Publications by authors named "María Santos"

1,217 Publications

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Giant lactating adenoma.

Autops Case Rep 2021 Apr 15;11:e2021252. Epub 2021 Apr 15.

Universidade Federal do Espírito Santo, Medical School, Department of Pathology, Vitória, ES, Brasil.

Lactating adenoma is a rare benign breast lesion that most often presents as a small (up to 3 cm), solid, well-circumscribed, solitary, painless, mobile, lobulated mass. The highest incidence occurs in primiparous women (20 to 40 years old) during the third trimester of pregnancy. However, in the rare case presented herein, in addition to its giant size (more than 10 centimeters on palpation), this lactating adenoma is distinctive due to the presence of multiple nodules, poorly defined ultrasonographic margins, worrisome radiologic features, growth since early pregnancy, presence of infarction and association with chronic mastitis. From the clinical-radiologic perspective, the differential diagnoses included abscess associated with puerperal mastitis, phyllodes tumor, and galactocele. Biopsy was performed, and pathologic examination revealed the classic characteristics of lactating adenoma with multiple infarcted areas, leading to an unexpected confirmed case of giant lactating adenoma.
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http://dx.doi.org/10.4322/acr.2021.252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087397PMC
April 2021

MUSIC INTERVENTIONS IN PEDIATRIC ONCOLOGY: systematic review and meta-analysis.

Complement Ther Med 2021 May 5:102725. Epub 2021 May 5.

Pediatrics Department of the University of São Paulo, Av. Dr Enéas Carvalho Aguiar No. 647, Cerqueira Cesar, São Paulo, CEP: 05403-901, Brazil. Electronic address:

Background: Pain is a disagreeable and distressing feeling that affects human beings in multi-dimensional ways. A number of non-pharmacological interventions have had varying degrees of success in treating cancer-related pain, such as breathing and relaxation techniques, and music therapy, which have been identified as beneficial therapies for alleviating pain and anxiety.

Objective: Identify the therapeutic effects of music interventions in psychological and physiological terms and on the quality of life of children undergoing cancer treatment.

Method: Systematic review of effectiveness based on the methodology of the Joanna Briggs Institute.

Results: Eleven articles were included with a total of 429 children, whose ages ranged from 0 to 18 years. The mean duration of the music intervention was 30.6 (±SD 9.8) minutes. In a combined estimate of five studies for pain and anxiety outcomes, there were benefits to using music when compared with the control group (SMD -1.05; CI 95% -1.70 - 0.40 N = 453 I = 90%). A combined analysis of five studies to assess quality of life showed that the use of music was favorable when compared with the control (SMD -0.80; CI 95% -1.17 - 0.43 N = 457= I = 71%).

Conclusion: After completing this review, it was determined that there is evidence to support the use of music to reduce pain and anxiety and improve the quality of life of children undergoing cancer treatment.
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http://dx.doi.org/10.1016/j.ctim.2021.102725DOI Listing
May 2021

Targeting p53 for Melanoma Treatment: Counteracting Tumour Proliferation, Dissemination and Therapeutic Resistance.

Cancers (Basel) 2021 Apr 1;13(7). Epub 2021 Apr 1.

LAQV/REQUIMTE, Laboratόrio de Microbiologia, Departamento de Ciências Biolόgicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal.

Melanoma is the deadliest form of skin cancer, primarily due to its high metastatic propensity and therapeutic resistance in advanced stages. The frequent inactivation of the p53 tumour suppressor protein in melanomagenesis may predict promising outcomes for p53 activators in melanoma therapy. Herein, we aimed to investigate the antitumor potential of the p53-activating agent SLMP53-2 against melanoma. Two- and three-dimensional cell cultures and xenograft mouse models were used to unveil the antitumor activity and the underlying molecular mechanism of SLMP53-2 in melanoma. SLMP53-2 inhibited the growth of human melanoma cells in a p53-dependent manner through induction of cell cycle arrest and apoptosis. Notably, SLMP53-2 induced p53 stabilization by disrupting the p53-MDM2 interaction, enhancing p53 transcriptional activity. It also promoted the expression of p53-regulated microRNAs (miRNAs), including miR-145 and miR-23a. Moreover, it displayed anti-invasive and antimigratory properties in melanoma cells by inhibiting the epithelial-to-mesenchymal transition (EMT), angiogenesis and extracellular lactate production. Importantly, SLMP53-2 did not induce resistance in melanoma cells. Additionally, it synergized with vemurafenib, dacarbazine and cisplatin, and resensitized vemurafenib-resistant cells. SLMP53-2 also exhibited antitumor activity in human melanoma xenograft mouse models by repressing cell proliferation and EMT while stimulating apoptosis. This work discloses the p53-activating agent SLMP53-2 which has promising therapeutic potential in advanced melanoma, either as a single agent or in combination therapy. By targeting p53, SLMP53-2 may counteract major features of melanoma aggressiveness.
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http://dx.doi.org/10.3390/cancers13071648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037490PMC
April 2021

Influence of Iron on Physiological Parameters and Intracellular Microcystin in Microcystis Panniformis Strain Isolated from a Reservoir in the Amazon.

Curr Microbiol 2021 Apr 28. Epub 2021 Apr 28.

Laboratório de Toxicologia e Ecofisiologia de Cianobactérias, Universidade Federal do Rio de Janeiro, Instituto de Biofísica Carlos Chagas Filho, Rio de Janeiro, CEP: 21949-902, Brazil.

