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1.
Anim Sci J ; 92(1): e13508, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33416198

RESUMO

The present study was conducted to evaluate the intake, digestibility and nitrogen balance of diets for finishing sheep, containing leucaena hay as a source of effective fibre and forage palm. Twenty-one male sheep were used in a randomized block design with three treatments, represented by total diets, where the forage was leucaena hay and forage palm in natura in proportions 350:650, 450:550 and 550:450 g/kg respectively. For the pH and NH3 -N in the ruminal fluid, and urea in the blood serum, plots split in time were adopted. Dry matter and nutrient digestibility, and the nitrogen balance were not influenced (p > .05) by the diets. The neutral detergent fibre digestibility decreased (p < .05) as the proportions of leucaena hay in the diets increased. The pH and NH3 -N were suitable for ruminal fermentation, and blood urea was maintained under normal physiological conditions for sheep. Combining 350 to 550 g/kg of leucaena hay with 450 to 650 g/kg of forage palm in total diets with a forage:concentrate ratio of 60:40 in late-maturing sheep meets the nutritional requirements for daily gain 200 g, characterizing leucaena hay as important source of effective fibre and nutrients in diets.

2.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 136-143, jan.-dez. 2021. fig
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1147704

RESUMO

Objetivo: realizar reflexão sobre a percepção de preceptores quanto ao aprimoramento de programas de Residência Multiprofissional em Saúde, em nível hospitalar. Método: estudo qualitativo, realizado por meio de entrevista individual com profissionais da saúde (preceptores) (n=34), junto a residentes multiprofissionais de um hospital universitário do Estado do Paraná, Brasil. As informações foram angariadas por meio de questionário e analisadas. Resultados: os preceptores investigados vislumbram pela melhoria na qualificação do programa e pelo fortalecimento de estratégias, sobre dois prismas. O primeiro refere-se ao capital humano, englobando reforços na consolidação das relações interpessoais e de habilidades de comunicação. O outro considera a gestão do trabalho, com vistas a potencializar de forma mais efetiva a organização do processo de trabalho. Conclusão: sugere-se que gestores de hospitais invistam na capacitação de seus agentes formadores, também no que tange a importância do processo avaliativo institucional, com vistas a angariar e regular a qualidade das residências


Objective: to reflect on the perception of preceptors regarding the improvement of Multiprofessional Health Residency programs at the hospital level. Method: qualitative study, conducted by means of an individual interview with health professionals (preceptors) (n = 34), with multiprofessional residents of a university hospital in the State of Paraná, Brazil. The information was collected through a questionnaire and analyzed. Results: the preceptors investigated look for the improvement in the qualification of the program and the strengthening of strategies, on two prisms. The first refers to human capital, encompassing reinforcements in the consolidation of interpersonal relations and communication skills. The other considers the work management, with a view to maximizing the organization of the work process more effectively. Conclusion: it is suggested that hospital managers invest in the training of their training agents, also regarding the importance of the institutional evaluation process, with a view to raising and regulating the quality of residences


Objetivo: realizar reflexión sobre la percepción de preceptores encuanto al perfeccionamiento de programas de Residencia Multiprofesional en Salud, a nível hospitalario. Método: estúdio cualitativo, realizado por medio de entrevista individual com profesionales de la salud (preceptores) (n = 34), junto a residentes multiprofesionales de un hospital universitário del Estado de Paraná, Brasil. La información fue recopilada por medio de uncuestionario y se analizó. Resultados: los preceptores investigados vislumbran por la mejora em La calificación del programa y por el fortalecimiento de estrategias, sobre dos prismas. El primero se refiere al capital humano, englobando refuerzos en la consolidación de las relaciones interpersonales y de habilidades de comunicación. El otro considera la gestión del trabajo, con miras a potenciar de forma más efectiva la organización del proceso de trabajo. Conclusión: se sugiere que gestores de hospitales inviertan en la capacitación de sus agentes formadores, también en lo que se refiere a la importância del proceso de evaluación institucional, con miras a recaudar y regular la calidad de las residencias


Assuntos
Humanos , Masculino , Feminino , Educação de Pós-Graduação em Enfermagem , Internato e Residência , Relações Interpessoais , Avaliação de Recursos Humanos em Saúde , Capacitação de Recursos Humanos em Saúde
3.
J Prosthodont Res ; 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32938858

