RESUMO
Phytotoxins produced by marine microalgae, such as paralytic shellfish toxins (PSTs), can accumulate in bivalve molluscs, representing a human health concern due to the life-threatening symptoms they cause. To avoid the commercialization of contaminated bivalves, monitoring programs were established in the EU. The purpose of this work is the implementation of a PST transforming enzyme-carbamoylase-in an impedimetric test for rapid simultaneous detection of several carbamate and N-sulfocarbamoyl PSTs. Carbamoylase hydrolyses carbamate and sulfocarbamoyl toxins, which may account for up to 90% of bivalve toxicity related to PSTs. Conformational changes of carbamoylase accompanying enzymatic reactions were probed by Fourier transform mid-infrared spectroscopy (FT-MIR) and electrochemical impedance spectroscopy (EIS). Furthermore, a combination of EIS with a metal electrode and a carbamoylase-based assay was employed to harness changes in the enzyme conformation and adsorption on the electrode surface during the enzymatic reaction as an analytical signal. After optimization of the working conditions, the developed impedimetric e-tongue could quantify N-sulfocarbamoyl toxins with a detection limit of 0.1 µM. The developed e-tongue allows the detection of these toxins at concentration levels observed in bivalves with PST toxicity close to the regulatory limit. The quantification of a sum of N-sulfocarbamoyl PSTs in naturally contaminated mussel extracts using the developed impedimetric e-tongue has been demonstrated.
Assuntos
Bivalves , Intoxicação por Frutos do Mar , Animais , Humanos , Toxinas Marinhas/química , Nariz Eletrônico , Bivalves/química , Frutos do Mar/análise , Carbamatos , Intoxicação por Frutos do Mar/etiologiaRESUMO
This systematic review aims to estimate the prevalence of sarcopenia in people living with HIV (PLHIV) and to assess whether there is a difference between the muscle mass of PLHIV and people living without HIV. A systematic review of randomized controlled trials, cohort studies, cross-sectional and case-control studies was carried out. PLHIV over 18 years of age and that had their muscle mass evaluated by dual-energy X-ray absorptiometry were included. Overall, 4,376 studies were found, of which 118 had their full texts evaluated. A total of 5,532 people living with HIV and 2,986 people living without HIV were identified in 41 studies. The frequency of sarcopenia defined by low muscle mass (Baumgartner's operational definition) alone was 30.3% (95%CI 24.3%, 37.1%) and the frequency of sarcopenia defined by low muscle mass with low muscle strength (EWGSOP definition) was 4.5% (95%CI 1.3%, 13.9%), p-valueâ¯=â¯0.0006. The standardized mean differences of muscle mass between PLHIV and controls was -0.211 units of standard deviation (95%CI -0.419, -0.003). In the meta-regression analysis muscle mass mean difference was associated with BMI, CD4, percentage of subjects on ART, and study design. PLHIV have a lower muscle mass when compared to people living without HIV. This difference appears to be attenuated by higher BMI, CD4 levels, and the percentage of subjects using ART. Furthermore, the frequencies of sarcopenia assessed by the operational definition of Baumgartner and the EWGSOP are not comparable and cannot be interchanged in PLHIV.
Assuntos
Infecções por HIV , Sarcopenia , Absorciometria de Fóton , Adolescente , Adulto , Estudos Transversais , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Força da Mão , Humanos , Força Muscular , Prevalência , Sarcopenia/diagnóstico por imagem , Sarcopenia/epidemiologiaRESUMO
BACKGROUND: Dyslipidemia and central obesity are the main components of metabolic syndrome, which represent important risk factors for cardiovascular diseases in people living with human immunodeficiency virus (HIV). The lipid accumulation product (LAP) index has been shown in studies as an efficient marker of metabolic syndrome in general adult population and its applicability in HIV-infected population is not discussed. We aimed to assess the accuracy of the LAP index to identify metabolic syndrome in people living with HIV. METHODS: It is a cross-sectional study with 141 HIV-infected patients on antiretroviral therapy, conducted in a reference centre of infectious diseases in southeast Brazil. Evaluations included LAP index, anthropometric measurements and clinical and laboratorial variables. Metabolic syndrome was defined by International Diabetes Federation (IDF) criteria. RESULTS: The prevalence of metabolic syndrome in our sample was 10.6%. A positive and significant correlation was found between the metabolic syndrome and LAP (r=0.401; P<0.01), metabolic syndrome and body mass index (r=0.361; P<0.01) and metabolic syndrome and waist circumference (r=0.427; P<0.01) in our sample. The analysis of the receiver-operating characteristic (ROC) curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 59.4 (sensitivity 80%, specificity 79% and area under the curve (AUC) of 0.875. In female and male, analysis of the ROC curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 56.3 (sensitivity 100%, specificity 82% and AUC of 0.929) and 52.0 (sensitivity 78%, specificity 74% and AUC of 0.838), respectively. CONCLUSION: Despite the low prevalence of metabolic syndrome in our sample, the ROC curves analyzes demonstrated a good diagnostic accuracy as an additional screening tool of metabolic syndrome according to the IDF.
