considered to occur infrequently. We report a case of a severe manifestation of PHI with meningoencephalitis in the setting of HIV seroconversion in an adolescent girl.

Doença de chagas: uma atualização bibliográfica / Chagas disease: a bibliographic update

É uma doença infecciosa causada por um protozoário parasita chamado Trypanosoma cruzi,nome dado por seu descobridor, o cientista brasileiro Carlos Chagas, em homenagem a outro cientista, também brasileiro, Oswaldo Cruz. Essa doença é conhecida popularmente como doença do coração crescido, além disso, os locais com mais índices dessa doença são as regiões do Norte e Sudeste e tem como formas de diagnósticos exames de sorologiaparasitários e xenodiagnóstico. E uma das principais formas de prevenção da doença vem sendo o uso de telas e repelentes.

It is an infectious disease caused by a protozoan parasite calledTrypanosoma cruzi, named after its discoverer, the Brazilian scientistCarlos Chagas, in honor of another scientist, also, Brazilian, Oswaldo Cruz. This disease is popularly known as a disease of the heart grown, in addition, the sites with the most indexes of this disease are the regions of the North and southeast and have as diagnostic methods serologica tests parasitic and xenodiagnosis. And one of the main forms of prevention of the disease has been the use of screens and repellents.

Síndrome da rubéola congênita / Congenital rubella syndrome

A rubéola é uma doença viral, caracterizada como autolimitada e com evolução benigna,porém o fator de maior preocupação relacionado ao vírus da rubéola ocorre quando a infecção acomete gestantes, devido à capacidade que o vírus possui de causar infecção transpondo a barreira placentária podendo gerar a síndrome da rubéola congênita (SRC). Objetivo: O estudo pesquisou dados atualizados sobre a temática para advertir a população sobre os riscos relacionados à síndrome da rubéola congênita, além de contribuir com conhecimento científico de acadêmicos, profissionais da saúde e pesquisadores. Método: Para a elaboração do artigo de atualização, foi realizada uma revisão bibliográfica na ferramenta de busca Google Acadêmico, Sistema de Informação de Agravos de Notificação (SINAN), Ministério da Saúde e alguns livros, a fim de selecionar artigos e conteúdos disponíveis e atualizados para proporcionar maior compreensão do tema. Considerações Finais: O surgimento da vacina contra o vírus da rubéola foi uma grande conquista para a humanidade, uma vez que, após sua inclusão, houve uma redução significativa no número de casos novos de síndrome da rubéola congênita. Além disso, observou-se no decorrer da pesquisa uma grande dificuldade de encontrar trabalhos recém-publicados relacionados ao tema estudado

Rubella is viral disease, characterized as self-limiting and with a benign course, however the factor of greater concern related to rubella virus occurs when the infection affects pregnant women, due to the ability of the virus to cause infection by transposing the placental barrier, cangenerate the congenital rubella syndrome (CRS). Objective: The study searched update data on the subject to warn the population on related risks congenital rubella syndrome besides contributing with scientific knowledge of academics, health professionals and researchers. Method: For the elaboration of the update article, a bibliographic review was carried out in the Google Scholar search tool, the Notification of Injury Information System (SINAN), the Ministry of Health and some books, in order to select articles and contents available and update to provide understanding of the theme. Final considerations: The emergence of the rubella virus vaccine was great achievement for mankind, since after its inclusion there was a significant a reduction in the number of new cases of congenital rubella syndrome. In addition, it was observed during the research a great difficulty to find recently published papers related to the subject studied

Aspectos epidemiológicos e clínicos de pacientes infectados por HIV / Epidemiological and clinical aspects of HIV infected patients

O HIV é o vírus da imunodeficiência adquirida, que leva o paciente a desenvolver a Síndrome da Imunodeficiência adquirida ­ AIDS, a manifestação clínica avançada do vírus. No período de 2012 a 2016, houve um aumento nos diagnósticos entre as pessoas que são portadoras de HIV, assim como a ampliação do número de pessoas em tratamento. A região nordeste do país evidencia o maior número de novos casos, sendo, atualmente, a quinta causa de morte entre adultos, principalmente entre mulheres de 15 a 49 anos de idade. Esse estudo descritivo-retrospectivo, observacional, qualitativo, com base em levantamento de dados de artigos em Português presentes nas plataformas Medline e SciELO, no período de janeiro de 2016 a abril de 2018, tem como finalidade contribuir com a atualização acerca do tema, abordando sobre agente etiológico, epidemiologia, fisiopatologia da doença, perfil do hemograma do paciente acometido com o vírus e o tratamento.

O HIV is the virus of immunodeficient syndrome has the patient in develop the syndrome of Imunodeficiency adquirida - AIDS, advanced clinical manifestation of the virus. From 2012 to 2016, there was an increase in diagnoses among people with HIV, as well as an increase in the number of people being treated. The Northeast region of the country shows the largest number of new cases, and is currently a 5th cause of death among adults, among women aged 15 to 49 years. This descriptive, retrospective, observational, and qualitative study, based on data collection with the presence of Portuguese articles on the Medline and SciELO platforms from January 2016 to April 2018 has as contribution to the update of the theme, addressing about etiological agent, epidemiology, pathophysiology of the disease, blood cell profile of the patient affected with the virus and treatment.