RESUMO

PURPOSE: To critically review the literature using mini-implants for prosthetic rehabilitation of growing patients and to analyze the survival rates and clinical behavior of mini-implants. STUDY SELECTION: Controlled clinical trials and case reports published in English, from January 2006 to October 2018, in a peer-reviewed journal in PubMed, Scopus, LILACS, and Cochrane Library databases. Studies using mini-implants for prosthetic rehabilitation in growing patients were included. Articles reporting mini-implants with a diameter greater than 3 mm, recruitment of adult participants, use of implants with other purposes than prosthodontic rehabilitation, and with a follow-up period shorter than 1 year, were excluded from the analysis. The selection was performed independently by two reviewers. RESULTS: The selection resulted in the inclusion of eight articles. Although the studies presented heterogeneous protocols and follow-ups (varying from 1 to 8 years), only one case of failure was reported, which corresponded to crown displacement. All rehabilitation procedures were performed in the anterior region using mini-implants with different diameters (1.3-2.9 mm) and lengths (9-14 mm). The prosthetic rehabilitation included individual crowns and/or overdentures. CONCLUSIONS: Mini-implant prosthetic rehabilitation seems to be a viable and promising option for provisional rehabilitation of growing patients, since it seems to preserve the bone structure while restoring function and esthetics until growth ceases, when then mini-implants can be replaced by standard implants.

4.
J Antimicrob Chemother ; 75(11): 3260-3268, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32780098

RESUMO

BACKGROUND: Conventional miltefosine dosing (2.5 mg/kg/day) for treatment of visceral leishmaniasis (VL) is less effective in children than in adults. A higher allometric dose (median 3.2 mg/kg/day) was therefore investigated in paediatric VL patients in Eastern Africa. Results of this trial showed an unforeseen, lower than dose-proportional increase in exposure. Therefore, we performed a pooled model-based analysis of the paediatric data available from both dosing regimens to characterize observed non-linearities in miltefosine pharmacokinetics (PK). METHODS: Fifty-one children with VL were included in this analysis, treated with either a conventional (n = 21) or allometric (n = 30) miltefosine dosing regimen. PK data were analysed using non-linear mixed-effects modelling. RESULTS: A two-compartment model following first-order absorption and linear elimination, with two separate effects on relative oral bioavailability, was found to fit these data best. A 69% lower bioavailability at treatment start was estimated, presumably due to initial malnourishment and malabsorption. Stagnation in miltefosine accumulation in plasma, hampering increased drug exposure, was related to the increase in cumulative dose (mg/kg/day). However, the allometric regimen increased exposure 1.7-fold in the first treatment week and reduced the time to reach the PK target by 17.4%. CONCLUSIONS: Miltefosine PK in children suffering from VL are characterized by dose-dependent non-linearities that obstruct the initially expected exposure levels. Bioavailability appeared to be affected by the cumulative dose, possibly as a consequence of impaired absorption. Despite this, allometric dosing led to a faster target achievement and increased exposure compared with conventional dosing.

5.
J Infect Dev Ctries ; 14(6.1): 42S-47S, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32614795

RESUMO

INTRODUCTION: In three health care facilities in the Oromia region, the aim of this study is to report on 1) the number of VL cases registered over time (2013-2018) and 2) the clinical profile, type of treatment used and response to treatment. METHODOLOGY: A retrospective cohort study was conducted among all VL cases admitted with a diagnosis of VL. RESULTS: A total of 434 VL cases were registered at the three health facilities, but patient files were available for only 188. Most (51.6%) were children and only three presented with VL relapse. 78 (41.5%) of the 188 patients presented within one month of symptom onset. Concurrent severe acute malnutrition (27.1%), tuberculosis (6.4%) and malaria (6.4%) were common. There were only two cases with HIV coinfection. Fourty-three percent were treated with antimonials, 34% with antimonials combined with paromomycin and 23% with AmBisome. Amongst the 188 patients with patient files there were no deaths and one treatment failure. Six months outcome data were however missing for all. Aggregated data from the 434 VL cases reported three deaths, two treatment failures and one relapse. CONCLUSIONS: Children were most commonly affected, suggesting long-term endemicity. While short-term outcomes are encouraging, long-term follow-up data are required.

