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1.
Clin Infect Dis ; 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39012174

RESUMO

Following the 2022 global mpox outbreak, diagnoses decreased worldwide, even in settings with limited vaccine access. In 2023-2024, a new outbreak emerged in Rio de Janeiro, Brazil, highlighting the importance of continuous surveillance, preventive measures such as vaccination in vulnerable populations, and treatment options, emphasizing equitable global health technology distribution.

2.
Lancet ; 401(10380): 939-949, 2023 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-36828001

RESUMO

BACKGROUND: People living with HIV have accounted for 38-50% of those affected in the 2022 multicountry mpox outbreak. Most reported cases were in people who had high CD4 cell counts and similar outcomes to those without HIV. Emerging data suggest worse clinical outcomes and higher mortality in people with more advanced HIV. We describe the clinical characteristics and outcomes of mpox in a cohort of people with HIV and low CD4 cell counts (CD4 <350 cells per mm3). METHODS: A network of clinicians from 19 countries provided data of confirmed mpox cases between May 11, 2022, and Jan 18, 2023, in people with HIV infection. Contributing centres completed deidentified structured case report sheets to include variables of interest relevant to people living with HIV and to capture more severe outcomes. We restricted this series to include only adults older than 18 years living with HIV and with a CD4 cell count of less than 350 cells per mm3 or, in settings where a CD4 count was not always routinely available, an HIV infection clinically classified as US Centers for Disease Control and Prevention stage C. We describe their clinical presentation, complications, and causes of death. Analyses were descriptive. FINDINGS: We included data of 382 cases: 367 cisgender men, four cisgender women, and ten transgender women. The median age of individuals included was 35 (IQR 30-43) years. At mpox diagnosis, 349 (91%) individuals were known to be living with HIV; 228 (65%) of 349 adherent to antiretroviral therapy (ART); 32 (8%) of 382 had a concurrent opportunistic illness. The median CD4 cell count was 211 (IQR 117-291) cells per mm3, with 85 (22%) individuals with CD4 cell counts of less than 100 cells per mm3 and 94 (25%) with 100-200 cells per mm3. Overall, 193 (51%) of 382 had undetectable viral load. Severe complications were more common in people with a CD4 cell count of less than 100 cells per mm3 than in those with more than 300 cells per mm3, including necrotising skin lesions (54% vs 7%), lung involvement (29% vs 0%) occasionally with nodules, and secondary infections and sepsis (44% vs 9%). Overall, 107 (28%) of 382 were hospitalised, of whom 27 (25%) died. All deaths occurred in people with CD4 counts of less than 200 cells per mm3. Among people with CD4 counts of less than 200 cells per mm3, more deaths occurred in those with high HIV viral load. An immune reconstitution inflammatory syndrome to mpox was suspected in 21 (25%) of 85 people initiated or re-initiated on ART, of whom 12 (57%) of 21 died. 62 (16%) of 382 received tecovirimat and seven (2%) received cidofovir or brincidofovir. Three individuals had laboratory confirmation of tecovirimat resistance. INTERPRETATION: A severe necrotising form of mpox in the context of advanced immunosuppression appears to behave like an AIDS-defining condition, with a high prevalence of fulminant dermatological and systemic manifestations and death. FUNDING: None.


Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Mpox , Adulto , Masculino , Humanos , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Contagem de Linfócito CD4 , Carga Viral
3.
Toxicol Appl Pharmacol ; 484: 116874, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38428464