Assuntos
Infecções por HIV , Produto da Acumulação Lipídica , Síndrome Metabólica , Adulto , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Circunferência da CinturaRESUMO
Out of control proliferation of toxic phytoplankton, called harmful algal blooms (HABs), have a significant economic impact on bivalve aquaculture and harvesting in coastal waters. Some phytotoxins, such as paralytic shellfish toxins (PSTs), are of concern due to the life-threatening symptoms they can cause. Development of rapid and low-cost screening tools would be a welcome addition to the laboratory methodologies employed in routine monitoring programs. However, most of the assays and biosensors for the screening of PSTs, are restricted to a single target, saxitoxin (STX), which is the most potent PST. The present study aimed at developing an assay for the detection of N-sulfocarbamoyl PST-GTX5, which is one of the most abundant toxins in bivalves during G. catenatum blooms as found on the Portuguese coast. Enzymatic assay employing PSTs' transforming enzyme-carbamoylase-was proposed. Carbamoylase was extracted and purified from the surf clam S. solida. Carbamoylase displayed similar specificity to both carbamate (STX) and N-sulfocarbamate toxins (GTX5 and C1+2) converting them into decarbamoyl saxitoxin (dcSTX) and decarbamoyl gonyautoxins 2+3 (dcGTX2+3), respectively. The enzymatic assay involved hydrolysis of GTX5 by carbamoylase and quantification of the product of enzymatic reaction, dcSTX, using a potentiometric chemical sensor. A potentiometric sensor with plasticized PVC membrane that displayed sensitivity to dcSTX and selectivity in the presence of GTX5 was employed. Enzymatic assay allowed determination of GTX5 in the concentration range from 0.43 to 3.30 µmolL-1, which encompasses levels of GTX5 in contaminated bivalve extracts with toxicities above PSTs regulatory limits. The feasibility of the carbamoylase-based potentiometric assay for detection of GTX5 was demonstrated.
Assuntos
Amidoidrolases/metabolismo , Bioensaio/métodos , Técnicas Biossensoriais/métodos , Toxinas Marinhas/análise , Amidoidrolases/química , Animais , Bivalves/química , Toxinas Marinhas/metabolismo , Potenciometria/métodosRESUMO
Cholecystectomy is considered as a safe procedure to treat patients with gallstones. However, epidemiological studies highlighted an association between cholecystectomy and metabolic disorders, such as type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease (MASLD), independently of the gallstone disease. Following cholecystectomy, bile acids flow directly from the liver into the intestine, leading to changes in the entero-hepatic circulation of bile acids and their metabolism. The changes in bile acids metabolism impact the gut microbiota. Therefore, cholecystectomized patients display gut dysbiosis characterized by a reduced diversity, a loss of bacteria producing short-chain fatty acids and an increase in pro-inflammatory bacteria. Alterations of both bile acids metabolism and gut microbiota occurring after cholecystectomy can promote the development of metabolic disorders. In this review, we discuss the impact of cholecystectomy on bile acids and gut microbiota and its consequences on metabolic functions.
