RESUMO
INTRODUCTION: The growing demographic presence of the transgender (TGD) population has sparked an increase in clinical investigations focusing on the impacts of gender-affirming hormone therapy (GAHT) in adults with gender dysphoria. Despite this surge in studies, there remains a significant gap in the literature regarding the health status of older TGD individuals. This review aims to assess prevalent pathological conditions within the TGD population, specifically concentrating on aging-related diseases investigated to date. METHODS: A systematic search across Embase Ovid, Scopus, PubMed, Cochrane Library, and Web of Science databases was conducted to identify articles reporting on the aging process in TGD individuals. Methodological quality was evaluated using Newcastle-Ottawa Scale (NOS) scores. RESULTS: Initial database searches yielded 12,688 studies, which were refined to 18 through elimination of duplicates and title/abstract review. Following a comprehensive appraisal, nine studies were included in the systematic review. These articles, published between 2017 and 2023, involved a total of 5403 participants. The evidence indicates a noteworthy percentage of the TGD population being at risk for cardiovascular diseases, experiencing depression or disability, and demonstrating hesitancy toward major recommended screening programs. CONCLUSIONS: Limited studies on older TGD individuals highlight not only an organic risk of chronic diseases but also a cognitive/psychiatric risk that should not be underestimated. Further research is imperative to deepen our understanding of the pathophysiological mechanisms involved in the health challenges faced by older TGD individuals.
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Envelhecimento , Pessoas Transgênero , Humanos , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Envelhecimento/fisiologia , Masculino , Feminino , Disforia de Gênero/psicologia , Disforia de Gênero/epidemiologiaRESUMO
AIMS: A comprehensive review comparing the effect of vegetarian (V) and non-vegetarian (NV) diets on the major cardiometabolic diseases' outcomes was performed. DATA SYNTHESIS: We performed literature research (up to December 31, 2022) of the evidence separately for vascular disease (VD), obesity (OB), dyslipidemia (Dysl), hypertension (HPT), type 2 diabetes (T2D), metabolic syndrome (MetS), analyzing only cohort studies and randomized controlled studies (RCTs) and comparing the effect of V and NV diets. Cohort studies showed advantages of V diets compared to NV diets on incidence and/or mortality risk for ischemic heart disease, overweight and OB risk. Most cohort studies showed V had lower risk of HPT and lower blood pressure (BP) than NV and V diets had positive effects on T2D risk or plasma parameters. The few cohort studies on the risk of MetS reported mixed results. In RCTs, V diets, mainly low-fat-vegan ones, led to greater weight loss and improved glycemic control than NV diets and in the only one RCT a partial regression of coronary atherosclerosis. In most RCTs, V diets significantly reduced LDL-C levels (but also decreased HDL-C levels) and BP. CONCLUSIONS: In this comprehensive review of the association between V diets and cardiometabolic outcomes, we found that following this type of diet may help to prevent most of these diseases. However, the non-uniformity of the studies, due to ethnic, cultural, and methodological differences, does not allow for generalizing the present results and drawing definitive conclusions. Further, well-designed studies are warranted to confirm the consistency of our conclusions.
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Diabetes Mellitus Tipo 2 , Hipertensão , Síndrome Metabólica , Humanos , Dieta Vegetariana/efeitos adversos , Obesidade , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/prevenção & controle , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta com Restrição de GordurasRESUMO
This cross-sectional study was conducted to determine the association between selected characteristics and body composition of mothers and children in early life. This study included 213 mother-child pairs 6 to 8 months involving in the cohort study of the Research and Development Project conducted in Kaffrine district. The main outcomes were fat-free mass (FFM) and body fat (BF), measured using deuterium dilution method and anthropometry. Independent variables were sociodemographic, dietary diversity and health characteristics. Descriptive, correlation, bivariate and multiple regression analyses were conducted. According to body mass index (BMI), 23% of mothers were underweight, 12% were overweight/obese and 11% had excess BF. Four per cent of children were below -2 weight-for-length z-score (WLZ), 10% were below -2 length-for-age z-score (LAZ) and 40% had excess BF. Maternal FFM was positively correlated with child FFM (r = 0.25, P = 0.002). Similarly, mothers' BMI, FFM and BF were significantly and positively correlated with children's LAZ. Stepwise regression showed an increased association between minimum dietary diversity (MDD) and WLZ score, FFM and BF of children. Among mothers, being employee and doing reproductive health care were determinants of higher BMI, FFM and BF. This study found a strong association between maternal and child body composition in early life. Adequate diet is the main determinant of children nutritional status. Among the mothers, having a job and doing primary health care seem to be beneficial for the nutritional status. Improvement of women's empowerment, quality of health care and dietary diversity could have a positive impact on maternal and child nutrition.