RESUMO

Melanoma is the most aggressive and deadly skin cancer. The difficulty in its treatment arises from its ability to suppress the immune system, making it crucial to find a substance that increases anti-tumor immunity. C-phycocyanin (C-PC) appears as a promising bioactive, with multifaceted effects against several cancers, but its efficacy against melanoma has only been tested in vitro. Therefore, we investigated C-PC's the anti-tumor and immunomodulatory action in a murine melanoma model. The tumor was subcutaneously induced in C57BL/6 mice by injecting B16F10 cells. The animals were injected subcutaneously with C-PC for three consecutive days. After euthanasia, the tumor was weighed and measured. The inguinal lymph node was removed, and the cells were stained with antibodies and analyzed by flow cytometry. The heart, brain and lung were analyzed by histopathology. C-PC increased the B cell population of the inguinal lymph node in percentage and absolute number. The absolute number of T lymphocytes and myeloid cells were also increased in the groups treated with C-PC. Thus, C-PC showed a positive immunomodulatory effect both animals with and without tumor. However, this effect was more pronounced in the presence of the tumor. Positive immune system modulation may be associated with a reduction in tumor growth in animals treated with C-PC. Administration of C-PC subcutaneously did not cause organ damage. Our findings demonstrate C-PC's immunomodulatory and anti-melanoma action, paving the way for clinical research with this bioactive.


Assuntos
Melanoma , Neoplasias Cutâneas , Animais , Camundongos , Ficocianina/farmacologia , Ficocianina/uso terapêutico , Camundongos Endogâmicos C57BL , Neoplasias Cutâneas/tratamento farmacológico , Imunomodulação
4.
Hum Genomics ; 17(1): 110, 2023 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-38062538

RESUMO

BACKGROUND: In recent years, the mitochondria/immune system interaction has been proposed, so that variants of mitochondrial genome and levels of heteroplasmy might deregulate important metabolic processes in fighting infections, such as leprosy. METHODS: We sequenced the whole mitochondrial genome to investigate variants and heteroplasmy levels, considering patients with different clinical forms of leprosy and household contacts. After sequencing, a specific pipeline was used for preparation and bioinformatics analysis to select heteroplasmic variants. RESULTS: We found 116 variants in at least two of the subtypes of the case group (Borderline Tuberculoid, Borderline Lepromatous, Lepromatous), suggesting a possible clinical significance to these variants. Notably, 15 variants were exclusively found in these three clinical forms, of which five variants stand out for being missense (m.3791T > C in MT-ND1, m.5317C > A in MT-ND2, m.8545G > A in MT-ATP8, m.9044T > C in MT-ATP6 and m.15837T > C in MT-CYB). In addition, we found 26 variants shared only by leprosy poles, of which two are characterized as missense (m.4248T > C in MT-ND1 and m.8027G > A in MT-CO2). CONCLUSION: We found a significant number of variants and heteroplasmy levels in the leprosy patients from our cohort, as well as six genes that may influence leprosy susceptibility, suggesting for the first time that the mitogenome might be involved with the leprosy process, distinction of clinical forms and severity. Thus, future studies are needed to help understand the genetic consequences of these variants.


Assuntos
Genoma Mitocondrial , Hanseníase , Humanos , Heteroplasmia , Genoma Mitocondrial/genética , Hanseníase/genética , Mitocôndrias/genética
5.
J Hand Ther ; 2024 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-38342638

RESUMO

INTRODUCTION: The capitate is the largest, most central bone and the first to ossify in the wrist. It has a well-protected anatomic location, making traumatic or stress fractures extremely rare in clinical practice. Isolated fractures of the capitate bone are very uncommon and often without displacement due to the great stability provided by the intracarpal ligaments. PURPOSE OF THE STUDY: This study aimed to report a case of isolated stress fracture of the capitate related to the work activity of a mechanic. CASE REPORT: We report the case of a 23-year-old patient complaining of pain and swelling in the left wrist for 2 months without improvement after using analgesics. On physical examination, he presented pain on palpation in the central region of the wrist, pain when performing flexion and extension movements of the wrist, and frustrated edema. Magnetic resonance imaging diagnosed a stress fracture of the capitate bone. Conservative treatment with forearm-palmar immobilization for 2 months, analgesic medication, and physical therapy rehabilitation after immobilization were performed. After the complete resolution of the symptoms, the patient started to work in a new role. DISCUSSION: There are five case reports of stress fractures in the capitate-two in teenagers and three in adults, but none of them was a mechanic. Clinical suspicion can be formulated when repetitive activity is associated with the wrist in extension and specific location of pain and swelling. Individuals with an immature skeleton are more susceptible. The development of occupational disease should be considered in similar cases of insidious and persistent pain in the palm of people with high work demands. CONCLUSION: Stress fractures of the capitate bone are a disease that must be suspected in insidious and persistent pain in the palm of the hand. Magnetic resonance imaging is the best image test to diagnose this disorder, and conservative treatment is indicated.