Assuntos
Ácidos e Sais Biliares , Colecistectomia , Microbioma Gastrointestinal , Doenças Metabólicas , Humanos , Colecistectomia/efeitos adversos , Microbioma Gastrointestinal/fisiologia , Ácidos e Sais Biliares/metabolismo , Doenças Metabólicas/etiologia , Fígado/metabolismo , DisbioseRESUMO
BACKGROUND: Cardiovascular diseases constitute an important group of causes of death in the country. Ischemic heart diseases that are the main causes of cardiopulmonary arrest, leading to an impact on the mortality of the cardiovascular diseases in the health system. OBJECTIVE: Assess the number of home deaths by cardiopulmonary arrest notified by the Mobile Emergency Medical Service (SAMU) in March 2018, 2019 and 2020. METHODS: Observational study carried out from the analysis of cardiopulmonary arrest mortality data of citizens assisted by SAMU in Belo Horizonte, Minas Gerais, Brazil. Social and clinical characteristics and occurrence information of the patients were analyzed. The mortality rate due to cardiopulmonary arrest in relation to the total number of attendances was assessed. A significance level of 95% was considered. RESULTS: There was increase of home deaths due to cardiopulmonary arrest in March 2020 compared to March 2018 (p<0.001) and March 2019 (p=0.050). Of the deaths reported in 2020, 63.8% of the patients were aged 60 years or older, 63.7% of the occurrences were performed in the afternoon and approximately 87% of the cardiopulmonary arrest notified had associated clinical comorbidities, with systemic arterial hypertension and heart failure represented by 22.87% and 13.03% of the reported cases, respectively. The majority of the evaluated sample of this study did not have any medical care follow-up (88.7%). CONCLUSION: Considering the increase in the number of the deaths, we suggest reflections and readjustments regarding the monitoring of chronic non-transmissible diseases during a pandemic, as well as improvements in death surveillance. (Arq Bras Cardiol. 2021; 116(2):266-271).
FUNDAMENTO: As doenças cardiovasculares constituem um grupo importante de causas de morte no Brasil. As doenças isquêmicas do coração são as principais causas de parada cardiorrespiratória, levando a um impacto na mortalidade devido às doenças cardiovasculares no sistema de saúde. OBJETIVO: Avaliar o número de óbitos domiciliares por parada cardiorrespiratória notificados pelo Serviço de Atendimento Móvel de Urgência (SAMU) em março de 2018, 2019 e 2020. MÉTODOS: Trata-se de um estudo observacional realizado a partir da análise de dados de mortalidade por parada cardiorrespiratória de cidadãos atendidos pelo SAMU em Belo Horizonte, Minas Gerais, Brasil. Foram analisadas as características sociais e clínicas e as informações de ocorrência. Foi avaliada a taxa de mortalidade por parada cardiorrespiratória em relação ao número total de atendimentos. Foi considerado um nível de significância de 95%. RESULTADOS: Houve um aumento nos óbitos domiciliares por parada cardiorrespiratória em março de 2020, em comparação com março de 2018 (p < 0,001) e março de 2019 (p = 0,050). Dos óbitos relatados em 2020, 63,8% dos pacientes tinham 60 anos ou mais; 63,7% das ocorrências foram à tarde e aproximadamente 87% dos casos de parada cardiorrespiratória notificados apresentavam comorbidades clínicas, com hipertensão arterial sistêmicas e parada cardíaca correspondendo a 22,87% e 13,03% dos casos relatados, respectivamente. A maioria da amostra avaliada deste estudo não teve acompanhamento médico (88,7%). CONCLUSÃO: Considerando o aumento do número de óbitos, sugerimos reflexões e reajustes quanto ao monitoramento das doenças crônicas não transmissíveis durante a pandemia, bem como melhorias na vigilância dos óbitos. (Arq Bras Cardiol. 2021; 116(2):266-271).
Assuntos
COVID-19 , Reanimação Cardiopulmonar , Parada Cardíaca , Brasil/epidemiologia , Parada Cardíaca/epidemiologia , Humanos , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2RESUMO
Paralytic shellfish toxins (PSTs) are a group of toxins that cause paralytic shellfish poisoning through blockage of voltage-gated sodium channels. PSTs are produced by prokaryotic freshwater cyanobacteria and eukaryotic marine dinoflagellates. Proliferation of toxic algae species can lead to harmful algal blooms, during which seafood accumulate high levels of PSTs, posing a health threat to consumers. The existence of PST-transforming enzymes was first remarked due to the divergence of PST profiles and concentrations between contaminated bivalves and toxigenic organisms. Later, several enzymes involved in PST transformation, synthesis and elimination have been identified. The knowledge of PST-transforming enzymes is necessary for understanding the processes of toxin accumulation and depuration in mollusk bivalves. Furthermore, PST-transforming enzymes facilitate the obtainment of pure analogues of toxins as in natural sources they are present in a mixture. Pure compounds are of interest for the development of drug candidates and as analytical reference materials. PST-transforming enzymes can also be employed for the development of analytical tools for toxin detection. This review summarizes the PST-transforming enzymes identified so far in living organisms from bacteria to humans, with special emphasis on bivalves, cyanobacteria and dinoflagellates, and discusses enzymes' biological functions and potential practical applications.
