Chest computed tomography findings of patients infected with Covid-19 and their association with disease evolution stages.

INTRODUCTION: To describe CT findings in patients with confirmed Covid-19 infection and correlate them with the disease evolution stages. METHODS: This is a historical cohort observational analytical study carried out with outpatients, inpatients, and emergency patients from a private hospital in Maceió/AL, Brazil. The final sample consisted of 390 patients with positive RT-PCR for Covid-19 with available laboratory tests and chest CT results. RESULTS: The most frequent initial symptoms were cough, fever, dyspnea and headache. The most commonly found comorbidities were hypertension, diabetes mellitus and obesity. A total of 22% of the CT scans showed no alterations; ground-glass opacity was the most frequently found one. There was a significant association between age, comorbidities, pulmonary involvement, ground-glass opacity, mosaic attenuation and percentage of pulmonary involvement with death. The analysis of the disease stages showed a significant association with laboratory data (CRP and platelet levels), ground-glass opacity and mosaic attenuation with the disease evolution stages in relation to the days since symptom onset. CONCLUSION: The disease evolution of Covid-19 occurs in stages, and this study describes tomographic findings in patients with confirmed Covid-19 infection and shows they vary depending on the disease evolution stages. IMPLICATIONS FOR PRACTICE: This paper provides important addition to the various records that have been accumulated through the Covid-19 pandemic.

Co-Infestation and Spatial Distribution of Bactrocera carambolae and Anastrepha spp. (Diptera: Tephritidae) in Common Guava in the Eastern Amazon.

Field infestation and spatial distribution of introduced Bactrocera carambolae Drew and Hancock and native species of Anastrepha in common guavas [Psidium guajava (L.)] were investigated in the eastern Amazon. Fruit sampling was carried out in the municipalities of Calçoene and Oiapoque in the state of Amapá, Brazil. The frequency distribution of larvae in fruit was fitted to the negative binomial distribution. Anastrepha striata was more abundant in both sampled areas in comparison to Anastrepha fraterculus (Wiedemann) and B. carambolae The frequency distribution analysis of adults revealed an aggregated pattern for B. carambolae as well as for A. fraterculus and Anastrepha striata Schiner, described by the negative binomial distribution. Although the populations of Anastrepha spp. may have suffered some impact due to the presence of B. carambolae, the results are still not robust enough to indicate effective reduction in the abundance of Anastrepha spp. caused by B. carambolae in a general sense. The high degree of aggregation observed for both species suggests interspecific co-occurrence with the simultaneous presence of both species in the analysed fruit. Moreover, a significant fraction of uninfested guavas also indicated absence of competitive displacement.

Trans fatty acid intake is associated with insulin sensitivity but independently of inflammation

High saturated and trans fatty acid intake, the typical dietary pattern of Western populations, favors a proinflammatory status that contributes to generating insulin resistance (IR). We examined whether the consumption of these fatty acids was associated with IR and inflammatory markers. In this cross-sectional study, 127 non-diabetic individuals were allocated to a group without IR and 56 to another with IR, defined as homeostasis model assessment-IR (HOMA-IR) >2.71. Diet was assessed using 24-h food recalls. Multiple linear regression was employed to test independent associations with HOMA-IR. The IR group presented worse anthropometric, biochemical and inflammatory profiles. Energy intake was correlated with abdominal circumference and inversely with adiponectin concentrations (r = -0.227, P = 0.002), while saturated fat intake correlated with inflammatory markers and trans fat with HOMA-IR (r = 0.160, P = 0.030). Abdominal circumference was associated with HOMA-IR (r = 0.430, P < 0.001). In multiple analysis, HOMA-IR remained associated with trans fat intake (β = 1.416, P = 0.039) and body mass index (β = 0.390, P < 0.001), and was also inversely associated with adiponectin (β = -1.637, P = 0.004). Inclusion of other nutrients (saturated fat and added sugar) or other inflammatory markers (IL-6 and CRP) into the models did not modify these associations. Our study supports that trans fat intake impairs insulin sensitivity. The hypothesis that its effect could depend on transcription factors, resulting in expression of proinflammatory genes, was not corroborated. We speculate that trans fat interferes predominantly with insulin signaling via intracellular kinases, which alter insulin receptor substrates.