6.
Prague Med Rep ; 125(2): 172-177, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38761051

RESUMO

The neuropathic compression of the tibial nerve and/or its branches on the medial side of the ankle is called tarsal tunnel syndrome (TTS). Patients with TTS presents pain, paresthesia, hypoesthesia, hyperesthesia, muscle cramps or numbness which affects the sole of the foot, the heel, or both. The clinical diagnosis is challenging because of the fairly non-specific and several symptomatology. We demonstrate a case of TTS caused by medial dislocation of the talar bone on the calcaneus bone impacting the tibial nerve diagnosed only by ultrasound with the patient in the standing position.


Assuntos
Tálus , Síndrome do Túnel do Tarso , Ultrassonografia , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/diagnóstico , Luxações Articulares/etiologia , Tálus/diagnóstico por imagem , Tálus/anormalidades , Síndrome do Túnel do Tarso/etiologia , Síndrome do Túnel do Tarso/diagnóstico , Síndrome do Túnel do Tarso/diagnóstico por imagem , Ultrassonografia/métodos , Suporte de Carga
7.
Malar J ; 22(1): 295, 2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37794476

RESUMO

BACKGROUND: In malaria infection, apoptosis acts as an important immunomodulatory mechanism that leads to the elimination of parasitized cells, thus reducing the parasite density and controlling immune cell populations. Here, it was investigated the association of INDEL variants in apoptotic genes-rs10562972 (FAS), rs4197 (FADD), rs3834129 and rs59308963 (CASP8), rs61079693 (CASP9), rs4647655 (CASP3), rs11269260 (BCL-2), and rs17880560 (TP53)-and the influence of genetic ancestry with susceptibility to malaria and parasite density in an admixed population from the Brazilian Amazon. METHODS: Total DNA was extracted from 126 malaria patients and 101 uninfected individuals for investigation of genetic ancestries and genotypic distribution of apoptosis-related variants by Multiplex PCR. Association analyses consisted of multivariate logistic regressions, considering the following comparisons: (i) DEL/DEL genotype vs. INS/DEL + INS/INS; and (ii) INS/INS vs. INS/DEL + DEL/DEL. RESULTS: Individuals infected by Plasmodium falciparum had significantly higher African ancestry proportions in comparison to uninfected controls, Plasmodium vivax, and mixed infections. The INS/INS genotype of rs3834129 (CASP8) seemed to increase the risk for P. falciparum infection (P = 0.038; OR = 1.867; 95% CI 0.736-3.725), while the DEL/DEL genotype presented a significant protective effect against infection by P. falciparum (P = 0.049; OR = 0.446; 95% CI 0.185-0.944) and mixed infection (P = 0.026; OR = 0.545; 95% CI 0.281-0.996), and was associated with lower parasite density in P. falciparum malaria (P = 0.009; OR = 0.383; 95% CI 0.113-1.295). Additionally, the INS/INS genotype of rs10562972 (FAS) was more frequent among individuals infected with P. vivax compared to P. falciparum (P = 0.036; OR = 2.493; 95% CI 1.104-4.551), and the DEL/DEL genotype of rs17880560 (TP53) was significantly more present in patients with mono-infection by P. vivax than in individuals with mixed infection (P = 0.029; OR = 0.667; 95% CI 0.211-1.669). CONCLUSIONS: In conclusion, variants in apoptosis genes are associated with malaria susceptibility and parasite density, indicating the role of apoptosis-related genetic profiles in immune responses against malaria infection.