In the Amazon, the leaching from soil left unprotected by deforestation increases the entry of iron, among other elements, in aquatic ecosystems, which can cause cyanobacterial blooms. This study aimed to investigate the physiological response of a strain of Microcystis panniformis to iron variation. The strain was isolated from a reservoir located in the Western Amazon and produces microcystin-LR. After a period of iron deprivation, the cultures were submitted to three conditions: control (223 μgFe.L), treatment with 23 μgFe.L, and absence of iron. At regular intervals for eight days, the cell density, levels of chlorophyll a and microcystins were determined. On the second and fourth day, transcription of genes responsive to iron limitation was quantified. Starting on the fourth day of the experiment, the different iron concentrations affected growth, and on the eighth day in the iron-free condition cell density was 90% lower than in control. Chlorophyll cell quota in 23 μgFe.L and control presented similar values, while without iron the cells became chlorotic as of the fourth day Toxin concentration in cells grow in 0 μgFe.L in relation to the control. Higher transcription levels of the feo and fut genes were observed in the 0 μgFe.L and 23 μgFe.L treatments, indicating that the cells were activating high-affinity capture systems to reestablish an adequate concentration of intracellular iron. The increasing deforestation in the Jamari River Basin (Amazon region), can contribute to the occurrence of toxic cyanobacterial blooms due to the greater entrance of iron in water bodies.
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http://dx.doi.org/10.1007/s00284-021-02499-5DOI Listing
April 2021

Sex dependent Vulnerability of Fetal Nonhuman Primate Cardiac Mitochondria to Moderate Maternal Nutrient Reduction.

Clin Sci (Lond) 2021 Apr 26. Epub 2021 Apr 26.

CNC-Center for Neuroscience and Cell Biology, Coimbra, Portugal.

Poor maternal nutrition in pregnancy affects fetal development, predisposing offspring to cardiometabolic diseases. The role of mitochondria during fetal development on later-life cardiac dysfunction caused by maternal nutrient reduction (MNR) remains unexplored. We hypothesized that MNR during gestation causes fetal cardiac bioenergetic deficits, compromising cardiac mitochondrial metabolism and reserve capacity. To enable human translation, we developed a primate baboon model (Papio spp) of moderate MNR in which mothers receive 70% of control nutrition during pregnancy, resulting in intrauterine growth restriction (IUGR) offspring and later exhibiting myocardial remodeling and heart failure at human equivalent ~25years. Term control and MNR baboon offspring were necropsied following cesarean-section, and left ventricle (LV) samples were collected. MNR adversely impacted fetal cardiac LV mitochondria in a sex-dependent fashion. Increased maternal plasma aspartate aminotransferase, creatine phosphokinase, and elevated cortisol levels in MNR concomitant with decreased blood insulin in male fetal MNR were measured. MNR resulted in a two-fold increase in fetal LV mtDNA. NMR resulted in increased transcripts for several respiratory chain (NDUFB8, UQCRC1, and cytochrome c) and ATP synthase proteins However, MNR fetal LV mitochondrial complex I and complex II/III activities were significantly decreased, possibly contributing to the 73% decreased ATP content and increased lipid peroxidation. MNR fetal LV showed mitochondria with sparse and disarranged cristae dysmorphology. Conclusions: MNR disruption of fetal cardiac mitochondrial fitness likely contributes to the documented developmental programming of adult cardiac dysfunction, indicating a programmed mitochondrial inability to deliver sufficient energy to cardiac tissues as a chronic mechanism for later-life heart failure.
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http://dx.doi.org/10.1042/CS20201339DOI Listing
April 2021

Idiopathic Chronic Eosinophilic Pneumonia.

Cureus 2021 Mar 22;13(3):e14047. Epub 2021 Mar 22.

Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT.

Idiopathic chronic eosinophilic pneumonia (CEP) is a rare disease of unknown cause characterized by eosinophilic alveolar and interstitial infiltration. The authors describe the case of a 46-year-old black man, presenting with insidious onset and progressive course of dyspnea on minimum exertion, cough, fever, night sweats, and weight loss for one year and worsening in the last three months. The main findings were serum eosinophilia. Chest radiographs showed multifocal infiltrations of irregular distribution in both lungs and a restrictive functional impairment. The patient underwent open lung biopsy, and the anatomopathological examination revealed consolidation by exudate constituted predominantly by macrophages (25%) and eosinophils (51%), which filled small air spaces, including respiratory and membranous bronchioles. The anatomopathological diagnosis was eosinophilic pneumonia (eosinophils > 25% is widely accepted for diagnosing eosinophilic pneumonia). The patient had a good clinical response after starting corticosteroid therapy.
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http://dx.doi.org/10.7759/cureus.14047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060025PMC
March 2021

Perceptions of senior nursing students regarding clinical decision-making.

Rev Bras Enferm 2021 9;74(1):e20200921. Epub 2021 Apr 9.

Escola Superior de Enfermagem de Lisboa. Lisboa, Portugal.

Objectives: to understand the perceptions of senior students in an undergraduate nursing course at a nursing college in Lisbon regarding skills related to clinical decision-making learned during their initial training.

Methods: qualitative study, of an exploratory and descriptive nature. Data collection occurred by carrying out a focus group with eight senior students in an undergraduate nursing course. Data treatment applied content analysis, performed with twebQDA® software.

Results: data were analyzed according to the four dimensions of Tanner's model of clinical judgment, and noticing and interpreting stood out as the most influential in clinical decision-making. Theoretical and clinical knowledge, validation of care planning, prioritization, and capacity to discuss and debate about situations emerged as the most representative skills.

Final Considerations: students make decisions by means of a complex process by using the knowledge and skills learned during their training.
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http://dx.doi.org/10.1590/0034-7167-2020-0921DOI Listing
April 2021

Predictors of kidney function recovery among incident ESRD patients.

BMC Nephrol 2021 Apr 21;22(1):142. Epub 2021 Apr 21.

University of Michigan Medical School, 1500 E. Medical Center Drive, SPC 5364, Ann Arbor, MI, 48109-5364, USA.

Background: ESRD is considered an irreversible loss of renal function, yet some patients will recover kidney function sufficiently to come off dialysis. Potentially modifiable predictors of kidney recovery, such as dialysis prescription, have not been fully examined.

Methods: Retrospective cohort study using United States Renal Data System (USRDS) data to identify incident hemodialysis (HD) patients between 2012 and 2016, the first 4 years for which dialysis treatment data is available. The primary outcome was kidney recovery within 1 year of ESRD and HD initiation, defined by a specific recovery code and survival off dialysis for at least 30 days. Patient and treatment characteristics were compared between those that recovered versus those that remained dialysis-dependent. A time-dependent survival model was used to identify independent predictors of kidney recovery.