6.
PLoS Negl Trop Dis ; 14(7): e0008429, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32687498

RESUMO

BACKGROUND: Few prospective data exist on incidence of post kala-azar dermal leishmaniasis (PKDL) and visceral leishmaniasis (VL) relapse after different treatment regimens. METHODOLOGY/PRINCIPAL FINDINGS: A Phase IV trial included 1761 VL patients treated between 2012-2014 with single dose AmBisome (SDA; N = 891), miltefosine-paromomycin (Milt-PM; n = 512), or AmBisome-miltefosine (AmB-Milt; n = 358). Follow-up for PKDL and VL relapse was scheduled for 6, 12 and 24 months after treatment, lasting until 2017. Patients with lesions consistent with PKDL were tested by rK39 rapid test, and if positive, underwent skin-snip sampling, smear microscopy and PCR. Probable PKDL was defined by consistent lesions and positive rK39; confirmed PKDL required additional positive microscopy or PCR. PKDL and relapse incidence density were calculated by VL treatment and risk factors evaluated in Cox proportional hazards models. Among 1,750 patients who completed treatment, 79 had relapse and 104 PKDL. Relapse incidence density was 1.58, 2.08 and 0.40 per 1000 person-months for SDA, AmB-Milt and Milt-PM, respectively. PKDL incidence density was 1.29, 1.45 and 2.65 per 1000 person-months for SDA, AmB-Milt and Milt-PM. In multivariable models, patients treated with Milt-PM had lower relapse but higher PKDL incidence than those treated with SDA; AmB-Milt rates were not significantly different from those for SDA. Children <12 years were at higher risk for both outcomes; females had a higher risk of PKDL but not relapse. CONCLUSIONS/SIGNIFICANCE: Active surveillance for PKDL and relapse, followed by timely treatment, is essential to sustain the achievements of VL elimination programs in the Indian sub-continent.


Assuntos
Anfotericina B/administração & dosagem , Antiprotozoários/administração & dosagem , Leishmaniose Cutânea/parasitologia , Leishmaniose Visceral/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Incidência , Índia/epidemiologia , Leishmaniose Cutânea/patologia , Leishmaniose Visceral/parasitologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Adulto Jovem
7.
Sci Total Environ ; 731: 139252, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32413649

RESUMO

In agroforestry systems, trees modify climatic parameters over a given area and create a complex microclimate through interactions between topography, plant composition and organizational structure of trees. In this way, indicators such as surface temperature of tree canopy and pasture, monitored by infrared thermography, are important to monitor the thermal environment of animal production and pasture establishment. Goals of this study were (1) to evaluate temporal and local variations of temperature and humidity leaf surface of tree canopy and pasture in agroforestry systems by infrared remote sensing and, (2) to validate infrared thermography as a potential tool for assessment microclimate in agroforestry systems. The study was carried out between June 2015 and February 2016 in an experimental area located at 54°370'W, 20°270'S and 530 m altitude, in Brazil. Surface temperatures and humidity of tree canopy and pasture in two agroforestry systems with different densities and tree spatial arrangements were determined using infrared thermography. Air, black globe and dew point temperatures, relative humidity and wind speed were measured using digital thermo-hygrometers with datalogger. Moderate to strong associations have been identified between microclimate parameters and those monitored by means of thermography measurements (0.45 ≥ r ≤ 0.78), suggesting positive relationships and equally well explained by air temperature, black globe temperature and relative air humidity (R2 = 0.68 ≥ R2 ≤ 0.98). Variations in hourly averages of temperatures and humidity of pasture and tree canopy show similar patterns between seasons, with consistently higheraverages during summer and under full sun, indicating the existence of a thermal band with leaf temperatures above air temperature. Therefore, this work's findings support use of infrared thermography as a tool for microclimate assessment in agroforestry systems.


Assuntos
Microclima , Termografia , Animais , Brasil , Umidade , Temperatura
8.
EBioMedicine ; 55: 102748, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32361248

RESUMO

BACKGROUND: Visceral leishmaniasis (VL) treatment in HIV patients very often fails and is followed by high relapse and case-fatality rates. Hence, treatment efficacy assessment is imperative but based on invasive organ aspiration for parasite detection. In the search of a less-invasive alternative and because the host immune response is pivotal for treatment outcome in immunocompromised VL patients, we studied changes in the whole blood transcriptional profile of VL-HIV patients during treatment. METHODS: Embedded in a clinical trial in Northwest Ethiopia, RNA-Seq was performed on whole blood samples of 28 VL-HIV patients before and after completion of a 29-day treatment regimen of AmBisome or AmBisome/miltefosine. Pathway analyses were combined with a machine learning approach to establish a clinically-useful 4-gene set. FINDINGS: Distinct signatures of differentially expressed genes between D0 and D29 were identified for patients who failed treatment and were successfully treated. Pathway analyses in the latter highlighted a downregulation of genes associated with host cellular activity and immunity, and upregulation of antimicrobial peptide activity in phagolysosomes. No signs of disease remission nor pathway enrichment were observed in treatment failure patients. Next, we identified a 4-gene pre-post signature (PRSS33, IL10, SLFN14, HRH4) that could accurately discriminate treatment outcome at end of treatment (D29), displaying an average area-under-the-ROC-curve of 0.95 (CI: 0.75-1.00). INTERPRETATION: A simple blood-based signature thus holds significant promise to facilitate treatment efficacy monitoring and provide an alternative test-of-cure to guide patient management in VL-HIV patients. FUNDING: Project funding was provided by the AfricoLeish project, supported by the European Union Seventh Framework Programme (EU FP7).