Assuntos
Coinfecção , Malária Falciparum , Malária Vivax , Parasitos , Humanos , Animais , Predisposição Genética para Doença , Brasil , Estudos de Casos e Controles , Apoptose/genética , Malária Vivax/genética , Malária Falciparum/genética , Plasmodium vivax/genética , Plasmodium falciparum/genética
8.
Curr Microbiol ; 80(6): 197, 2023 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-37119300

RESUMO

Crushed and ground printed circuit board (PCB) samples were characterized to evaluate copper, lead, and aluminum using X-ray fluorescence spectroscopy (XRF) and the morphology was done by scanning electron microscopy (SEM). The XRF characterizations showed 0.12% lead, 3.72% copper, and 12.73% aluminum in the PCBs. The metal solubilization experiments using Acidithiobacillus ferrooxidans indicated higher values of total metal solubilization when the initial pH of the inoculum was adjusted. However, these experiments did not show higher metal solubilization by bioleaching. The sequential bioremoval experiments using mixed culture after bioleaching assays with A. ferrooxidans with initial adjustment of inoculum pH and without applying a magnetic field removed 100% of Al, 27.34% of Cu, and 96.43% of Pb from the lixiviate medium; with magnetic field application, 100% of Al, 83.82% of Cu, and 98.27% of Pb were removed. A similar bioleaching experiment without inoculum pH adjustment and without field application achieved 99.74% removal for Cu and 91.92% for Pb. When the magnetic field was applied, 100% of Cu and 95.76% of Pb were removed. Bioreactors with a magnetic field do not show significantly better removal of any of the metals analyzed.


Assuntos
Acidithiobacillus , Cobre , Alumínio , Chumbo
9.
Mem Inst Oswaldo Cruz ; 118: e230090, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37646742

RESUMO

BACKGROUND: According to the last 2023 Monkeypox (Mpox) Outbreak Global Map from the Centres for Disease Control and Prevention (CDC), more than 100 countries with no Mpox infection report cases. Brazil stands out in this group and is the second country with the highest number of cases in the last outbreak. OBJECTIVE: To contribute to knowledge of the virus infection effects in a cellular model, which is important for diagnosis infections not yet included in a provider´s differential diagnosis and for developing viral inhibition strategies. METHODS: We describe a virus isolation protocol for a human clinical sample from a patient from Brazil, the viral growth in a cell model through plaque forming units (PFU) assay, reverse transcriptase polymerase chain reaction (RT-PCR) and transmission electron microscopy (TEM). FINDINGS: We follow the viral isolation in Vero cell culture from a Mpox positive clinically diagnosed sample and show the infection effects on cellular structures using a TEM. MAIN CONCLUSIONS: Understanding the impact of viral growth on cellular structures and its replication kinetics may offer better strategies for the development of new drugs with antiviral properties.


Assuntos
Mpox , Humanos , Brasil , Bioensaio , Diagnóstico Diferencial , Surtos de Doenças
10.
BMC Oral Health ; 23(1): 389, 2023 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-37316791

RESUMO

OBJECTIVE: To compare effectiveness of counselling program versus counselling program plus jaw exercises to reduce pain and click in patients with temporomandibular joint disc displacement with reduction (DDWR). MATERIALS AND METHODS: Patients were divided into two groups: instructions for temporomandibular disorders (TMD) plus jaw exercises (test, n = 34), only TMD instructions (control, n = 34). Pain was analyzed by palpation (RDC/TMD). It was investigated if the click caused discomfort. Both groups were evaluated at baseline, 24 h, 7 days, and 30 days' post treatment. RESULTS: The click was present in 85.7% (n = 60). In 30-day evaluation, there was a statistically significant difference between groups in the right median temporal muscle (p = 0.041); and there was a statistically significant difference in treatment self-perception (p = 0.002) and click's discomfort (p < 0.001). CONCLUSION: The exercise with recommendations showed better results, resolution of the click, and self-perception of the treatment effectiveness. CLINICAL RELEVANCE: This study presents therapeutic approaches that are easy to perform and that can be monitored remotely. In view of the current stage of the global pandemic, these treatment options become even more valid and useful. CLINICAL TRIAL REGISTER: This clinical trial was registered at Brazilian Clinical Trials Registry (ReBec) under protocol RBR-7t6ycp ( http://www.ensaiosclinicos.gov.br/rg/RBR-7t6ycp/ ), Date of registration: 26/06/2020.