Assuntos
Toxinas Bacterianas/metabolismo , Cianobactérias/enzimologia , Dinoflagellida/enzimologia , Enzimas/metabolismo , Proliferação Nociva de Algas , Toxinas Marinhas/metabolismo , Intoxicação por Frutos do Mar/microbiologia , Frutos do Mar/microbiologia , Animais , Biotransformação , Bivalves/enzimologia , Bivalves/microbiologia , Peixes/metabolismo , Peixes/microbiologia , Humanos , Especificidade por SubstratoRESUMO
Neisseria gonorrhoeae is an obligate human pathogen that expresses an array of molecular systems to detoxify reactive oxygen species as defense mechanisms during colonization and infection. One of these is the bacterial peroxidase that reduces H2O2 to water in its periplasm. The soluble form of this enzyme was heterologously expressed in E. coli in the holo-form binding two c-types hemes, a high-potential E heme and a low-potential P heme, with redox potentials of (+310mV) and (-190mV/-300mV), respectively in the presence of calcium ions, at pH7.5. Visible and EPR spectroscopic analysis together with activity assays indicate the presence of a calcium dependent reductive activation mechanism in thgonorrhoeaeNeisseria gonorrhoeae bacterial peroxidase, in which P heme is bis-His coordinated low-spin in the fully oxidized state of the enzyme, and becomes penta-coordinated high-spin upon reduction of E heme in the presence of calcium ions. The activated enzyme has a high affinity for H2O2 (KM of 4±1µM), with maximum activity being attained at pH7.0 and 37°C, with the rate-limiting step in the catalytic cycle being the electron transfer between the two hemes. In this enzyme, dimer formation is not promoted at high ionic strength, thus differing from the classical bacterial peroxidases. These results contribute to the understanding of the involvement of Neisseria gonorrhoeae bacterial peroxidase has a first line defense mechanism against exogenously produced hydrogen peroxide in the host environment.
Assuntos
Neisseria gonorrhoeae/enzimologia , Peroxidase/metabolismo , Varredura Diferencial de Calorimetria , Escherichia coli/genética , Peróxido de Hidrogênio/metabolismo , Cinética , Modelos Moleculares , Neisseria gonorrhoeae/genética , Oxirredução , Peroxidase/química , Peroxidase/genética , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alinhamento de SequênciaRESUMO
INTRODUCTION: Metabolic disorders in people living with HIV/AIDS (PLH) have been described even before the introduction of antiretroviral (ARV) drugs in the treatment of HIV infection and are risk factors for cardiovascular diseases. Based on this, the purpose of this study was to assess metabolic disorders and cardiovascular risk in PLH before the initiation of antiretroviral treatment (ART). METHODS: This was a cross-sectional descriptive study of 87 PLH without the use of ART, which was carried out between January and September 2012 at a specialized infectious diseases center in Minas Gerais, Brazil. RESULTS: The main metabolic disorders in the population were low serum levels of HDL-cholesterol, hypertriglyceridemia and abdominal obesity. Dyslipidemia was prevalent in 62.6% of the study population, whereas metabolic syndrome (MS) was prevalent in 11.5% of patients assessed by the International Diabetes Federation (IDF) criteria and 10.8% assessed by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII) criteria. Regarding cardiovascular risk, 89.7% of the population presented a low coronary risk according to the Framingham Risk Score. A greater proportion of patients diagnosed with MS presented low cardiovascular risk (80% assessed by IDF criteria and 77.8% assessed by NCEP-ATPIII criteria). CONCLUSIONS: Metabolic disorders in this population may be due to HIV infection or lifestyle (smoking, sedentary lifestyle and inadequate diet). The introduction of ART can enhance dyslipidemia, increasing cardiovascular risk, especially among those who have classic risks of cardiovascular disease.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/virologia , Dislipidemias/epidemiologia , Dislipidemias/virologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/virologia , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Adulto , Fatores Etários , Terapia Antirretroviral de Alta Atividade , Índice de Massa Corporal , Brasil/epidemiologia , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco/métodos , Fatores de Risco , Comportamento Sedentário , Fatores Sexuais , Estatísticas não Paramétricas , Triglicerídeos/sangue , Adulto JovemRESUMO