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Composição Corporal , Estado Nutricional , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Lactente , Relações Mãe-Filho , Mães , SenegalRESUMO
Insect saliva induces significant antibody responses associated with the intensity of exposure to bites and the risk of disease in humans. Several salivary biomarkers have been characterized to determine exposure intensity to Old World Anopheles mosquito species. However, new tools are needed to quantify the intensity of human exposure to Anopheles bites and understand the risk of malaria in low-transmission areas in the Americas. To address this need, we conducted proteomic and bioinformatic analyses of immunogenic candidate proteins present in the saliva of uninfected Anopheles albimanus from two separate colonies-one originating from Central America (STECLA strain) and one originating from South America (Cartagena strain). A ~65 kDa band was identified by IgG antibodies in serum samples from healthy volunteers living in a malaria endemic area in Colombia, and a total of five peptides were designed from the sequences of two immunogenic candidate proteins that were shared by both strains. ELISA-based testing of human IgG antibody levels against the peptides revealed that the transferrin-derived peptides, TRANS-P1, TRANS-P2 and a salivary peroxidase peptide (PEROX-P3) were able to distinguish between malaria-infected and uninfected groups. Interestingly, IgG antibody levels against PEROX-P3 were significantly lower in people that have never experienced malaria, suggesting that it may be a good marker for mosquito bite exposure in naïve populations such as travelers and deployed military personnel. In addition, the strength of the differences in the IgG levels against the peptides varied according to location, suggesting that the peptides may able to detect differences in intensities of bite exposure according to the mosquito population density. Thus, the An. albimanus salivary peptides TRANS-P1, TRANS-P2, and PEROX-P3 are promising biomarkers that could be exploited in a quantitative immunoassay for determination of human-vector contact and calculation of disease risk.
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Anopheles/metabolismo , Malária/imunologia , Proteínas e Peptídeos Salivares/imunologia , Proteínas e Peptídeos Salivares/isolamento & purificação , Animais , Formação de Anticorpos , Antígenos , Biomarcadores/sangue , Colômbia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Mordeduras e Picadas de Insetos , Proteínas de Insetos/imunologia , Mosquitos Vetores , Projetos Piloto , Proteômica , Saliva/químicaRESUMO
BACKGROUND: Senegal introduced a 13-valent pneumococcal conjugate vaccine (PCV13) in October 2013, given at 6, 10, and 14 weeks of age. We document trends of meningitis and pneumonia after the PCV13 introduction. METHODS: From October 2010-October 2016, hospitalization data for clinical meningitis and pneumonia in children aged <5 years were collected from logbooks at a large, tertiary, pediatric hospital in Dakar. We used a set of predetermined keywords to define hospitalizations for extraction from hospital registers. We conducted a time-series analysis and compared hospitalizations before and after the PCV13 introduction, accounting for seasonality. The initial PCV13 uptake period (October 2013-September 2014) was considered to be transitional and was excluded. RESULTS: Over the 7-year period, 1836 and 889 hospitalizations with a discharge diagnosis of pneumonia and meningitis, respectively, occurred in children aged <5 years. In children aged <12 months, a small, significant reduction in pneumonia was observed post-PCV13 (-3.8%, 95% confidence interval [CI] -1.5 to -5.9%). No decline was observed among children aged 12-59 months (-0.7%, 95% CI -0.8 to 2.2%). Meningitis hospitalizations remained stable for children aged <12 months (1.8%, 95% CI -0.9 to 4.4%) and 12-59 months (-0.5%, 95% CI -3.6 to 2.6%). CONCLUSIONS: We used data from 1 hospital to detect a small, significant reduction in all-cause pneumonia hospitalizations 2 years post-PCV13 introduction in infants; the same trend was not measurable in children aged 12-59 months or in meningitis cases. There is a need for continued surveillance to assess the long-term impact of sustained PCV13 use and to monitor how pneumococcus is causing disease in the meningitis belt.