Assuntos
Terapia por Exercício , Transtornos da Articulação Temporomandibular , Humanos , Aconselhamento , Exercício Físico , Pacientes , Brasil , Dor , Transtornos da Articulação Temporomandibular/terapia
11.
Trop Med Int Health ; 27(4): 397-407, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35128767

RESUMO

OBJECTIVES: To analyse the spatial distribution of rates of COVID-19 cases and its association with socio-economic conditions in the state of Pernambuco, Brazil. METHODS: Autocorrelation (Moran index) and spatial association (Geographically weighted regression) models were used to explain the interrelationships between municipalities and the possible effects of socio-economic factors on rates. RESULTS: Two isolated clusters were revealed in the inner part of the state in sparsely inhabited municipalities. The spatial model (Geographically Weighted Regression) was able to explain 50% of the variations in COVID-19 cases. The variables proportion of people with low income, percentage of rented homes, percentage of families in social programs, Gini index and running water had the greatest explanatory power for the increase in infection by COVID-19. CONCLUSIONS: Our results provide important information on socio-economic factors related to the spread of COVID-19 and can serve as a basis for decision-making in similar circumstances.


Assuntos
COVID-19 , Brasil/epidemiologia , COVID-19/epidemiologia , Fatores Econômicos , Humanos , Fatores Socioeconômicos , Análise Espacial
12.
J Perinat Med ; 50(6): 645-652, 2022 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34883002

RESUMO

OBJECTIVES: To analyze the spatial-temporal patterns of fetal mortality according to its relationship with social vulnerability, identifying priority areas for intervention. METHODS: Ecological study conducted in the state of Pernambuco, Northeast region of Brazil, from 2011 to 2018. The mean fetal mortality rate per city was calculated for the studied period. A cluster analysis was performed to select cities with homogeneous characteristics regarding fetal mortality and social vulnerability, then the Attribute Weighting Algorithm and Pearson correlation techniques were employed. In the spatial analysis it was used the local empirical Bayesian modeling and global and local Moran statistics. RESULTS: Twelve thousand nine hundred and twelve thousand fetal deaths were registered. The fetal mortality rate for the period was 11.44 fetal deaths per 1,000 births. The number of groups formed was 7, in which correlation was identified between fetal mortality and dimensions, highlighting the correlations between fetal mortality rate and the Index of Social Vulnerability urban infrastructure for the municipalities in group 1 and 5, the values of the correlations found were 0.478 and 0.674 respectively. The spatial analysis identified areas of higher risk for fetal mortality distributed in regions of medium, high and very high social vulnerability. CONCLUSIONS: The study allowed observing the existing correlations between fetal mortality and social vulnerability and identifying priority areas for intervention, with a view to reducing fetal mortality in the state.


Assuntos
Mortalidade Fetal , Vulnerabilidade Social , Teorema de Bayes , Brasil/epidemiologia , Feminino , Morte Fetal , Humanos
13.
Vet Ophthalmol ; 25(1): 62-72, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34240563