Results: During the study period, there were 372,387 incident HD patients with available data, among whom 16,930 (4.5%) recovered to dialysis-independence. Compared to non-recovery, a higher proportion of patients with kidney recovery were of white race, and non-Hispanic ethnicity. Both groups had a similar age distribution. Patients with an acute kidney injury diagnosis as primary cause of ESRD were most likely to recover, but the most common ESRD diagnosis among recovering patients was type 2 diabetes (29.8% of recovery cases). Higher eGFR and lower albumin at ESRD initiation were associated with increased likelihood of recovery. When examining HD ultrafiltration rate (UFR), each quintile above the first quintile was associated with a progressively lower likelihood of recovery (HR 0.45, 95% CI 0.43-0.48 for highest versus lowest quintile, p < 0.001).

Conclusions: We identified non-modifiable and potentially modifiable factors associated with kidney recovery which may assist clinicians in counseling and monitoring incident ESRD patients with a greater chance to gain dialysis-independence. Clinical trials are warranted to examine the impact of dialysis prescription on subsequent kidney function recovery.
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http://dx.doi.org/10.1186/s12882-021-02345-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059163PMC
April 2021

Behavioral Responses of Asian Citrus Psyllid (Hemiptera: Liviidae) to Salinity-Stressed Citrus.

Environ Entomol 2021 Apr 14. Epub 2021 Apr 14.

Embrapa Cassava and Fruits, Cruz das Almas, CP 007, BA 44380-000, Brazil.

Most commercial citrus varieties are intolerant of salinity stress, but some rootstocks, such as Rangpur lime, tolerate moderately saline irrigation water. Development of salinity-tolerant citrus may allow for citriculture in semiarid and arid regions where salinity stress is problematic. Because salinity stress influences shoot growth in citrus, we compared the behavioral responses of Asian citrus psyllid, Diaphorina citri Kuwayama, to salinity-stressed versus nonstressed Rangpur lime seedlings. The effects of salinity stress on key physiological processes in the seedlings were also examined. Seedlings in the control group were fertilized with a solution having a salinity of 1.7 dS m-1 while seedlings in the salinity-stressed group were fertilized with a solution having a salinity of 10 dS m-1. The seedlings were exposed to salinity stress for increasing durations (15, 20, or 60 d). Seedlings presented differential physiological responses 15 d after the imposition of salinity stress, and differences in psyllid settling rate on control versus salinity-stressed seedlings were discernable within 1 h following the imposition of salinity stress. The levels of settling, oviposition, and egg survivorship were significantly lower on salinity-stressed versus control seedlings. Olfactometer tests showed that female psyllids preferred the odor from control seedlings, suggesting that the odors of control and salinity-stressed seedlings were different. The results showed that D. citri avoids salinity-stressed seedlings; this suggests the possibility of using moderate salinity stress as a management strategy to minimize psyllid settlement and reproduction and to reduce the spread of huanglongbing, especially in citrus grown in semiarid and arid areas.
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http://dx.doi.org/10.1093/ee/nvab028DOI Listing
April 2021

Student and Faculty Diversity is Insufficient to Ensure High-Quality Medical Spanish Education in US Medical Schools.

J Immigr Minor Health 2021 Apr 9. Epub 2021 Apr 9.

Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Medical Spanish education aims to reduce linguistic barriers in healthcare and has historically been led by Hispanic/Latinx students and faculty, often without formal training or institutional support. We surveyed 158 US medical schools about their medical Spanish programs. We then examined national trends in Underrepresented in Medicine and Hispanic/Latinx faculty and students as factors associated with meeting medical Spanish basic standards for curricula, educators, assessment, and course credit. We received responses from 125 schools (79%), of which 98 (78%) reported offering some form of medical Spanish. Schools with greater racial/ethnic diversity were more likely to have medical Spanish required courses (P-values < 0.01) but not curricular electives. Overall, likelihood of meeting all basic standards did not differ by diversity characteristics. High-quality medical Spanish requires more than recruitment of diverse students and faculty. Institutions should prioritize meaningful inclusion by supporting evidence-based curricula and faculty educators.
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http://dx.doi.org/10.1007/s10903-021-01198-4DOI Listing
April 2021

MPV17 Mutations Are Associated With a Quiescent Energetic Metabolic Profile.

Front Cell Neurosci 2021 17;15:641264. Epub 2021 Mar 17.

Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany.

Mutations in the MPV17 gene are associated with hepatocerebral form of mitochondrial depletion syndrome. The mechanisms through which MPV17 mutations cause respiratory chain dysfunction and mtDNA depletion is still unclear. The MPV17 gene encodes an inner membrane mitochondrial protein that was recently described to function as a non-selective channel. Although its exact function is unknown, it is thought to be important in the maintenance of mitochondrial membrane potential (ΔΨm). To obtain more information about the role of MPV17 in human disease, we investigated the effect of MPV17 knockdown and of selected known MPV17 mutations associated with MPV17 disease . We used different approaches in order to evaluate the cellular consequences of MPV17 deficiency. We found that lower levels of MPV17 were associated with impaired mitochondrial respiration and with a quiescent energetic metabolic profile. All the mutations studied destabilized the protein, resulting in reduced protein levels. We also demonstrated that different mutations caused different cellular abnormalities, including increased ROS production, decreased oxygen consumption, loss of ΔΨm, and mislocalization of MPV17 protein. Our study provides novel insight into the molecular effects of MPV17 mutations and opens novel possibilities for testing therapeutic strategies for a devastating group of disorders.
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http://dx.doi.org/10.3389/fncel.2021.641264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011494PMC
March 2021

Association of body mass index with Juvenile Idiopathic Arthritis disease activity: a Portuguese and Brazilian collaborative analysis.

Acta Reumatol Port 2021 Jan-Mar;46(1):7-14

Comprehensive Health Research Center (CHRC), NOVA Medical School, Lisbon. CEDOC, EpiDoC Unit, NOVA Medical School, Lisbon.

Objective: To investigate the relationship between body mass index (BMI) and disease activity in patients with Juvenile Idiopathic Arthritis (JIA).

Methods: Patients with JIA, aged ≤18 years, registered at the Rheumatic Diseases Portuguese Register (Reuma.pt) in Portugal and Brazil were included. Age- and sex-specific BMI percentiles were calculated based on WHO growth standard charts and categorized into underweight (P <3), normal weight (3≤P≤85), overweight (85

97). Disease activity was assessed by Juvenile Arthritis Disease Activity Score (JADAS-27). Uni- and multivariate analyses were performed.