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Hospitalização/estatística & dados numéricos , Meningites Bacterianas/epidemiologia , Vacinas Pneumocócicas/administração & dosagem , Pneumonia Pneumocócica/epidemiologia , Sistema de Registros , Pré-Escolar , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Meningites Bacterianas/prevenção & controle , Pneumonia Pneumocócica/prevenção & controle , Senegal/epidemiologia , Vacinas Conjugadas/administração & dosagemRESUMO
BACKGROUND: Bacterial meningitis is a major cause of mortality among children under 5 years of age. Senegal is part of World Health Organization-coordinated sentinel site surveillance for pediatric bacterial meningitis surveillance. We conducted this analysis to describe the epidemiology and etiology of bacterial meningitis among children less than 5 years in Senegal from 2010 and to 2016. METHODS: Children who met the inclusion criteria for suspected meningitis at the Centre Hospitalier National d'Enfants Albert Royer, Senegal, from 2010 to 2016 were included. Cerebrospinal fluid specimens were collected from suspected cases examined by routine bacteriology and molecular assays. Serotyping, antimicrobial susceptibility testing, and whole-genome sequencing were performed. RESULTS: A total of 1013 children were admitted with suspected meningitis during the surveillance period. Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus accounted for 66% (76/115), 25% (29/115), and 9% (10/115) of all confirmed cases, respectively. Most of the suspected cases (63%; 639/1013) and laboratory-confirmed (57%; 66/115) cases occurred during the first year of life. Pneumococcal meningitis case fatality rate was 6-fold higher than that of meningococcal meningitis (28% vs 5%). The predominant pneumococcal lineage causing meningitis was sequence type 618 (n = 7), commonly found among serotype 1 isolates. An ST 2174 lineage that included serotypes 19A and 23F was resistant to trimethoprim-sulfamethoxazole. CONCLUSIONS: There has been a decline in pneumococcal meningitis post-pneumococcal conjugate vaccine introduction in Senegal. However, disease caused by pathogens covered by vaccines in widespread use still persists. There is need for continued effective monitoring of vaccine-preventable meningitis.
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Meningites Bacterianas/epidemiologia , Vacinas Pneumocócicas/administração & dosagem , Vigilância de Evento Sentinela , Pré-Escolar , Feminino , Haemophilus influenzae/classificação , Humanos , Lactente , Recém-Nascido , Masculino , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/mortalidade , Neisseria meningitidis/classificação , Senegal/epidemiologia , Sorotipagem , Streptococcus pneumoniae/classificação , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Vacinas Conjugadas/administração & dosagem , Sequenciamento Completo do GenomaRESUMO
Chronic pain and recurrence rates are the main challenge in modern inguinal hernia surgery. Several trials have investigated the role of self-adhesive mesh repair for inguinal hernia, with special attention to the incidence of chronic postoperative inguinal pain and recurrence. The purpose of our study was to retrospectively evaluate the early and long-term results using a self-gripping mesh (Parietex Progrip® , Covidien) in our institution. A total of 204 patients, mean age 50.3 standard deviation (SD) 15.3, was included in the study. The repair was performed under local anaesthesia in 159 (78%) cases and locoregional anaesthesia in remaining 45 (22%). Mean operative time was 39 ± 20 minutes. The time for self-gripping mesh placement ranged from 5 to 9 minutes (mean 7 ± 2 minutes). There were no intraoperative complications. Clinical follow-up was performed at 1 month, 1 year and 2 years and consisted in the evaluation of complications, discomfort/pain and recurrence. One case of cutaneous infection and three cases of seroma were observed at one-month follow-up and were all treated conservatively. 8 patients were lost at one year follow-up, and another 4 were lost at 2 years. 3 patients died for other causes during follow-up. At 1 year and 2 years follow-up no cases of seroma, testicular complications or mesh infection were observed. Two cases of recurrence were recorded at 2 years follow up. No patient reported VAS score > 2 at one month, 1 year and 2 years follow-up. There were no readmissions, systemic complications or death during 2 years follow-up. Lichtenstein open repair using Parietex Progrip® mesh is a simple, rapid, effective and safe method for inguinal hernia repair. The main advantage of self-fixing mesh is the reduced operative time. A suturless fixation seems to prevent the development of postoperative chronic pain, without increasing recurrence rate in the majority of the trials.