RESUMO

OBJECTIVES: To determine the concentrations of total protein (TP), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and hyaluronic acid (HA) in amniotic membranes (AMs) harvested from placentas of bitches of different ages and cryopreserved for different time points. The outcomes of complicated corneal defects of dogs repaired with AMs stored for the same time points were also evaluated. PROCEDURES: Ten cryopreserved canine AMs were stored for short term (2-50 days), middle term (92-210 days), or long term (256-357 days). TP was quantified by Bradford's test, whereas TIMP-1 and HA were quantified by ELISA. Twenty-one dogs that had an AM transplantation to restore deep or perforating corneal wounds were selected. RESULTS: TIMP-1 levels were lower in AMs cryopreserved for middle term (p = .02) and long term (p = .0009), when compared to AMs stored for short term. TP (p = .39) and HA (p = .18) concentrations in AMs did not differ among the storage time. TIMP-1 concentration in AMs correlated with storage time (R = -.65, p < .0001), while TP (R = -.33, p = .07) and HA concentrations did not (R = -.15, p = .41). The age of donors did not correlate with the components evaluated in the AMs. Corneal defects repaired with AMs stored for short term healed sooner than the ones repaired with AMs stored for middle (p < .01) and long term (p = .02). Additionally, TIMP-1 levels in AMs correlated negatively with the epithelization time (R = -.62, p = .002). Graft opacity was severe in 55% of cases. However, the HA levels in AMs correlated negatively with the opacification score (R = -.47, p = .03). Vision was observed in more patients who presented deep ulcers and descemetoceles, than in the ones with perforations (p = .004). CONCLUSIONS: TIMP-1 concentration in canine AMs significantly decreased over a year storage time, while TP and HA concentrations did not change during the same period. The age of donors did not correlate with the components evaluated in the AMs. Complicated corneal defects repaired with AMs cryopreserved for short term healed sooner and tended to be less opaque; however, satisfactory to optimal outcomes were achieved even in the eyes repaired with AMs stored for up to a year.


Assuntos
Úlcera da Córnea , Doenças do Cão , Âmnio/transplante , Animais , Úlcera da Córnea/veterinária , Doenças do Cão/cirurgia , Cães , Feminino , Ácido Hialurônico , Metaloproteinase 1 da Matriz , Gravidez , Inibidor Tecidual de Metaloproteinase-1
14.
Int J Mol Sci ; 23(18)2022 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-36142557

RESUMO

Leprosy is a chronic neurodermatological disease caused by the bacillus Mycobacterium leprae. Recent studies show that SNPs in genes related to miRNAs have been associated with several diseases in different populations. This study aimed to evaluate the association of twenty-five SNPs in genes encoding miRNAs related to biological processes and immune response with susceptibility to leprosy and its polar forms paucibacillary and multibacillary in the Brazilian Amazon. A total of 114 leprosy patients and 71 household contacts were included in this study. Genotyping was performed using TaqMan Open Array Genotyping. Ancestry-informative markers were used to estimate individual proportions of case and control groups. The SNP rs2505901 (pre-miR938) was associated with protection against the development of paucibacillary leprosy, while the SNPs rs639174 (DROSHA), rs636832 (AGO1), and rs4143815 (miR570) were associated with protection against the development of multibacillary leprosy. In contrast, the SNPs rs10739971 (pri-let-7a1), rs12904 (miR200C), and rs2168518 (miR4513) are associated with the development of the paucibacillary leprosy. The rs10739971 (pri-let-7a1) polymorphism was associated with the development of leprosy, while rs2910164 (miR146A) and rs10035440 (DROSHA) was significantly associated with an increased risk of developing multibacillary leprosy.


Assuntos
Hanseníase Multibacilar , Hanseníase Paucibacilar , Hanseníase , MicroRNAs , Humanos , Hanseníase/genética , Hanseníase Paucibacilar/genética , MicroRNAs/genética , Mycobacterium leprae/genética , Polimorfismo de Nucleotídeo Único
15.
Clin Infect Dis ; 73(7): e2436-e2443, 2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-32766829