A terapia antirretroviral (TARV) promoveu reduções drásticas na morbidade e mortalidade de pessoas vivendo com HIV (PVH). A utilização adequada da TARV requer monitoramento contínuo para avaliar a resposta terapêutica e identificar eventos adversos relacionados à administração a longo prazo. Trata-se de um estudo de coorte, realizado em centro de referência em doenças infecciosas, Belo Horizonte, Minas Gerais, com o objetivo de avaliar a efetividade da TARV entre 2012 e 2018. A população do estudo foi composta por 82 PVH que tiveram indicação para início da TARV entre janeiro a dezembro de 2012. A efetividade da TARV, definida como carga viral < 50 cópias/mL, foi de 75,6% e 80,5% após 12 e 66 meses de seu início, respectivamente. Os casos de falha terapêutica continham em prontuário informações sobre má-adesão e/ou abandono. Apesar da introdução tardia da TARV, a resposta terapêutica foi melhor às estimadas pelo Ministério da Saúde e semelhante a estudos de eficácia, demonstrando efetividade da TARV nos períodos analisados. Estes dados ratificam que a política brasileira de enfrentamento da epidemia de HIV/ Aids, de distribuição universal, é exitosa e deve ser mantida e aprimorada para evitar eventuais falhas terapêuticas.
The antiretroviral therapy (ART) has caused a significant reduction in morbidity and mortality in people living with HIV (PLH). The appropriate use of the ART demands continuous monitoring in order to assess the therapeutic response and identify adverse events related to medium and long-term ART exposure. The aim of this study is to evaluate the effectiveness of ART between 2012 and 2018. It is a prospective cohort study carried out at a reference centre of infectious diseases in Belo Horizonte, Minas Gerais - Brazil. The population of this study was composed of 82 PLH who had indication for the beginning of ART between January and December 2012. The effectiveness of ART, defined as viral load < 50 copies/mL, was of 75.6% and 80.5% after 12 and 66 months, respectively. The cases of treatment failure registered in medical records had information of poor adhesion and abandonment of treatment. In spite of the late introduction of ART in this population, the therapeutic response was better than the values described by Ministry of Health and similar to efficacy studies. These data ratify that the Brazilian public policies of combating HIV/AIDS epidemic, of universal distribution, have been successful and must be kept and improved to avoid possible treatment failures.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Efetividade , Terapia Antirretroviral de Alta Atividade , Antirretrovirais/uso terapêutico , Doenças Transmissíveis , HIV , Carga ViralRESUMO
O objetivo deste artigo é relatar um caso clínico no qual foi instalado dois implantes com a necessidade da utilização de enxerto ósseo, sendo associado com membrana de fibrina rica em plaquetas, visando à reabilitação do paciente. Paciente gênero feminino, 55 anos, compareceu ao consultório odontológico tendo como queixa principal à ausência das coroas dos elementos dentais 36 e 37. Desta forma, foi realizada a exodontia e em seguida foi instalado na região dois implantes, do tipo Titamax Cone Morse 4,1 X 11,5 da empresa *Neodent. A mesma tinha um defeito alveolar que resultou em um volume ósseo insuficiente, por conta disso foi inserido o enxerto ósseo com osso liofilizado bovino Bio-oss granulado (Geistlich*). O tratamento obteve um excelente resultado, tendo como consequência o sucesso cirúrgico com um pós-operatório sem complicações. De acordo com o caso relatado foi observado, que a fibrina rica em plaquetas associada ao enxerto Bio-Oss® auxiliou e favoreceu no processo de reparo tecidual, contribuindo para aceleração e neoformação tecidual e óssea, fazendo assim uma reparação mais rápida do tecido, permitindo reabilitar o paciente em curto período de tempo e com biomaterial do próprio paciente(AU)