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Colágeno/uso terapêutico , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Poliésteres/uso terapêutico , Telas Cirúrgicas , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia por Condução/estatística & dados numéricos , Anestesia Local/estatística & dados numéricos , Dor Crônica/etiologia , Feminino , Seguimentos , Herniorrafia/efeitos adversos , Humanos , Perda de Seguimento , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Dor Pós-Operatória/etiologia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
Antigen-based immunoassays are currently needed for point-of-care quantification of Loa loa microfilariae (mf). Coupling transcriptomic approaches with bioinformatic analysis, we have identified 11 specific putative proteins (coding mRNAs) with potential utility as biomarkers of patent (mf + ) L. loa infection. We successfully developed antigen capture immunoassays to quantify 2 (LOAG_14221 and LOAG_15846) of these proteins in individual plasma/serum samples. Of the 2 quantifiable circulating biomarkers, LOAG_14221 showed the highest degree of specificity, particularly with a monoclonal antibody-based immunoassay. Moreover, the levels of LOAG_14221 in L. loa mf + patients were positively correlated to the mf densities in the corresponding blood samples (r = 0.53 and P = 0.008 for polyclonal assay; r = 0.54 and P = 0.004 for monoclonal assay). Thus, LOAG_14221 is a very promising biomarker that will be exploited in a quantitative point-of-care immunoassay for determination of L. loa mf densities.
Assuntos
Antígenos de Helmintos/sangue , Loa/imunologia , Loíase/diagnóstico , Microfilárias/imunologia , Proteínas de Protozoários/sangue , Animais , Anticorpos Monoclonais/imunologia , Antígenos de Helmintos/imunologia , Biomarcadores/sangue , Biologia Computacional , Perfilação da Expressão Gênica , Humanos , Imunoensaio/métodos , Loíase/imunologia , Loíase/parasitologia , Onchocerca volvulus/imunologia , Sistemas Automatizados de Assistência Junto ao Leito , Proteínas de Protozoários/imunologia , Wuchereria bancrofti/imunologiaRESUMO
BACKGROUND: Interest in vegetarian diets is growing in Italy and elsewhere, as government agencies and health/nutrition organizations are emphasizing that regular consumption of plant foods may provide health benefits and help prevent certain diseases. METHODS AND RESULTS: We conducted a Pubmed search, up to September, 2015, for studies on key nutrients (proteins, vitamin B12, iron, zinc, calcium, vitamin D, and n-3 fatty acids) in vegetarian diets. From 295 eligible publications the following emerged: Vegetarians should be encouraged to supplement their diets with a reliable source of vitamin B12 (vitamin-fortified foods or supplements). Since the plant protein digestibility is lower than that of animal proteins it may be appropriate for vegetarians to consume more proteins than recommended for the general population. Vegetarians should also be encouraged to habitually consume good sources of calcium, iron and zinc - particularly vegetables that are low in oxalate and phytate (e.g. Brassicaceae), nuts and seeds, and calcium-rich mineral water. Calcium, iron, and zinc bioavailability can be improved by soaking, germination, and sour-dough leavening that lower the phytate content of pulses and cereals. Vegetarians can ensure good n-3 fatty acid status by habitually consuming good sources of a-linolenic acid (walnuts, flaxseeds, chia seeds, and their oils) and limiting linoleic acid intake (corn and sunflower oils). CONCLUSIONS: Well-planned vegetarian diets that include a wide variety of plant foods, and a reliable source of vitamin B12, provide adequate nutrient intake. Government agencies and health/nutrition organizations should provide more educational resources to help Italians consume nutritionally adequate vegetarian diets.
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Dieta Saudável/normas , Dieta Vegetariana/normas , Ciências da Nutrição/normas , Estado Nutricional , Valor Nutritivo , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Dieta Vegana/normas , Suplementos Nutricionais/normas , Feminino , Humanos , Lactente , Recém-Nascido , Itália , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Gravidez , Recomendações Nutricionais , Sociedades Médicas , Adulto JovemRESUMO
BACKGROUND: The estimates of risk of malaria in early childhood are imprecise given the current entomologic and parasitological tools. Thus, the utility of anti-Anopheles salivary gSG6-P1 peptide antibody responses in measuring exposure to Anopheles bites during early infancy has been assessed. METHODS: Anti-gSG6-P1 IgG and IgM levels were evaluated in 133 infants (in Benin) at three (M3), six (M6), nine (M9) and 12 (M12) months of age. Specific IgG levels were also assessed in their respective umbilical cord blood (IUCB) and maternal blood (MPB). RESULTS: At M3, 93.98 and 41.35% of infants had anti-gSG6-P1 IgG and IgM Ab, respectively. Specific median IgG and IgM levels gradually increased between M3 and M6 (p < 0.0001 and p < 0.001), M6-M9 (p < 0.0001 and p = 0.085) and M9-M12 (p = 0.002 and p = 0.03). These levels were positively associated with the Plasmodium falciparum infection intensity (p = 0.006 and 0.003), and inversely with the use of insecticide-treated bed nets (p = 0.003 and 0.3). Levels of specific IgG in the MPB were positively correlated to those in the IUCB (R = 0.73; p < 0.0001) and those at M3 (R = 0.34; p < 0.0001). CONCLUSION: The exposure level to Anopheles bites, and then the risk of malaria infection, can be evaluated in young infants by assessing anti-gSG6-P1 IgM and IgG responses before and after 6-months of age, respectively. This tool can be useful in epidemiological evaluation and surveillance of malaria risk during the first year of life.