Results: A total of 275 patients were included. The prevalence of underweight, normal weight, overweight and obesity was 6.9%, 67.3%, 15.3% and 10.5%, respectively. Underweight patients had significantly higher number of active joints (p <0.001), patient's/parent's global assessment of disease activity (PGA) (p=0.020), physician's global assessment of disease activity (PhGA) (p <0.001), erythrocyte sedimentation rate (ESR) (p=0.032) and overall higher JADAS-27 (p <0.001), compared to patients with normal weight, overweight and obesity. In the multivariate regression, underweight persisted significantly associated with higher disease activity, compared to normal weight (B=-9.430, p <0.001), overweight (B=-9.295, p=0.001) and obesity (B=-9.120, p=0.001), when adjusted for age, gender, country, ethnicity, JIA category and therapies used. The diagnosis of RF- (B=3.653, p=0.006) or RF+ polyarticular JIA (B=5.287, p=0.024), the absence of DMARD therapy (B=5.542, p <0.001) and the use of oral GC (B=4.984, p=0.002) were also associated with higher JADAS-27.

Conclusion: We found an independent association between underweight and higher disease activity in patients with JIA. Further studies are needed to understand the underlying mechanisms of this association.

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April 2021

Tryptophanol-Derived Oxazolopyrrolidone Lactams as Potential Anticancer Agents against Gastric Adenocarcinoma.

Pharmaceuticals (Basel) 2021 Mar 2;14(3). Epub 2021 Mar 2.

Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal.

Gastric cancer is one of the deadliest cancers in modern societies, so there is a high level of interest in discovering new drugs for this malignancy. Previously, we demonstrated the ability of tryptophanol-derived polycyclic compounds to activate the tumor suppressor protein p53, a relevant therapeutic target in cancer. In this work, we developed a novel series of enantiomerically pure tryptophanol-derived small molecules to target human gastric adenocarcinoma (AGS) cells. From an initial screening of fourteen compounds in AGS cell line, a hit compound was selected for optimization, leading to two derivatives selective for AGS gastric cells over other types of cancer cells (MDA-MB-231, A-549, DU-145, and MG-63). More importantly, the compounds were non-toxic in normal cells (HEK 293T). Additionally, we show that the growth inhibition of AGS cells induced by these compounds is mediated by apoptosis. Stability studies in human plasma and human liver microsomes indicate that the compounds are stable, and that the major metabolic transformations of these molecules are mono- and di-hydroxylation of the indole ring.
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http://dx.doi.org/10.3390/ph14030208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001353PMC
March 2021

Invasion and Spreading of Drosophila nasuta (Diptera, Drosophilidae) in the Caatinga Biome, Brazil.

Neotrop Entomol 2021 Apr 1. Epub 2021 Apr 1.

Centro Acadêmico de Vitória, Univ Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil.

Biological invasions are one of the main causes of biodiversity loss, and it is essential to understand the pattern and rate of expansion of invasive species outside their native distribution. In this study, we documented the invasion of the Asian fruit fly, Drosophila nasuta Lamb, in the Caatinga, and measured its geographical distribution in this environment, which covers 11% of the Brazilian territory. We collected drosophilids in eight sites distributed in the north of the Caatinga (in the state of Ceará), in the south (in Bahia), in the east (in Pernambuco), and in the west (in Piauí), as well as in sites in the central area of the biome. Drosophila nasuta occurred in all areas and was one of the most frequently occurring species in half of the sampled sites. We observed greater abundance in areas with arboreal vegetation and a possible preference of this species for areas with higher annual rainfall in the Caatinga. Of all the biomes where D. nasuta is found in Brazil, the area occupied in the Caatinga is the largest documented to date. Our results show D. nasuta's success in invading the Caatinga and the vast area this species has colonized in this biome. The success of this invasion can be explained by the high fertility and short life cycle as well as by the ability of D. nasuta to use different trophic resources.
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http://dx.doi.org/10.1007/s13744-021-00875-1DOI Listing
April 2021

Differences sustained between diffuse and limited forms of juvenile systemic sclerosis in expanded international cohort. www.juvenile-scleroderma.com.

Arthritis Care Res (Hoboken) 2021 Mar 30. Epub 2021 Mar 30.

Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

Objectives: To evaluate the baseline clinical characteristics of juvenile systemic sclerosis (jSSc) patients in the international Juvenile SSc Inception Cohort (jSScC), compare these characteristics between the classically defined diffuse (dcjSSc) and limited cutaneous (lcjSSc) subtypes, and among those with overlap features.

Methods: A cross-sectional study was performed using baseline visit data. Demographic, organ system evaluation, treatment, and patient and physician reported outcomes were extracted and summary statistics applied. Comparisons between dcjSSc and lcSSc subtypes and patients with and without overlap features were performed using Chi-square and Mann Whitney U-tests.

Results: At data extraction 150 jSSc patients were enrolled across 42 centers, 83% were Caucasian, 80% female, dcjSSc predominated (72%), and 17% of the cohort had overlap features. Significant differences were found between dcjSSc and lcjSSc regarding the modified Rodnan Skin Score, presence of Gottron's papules, digital tip ulceration, 6 Minute walk test, composite pulmonary and cardiac involvement. All more frequent in dcSSc except for cardiac involvement. DcjSSc patients had significantly worse scores for physician rated disease activity and damage. A significantly higher occurrence of Gottron's papules, musculoskeletal involvement and composite pulmonary involvement, and significantly lower frequency of Raynaud's phenomenon, were seen in those with overlap features.

Conclusion: Results from a large international jSSc cohort demonstrate significant differences between dcjSSc and lcjSSc patients including more globally severe disease and increased frequency of ILD in dcjSSc patients, while those with lcSSc have more frequent cardiac involvement. Those with overlap features had an unexpected higher frequency of interstitial lung disease.
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http://dx.doi.org/10.1002/acr.24609DOI Listing
March 2021

Medical Spanish in US Medical Schools: a National Survey to Examine Existing Programs.