9.
J Microbiol Methods ; 173: 105935, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32376283

RESUMO

BACKGROUND: Molecular detection techniques using peripheral blood are preferred over invasive tissue aspiration for the diagnosis and post-treatment follow-up of visceral leishmaniasis (VL) patients. This study aims to identify suitable stabilizing reagents to prevent DNA and RNA degradation during storage and transport to specialized laboratories where molecular diagnosis is performed. METHODOLOGY: The stabilizing capacities of different commercially available reagents were compared using promastigote-spiked human blood and peripheral blood of Syrian golden hamsters subjected to experimental infection, treatment (miltefosine or aminopyrazole DNDi-1044) and immunosuppression. The impact of various storage temperature conditions was tested in combination with an established kinetoplast DNA (kDNA) qPCR and a recently developed spliced leader RNA (SL-RNA) assay for Leishmania detection. PRINCIPAL FINDINGS: Irrespective of the blood type and stabilizer used, threshold (cT) values obtained with the SL-RNA qPCR were systematically lower than those obtained with the kDNA assay, confirming the advantage of the SL-RNA assay over the widely used kDNA assay for low-level Leishmania detection. Peripheral blood parasite levels correlated relatively well with hepatic burdens. RNA protect cell reagent provided the most optimal simultaneous DNA and RNA stabilization in both human and hamster blood. However, this stabilizer requires an erythrocyte lysis step, which can be challenging under field conditions. DNA/RNA shield provides a good alternative for downstream kDNA and SL-RNA assays, especially if sample storage capacity at 4 °C can be guaranteed. CONCLUSIONS/SIGNIFICANCE: The recommended stabilizing reagents are compatible with RNA- and DNA-based Leishmania detection in peripheral blood in the VL hamster model and spiked human blood. Since molecular detection techniques using peripheral blood are less invasive than microscopic assessment of tissue aspirates, the findings of this study may be applied to human VL clinical studies.

10.
PLoS Negl Trop Dis ; 14(5): e0008245, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32453768

RESUMO

BACKGROUND: The WHO established targets for 2030 to globally reduce new viral hepatitis B and C infections by 90% and deaths by 65% and recommends searching for coinfections that increase the progression of chronic liver infections towards cirrhosis and hepatocellular carcinoma. AIMS AND METHODOLOGY: This study aimed to add information concerning the influence of human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2) infections in hepatitis B and C, since in Brazil, these human retroviruses are endemic but neglected. Serum samples from 1,910 patients with hepatitis B and 1,315 with hepatitis C from São Paulo, southeast Brazil, that were previously tested and grouped for HIV and HTLV-1/-2 coinfections were analyzed for hepatitis B virus (HBV) and hepatitis C virus (HCV) loads measurements and subsequent clearance using data from laboratory records. KEY RESULTS: Briefly, the lowest HBV viral load (VL) was detected in HBV/HTLV-2 coinfected patients, regardless of whether they were infected with HIV (all comparisons p<0.05). In contrast, higher HCV VL was detected in HCV/HIV, HCV/HIV/HTLV-1/-2 coinfected patients (all p<0.05), and the lowest HCV VL was detected in HCV/HTLV-2 coinfected patients. Curiously, 61.1% of the patients with HBV/HTLV-2 coinfection had an undetectable HBV VL at the beginning of the study versus 21.4% in the patients with HBV/HTLV-1 coinfection. Although the percentages of undetectable HCV loads in HCV/HTLV-1 and HCV/HTLV-2 coinfected patients were quite similar, during follow-up, more HCV clearance was detected in patients with HCV/HTLV-2 coinfection [OR 2.65; 95% IC (1.17-5.99)]. MAJOR CONCLUSIONS: HTLV-2 positively impacts HBV and HCV viral loads and HCV clearance, while HIV and/or HTLV-1 negatively impacts HCV viral load. Thus, the search for HTLV-1/-2 in viral hepatitis B and C infected patients has virological prognostic value, which is a strong reason to suggest including HTLV serology in the follow-up of patients.