Trans fatty acid intake is associated with insulin sensitivity but independently of inflammation.

High saturated and trans fatty acid intake, the typical dietary pattern of Western populations, favors a proinflammatory status that contributes to generating insulin resistance (IR). We examined whether the consumption of these fatty acids was associated with IR and inflammatory markers. In this cross-sectional study, 127 non-diabetic individuals were allocated to a group without IR and 56 to another with IR, defined as homeostasis model assessment-IR (HOMA-IR) >2.71. Diet was assessed using 24-h food recalls. Multiple linear regression was employed to test independent associations with HOMA-IR. The IR group presented worse anthropometric, biochemical and inflammatory profiles. Energy intake was correlated with abdominal circumference and inversely with adiponectin concentrations (r = -0.227, P = 0.002), while saturated fat intake correlated with inflammatory markers and trans fat with HOMA-IR (r = 0.160, P = 0.030). Abdominal circumference was associated with HOMA-IR (r = 0.430, P < 0.001). In multiple analysis, HOMA-IR remained associated with trans fat intake (ß = 1.416, P = 0.039) and body mass index (ß = 0.390, P < 0.001), and was also inversely associated with adiponectin (ß = -1.637, P = 0.004). Inclusion of other nutrients (saturated fat and added sugar) or other inflammatory markers (IL-6 and CRP) into the models did not modify these associations. Our study supports that trans fat intake impairs insulin sensitivity. The hypothesis that its effect could depend on transcription factors, resulting in expression of proinflammatory genes, was not corroborated. We speculate that trans fat interferes predominantly with insulin signaling via intracellular kinases, which alter insulin receptor substrates.

[Asymptomatic cholelithiasis in an extreme premature child] / Colelitíase assintomática em criança prematura extrema.

OBJECTIVE: To report a case of asymptomatic cholelithiasis in a premature young infant, presenting literature review. METHODS: The authors describe a case of asymptomatic cholelithiasis, incidentally diagnosed during a routine ultrasonographic exam, with spontaneous resolution. Literature review has been done from Medline and Lilacs, with quotations from articles of the last 45 years. RESULTS: Premature patient 28 weeks old with a cholelithiasis diagnosis at 5 months, presenting the following risk factors: prematurity, total parenteral nutrition, prolonged use of Furosemide and sepsis. The patient remained asymptomatic until the spontaneous resolution occurred. CONCLUSION: Cholelithiasis in childhood has been reported in the literature as a rare condition, usually associated with Hemolytic disease. The widespread use of ultrasonography has contributed to an increase in the diagnosis of neonates and young infants in this condition. This case report highlights the idea of possible spontaneous resolution in cases of asymptomatic cholelithiasis incidentally diagnosed.

Estado nutricional das crianças de 0 a 6 anos na Unidade Básica de Saúde do Jardim Uniäo da Vitória - Londrina, PR / Nutritional status of children from 0 to 6 years old in the Jardim Uniäo da Vitória, Health Basic Unit - Londrina, PR

Com o objetivo de determinar o estado nutricional das crianças de 0 a 6 anos do Jardim Uniäo da Vitória, Zona Sul de Londrina, analisou-se uma amostra de 241 crianças entre 0 a 6 anos de idade atendidas na Unidade Básica de Saúde Orlando Cestari, localizada no Jardim Uniäo da Vitória. Os dados antropométricos (peso e altura) e outros obtidos através de um questionário contendo informaçöes sobre o nível de escolaridade, renda familiar, realizaçäo de pré-natal pelas mäes, uso de drogas e tabaco na gravidez, baixo peso ao nascer, ocorrência de hospitalizaçäo por infecçäo nos últimos 12 meses, foram analisados estatisticamente pelo Teste do Qui- quadrado ou Teste Exato de Fisher. Os resultos obtidos demonstraram que 33 por cento das crianças apresentam desnutriçäo. Os fatores associados na determinaçäo da desnutriçäo da populaçäo estudada foram o baixo peso ao nascer em menores de 12 meses e maior número de hospitalizaçöes por infecçäo