J Gen Intern Med 2021 Mar 29. Epub 2021 Mar 29.

Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: Most medical schools offer medical Spanish education to teach patient-physician communication skills with the growing Spanish-speaking population. Medical Spanish courses that lack basic standards of curricular structure, faculty educators, learner assessment, and institutional credit may increase student confidence without sufficiently improving skills, inadvertently exacerbating communication problems with linguistic minority patients.

Objective: To conduct a national environmental scan of US medical schools' medical Spanish educational efforts, examine to what extent existing efforts meet basic standards, and identify next steps in improving the quality of medical Spanish education.

Design: Data were collected from March to November 2019 using an IRB-exempt online 6-item primary and 14-item secondary survey.

Participants: All deans of the Association of American Medical Colleges member US medical schools were invited to complete the primary survey. If a medical Spanish educator or leader was identified, that person was sent the secondary survey.

Main Measures: The presence of medical Spanish educational programs and, when present, whether the programs met four basic standards: formal curricular structure, faculty educator, learner assessment, and course credit.

Key Results: Seventy-nine percent of medical schools (125 out of 158) responded to either or both the primary and/or secondary surveys. Among participating schools, 78% (98/125) of medical schools offered medical Spanish programming; of those, 21% (21/98) met all basic standards. Likelihood of meeting all basic standards did not significantly differ by location, school size, or funding type. Fifty-four percent (53/98) report formal medical Spanish curricula, 69% (68/98) have faculty instructors, 57% (56/98) include post-course assessment, and 31% (30/98) provide course credit.

Conclusions: Recommended next steps for medical schools include formalizing medical Spanish courses as electives or required curricula; hiring and/or training faculty educators; incorporating learner assessment; and granting credit for student course completion. Future studies should evaluate implementation strategies to establish best practice recommendations beyond basic standards.
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http://dx.doi.org/10.1007/s11606-021-06735-3DOI Listing
March 2021

Nearly fatal hypokalaemia due to non-hypertensive primary hyperaldosteronism in the post partum.

BMJ Case Rep 2021 Mar 22;14(3). Epub 2021 Mar 22.

Endocrinology Department, Braga Hospital, Braga, Portugal.

A previously healthy postpartum 33-year-old woman was admitted at the emergency department after two episodes of syncope. In the waiting room, she collapsed, ventricular fibrillation was detected, and she was reanimated by electric cardioversion. At admission, she was conscient, with blood pressure of 102/74 mm Hg and heart rate of 78 bpm. In the laboratory workup, severe hypokalaemia was found (K 1.77 mEq/L). Abdominopelvic CT revealed a 27 mm nodule in the right adrenal gland. High aldosterone and low plasma renin levels were detected, and the diagnosis of primary hyperaldosteronism was made, although she never had hypertension. Posteriorly, a cosecretion of aldosterone and cortisol was found. Two months after admission, the patient remained stable with normal K levels under spironolactone and a right adrenalectomy was performed. The cure of primary hyperaldosteronism and a partial adrenal insufficiency were confirmed. K levels and blood pressure remained normal without treatment and 10 months after surgery hydrocortisone was suspended.
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http://dx.doi.org/10.1136/bcr-2020-240018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986951PMC
March 2021

Addison's Disease: A Diagnosis Easy to Overlook.

Cureus 2021 Feb 15;13(2):e13364. Epub 2021 Feb 15.

Endocrinology, Hospital de Braga, Braga, PRT.

Addison's disease is a rare and potentially life-threatening clinical condition that often presents with an insidious onset of nonspecific symptoms and signs, frequently resulting in a significant delay in diagnosis. Clinical presentation usually includes fatigue and electrolyte imbalance disorders such as hyponatremia. However, specific diagnostic features, such as hyperpigmentation, should raise clinical suspicion. This case report describes a 43-year-old Caucasian male who presented with general malaise, fatigue, anorexia, and weight loss (7 Kg in four weeks). On physical examination, he was found to have severe hyperpigmentation of the skin and mucosal surfaces as well as hypotension. Laboratory tests revealed hypoosmolar hyponatremia and serum potassium levels in the upper limit of normal. Findings of high serum adrenocorticotropic hormone (ACTH) and renin, as well as low cortisol and aldosterone levels, helped establish a diagnosis of Addison's disease. After the initiation of treatment, the patient experienced full recovery of symptoms, normalization of hyponatremia, and improvement of hyperpigmentation. Patients with Addison's disease have the potential to resume normal daily activities with a highly functional status. However, this condition requires lifelong follow-up and surveillance.
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http://dx.doi.org/10.7759/cureus.13364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970155PMC
February 2021

Evaluation of different skin regions derived from a postmortem jaguar, Panthera onca (Linnaeus, 1758), after vitrification for development of cryobanks from captive animals.

Zoo Biol 2021 Mar 19. Epub 2021 Mar 19.

Laboratory of Animal Biotechnology, Center for Biological and Health Sciences, Federal Rural University of Semi-Arid, Mossoro, Rio Grande do Norte, Brazil.

Biological resource banks represent valuable tools for the conservation of species vulnerable to extinction, such as the jaguar. Cryobanks of skins have the potential to safeguard rare genotypes, allowing the potential exploitation of biological samples in animal multiplication technologies and the study of genetic variability. Determination of the most suitable skin regions for tissue conservation can help increase the efficiency of cryobanks and the storage of biological samples. To this end, we evaluated the effects of vitrification of skin tissues from the ear, caudal, and femoral regions of a post-mortem jaguar belonging to a zoo in Brazil. Non-vitrified and vitrified samples were evaluated and compared using quantitative methods, focusing on skin thickness, cell quantification, number of perinuclear halos, collagen and elastic density, and proliferative activity. No differences were observed in skin thickness, number of perinuclear halos, elastic density, and proliferative activity between non-vitrified and vitrified tissues in skin from any region. However, vitrified tissues derived from femoral skin showed a reduction in the number of fibroblasts, epidermal cells and collagen density compared to non-vitrified tissues. In summary, the ear and caudal regions provided the best conservation of somatic tissues derived from jaguars, and skin samples from these regions are therefore the most suitable for the formation of cryobanks.
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http://dx.doi.org/10.1002/zoo.21605DOI Listing
March 2021

Prevalence of M184V and K65R in proviral DNA from PBMCs in HIV-infected youths with lamivudine/emtricitabine exposure.