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Anopheles/imunologia , Biomarcadores/sangue , Mordeduras e Picadas/imunologia , Malária/epidemiologia , Malária/transmissão , Proteínas e Peptídeos Salivares/imunologia , Animais , Anopheles/química , Feminino , Humanos , Imunidade Materno-Adquirida/imunologia , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Lactente , GravidezRESUMO
Rapid and accurate tests are currently needed to identify individuals with high levels of Loa loa microfilaria (mf), so that these individuals may be excluded from mass ivermectin administration campaigns against onchocerciasis and lymphatic filariasis being conducted in areas where Onchocerca volvulus, Wuchereria bancrofti, and L. loa are coendemic. To address this need, colorimetric loop-mediated isothermal amplification (LAMP) assays targeting the L. loa-specific gene sequences LLMF72 and LLMF342 were developed for the detection and quantification of L. loa microfilaremia. Both LAMP assays were highly specific (100%) for L. loa infection compared to the absence of infection or infection with related filarial pathogens. The LLMF72-based LAMP assay showed greater analytic sensitivity (limit of detection, 0.1 pg/ml of genomic DNA [gDNA] and/or 5 mf/ml) than the LLMF342-based LAMP assay (10 pg/ml of gDNA and/or 50 mf/ml), and its analytic sensitivity was similar to that of LLMF72-based quantitative PCR (qPCR). A high level of correlation was observed between microfilaria counts as determined by LLMF72-based qPCR and time to positivity by the LAMP assay, and performance measures of sensitivity, specificity, and positive and negative predictive values were similar for both assays when applied to field-collected clinical samples. By simply varying the run time, the LAMP assay was able to accurately distinguish individuals at risk for serious adverse events (SAEs) after exposure to ivermectin, using thresholds of >5,000 mf/ml and >30,000 mf/ml as indicators of increasing levels of risk. In summary, LLMF72 LAMP represents a new molecular diagnostic tool that is readily applicable as a point-of-care method for L. loa microfilarial detection and quantification in resource-limited countries where L. loa infection is endemic.
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Loa/genética , Loa/isolamento & purificação , Loíase/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Animais , Colorimetria/métodos , Primers do DNA/genética , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
AIMS: Considering the impact of sarcopenia on mortality, and the difficulty to assessment of body composition, the hypothesis of the study is that calf circumference (CC) is closely related to mortality in older patients. The aim of the study was to analyze the potential role of CC to predict mortality in old individuals at 3, 6 and 12 months after discharge from hospital. METHODS: Patients aged >65 years were recruited for this retrospective study from September 2021 to March 2022. Their physical and body composition characteristics (including Body Mass Index-BMI and Mini Nutritional Assessment-MNA) were measured; data on mortality at 3 (T3), 6 (T6) and 12 (T12) months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria. RESULTS: Participants were 192 older adults (92 women), with a mean age of 82.8±7.0 years. Sarcopenic people were 41. The mortality rate was higher in sarcopenic people only at T3 and T6. CC had comparable validity in predicting mortality to that of MNA and ASMMI (Appendicular Skeletal Muscle Mass), and was better than BMI and serum albumin at each time point. Youden's index showed that the best cut-off for CC for predicting mortality was 30.6 cm both at T3 (sensitivity: 74%; specificity: 75%) and T6 (sensitivity: 75%; specificity: 67%). At the Cox regression model for mortality, high values of CC (HR 0.73, CI95% 0.60-0.89/p<0.001) and ADL scores (HR 0.72, CI95% 0.54-0.96/p=0.04) were protective factors at T6 and T12 respectively; at T12 high comorbidity rate was a risk factor (HR 1.28, IC95% 1.02-1.62/p=0.04). CONCLUSIONS: CC has a validity comparable to MNA and ASMMI in predicting mortality at 3, 6 and 12 months after hospital discharge. Moreover, it can be considered an independent predictor of medium-term mortality in the hospitalized older population. CC can be an effective method for the prognostic stratification of these patients, due to its simplicity and immediacy.