Meningite bacteriana: uma atualização / Bacterial meningitis: an update

A meningite é um processo inflamatório das meninges que envolve as duas membranas cerebrais (pia-máter e aracnoide) e o líquido cefalorraquidiano (LCR), podendo ser causado por diversos fatores, infeccioso ou não. Para o desenvolvimento do trabalho realizou-se uma pesquisa por artigos que estivessem disponíveis na base de dados SciELO, PubMed e Sinan, entre os anos de 2013 a 2018, utilizando os seguintes descritores: meningite, meningite bacteriana, diagnóstico, epidemiologia e fisiopatologia. O presente estudo tem como objetivo explanar informações atualizadas sobre a meningite bacteriana quanto à sua ocorrência no Brasil, abordando dados epidemiológicos, bem como suas manifestações clínicas, forma de diagnóstico, transmissão e tratamento.

Métodos de diagnóstico para a doença de Chagas: uma atualização / Diagnostic methods of Chagas disease: an update

A doença de Chagas (ou tripanossomíase americana) é a infecção causada pelo protozoário Trypanosoma cruzi. Apresenta uma fase aguda (doença de Chagas aguda ­ DCA) que pode ser sintomática ou não, podendo evoluir para as formas crônicas caso não seja tratada precocemente com medicamento específico. O tratamento é baseado em drogas anti-parasitárias, para aniquilar o parasita, e no controle dos sinais e sintomas da infecção. Em casos de intolerância ou que não respondam ao tratamento, especialmente casos agudos e de reativação da doença de Chagas em imunossuprimidos, o indicado é o nifurtimox como alternativa de tratamento. Existem diagnósticos diferentes tanto na fase aguda quanto na fase crônica. A fase aguda é determinada pela presença de parasitos circulantes em exames parasitológicos diretos de sangue periférico (exame a fresco, esfregaço, gota espessa); presença de sintomas por mais de trinta dias são recomendados métodos de concentração devido ao declínio da parasitemia (teste de Strout, micro-hematócrito, QBC); presença de anticorpos IgM anti-T. cruzi no sangue indica doença aguda quando associada a fatores clínicos e epidemiológicos compatíveis. Já na fase crônica, o indivíduo apresenta anticorpos IgG anti-T. cruzi detectados por testes sorológicos de princípios distintos, a Imunofluorescência indireta, a Hemoaglutinação e o ELISA.

Prevenção da doença meningocóccica: o arsenal de vacinas disponíveis / Meningococcal disease prevention: the vaccines arsenal available

A doença meningocóccica (DM) é uma infecção bacteriana aguda causada pela bactéria Neisseria meningitidis, sendo considerada uma das mais importantes emergências médicas devido ao seu prognóstico estar relacionado ao seu diagnóstico e tratamento serem iniciados precocemente. A prevenção é feita principalmente através de vacinação, hoje existente para diversos sorotipos da bactéria que causa a doença, sendo, dessa forma, uma importante estratégia no controle da enfermidade. O principal objetivo deste artigo é informar sobre a existência dos diversos tipos de vacinas existentes para prevenir a doença meningocóccica. O estudo mostrou as suas especificidades e usos, além de ressaltar a importância de sua presença nos planos de vacinações de diversos países.

The meningococcal disease (MD) is a acute bacterial infection caused by Neisseria meningitidis, been considerated one of the most importants medical emergencys, because the definition of your prognosis is related with early diagnosis and treatment. The prevention is mainly done throughvaccination, nowadays existing too many diferents serotypes from theba cterium that causes the disease, being that way, a important strategy in disease's control. The main objective from this article is to emphasize the existence of the many types of vaccines that can be used in meningococcal disease's prevention. The study showed their specifities and how can be used, beside the importance to have that vaccine in the vaccination plan in many countries

Dengue e seus avanços / Dengue fever and its advances

A Dengue é uma arbovirose presente em várias regiões do mundo, inclusive no Brasil, sob a forma de epidemias de grande magnitude, e sob a forma hiperendêmica nos lugares onde um ou mais sorotipos circularam anteriormente. Mesmo tendo os conhecimentos disponíveis para preveni-la, sob bases científicas, as futuras ocorrências de epidemias das formas graves da doença, a atual situação epidemiológica e entomológica de extensas áreas de vários continentes evidenciam grandes possibilidades para agravamento do cenário atual, pois os fatores que determinam a re-emergência destas infecções são difíceis de serem eliminados e requer colaboração em conjunto com a população e no combate do agente transmissor. No presente estudo, realizou-se uma atualização de artigos publicados na literatura científica sobre seu agente etiológico, fisiopatologia da doença, diagnóstico e tratamento acerca da doença.

Dengue is an arbovirose present in several regions of the world, including Brazil, in the form of epidemics of great magnitude, and in hyperendemic form, in places where one or more serotypes have previously circulated. Although the available knowledge to prevent future occurrences of severe disease epidemics from occurring on a scientific basis, the current epidemiological and entomological situation in large areas of several continents shows great possibilities for aggravating the current scenario, since the factors that determine the reemergence of these infections are difficult to eliminate and requires collaboration in conjunction with the population and in combating the transmitting agent. In the present study, an integrative review of articles published in the scientific literature on its etiological agent, pathophysiology of the disease, diagnosis and treatment of the disease was carried out