J Antimicrob Chemother 2021 Mar 18. Epub 2021 Mar 18.

Pediatric Infectious Diseases Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón (IiSGM) and RITIP, Madrid, Spain.

Objectives: We analysed the prevalence of M184V/I and/or K65R/E/N mutations archived in proviral DNA (pDNA) in youths with perinatal HIV, virological control and who previously carried these resistance mutations in historic plasma samples.

Methods: We included vertically HIV-infected youths/young adults aged ≥10 years in the Madrid Cohort of HIV-1 Infected Children and Adolescents, exposed to lamivudine and/or emtricitabine, with M184V/I and/or K65R/E/N in historic plasma samples, on antiretroviral therapy (ART), virologically suppressed (HIV-1 RNA <50 copies/mL), and with available PBMCs in the Spanish HIV BioBank. Genomic DNA was extracted from PBMCs and HIV-1 RT gene was amplified and sequenced for resistance testing by Stanford HIV Resistance tool.

Results: Among the 225 patients under follow-up in the study cohort, 13 (5.8%) met selection criteria, and RT sequences were recovered in 12 (92.3%) of them. All but one were Spaniards, carrying subtype B, with a median age at PBMCs sampling of 21.3 years (IQR: 15.6-23.1) with 4 years (IQR 2.1-6.5) of suppressed viral load (VL). Nine (75%) youths did not present M184V/I in pDNA after at least 1 year of viral suppression. In December 2019, the remaining three subjects carrying M184V/I in pDNA maintained suppressed viraemia, and two still used emtricitabine in ART.

Conclusions: The prevalence of resistance mutations to lamivudine and emtricitabine in pDNA in a cohort of youths perinatally infected with HIV who remain with undetectable VL, previously lamivudine and/or emtricitabine experienced, was infrequent. Our results indicate that ART including lamivudine or emtricitabine may also be safe and successful in youths with perinatal HIV with previous experience of and resistances to these drugs detected in plasma.
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http://dx.doi.org/10.1093/jac/dkab080DOI Listing
March 2021

The relationship of oleic acid/albumin molar ratio and clinical outcomes in leptospirosis.

Heliyon 2021 Mar 8;7(3):e06420. Epub 2021 Mar 8.

Laboratório Integrado de Nefrologia, Department of Internal Medicine, Medical Sciences School, State University of Rio de Janeiro, Brazil.

Human leptospirosis is an acute infectious zoonosis presenting specific lipid disorders. Previous studies showed both leptospira glycolipoprotein endotoxin, and high oleic acid levels were associated with Na/K-ATPase inhibition that is amplified by the reduction of circulating albumin levels. In this study, we aimed to investigate the relationship of oleic acid/albumin (OA/A) molar ratio and clinical outcomes in Leptospirosis. Through a prospective observational cohort study employing high-performance liquid chromatography (HPLC) we sequentially determined serum concentrations of nonesterified fatty acids (NEFA) and albumin in twenty-eight patients with severe leptospirosis since their hospital admission. Twenty patients recovered, and eight died. Data was distributed in two groups according to clinical outcomes. Oleic acid/albumin molar ratios (OA/A), initial samples, were higher than those in healthy donors. The ratio OA/A, however, persisted high in dying patients, whereas patients who survived had a reduction matching to healthy donors. Biochemical alterations suggest that cure is correlated to the reestablishment of the OA/A molar ratio, while fatal outcomes related to persisting OA/A imbalances. Analysis by receiver operating characteristic (ROC) showed the area under the curve of 0.864 and the cutoff value of 0.715 being associated with a high odds ratio. Lipid analysis from patients with leptospirosis had an acute high serum OA/A molar ratio, and sustained imbalance has a high odds ratio and strong correlation with mortality.
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http://dx.doi.org/10.1016/j.heliyon.2021.e06420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944043PMC
March 2021

[Factors associated with personal autonomy among the elderly: a systematic review of the literature].

Cien Saude Colet 2021 Mar 4;26(3):1035-1046. Epub 2019 May 4.

Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.

The scope of this article is to identify factors associated with personal autonomy among the elderly. It is a systematic review of analytical epidemiological studies selected from the PubMed, Web of Science, Scopus and Lilacs databases, without time and language constraints. The search located 3,435 articles and selection was conducted in two phases: reading of abstracts and entire articles, with inclusion and exclusion criteria, by two independent reviewers, resulting in seven selected studies. The risk of bias was assessed using the Newcastle-Ottawa Scale protocol. All studies included were of sectional design and analyzed autonomy from the perspective of the perception of increased autonomy. The instruments used were the Hertz Perceived Entity of Autonomy Scale and the Chinese version of Perceived Enactment of Autonomy Scale. The factors associated with the autonomy of the elderly identified were grouped by functionality, family relations, interpersonal relations, life perception, satisfaction with health services, demographic factors, schooling, general health status and quality of life. The study of personal autonomy among the elderly presented a multifactorial and biopsychosocial character, although it is a recent theme in which further research with more detailed scientific evidence is necessary.
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http://dx.doi.org/10.1590/1413-81232021263.08222019DOI Listing
March 2021

The Impact of Oral-Gut Inflammation in Cerebral Palsy.

Front Immunol 2021 25;12:619262. Epub 2021 Feb 25.

Postgraduate Program in Dentistry, Department of Individuals With Special Needs, Cruzeiro do Sul University, São Paulo, Brazil.