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Sarcopenia , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/diagnóstico , Estudos Retrospectivos , Antropometria , Índice de Massa Corporal , Composição CorporalRESUMO
One century after the discovery of Chagas disease, it is still considered as a major health problem, causing more deaths in the Americas than any other parasitic disease. The northwest region of São Paulo, a macro-region that includes cities with a high-quality of life, has particularly high rates of Chagas disease. Therefore, this study aimed to assess the number of patients with Chagas disease, and to identify the triatomine fauna in the northwest region of São Paulo State, and to cytogenetically analyze Triatoma sordida mutants, thus providing new knowledge to control these species and avoid possible infections by Chagas disease. A total of 700 Chagas patients of both genders and variable age, who were born in and residents of the northwest region of the State of São Paulo were recruited for this study. Regarding the entoepidemiological fauna, both T. sordida and Rhodnius neglectus were captured from 2004 to 2011 in the northwest region of the São Paulo; however, T. sordida was the predominant species. Some of these collected triatomines were infected by Trypanosoma cruzi in several developmental stages. Furthermore, the lactoacetic orcein method was used for cytogenetic analysis. Several abnormalities were observed during meiosis of the T. sordida mutants, including condensed chromosomes with no chiasma, chromatin bridges between the autosomes, and some non-pairing homologous chromosomes. Thus, our study suggests that Chagas disease is currently not under control in Brazil. Furthermore, we suggest that cryptic speciation may be occurring in populations of T. sordida of Brazil. Further studies are necessary to understand the mechanisms behind these phenomena.
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Doença de Chagas/epidemiologia , Cromossomos de Insetos/genética , Rhodnius/genética , Triatoma/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil , Doença de Chagas/transmissão , Criança , Pré-Escolar , Ecossistema , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Filogeografia , Rhodnius/parasitologia , Triatoma/parasitologia , Trypanosoma cruzi/patogenicidadeRESUMO
Wastewater treatment plant (WWTP) effluents are considered to be a major source for the release in the aquatic environment of endocrine-disrupting compounds (EDCs). Ozone has proved to be a suitable solution for polishing secondary domestic effluents. In this work, the performance of a full-scale ozonation plant was investigated in order to assess the removal efficiency of four target EDCs: nonylphenol, nonylphenol monoethoxylate, nonylphenol diethoxylate and bisphenol A. The studied system was the tertiary treatment stage of a municipal WWTP which receives an important industrial (textile) load. Chemical analyses showed that the considered substances occurred with a significant variability, typical of real wastewaters; based on this, ozonation performance was carefully evaluated and it appeared to be negatively affected by flow-rate increase (during rainy days, with consequent contact time reduction). Moreover, EDCs' measured removal efficiency was lower than what could be predicted based on literature data, because of the relatively high residual content of biorefractory compounds still present after biological treatment.
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Compostos Benzidrílicos/isolamento & purificação , Estrogênios não Esteroides/isolamento & purificação , Ozônio/química , Fenóis/isolamento & purificação , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/química , Compostos Benzidrílicos/análise , Compostos Benzidrílicos/química , Disruptores Endócrinos/análise , Disruptores Endócrinos/química , Disruptores Endócrinos/isolamento & purificação , Estrogênios não Esteroides/análise , Estrogênios não Esteroides/química , Fenóis/análise , Fenóis/química , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/química , Poluentes Químicos da Água/isolamento & purificação , Purificação da Água/métodosRESUMO
BACKGROUND AND OBJECTIVES: One of the pathogenetic hypotheses of delirium is the "neuroinflammatory theory" with consequent neurotoxicity of brain connectivity networks. Micronutrients may play a significant role in the prevention of neuroinflammation. This systematic review addresses the role of micronutrients in the development of delirium in older populations. METHODS: The EBSCO, Cochrane, PubMed, and Web of Science databases were searched for articles on delirium and micronutrients. The methodological quality of the studies included in the review was evaluated with the Newcastle-Ottawa Scales for observational studies and for case-control studies. RESULTS: 1326 papers were identified from the searches, 7 of which met the inclusion criteria (see section 2.3). All the papers included were written in English. Delirium was predominantly secondary to post-operative dysfunction or acute medical conditions. By altering the production of neurotransmitters resulting in an imbalance, and by reducing their immunomodulatory role with a consequent increase in inflammatory oxidative stress, micronutrient deficiency seems to be associated with an increased incidence of delirium. CONCLUSIONS: This review supports the existence of an association between micronutrient deficiency (i.e. cobalamin, thiamine, and vitamin D) and an increased incidence of delirium, with a greater prevalence in hospitalized patients.