Assuntos
Infecções por HTLV-I/complicações , Infecções por HTLV-II/complicações , Hepatite B/complicações , Hepatite C/complicações , Vírus Linfotrópico T Tipo 1 Humano , Vírus Linfotrópico T Tipo 2 Humano , Brasil/epidemiologia , Coinfecção , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-II/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Carga Viral
11.
PLoS Negl Trop Dis ; 14(5): e0008245, May 26, 2020. tab, graf
Artigo em Inglês | LILACS, Sec. Est. Saúde SP, SESSP-IALPROD, Sec. Est. Saúde SP, SESSP-IALACERVO | ID: biblio-1128443

RESUMO

The human T-lymphotropic viruses type 1 (HTLV-1) and type 2 (HTLV-2) are endemic and neglected in Brazil, and although these viruses were considered to have prognostic value when associated with HIV, e.g., HTLV-1 has been associated with fast progression and death to AIDS and more cases of lymphoma and neurological disorders, and HTLV-2 has been associated with slow progression to AIDS, their impact on hepatitis B virus (HBV) and hepatitis C virus (HCV) outcomes remain unknown. The present study analyzed the influence of HTLV-1 and HTLV-2 coinfection on HBV and HCV virological outcomes (viral load levels and virus clearance during follow-up) in serum samples from 1,910 patients with hepatitis B and 1,315 patients with hepatitis C from São Paulo, southeast Brazil. The results obtained confirmed the positive impact of HTLV-2 on HBV and HCV virological outcomes (lower HBV and HCV viral loads and increased HCV clearance when compared with HCV-monoinfected patients) and the opposite effect of HTLV-1; these findings are similar to the effects observed in HIV/AIDS patients. Taking into consideration these results and the differential impact of HTLV-1 and HTLV-2 in viral hepatitis B and C, we suggest including the serology of HTLV-1/2 in the follow-up of such patients in Brazil. (AU)


Assuntos
Humanos , Masculino , Feminino , Pacientes , Sorologia , Vírus Linfotrópico T Tipo 1 Humano , Vírus Linfotrópico T Tipo 2 Humano , Hepatite Viral Humana
12.
PLoS negl. trop. dis ; 14(5): 0008245, May 2020. tab, ilus
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IIERPROD, Sec. Est. Saúde SP | ID: biblio-1100279

RESUMO

BACKGROUND: The WHO established targets for 2030 to globally reduce new viral hepatitis B and C infections by 90% and deaths by 65% and recommends searching for coinfections that increase the progression of chronic liver infections towards cirrhosis and hepatocellular carcinoma. AIMS AND METHODOLOGY: This study aimed to add information concerning the influence of human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2) infections in hepatitis B and C, since in Brazil, these human retroviruses are endemic but neglected. Serum samples from 1,910 patients with hepatitis B and 1,315 with hepatitis C from São Paulo, southeast Brazil, that were previously tested and grouped for HIV and HTLV-1/-2 coinfections were analyzed for hepatitis B virus (HBV) and hepatitis C virus (HCV) loads measurements and subsequent clearance using data from laboratory records. KEY RESULTS: Briefly, the lowest HBV viral load (VL) was detected in HBV/HTLV-2 coinfected patients, regardless of whether they were infected with HIV (all comparisons p<0.05). In contrast, higher HCV VL was detected in HCV/HIV, HCV/HIV/HTLV-1/-2 coinfected patients (all p<0.05), and the lowest HCV VL was detected in HCV/HTLV-2 coinfected patients. Curiously, 61.1% of the patients with HBV/HTLV-2 coinfection had an undetectable HBV VL at the beginning of the study versus 21.4% in the patients with HBV/HTLV-1 coinfection. Although the percentages of undetectable HCV loads in HCV/HTLV-1 and HCV/HTLV-2 coinfected patients were quite similar, during follow-up, more HCV clearance was detected in patients with HCV/HTLV-2 coinfection [OR 2.65; 95% IC (1.17­5.99)]. MAJOR CONCLUSIONS: HTLV-2 positively impacts HBV and HCV viral loads and HCV clearance, while HIV and/or HTLV-1 negatively impacts HCV viral load. Thus, the search for HTLV-1/-2 in viral hepatitis B and C infected patients has virological prognostic value, which is a strong reason to suggest including HTLV serology in the follow-up of patients


Assuntos
Humanos , Masculino , Feminino , Vírus Linfotrópico T Tipo 1 Humano , Vírus Linfotrópico T Tipo 2 Humano , Hepatite C , Hepatite B
13.
PLoS Negl Trop Dis ; 14(4): e0008253, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32324738