Oral-gut inflammation has an impact on overall health, placing subjects at risk to acquire chronic conditions and infections. Due to neuromotor disturbances, and medication intake, cerebral palsy (CP) subjects present intestinal constipation, impacting their quality of life (QOL). We aimed to investigate how oral inflammatory levels predicted gut phenotypes and response to therapy. A total of 93 subjects aging from 5 to 17 years were included in the study, and assigned into one of the 4 groups: CP with constipation (G1, = 30), CP without constipation (G2, = 33), and controls without CP with constipation (G3, = 07) and without CP and without constipation (G4, = 23). In addition to characterizing subjects' clinical demographics, medication intake, disease severity levels, salivary cytokine levels [TNF-α, interleukin (IL)-1β, IL-6, IL-8, IL-10], and Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Statistical significance was evaluated by Shapiro-Wilks, Student's -Test, ANOVA, and ANCOVA analysis. Salivary proinflammatory cytokines were highly correlated with the severe form of gut constipation in G1 ( < 0.001), and out of all cytokines IL-1β levels demonstrated highest correlation with all gut constipation < 0.05). A significant relationship was found between the type of medication, in which subjects taking Gamma-Aminobutyric Acid (GABA) and GABA+ (GABA in association with other medication) were more likely to be constipated than the other groups ( < 0.01). Cleary salivary inflammatory levels and gut constipation were correlated, and impacted QOL of CP subjects. G1 presented a lower QOL mean score of CPCHILD (49.0 ± 13.1) compared to G2 (71.5 ± 16.7), when compared to G3 (88.9 ± 7.5), and G4 (95.5 ± 5.0) ( < 0.01). We accounted for gingival bleeding as a cofounder of oral inflammation, and here were no differences among groups regarding gender ( = 0.332) and age ( = 0.292). Collectively, the results suggest that saliva inflammatory levels were linked to gut constipation, and that the clinical impact of medications that controlled gut was reliably monitored via oral cytokine levels, providing reliable and non-invasive information in precision diagnostics.
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http://dx.doi.org/10.3389/fimmu.2021.619262DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7953843PMC
February 2021

Psychometric Properties of the Sensory Processing and Self-Regulation Checklist: English Version.

Occup Ther Int 2021 20;2021:6658786. Epub 2021 Feb 20.

Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.

Background: Sensory processing supports children's development and abilities to participate in activities across contexts. Self-regulation skills may influence how children process various sensory experiences in daily life activities. The Sensory Processing and Self-Regulation Checklist (SPSRC) is a 130-item caregiver-reported checklist, covering children's essential sensory processing and self-regulation performance in daily activities.

Objectives: This study examines the psychometric properties of the SPSRC (English version) in measuring the sensory processing and self-regulation abilities of children.

Methods: A preliminary field testing of the SPSRC-English was conducted in a sample of = 194 children (164 without disability and 30 with a disability) to evaluate its reliability and validity properties.

Results: The SPSRC-English was shown to have high internal consistency and test-retest reliability; and good discriminant, structural, and criterion validity in the sensory processing and self-regulation abilities of children with and without disability ages 4-12 years.

Conclusion: The current study provides initial evidence on the reliability and validity of SPSRC-English in measuring the sensory processing and self-regulation abilities in children with and without a disability. The SPSRC-English may provide salient information supporting the understanding of sensory processing difficulties among children.
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http://dx.doi.org/10.1155/2021/6658786DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920736PMC
March 2021

COVID-19 in a Patient with Liver Cirrhosis.

Am J Case Rep 2021 Mar 9;22:e929948. Epub 2021 Mar 9.

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu, SP, Brazil.

BACKGROUND The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which manifests mainly as a respiratory condition, has become a global pandemic that causes coronavirus disease-2019 (COVID-19). Although the symptoms remain mild in most patients, the elderly and patients with previous comorbidities have higher rates of morbidity and mortality. Patients with liver cirrhosis, especially after decompensation, may be more susceptible to SARS-CoV-2 infection due to systemic immune dysfunction. CASE REPORT The patient was a 51-year-old man who was hypertensive, an ex-alcoholic abstinent for 6 months, and a smoker. He was diagnosed with alcoholic liver cirrhosis in July 2019, and was using norfloxacin at home for secondary prophylaxis of bacterial peritonitis. He was also using furosemide and spironolactone to control ascites and propranolol for primary prophylaxis of esophageal varices. The patient entered our hospital in July 2020 with cough, dyspnea, runny nose, diarrhea, and fever. During hospitalization, we confirmed infection by COVID-19 and secondary nosocomial pulmonary infection. Chest tomography compatible with ground-glass standard was performed. The patient developed the need for auxiliary oxygen but without invasive mechanical ventilation. The patient received dexamethasone 6 mg/day and broad-spectrum antibiotic therapy (he was started on cefepime but switched to meropenem). At the end of the 14-day isolation period, he was discharged with improved respiratory status. CONCLUSIONS Despite high mortality rates in patients with advanced cirrhosis who become infected with COVID-19, we report a case with a favorable outcome. Success has been achieved with the use of medications in studies of broad-spectrum antibiotics and the rapid detection of complications caused by the virus. Further studies in SARS-CoV-2 patients with chronic liver disease are needed.
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http://dx.doi.org/10.12659/AJCR.929948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959101PMC
March 2021

Chronic myeloid leukemia-from the Philadelphia chromosome to specific target drugs: A literature review.

World J Clin Oncol 2021 Feb;12(2):69-94

Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil.

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly - the presence of the Philadelphia chromosome. The advances in cytogenetic and molecular assays are of great importance to the diagnosis, prognosis, treatment, and monitoring of CML. The discovery of the fusion oncogene has revolutionized the treatment of CML patients by allowing the development of targeted drugs that inhibit the tyrosine kinase activity of the BCR-ABL oncoprotein. Tyrosine kinase inhibitors (known as TKIs) are the standard therapy for CML and greatly increase the survival rates, despite adverse effects and the odds of residual disease after discontinuation of treatment. As therapeutic alternatives, the subsequent TKIs lead to faster and deeper molecular remissions; however, with the emergence of resistance to these drugs, immunotherapy appears as an alternative, which may have a cure potential in these patients. Against this background, this article aims at providing an overview on CML clinical management and a summary on the main targeted drugs available in that context.
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http://dx.doi.org/10.5306/wjco.v12.i2.69DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918527PMC
February 2021

Coconut Oil Supplementation Does Not Affect Blood Pressure Variability and Oxidative Stress: A Placebo-Controlled Clinical Study in Stage-1 Hypertensive Patients.

Nutrients 2021 Feb 28;13(3). Epub 2021 Feb 28.

Biotechnology Center, Federal University of Paraiba, Joao Pessoa 58051-900, Brazil.