The purpose of this article is to report a clinical case in which two implants were installed with the need for the use of bone graft, being associated with a fibrin membrane rich in platelets, aiming at the rehabilitation of the patient. Female patient, 55 years old, came to the dental office with the main complaint of the absence of crowns of dental elements 36 and 37. Therefore, extraction was performed and then two implants, of the type Titamax Cone Morse 4, were installed in the region, 1 X 11.5 from the company *Neodent. It had an alveolar defect that resulted in an insufficient bone volume, for this reason the bone graft with granulated Bio-osseous bovine freeze-dried bone (Geistlich*) was inserted. The treatment obtained an excellent result, resulting in surgical success with a post-operative without complications. According to the reported case, it was observed that the platelet-rich fibrin associated with the Bio-Oss® graft helped and favored the tissue repair process, contributing to acceleration and tissue and bone neoformation, thus making a faster tissue repair, allowing rehabilitate the patient in a short period of time and with the patient's own biomaterial(AU)
El propósito de este artículo es reportar un caso clínico en el que se instalaron dos implantes con la necesidad del uso de injerto óseo, estando asociados a una membrana de fibrinarica en plaquetas, con el objetivo de la rehabilitación del paciente. Paciente de sexo femenino, de 55 años, acudió al consultorio odontológico teniendo como principal queja la ausencia de las coronas de los elementos dentales 36 y 37. Por lo tanto, se realizó la extracción y luego se instalaron dos implantes, del tipo Titamax Cone Morse 4, en la región, 1 X 11,5 de la empresa *Neodent. Presentaba un defecto alveolar que resultaba en un volumen óseo insuficiente, por lo que se insertó el injerto óseo con hueso granulado bioóseo bovino liofilizado (Geistlich*). El tratamiento obtuvo un excelente resultado, resultando en éxito quirúrgico con un postoperatorio sin complicaciones. Según el caso reportado, se observó que la fibrina rica en plaquetas asociada al injerto Bio-Oss® ayudó y favoreció el proceso de reparación tisular, contribuyendo a la aceleración y neoformación tisular y ósea, haciendo así una reparación tisular más rápida, permitiendo rehabilitar al paciente en un corto período de tiempo y con el biomaterial del propio paciente(AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Implantes Dentários , Transplante Ósseo , Fibrina Rica em Plaquetas , Cirurgia Bucal , Materiais BiocompatíveisRESUMO
Resumo Fundamento As doenças cardiovasculares constituem um grupo importante de causas de morte no Brasil. As doenças isquêmicas do coração são as principais causas de parada cardiorrespiratória, levando a um impacto na mortalidade devido às doenças cardiovasculares no sistema de saúde. Objetivo Avaliar o número de óbitos domiciliares por parada cardiorrespiratória notificados pelo Serviço de Atendimento Móvel de Urgência (SAMU) em março de 2018, 2019 e 2020. Métodos Trata-se de um estudo observacional realizado a partir da análise de dados de mortalidade por parada cardiorrespiratória de cidadãos atendidos pelo SAMU em Belo Horizonte, Minas Gerais, Brasil. Foram analisadas as características sociais e clínicas e as informações de ocorrência. Foi avaliada a taxa de mortalidade por parada cardiorrespiratória em relação ao número total de atendimentos. Foi considerado um nível de significância de 95%. Resultados Houve um aumento nos óbitos domiciliares por parada cardiorrespiratória em março de 2020, em comparação com março de 2018 (p < 0,001) e março de 2019 (p = 0,050). Dos óbitos relatados em 2020, 63,8% dos pacientes tinham 60 anos ou mais; 63,7% das ocorrências foram à tarde e aproximadamente 87% dos casos de parada cardiorrespiratória notificados apresentavam comorbidades clínicas, com hipertensão arterial sistêmicas e parada cardíaca correspondendo a 22,87% e 13,03% dos casos relatados, respectivamente. A maioria da amostra avaliada deste estudo não teve acompanhamento médico (88,7%). Conclusão Considerando o aumento do número de óbitos, sugerimos reflexões e reajustes quanto ao monitoramento das doenças crônicas não transmissíveis durante a pandemia, bem como melhorias na vigilância dos óbitos. (Arq Bras Cardiol. 2021; 116(2):266-271)