RESUMO

BACKGROUND: In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonosis in which the dog is the primary domestic reservoir, although wildlife may have a leading role in the sylvatic cycle of the disease in some areas. Infections without disease are very frequent. There is limited information regarding the role that VL patients and asymptomatic infected individuals could be playing in the transmission of L. infantum. Xenodiagnosis of leishmaniasis has been used in this descriptive study to explore the role of symptomatic and asymptomatic infected individuals as reservoirs in a recent focus of leishmaniasis in southwestern Madrid, Spain. METHODOLOGY AND MAIN FINDINGS: Asymptomatic blood donors (n = 24), immunocompetent patients who were untreated (n = 12) or treated (n = 11) for visceral leishmaniasis (VL), and immunocompromised patients with VL (n = 3) were enrolled in the study. Their infectivity to Phlebotomus perniciosus was studied by indirect xenodiagnosis on peripheral blood samples. Quantitative polymerase chain reaction of blood samples from immunocompetent patients untreated for VL and immunocompromised untreated, treated and under secondary prophylaxis for VL was performed. Antibodies against Leishmania were studied by indirect fluorescent antibody and rK39-immunochromatographic tests. A lymphoproliferative assay with a soluble Leishmania antigen was used to screen for leishmaniasis infection in the healthy population. Sixty-two xenodiagnostic tests were carried out and 5,080 sand flies were dissected. Positive xenodiagnosis was recorded in four patients, with different sand fly infection rates: 1 immunosuppressed HIV / L. infantum coinfected asymptomatic patient, 1 immunosuppressed patient with multiple myeloma and symptomatic active VL, and 2 immunocompetent patients with untreated active VL. All blood donors were negative for both xenodiagnosis and conventional PCR. CONCLUSIONS / SIGNIFICANCE: There is no consensus amongst authors on the definition of an 'asymptomatic case' nor on the tools for screening; we, therefore, have adopted one for the sake of clarity. Immunocompetent subjects, both infected asymptomatics and those treated for VL, are limited in number and appear to have no epidemiological relevance. The impact is limited for immunocompetent patients with untreated active VL, whilst immunosuppressed individuals undergoing immunosuppressive therapy and immunosuppressed individuals HIV / L. infantum coinfected were the most infectious towards sand flies. It is noteworthy that the HIV / L. infantum coinfected patient with asymptomatic leishmaniasis was easily infectious to sand flies for a long time, despite being under continuous prophylaxis for leishmaniasis. Accordingly, screening for latent Leishmania infection in HIV-infected patients is recommended in scenarios where transmission occurs. In addition, screening for VL in HIV-infected patients who have spent time in VL-endemic areas should also be implemented in non-endemic areas. More research is needed to better understand if some asymptomatic coinfected individuals contribute to transmission as 'super-spreaders'.


Assuntos
Reservatórios de Doenças , Transmissão de Doença Infecciosa , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/transmissão , Adulto , Animais , Anticorpos Antiprotozoários/sangue , Doenças Assintomáticas/epidemiologia , DNA de Protozoário/sangue , Feminino , Humanos , Leucócitos Mononucleares/imunologia , Masculino , Pessoa de Meia-Idade , Psychodidae/parasitologia , Espanha/epidemiologia
14.
PLoS Negl Trop Dis ; 14(4): e0008246, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32324742

RESUMO

The development of an accurate protein-based antigen detection assay for diagnosis of active visceral leishmaniasis (VL) would represent a major clinical advance. VL is a serious and fatal disease caused by the parasites Leishmania infantum and Leishmania donovani. The gold standard confirmatory diagnostic test for VL is the demonstration of parasites or their DNA from aspirates from spleen, lymph node, and bone marrow or from blood buffy coats. Here we describe the production and use of monoclonal antibodies (mAbs) for the development of a sensitive and specific antigen detection capture ELISA for VL diagnosis. This test simultaneously detects six leishmania protein biomarkers that we have previously described (Li-isd1, Li-txn1, Li-ntf2, Ld-mao1, Ld-ppi1 and Ld-mad1). The initial clinical validation of this new mAb-based multiplexed capture ELISA showed a sensitivity of ≥93%. The test was negative with 35 urine samples from healthy control subjects as well as with 30 patients with confirmed non-VL tropical diseases (cutaneous leishmaniasis, n = 6; Chagas disease, n = 6; schistosomiasis, n = 6; and tuberculosis, n = 12). These results strongly support the possible utility of this mAb-based multiplexed capture ELISA as a promising diagnostic test for active VL as well as for monitoring the treatment efficacy of this disease. The test is ready for upscaling and validation for clinical use.


Assuntos
Anticorpos Monoclonais/imunologia , Antígenos de Protozoários/urina , Leishmania donovani/química , Leishmania infantum/química , Leishmaniose Visceral/diagnóstico , Urinálise/métodos , Urina/química , Adolescente , Adulto , Idoso , Anticorpos Antiprotozoários/imunologia , Antígenos de Protozoários/imunologia , Biomarcadores/urina , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
15.
Semin Immunopathol ; 42(3): 231-246, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32189034

RESUMO

Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.