Exploring an alternative to improve the clinical management of hypertension, we tested the hypothesis that food supplementation with coconut oil (EVCO), alone or combined with aerobic exercise training, could exert an antihypertensive effect (primary outcome) in patients with stage 1 hypertension. Forty-five hypertensive volunteers of both genders participated in a placebo-controlled clinical trial. The volunteers were submitted to 24-hour ambulatory blood pressure monitoring, analysis of blood pressure variability (BPV), measurement of serum malondialdehyde (MDA) and nutritional assessment. Results indicate that EVCO consumption had no adverse effects. The supplementation did not increase the caloric intake compared with placebo, and the dietary constituents were similar between groups, except for the saturated fats, especially lauric acid. The analysis of blood pressure indicated absence of antihypertensive effect of EVCO alone or combined with physical training. Furthermore, no effects on blood pressure variability and oxidative stress were observed in the supplemented hypertensive patients. Thus, despite the results observed in pre-clinical studies, the current clinical study did not provide evidence to support the use of coconut oil as an adjuvant in the management of hypertension in humans.
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http://dx.doi.org/10.3390/nu13030798DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997205PMC
February 2021

Continental Origin for Q Haplogroup Patrilineages in Argentina and Paraguay.

Hum Biol 2021 02;92(2):63-80

Instituto Multidisciplinario de Biología Celular (IMBICE), Consejo Nacional de Investigaciones Científicas y Técnicas de la Republica Argentina (CONICET)-Comisión de Investigaciones Científicas (CIC)-Universidad Nacional de La Plata (UNLP), La Plata, Argentina,

Haplogroup Q originated in Eurasia around 30,000 years ago. It is present in Y-chromosomes from Asia and Europe at rather low frequencies. Since America is undoubtedly one of the continents where this haplogroup is highly represented, it has been defined as one of the founding haplogroups. Its M3 clade has been early described as the most frequent, with pan-American representation. However, it was also possible to find several other haplogroup Q clades at low frequencies. Numerous mutations have been described for haplogroup Q, allowing analysis of its variability and assignment of its geographic origin. We have analyzed 442 samples of unrelated men from Argentina and Paraguay belonging to haplogroup Q; here we report specifically on 27 Q (xM3) lineages. We tested 3 single-nucleotide polymorphisms (SNPs) by amplified product-length polymorphism (APLP) analysis, 3 SNPs for restriction fragment length polymorphism (RFLP) analysis, 15 SNPs by Sanger sequencing, and 17 short tandem repeats (STRs). Our approach allowed us to identify five subhaplogroups. Q-M3 and Q-CTS2730/Z780 are undoubtedly autochthonous lineages and represent the most frequent subhaplogroups, with significant representation in self-defined aboriginal populations, and their autochthonous status has been previously described. The aim of present work was to identify the continental origin of the remaining Q lineages. Thus, we analyzed the STR haplotypes for the samples and compared them with haplotypes described by other authors for the rest of the world. Even when haplogroup Q lineages have been extensively studied in America, some of them could have their origin in post-Columbian human migration from Europe and Middle East.
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http://dx.doi.org/10.13110/humanbiology.92.2.01DOI Listing
February 2021

[Sexually transmissible infections in African-descendant women in maroon communities in Brazil: prevalence and associated factors].

Cad Saude Publica 2021 10;37(2):e00174919. Epub 2021 Feb 10.

Universidade Federal do Espírito Santo, Vitória, Brasil.

The study aimed to estimate the prevalence of sexually transmissible infections (STIs) and associated factors in women in quilombola (maroon) communities in Brazil. This was a population-based cross-sectional study of quilombola women from March 2017 to January 2019. A questionnaire was used with sociodemographic, behavioral, and clinical information. A gynecological examination was performed for the collection of uterine cervical cells for oncotic cytology and the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and human papillomavirus (HPV) via polymerase chain reaction. Rapid tests for HIV and syphilis were performed. The main outcome was defined as infection with one or more sexually transmissible pathogens. The analysis used chi-square test and hierarchical logistic regression. From a total of 380 women, 352 (92.6%) were included in the study. Prevalence of at least one STI was 18.5% (95%CI: 14.76-22.85). The highest prevalence was for HPV, with 11.1%, followed by 6.3% for T. vaginalis and 4.3% for C. trachomatis. There were no cases of N. gonorrhoeae. Prevalence was 0.3% for HIV and 4.3% for syphilis. Cervical-vaginal cytology was altered in 7.7% of the women. Detection of one or more STIs was significantly associated with age 25 to 44 years (OR = 2.33; 95%CI: 1.05-5.18), alcohol consumption (OR = 1.96; 95%CI: 1.06-3.64), altered cervical cytology (OR = 3.96; 95%CI: 1.65-9.48), and bacterial vaginosis (OR = 3.61; 95%CI: 2.01-6.47). Quilombola women showed high prevalence of one or more STIs, emphasizing the importance of organizing prevention strategies targeted to these women.
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http://dx.doi.org/10.1590/0102-311X00174919DOI Listing
April 2021

Analysis of vaccine loss due to temperature change.

Rev Bras Enferm 2021 22;74(1):e20190762. Epub 2021 Feb 22.

Faculdade de Medicina de São José do Rio Preto. São José do Rio Preto, São Paulo, Brazil.

Objectives: to analyze vaccine losses in a Health Region in the Northwest of São Paulo.

Methods: retrospective cross-sectional study with secondary data obtained from Temperature Change Notification Forms used by the Epidemiological Surveillance Group XXIX of São José do Rio Preto between 2010 and 2017. Descriptive and inferential analysis were performed using multiple linear regression and significance level of 95%.

Results: in total, 341 notifications of temperature changes were analyzed, of which 70.1% were caused by structural reasons, 57.8% in industrial refrigerators and 91.2% in primary care services. Of the doses that suffered a change in temperature, 41.4% were lost and 58.6% were administered to the population. The highest percentage of lost doses compared to those applied occurred in smaller municipalities, although they reported less.

Conclusions: nursing workers who work in vaccination rooms should make efforts to prevent temperature changes and avoid losses and higher public expenses.
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http://dx.doi.org/10.1590/0034-7167-2019-0762DOI Listing
February 2021