Abstract Background Cardiovascular diseases constitute an important group of causes of death in the country. Ischemic heart diseases that are the main causes of cardiopulmonary arrest, leading to an impact on the mortality of the cardiovascular diseases in the health system. Objective Assess the number of home deaths by cardiopulmonary arrest notified by the Mobile Emergency Medical Service (SAMU) in March 2018, 2019 and 2020. Methods Observational study carried out from the analysis of cardiopulmonary arrest mortality data of citizens assisted by SAMU in Belo Horizonte, Minas Gerais, Brazil. Social and clinical characteristics and occurrence information of the patients were analyzed. The mortality rate due to cardiopulmonary arrest in relation to the total number of attendances was assessed. A significance level of 95% was considered. Results There was increase of home deaths due to cardiopulmonary arrest in March 2020 compared to March 2018 (p<0.001) and March 2019 (p=0.050). Of the deaths reported in 2020, 63.8% of the patients were aged 60 years or older, 63.7% of the occurrences were performed in the afternoon and approximately 87% of the cardiopulmonary arrest notified had associated clinical comorbidities, with systemic arterial hypertension and heart failure represented by 22.87% and 13.03% of the reported cases, respectively. The majority of the evaluated sample of this study did not have any medical care follow-up (88.7%). Conclusion Considering the increase in the number of the deaths, we suggest reflections and readjustments regarding the monitoring of chronic non-transmissible diseases during a pandemic, as well as improvements in death surveillance. (Arq Bras Cardiol. 2021; 116(2):266-271)
Assuntos
Humanos , Reanimação Cardiopulmonar , COVID-19 , Parada Cardíaca/epidemiologia , Brasil/epidemiologia , Pandemias , SARS-CoV-2 , Pessoa de Meia-IdadeRESUMO
Abstract INTRODUCTION: Metabolic disorders in people living with HIV/AIDS (PLH) have been described even before the introduction of antiretroviral (ARV) drugs in the treatment of HIV infection and are risk factors for cardiovascular diseases. Based on this, the purpose of this study was to assess metabolic disorders and cardiovascular risk in PLH before the initiation of antiretroviral treatment (ART). METHODS: This was a cross-sectional descriptive study of 87 PLH without the use of ART, which was carried out between January and September 2012 at a specialized infectious diseases center in Minas Gerais, Brazil. RESULTS: The main metabolic disorders in the population were low serum levels of HDL-cholesterol, hypertriglyceridemia and abdominal obesity. Dyslipidemia was prevalent in 62.6% of the study population, whereas metabolic syndrome (MS) was prevalent in 11.5% of patients assessed by the International Diabetes Federation (IDF) criteria and 10.8% assessed by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII) criteria. Regarding cardiovascular risk, 89.7% of the population presented a low coronary risk according to the Framingham Risk Score. A greater proportion of patients diagnosed with MS presented low cardiovascular risk (80% assessed by IDF criteria and 77.8% assessed by NCEP-ATPIII criteria). CONCLUSIONS: Metabolic disorders in this population may be due to HIV infection or lifestyle (smoking, sedentary lifestyle and inadequate diet). The introduction of ART can enhance dyslipidemia, increasing cardiovascular risk, especially among those who have classic risks of cardiovascular disease.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/virologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/virologia , Dislipidemias/epidemiologia , Dislipidemias/virologia , Triglicerídeos/sangue , Brasil/epidemiologia , Índice de Massa Corporal , Fatores Sexuais , Colesterol/sangue , Prevalência , Estudos Transversais , Fatores de Risco , Fatores Etários , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Estatísticas não Paramétricas , Medição de Risco/métodos , Terapia Antirretroviral de Alta Atividade , Comportamento Sedentário , Pessoa de Meia-IdadeRESUMO
Resume la situación del manejo de los residuos sólidos en la provincia de Salta, Argentina, refiriéndose tanto al servicio de aseo urbano como a la disposición final constituyendo una de las principales causas de contaminación de los recursos hídricos