Conhecimento, atitudes e práticas relacionadas à DST/AIDS: avaliaçäo de adolescentes atendidos em uma unidade de atençäo primária / Knowledge, attitudes and practice related at STD/AIDS: evaluation of adolescents in a primary attention unit

No Brasil, 32,9 por cento do total acumulado de casos de AIDS, até 30 de junho de 1995, estavam situados na faixa etária compreendida entre 20-30 anos. Provavelmente, a contaminaçäo ocorreu durante a adolescência, em funçäo do longo período de latência da doença. Objetivos. - Identificar conhecimentos e comportamentos referentes às DST/AIDS e avaliar o interesse dos adolescentes em receber informaçäo adicional. Metodologia. - Os dados foram obtidos a partir de um questionßrio desenvolvido especialmente para este estudo. O questionário foi composto por perguntas abertas sobre conhecimentos e comportamentos diante às DST/AIDS e foi aplicado em entrevistas individuais pela equipe de trabalho do Ambulatório Avançado do Morro do Pau-da-Bandeira (bairro de Vila Isabel, RJ-RJ), durante o horário de atendimento. Resultados. - Foram entrevistados 142 adolescentes do gênero feminino (84 por cento) e 27 do masculino (16 por cento). Dentre os 169 adolescentes entrevistados, 157 (92,9 por cento) já tinham ouvido falar sobre DST, portanto, as mais citadas foram: AIDS (95,5 por cento), gonorréia (51,6 por cento) e sífilis (35,7 por cento). A maioria dos adolescentes (78,7 por cento) reconheceu, pelo menos, uma forma de transmissäo de DST, e foram citadas principalmente: via sexual (97,7 por cento), via sangüínea (17,3 por cento) e uso de drogas (12,8 por cento). Dentre os 52,1 por cento de adolescentes sexualmente ativos, 50 por cento faziam alguma coisa para prevenir as DSTs e 39,8 por cento usavam o preservativo. Do total de entrevistados, 98,8 por cento já tinham ouvido falar sobre AIDS, e a doença foi mais freqüentemente associada a näo ser curável. Quanto às formas de sua transmissäo, 90,5 por cento dos adolescentes sabiam como a doença é transmitida, e as formas mais citadas foram via sexual (94,1 por cento), sangue (70,6 por cento) e seringas contaminadas (41,2 por cento). Dentre os adolescentes entrevistados, 51,1 por cento faziam algo para näo pegar a doença e 36,4 por cento afirmaram usar preservativos. Conclusöes. - As principais fontes de informaçäo para os adolescentes é a escola (54,1 por cento) e o Ambulatório Avançado (51,6 por cento). O nível de conhecimento demonstrado foi elevado, uma vez que 92,2 por cento tinham ouvido falar sobre DST, 98,8 por cento sobre AIDS, 90,5 por cento responderam que sabiam como a AIDS é transmitidas e 78,8 por cento como as DSTs säo transmitidas...

Modelo de atencao integral a saude do adolescente: Projeto MAISA II - Unidade Clinica de Adolescentes - UERJ / Model of integral attention to Realth of the adolescent: Project MAISA II - Unit clinic of adolescents - UERJ

A Unidade Clinica de Adolescentes da Universidade do Estado do Rio de Janeiro, atraves do Projeto Modelo de Atencao Integral a Saude do Adolescente (Projeto MAISA II), apoiado pela Fundacao W.K.Kellogg, vem desenvolvendo uma experiencia de integracao das unidades de servico de saude nas comunidades proximas ao Campus Universitario. Para tal, vem se articulando com escolas do1o. e 2o. Graus, empresas, com o Camp vila Isabel, do Programa de Patrulheirismo; com algumas instituicoes de saude e organizacoes comunitarias. Este artigo traz os primeiros resultados deste projeto, demonstrando a importancia de se garantir a populacao adolescente, formas resolutivas e desburocratizadas na atencao a sua saude .