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Delírio , Vitaminas , Humanos , Idoso , Encéfalo , Estudos de Casos e Controles , Micronutrientes , Delírio/etiologiaRESUMO
OBJECTIVES: To review clinical characteristics, treatment, outcome and prognostic factors in dogs with solid cancer-bearing bone metastases. MATERIALS AND METHODS: Records were reviewed from dogs with histologically-proven solid cancer and bone metastases. Clinicopathologic variables, bone metastases characteristics and skeletal-related events were recorded. Endpoints were time to bone metastases and survival. RESULTS: Fifty dogs were included, 20 of them with synchronous and 30 of them with metachronous bone metastases. In the latter group, median time to diagnosis of bone metastases was 210 days (range, 30 to 1835). Most common primary cancer locations included mammary gland (n=6), spleen (n=5) and tonsil (n=5). Most common histotypes were carcinoma (n=32) and hemangiosarcoma (n=10). Nineteen dogs had multiple bones involvement, with humeri and vertebrae more commonly affected. Twenty-four dogs received antitumoural therapy, five symptomatic treatment and 21 were not treated. Overall median survival after bone metastases diagnosis was 30 days (range, 11 to 49); 83% of dogs died because of skeletal-related events. Lack of antitumoural therapy was significantly associated with shorter survival (hazard ratio: 2.7; 95% confidence interval: 1.3 to 5.6) and with increased risk of skeletal-related death (hazard ratio: 3.3; 95% confidence interval: 1.4 to 7.4). Dogs with endocrine/neuroendocrine tumours (odds ratio: 8.8; 95% confidence interval: 1.2 to 63.9), without appendicular metastases (odds ratio: 5.1; 95% confidence interval: 1.0 to 25.8), without extra-skeletal metastases (odds ratio: 5.2; 95% confidence interval: 1.1 to 24.5) and receiving antitumoural therapy (odds ratio: 14.8; 95% confidence interval: 1.7 to 131.4) had an increased chance of surviving more than 100 days. CLINICAL SIGNIFICANCE: Bone metastases in dogs with solid cancers are associated with poor prognosis and a high risk of skeletal-related events. Treatment appears to have an impact on survival.
Assuntos
Neoplasias Ósseas , Doenças do Cão , Cães , Animais , Estudos Retrospectivos , Neoplasias Ósseas/veterinária , Prognóstico , Doenças do Cão/patologiaRESUMO
BACKGROUND: Urban malaria can be a serious public health problem in Africa. Human-landing catches of mosquitoes, a standard entomological method to assess human exposure to malaria vector bites, can lack sensitivity in areas where exposure is low. A simple and highly sensitive tool could be a complementary indicator for evaluating malaria exposure in such epidemiological contexts. The human antibody response to the specific Anopheles gSG6-P1 salivary peptide have been described as an adequate tool biomarker for a reliable assessment of human exposure level to Anopheles bites. The aim of this study was to use this biomarker to evaluate the human exposure to Anopheles mosquito bites in urban settings of Dakar (Senegal), one of the largest cities in West Africa, where Anopheles biting rates and malaria transmission are supposed to be low. METHODS: One cross-sectional study concerning 1,010 (505 households) children (n = 505) and adults (n = 505) living in 16 districts of downtown Dakar and its suburbs was performed from October to December 2008. The IgG responses to gSG6-P1 peptide have been assessed and compared to entomological data obtained in or near the same district. RESULTS: Considerable individual variations in anti-gSG6-P1 IgG levels were observed between and within districts. In spite of this individual heterogeneity, the median level of specific IgG and the percentage of immune responders differed significantly between districts. A positive and significant association was observed between the exposure levels to Anopheles gambiae bites, estimated by classical entomological methods, and the median IgG levels or the percentage of immune responders measuring the contact between human populations and Anopheles mosquitoes. Interestingly, immunological parameters seemed to better discriminate the exposure level to Anopheles bites between different exposure groups of districts. CONCLUSIONS: Specific human IgG responses to gSG6-P1 peptide biomarker represent, at the population and individual levels, a credible new alternative tool to assess accurately the heterogeneity of exposure level to Anopheles bites and malaria risk in low urban transmission areas. The development of such biomarker tool would be particularly relevant for mapping and monitoring malaria risk and for measuring the efficiency of vector control strategies in these specific settings.