16.
Int J Biometeorol ; 64(5): 881-888, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32152728

RESUMO

The objective of this study was to assess the use of infrared thermography as a microclimate-evaluating tool and an estimate of the thermal comfort provided by four types of tree to cattle under grazing conditions in the central region of Brazil. The experiment was conducted at the Embrapa Beef Cattle Company, in Campo Grande, MS, Brazil, from June to August 2015. Evaluations were carried out over four consecutive days, at 1-hour intervals, from 8:00 a.m. to 4:00 p.m. (local time; GMT - 4:00). Infrared thermography images of tree crowns and soil surface underneath them from the shadow projection of four tree species native to the Brazilian cerrado (savannah-like) biome were obtained. The microclimate was assessed by estimation of thermal indices: temperature and humidity index, black globe, and radiation thermal load. The previous was calculated based on records of air temperature, dew point temperature, black globe temperature, air relative humidity, wind speed, and solar radiation. The geometrical settings of the trees were assessed for each tree component. Five thematic groups were formed based on multiple factor analysis that summarizes three synthetic analytical dimensions to explain the total variance among the studied elements and the existing correlations between groups. Positive linear correlations were found between thermography and the temperature measurements, thermal comfort indices, and radiation, suggesting that infrared thermography can be used as a tool for estimating and monitoring the microclimate and thermal comfort, presenting a potential use of measurement in agroforestry systems.


Assuntos
Gado , Termografia , Animais , Brasil , Bovinos , Umidade , Microclima , Temperatura
17.
Trop Anim Health Prod ; 52(5): 2273-2281, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32144659

RESUMO

The aim of this study was to evaluate the impact of increased shadow supply in integrated crop-livestock-forest systems on in vitro embryonic development and physiological parameters related to stress response in Nellore heifers (Bos indicus). For the study, animals (n = 16) were randomly divided into two groups and kept in areas with different afforestation systems, the integrated crop-livestock-forest (ICLF) and the integrated crop-livestock (ICL) system. The microclimate of the ICLF system provided better comfort conditions than ICL. No differences of respiratory rate, rectal temperature, cortisol, T3, T4, oocyte quality, and cleavage rate between the systems were verified. A higher blastocyst rate was observed in the ICLF (p < 0.05). The results demonstrate that Nellore heifers managed in ICLF during summer in Midwest of Brazil showed higher production of in vitro embryos, without typical changes in its physiological parameters. The results observed in the present study indicate that zebu females are able to respond satisfactorily to the intense heat conditions; however, we believe that the long period to which these animals are exposed to these conditions interferes in the oocyte competence and embryo development.


Assuntos
Bovinos/fisiologia , Embrião de Mamíferos/fisiologia , Fertilização In Vitro/veterinária , Microclima , Animais , Desenvolvimento Embrionário , Feminino , Temperatura Alta
18.
RGO (Porto Alegre) ; 68: e20200023, 2020.
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1136046

RESUMO

ABSTRACT Objective: The study sought to know mothers' perception of neonates on lingual frenotomy performed by a dental care program of a university hospital in Paraná Methods: It is a descriptive research with a qualitative approach, developed with mothers of newborns and whose children were submitted to a lingual frenzy procedure during maternal hospitalization (n = 09). Data were collected through a focus group interview and analyzed according to the content analysis technique Results: It was identified five thematic nuclei linked to lingual frenotomy in infants: 'maternal impressions agaisnt the professional indication'; 'Family trial'; 'Need to perform frenotomy'; 'Feelings after the completion of the frenotomy'; 'Changes in baby behavior'. The main maternal impressions were linked to fear and suffering related to the babies reaction. Regarding to the need to perform the lingual frenotomy, the intrinsic opinions were initially divergent, however, all evidenced that the procedure was indispensable for the baby, mainly for speech. After the frenotomy completion, the mothers reported well-being for the improvement in the lingual physiology and babies' quality of life, with emphasis on breastfeeding and improvement in the baby's behavior Conclusion: The results obtained are encouraging for the hospital managers to consider, in their clinical protocols, the technique of lingual frenotomy in newborns, with a view to facilitating mothers' access to the procedure, qualifying breastfeeding and consequently expanding the maternal and child bond.


RESUMO Objetivo: Conhecer a percepção de mães de neonatos sobre a frenotomia lingual, realizada por um programa de atenção odontológica de um hospital universitário do Paraná. Métodos: Trata-se de pesquisa descritiva com abordagem qualitativa, desenvolvida junto a mães de recém-nascidos e cujos filhos sofreram o procedimento de frenotomia lingual durante a internação materna (n=09). Os dados foram coletados por meio de entrevista em grupo focal e analisados conforme a técnica de análise de conteúdo. Resultados: Identificou-se cinco núcleos temáticos atrelados a frenotomia lingual em bebês: 'impressões maternas frente a indicação profissional'; 'julgamento da família'; 'necessidade de realização da frenotomia'; 'sentimentos após a realização da frenotomia'; 'alterações no comportamento do bebê'. As principais impressões maternas estavam atrelados ao medo e sofrimento relacionadas à reação dos bebês. Quanto à necessidade de realização da frenotomia lingual, as opiniões intrínsecas foram inicialmente divergentes, entretanto, todas evidenciaram que o procedimento era indispensável ao seu bebê, principalmente para a fala. Após a realização da frenotomia, as mães relataram bem-estar pela melhoria na fisiologia lingual e qualidade de vida dos bebês, com ênfase na amamentação e melhora no comportamento do bebê. Conclusão: Os resultados alcançados são encorajadores para gestores de hospitais considerarem, em seus protocolos clínicos, a técnica da frenotomia lingual em recém-nascidos, com vistas à facilitação do acesso de mães ao procedimento, à qualificação da amamentação materna e à consequente ampliação do vínculo maternoinfantil.