RESUMO

BACKGROUND: Chikungunya virus (CHIKV) emerged in the Americas in 2013 and has caused approximately 2.1 million cases and >600 deaths. A retrospective investigation was undertaken to describe clinical, epidemiological, and viral genomic features associated with deaths caused by CHIKV in Ceará state, northeast Brazil. METHODS: Sera, cerebrospinal fluid (CSF), and tissue samples from 100 fatal cases with suspected arbovirus infection were tested for CHIKV, dengue virus (DENV), and Zika virus (ZIKV). Clinical, epidemiological, and death reports were obtained for patients with confirmed CHIKV infection. Logistic regression analysis was undertaken to identify independent factors associated with risk of death during CHIKV infection. Phylogenetic analysis was conducted using whole genomes from a subset of cases. RESULTS: Sixty-eight fatal cases had CHIKV infection confirmed by reverse-transcription quantitative polymerase chain reaction (52.9%), viral antigen (41.1%), and/or specific immunoglobulin M (63.2%). Co-detection of CHIKV with DENV was found in 22% of fatal cases, ZIKV in 2.9%, and DENV and ZIKV in 1.5%. A total of 39 CHIKV deaths presented with neurological signs and symptoms, and CHIKV-RNA was found in the CSF of 92.3% of these patients. Fatal outcomes were associated with irreversible multiple organ dysfunction syndrome. Patients with diabetes appear to die at a higher frequency during the subacute phase. Genetic analysis showed circulation of 2 CHIKV East-Central-South African (ECSA) lineages in Ceará and revealed no unique virus genomic mutation associated with fatal outcome. CONCLUSIONS: The investigation of the largest cross-sectional cohort of CHIKV deaths to date reveals that CHIKV-ECSA strains can cause death in individuals from both risk and nonrisk groups, including young adults.


Assuntos
Febre de Chikungunya , Vírus da Dengue , Dengue , Infecção por Zika virus , Zika virus , Brasil/epidemiologia , Febre de Chikungunya/epidemiologia , Estudos Transversais , Humanos , Filogenia , Estudos Retrospectivos , Adulto Jovem , Zika virus/genética , Infecção por Zika virus/epidemiologia
16.
J Oral Rehabil ; 48(4): 369-374, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33206400

RESUMO

OBJECTIVE: The aim of this study was to compare the effectiveness of two types of treatment (counselling programme versus counselling programme plus jaw exercises) to improve the quality of life of patients with disc displacement with reduction (DDWR). MATERIALS AND METHODS: Patients were divided into two groups. The test group received guidelines for temporomandibular disorders (TMD) plus jaw exercises for DDWR, and the control group received only guidelines for TMD. The total number of investigated patients was 70, thus 35 per group. The oral health-related quality of life was assessed by the OHIP-14 questionnaire. Both groups were evaluated at the baseline and 30 days post-treatment. RESULTS: In the counselling group, there was statistically significant decrease in pain (P = .015) and social disability (P = .046) subscales. In the counselling plus jaw exercise group, there was statistically significant decrease in all subscales (P < .05). At 30 days follow-up, there was a statically significant difference between the two groups in pain (P = .004), psychological discomfort (P < .001), psychological disability (P < .001) and social disability (P = .029) subscales. CONCLUSION: The counselling programme plus jaw exercise protocol showed greater improvement in oral health-related quality of life than the group performing only the counselling programme in patients with DDWR.


Assuntos
Luxações Articulares , Transtornos da Articulação Temporomandibular , Aconselhamento , Terapia por Exercício , Humanos , Qualidade de Vida , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/terapia
17.
Arch Anim Nutr ; 75(1): 64-77, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33307796

RESUMO

Several peptides found in hydrolysed poultry byproduct meal can inhibit angiotensin-converting enzyme (ACE) activity, a property that indicates potential antihypertensive and health-promoting effects. This study aimed to assess the effects of extruded diets containing enzymatically hydrolysed poultry byproduct meal (HPM) on cat serum ACE activity and aldosterone (ALD) concentration, nutrient digestibility, and faecal characteristics. On the basis of a preliminary in vitro ACE inhibitory activity assay, a commercial HPM and a commercial conventional poultry byproduct meal (CPM) were selected for further investigation. Two isoenergetic and isonitrogenous diets were formulated: CPM diet (25.7% CPM) and HPM diet (24.7% HPM). In trial 1, the effect of diet on serum ACE activity and ALD concentration was evaluated using 8 healthy cats (4 female and 4 male, 4.1 ± 0.38 kg BW) in a crossover design, with 5 d of adaptation and blood collection on d 6. In trial 2, apparent total tract digestibility and faecal characteristics were evaluated using 12 cats (6 female and 6 male, 4.0 ± 0.72 kg BW) in a completely randomised design. Serum ACE and ALD were analysed using a mixed model, with diet as the fixed effect and cat as the random effect. Data from trial 2 were subjected to analysis of variance, and means were compared by Tukey's test. In vitro ACE inhibitory activity of HPM (90.4%) was higher than that of CPM (52.0%). Cats fed the HPM diet tended to have lower serum ACE activity than those fed the CPM diet (126 versus 142 U/l, p = 0.09). Serum ALD was not influenced by diet. Diets had similar digestibility values, and faecal consistency scores tended to be higher (firmer faeces) in cats fed the CPM diet than in cats fed the HPM diet (4.6 versus 4.0, p = 0.09). Inclusion of HPM in extruded diets may reduce cat serum ACE activity and promote good faecal consistency without affecting digestibility. Further investigations are needed to explore the potential health benefits of HPM in hypertensive cats.