Assuntos
Anopheles/imunologia , Exposição Ambiental , Imunoglobulina G/sangue , Mordeduras e Picadas de Insetos/imunologia , Proteínas e Peptídeos Salivares/imunologia , População Urbana , Adulto , Análise de Variância , Animais , Formação de Anticorpos , Criança , Pré-Escolar , Feminino , Humanos , Insetos Vetores/imunologia , Masculino , Senegal , Adulto JovemRESUMO
Pulmonic stenosis is a frequent congenital heart disease in dogs, and the treatment of choice is balloon valvuloplasty which is usually safe and successful. The authors describe for the first time a severe complication after balloon valvuloplasty in a five-month-old dog. After effective treatment, with a considerable drop in right ventricular pressures, the dog developed hypoxemia and dyspnea due to pulmonary edema. The dog underwent intensive care and symptoms improved after a few hours of oxygen therapy, continuous positive airway pressure, and furosemide. Although this event is rare, it could have a large impact on patient survival and should be considered in the treatment of severe pulmonary valve stenosis in the future.
Assuntos
Valvuloplastia com Balão , Doenças do Cão , Edema Pulmonar , Estenose da Valva Pulmonar , Animais , Valvuloplastia com Balão/efeitos adversos , Valvuloplastia com Balão/veterinária , Doenças do Cão/etiologia , Doenças do Cão/terapia , Cães , Edema Pulmonar/etiologia , Edema Pulmonar/terapia , Edema Pulmonar/veterinária , Estenose da Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/etiologia , Estenose da Valva Pulmonar/terapia , Estenose da Valva Pulmonar/veterinária , Resultado do TratamentoRESUMO
A five-year-old intact male Golden Retriever was sent to our center for a second cardiac evaluation after the diagnosis of right atrial dilatation. Transthoracic and transesophageal echocardiographic evaluation and echo-contrast study were performed. A diagnosis of aneurysmal right auricle was issued without any sign of other cardiac pathologies. The tomographic evaluation was necessary to estimate the dimension of the aneurysmal area and exclude pericardial defects that may justify this anomaly. This report describes a rare case of aneurysmal giant right auricle in dogs. The diagnosis is accurate with the association of echocardiography and computed tomography.
Assuntos
Apêndice Atrial , Doenças do Cão , Cardiopatias , Animais , Doenças do Cão/diagnóstico por imagem , Cães , Ecocardiografia/veterinária , Ecocardiografia Transesofagiana/métodos , Cardiopatias/veterinária , Masculino , Tomografia Computadorizada por Raios X/veterináriaRESUMO
Background: The control of snails intermediate hosts remains an effective strategy to limit schistosomiasis transmission despite the widespread mass de-worming campaign based on praziquantel. Therefore, the study of snail biology could help to improve snails control strategies. This study evaluated the development of Biomphalaria pfeifferi, Bulinus senegalensis and Bulinus truncatus in various water sources and their resistance to salinity. Methods: Five day-old juveniles individuals issued from adult snails non-shedding Schistosoma spp cercariae were breed in distilled water, commercial mineral water, ground pump water and well water. Snail's survival rate and size were measured over a period of 40 days. These two parameters were also measured over 30 days in increasing saline solutions (1 g/l, 3.5 g/l and 4 g/l) made of well water to which sodium chloride was added. Results: B. truncatus growth was not hampered by any water sources with a survival rate between 68% and 84% (log rank X2 = 1.86, df = 3, p = 0.60). Despite a poor survival rate (8%) in distilled water, B. pfeifferi, has adapted to other water sources with a survival fraction between 88% and 96% (log rank X2 = 61.94, df = 3, p < 0.0001). B. senegalensis development was very delicate with low survival rate of 4% in distilled water, 20% in well water and 24% in commercial mineral water and ground pump water (log rank X2 = 13.24, df = 3, p = 0,004). For each species, even if the difference is not significant, the size of snails is larger with well water and pump water compared to distilled and commercial mineral water.B. pfeifferi survival rate was at 45% in both three saline solutions at day 30. B. senegalensis population collapsed at day 10 in 4 g/l saline solution and persisted until day 30 in both 1.5 g/l and 3.5 g/l solution. B. truncatus also persisted with a survival rate at 20% in 1.5 g/l but collapsed at day 5 and 15 in 4 g/l and 3.5 g/l solution, respectively. Conclusion: The differences in adaptation between snails species show the need to take into account the water sources for snail breeding in the laboratory. Further studies could help to determine the optimal water quality for each snail species in order to standardize breeding conditions. This study could contribute to the understanding of the dynamics and distribution of snails in natural conditions.