19.
PLoS One ; 14(10): e0223190, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31574119

RESUMO

The objective was to evaluate vaginal temperature as a thermoregulatory response of Nellore heifers under different microclimatic conditions. The study was conducted during one year in an experimental area located at 54°37'W, 20°27'S, and 530 m of altitude in Brazil. Twenty-four Nellore females were reared in integrated crop-livestock-forestry systems with different shading patterns. The randomized complete block experimental design was utilized with a sub subdivided plots scheme, with plot corresponding to the production systems, the subplot to the season of the year, and the sub subplot, the hours of the day. To characterize the microclimate, data regarding air and black globe temperatures, and air relative humidity were collected and from them, temperature-humidity index was calculated. Vaginal temperature was obtained by using a bottom-type temperature logger (i-button) attached to an adapted intravaginal device. The black-globe temperature explained the variation on vaginal temperature. Increases on vaginal temperature were only observed, on average, two hours after the increase of black-globe temperature. The microclimatic conditions found in the systems, resulting from the various tree densities, modify the vaginal temperature in different degrees, demonstrating that the shading effect is not always accompanied by improvements in thermal comfort. The system with intermediate density showed a better microclimatic condition and, consequently, a lower increase in vaginal temperature. The interaction between air temperature, humidity and solar radiation resulted in adverse environmental conditions, however, Nellore heifers showed good adaptation to the environment. In conclusion, vaginal temperature is a good indicator to evaluate the thermoregulatory response in Nellore heifers.


Assuntos
Regulação da Temperatura Corporal/fisiologia , Microclima , Vagina/fisiologia , Animais , Brasil , Bovinos , Feminino , Umidade , Gado , Estações do Ano , Temperatura , Sensação Térmica/fisiologia
20.
PLoS Negl Trop Dis ; 13(9): e0007726, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31557162

RESUMO

BACKGROUND: An earlier open label, prospective, non-randomized, non-comparative, multi-centric study conducted within public health facilities in Bihar, India (CTRI/2012/08/002891) measured the field effectiveness of three new treatment regimens for visceral leishmaniasis (VL): single dose AmBisome (SDA), and combination therapies of AmBisome and miltefosine (AmB+Milt) and miltefosine and paromomycin (Milt+PM) up to 6 months follow-up. The National Vector Borne Disease Control Program (NVBDCP) recommended an extended follow up at 12 months post-treatment of the original study cohort to quantify late relapses. METHODS: The 1,761 patients enrolled in the original study with the three new regimens were contacted and traced between 10 and 36 months following completion of treatment to determine their health status and any occurrence of VL relapse. RESULTS: Of 1,761 patients enrolled in the original study, 1,368 were traced at the extended follow-up visit: 711 (80.5%), 295 (83.2%) and 362 (71.5%) patients treated with SDA, AmB+Milt and Milt+PM respectively. Of those traced, a total of 75 patients were reported to have relapsed by the extended follow-up; 45 (6.3%) in the SDA, 25 (8.5%) in the AmB+Milt and 5 (1.4%) in the Milt+PM arms. Of the 75 relapse cases, 55 had already been identified in the 6-months follow-up and 20 were identified as new cases of relapse at extended follow-up; 7 in the SDA, 10 in the AmB+Milt and 3 in the Milt+PM arms. CONCLUSION: Extending follow-up beyond the standard 6 months identified additional relapses, suggesting that 12-month sentinel follow-up may be useful as a programmatic tool to better identify and quantify relapses. With limited drug options, there remains an urgent need to develop effective new chemical entities (NCEs) for VL.


Assuntos
Antiprotozoários/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Adolescente , Anfotericina B/uso terapêutico , Criança , Pré-Escolar , Estudos de Coortes , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Índia , Masculino , Paromomicina/uso terapêutico , Fosforilcolina/análogos & derivados , Fosforilcolina/uso terapêutico , Recidiva , Resultado do Tratamento
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