Assuntos
Aldosterona/metabolismo , Ração Animal/análise , Gatos/fisiologia , Peptidil Dipeptidase A/metabolismo , Produtos Avícolas/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Estudos Cross-Over , Dieta/veterinária , Enzimas/química , Fezes/química , Feminino , Hidrólise , Masculino , Distribuição Aleatória
18.
J Mol Recognit ; 33(11): e2870, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32648306

RESUMO

Lectins are a group of proteins of non-immune origin recognized for their ability to bind reversibly to carbohydrates. Researchers have been intrigued by oligosaccharides and glycoconjugates for their involvement as mediators of complex cellular events and then many biotechnological applications of lectins are based on glycocode decoding and their activities. Here, we report a structural and biological study of a ConA-like mannose/glucose-specific lectin from Canavalia bonariensis seeds, CaBo. More specifically, we evaluate the binding of CaBo with α-methyl-D-mannoside (MMA) and mannose-1,3-α-D-mannose (M13) and the resultant in vivo effects on a rat model of acute inflammation. A virtual screening was also carried out to cover a larger number of possible bindings of CaBo. In silico analysis demonstrated the stability of CaBo interaction with mannose-type ligands, and the lectin was able to induce acute inflammation in rats with the participation of the carbohydrate recognition domain (CRD) and histamine release. These results confirm the ability of CaBo to interact with hybrid and high-mannose N-glycans, supporting the hypothesis that CaBo's biological activity occurs primarily through its interaction with cell surface glycosylated receptors.


Assuntos
Carboidratos/química , Inflamação/tratamento farmacológico , Lectinas de Ligação a Manose/farmacologia , Lectinas de Plantas/farmacocinética , Animais , Sítios de Ligação , Histamina/farmacologia , Humanos , Inflamação/induzido quimicamente , Inflamação/patologia , Manose/química , Lectinas de Ligação a Manose/química , Manosídeos/química , Lectinas de Plantas/química , Lectinas de Plantas/farmacologia , Polissacarídeos/química , Ratos
20.
J Craniofac Surg ; 31(4): e391-e393, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32168129

RESUMO

Syngnathia is a rare facial anomaly associated with neonatal problems, including a compromised airway, and the inability to take in solids and/or liquids. Syngnathia is included within the spectrum of oromandibular limb hypogenesis syndrome, an extremely rare condition characterized by varying degrees of congenital malformation involving the tongue, mandible, and limbs. In this report, we describe the case of a 41-day-old Caucasian female infant who was unable to open her mouth beginning at birth. The authors performed osteotomies to separate fused bone, and placed a bite block at the osteotomy sites to prevent bone fusion recurrence. At 2 years of follow-up patient remained with 14 mm of mouth opening.


Assuntos
Anormalidades Maxilomandibulares/diagnóstico por imagem , Anormalidades da Boca/diagnóstico por imagem , Anormalidades Múltiplas , Feminino , Humanos , Lactente , Anormalidades Maxilomandibulares/cirurgia , Mandíbula/anormalidades , Anormalidades da Boca/cirurgia , Osteotomia , Língua/anormalidades
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