Assuntos
Argentina , Eliminação de Resíduos , Gerenciamento de Resíduos , Participação da Comunidade , Volume de Resíduos SólidosRESUMO
Resume la situación del manejo de los residuos sólidos en la provincia de Salta, Argentina, refiriéndose tanto al servicio de aseo urbano como a la disposición final constituyendo una de las principales causas de contaminación de los recursos hídricos
Assuntos
Argentina , Eliminação de Resíduos , Volume de Resíduos Sólidos , Participação da Comunidade , Gerenciamento de ResíduosRESUMO
As próteses reforçadas com fibras têm se mostrado como uma alternativa nas reabilitaçöes orais, apresentando resistência adequada e estética favorável, além de suas propriedades adesivas que favorecem a cimentaçäo. Neste trabalho, os autores descrevem um caso clínico utilizando fibra de reforço para confecçäo de uma prótese adesiva provisória
Assuntos
Prótese Adesiva , Prótese Parcial TemporáriaRESUMO
Durante o tratamento dentário existe o risco de desenvolvimento de bacteremias com repercussöes sistêmicasgraves. A bacteremia pode ocorrer em qualquer intervençäo odontológica que provoque sangramento. As bactérias transportadas pela corrente sangüínea podem alojar-se em válvulas cardíacas lesionadas, no endocárdio ou no endotélio, próximo a defeitos congênitos, originando a endocardite infecciosa, que é uma infecçäo das válvulas cardíacas ou das superfícies endoteliais do coraçäo. Portanto, é necessário o emprego de medidas profiláticas em pacientes portadores de cardiopatias, visando inibir esta bacteremia. No presente trabalho, os autores relatam um caso clínico de Endocardite infecciosa provocada por manipulaçäo endodôntica
Assuntos
Humanos , Feminino , Adulto , Doenças da Boca/complicações , Endocardite/etiologia , Antibioticoprofilaxia , Profilaxia DentáriaRESUMO
Neste trabalho procuramos analisar alguns critérios para a seleçäo dos materiais restauradores mais usadosem dentística, observando suas propriedades físico-mecânicas frente às forças oclusais. Baseados nesta revisäo de literatura, também nos foi possível relacionar a localizaçäo e a intensidade dos contatos oclusais com a indicaçäo do material restaurador. Assim sendo, ficou estabelecido que a resina composta, pode ser usada em dentes posteriores, dependendo da posiçäo no arco, do tamanho da cavidade e do paciente, condiçöes bucais e hábitos de higiene. O amálgama é um material com vasta indicaçäo em restauraçöes pequenas e médias. Com o advento dos adesivos dentinários, o amálgama pode ser indicado em amplas cavidades. As restauraçöes fundidas em ligas de ouro ou alternativas apresentam um excelente comportamento oclusal. As inlays e onlays de porcelanas e outros materiais, como os polímeros de vidro säo boas opçöes para restauraçöes indiretas nos dentes posteriores
Assuntos
Materiais Dentários , Oclusão Dentária , Restauração Dentária PermanenteRESUMO
Com o desenvolvimento da fitoterapia, a populaçäo carente e os usuários de tratamentos alternativos, podem contar com uma nova fonte de medicamentos, a qual promove menor agressäo ao organismo. Este trabalho teve como objetivo, testar a atividade antimicrobiana de algumas plantas medicinais e o feromônio de agregaçäo (rincoforol) do besouro Rincophorus palmarum, após terem sido induzidas alveolites em 10 (dez) ratos (Rattus novergicus albinus, Wistar) e coletado o material infectado. Foram identificadas 8 (oito) bactérias as quais foram submetidas a testes antimicrobianos. Dentre as substâncias testadas a Aroeira (Schimus terebinthipholius), Rincoforol e Lafoensia (Lafoensia pacari) apresentaram os maiores halos de inibiçäo
Assuntos
Alvéolo Seco , Medicina Herbária , Plantas Medicinais/microbiologiaRESUMO
No presente trabalho testou-se a açäo cicatrizante do mastruço (Chenopodium ambrosioides) e da aroeira (Schinus terebinthifolius) em alvéolos de ratos pós-exodontia, onde os animais foram divididos em três grupos; um controle e nos outros dois foram avaliadas as plantas citadas. Após o período de observaçäo de cinco e de 15 dias de pós-operátorio, foi realizado estudo histológico no qual foram observadas diferenças entre os grupos experimentais e o controle na qualidade do reparo