THE CASE AGAINST PERFECTION: ETHICS IN THE AGE OF GENETIC ENGINEERING

utilizam a obra “Contra a perfeição: Ética na era da engenharia genética”, tradução brasileira, publicada em 2018, de “The Case Against Perfection: Ethics in the Age of Genetic Engineering” (2003), de Michael J. Sandel, na qual, a partir de análises fáticas, há o confronto de questionamentos éticos e morais no que tange ao uso das novas tecnologias para realização da edição genética em humanos e seus desdobramentos na sociedade contemporânea, acarretando no debate bioético dos limites de dominação do ser humano e o respeito a sua personalidade

Estimation of specific VO2max for elderly in cycle ergometer

The aim of the present study was to develop and validate a specific estimation model of maximal oxygen consumption (VO2max) based on submaximal ventilatory indicators on a cycle ergometer test protocol in elderly men. We tested, using an incremental protocol, 181 healthy and non-athletes male volunteers, aged between 60 and 79 years old, randomly divided into two groups: group A, of estimation (n = 137), and group B, of validation (n = 44). The independent variables were: body mass in kg, second workload threshold (WT2) and heart rate at the second ventilatory threshold (VT2). The cross-validation method was used in group B, with group A serving as the basis for the model and the validation dataset. The results presented a multiple linear regression model for estimation of VO2max = 31.62 + 0.182 (WT2) – 0.302 (body mass) in mlO2/kg/min-1; adjusted R2 = 0.98 and SEE = 0.682 (mlO2/Kg/min-1). The construction of this specific model for healthy and non-athletes elderly men can demonstrate that it is possible to estimate VO2max with a minimum error (SEE < 1.00) from indicators of ventilatory thresholds obtained in an incremental submaximal test

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Contra la perfección: Ética en la era de la ingeniería genética

En la presente recensión se nos informa que la obra fue publicada en su versión original en inglés: The Case Against Perfection: Ethics in the Age of Genetic Engineering (2007), cuyo autor es el profesor de filosofía y política de la Universidad de Harvard, el escritor y filósofo norteamericano Michael J. Sandel, autor del también reconocido Justice - What is doing the right thing, resaltando que el libro es el producto de la vasta experiencia del autor en temas de actualidad relacionados con la bioética, que incluso le llevó a formar parte del Consejo de Bioética del entonces presidente de los Estados Unidos, George W. Bush, en 2001. La obra alude al hecho de que todo conduce al deseo de mejora e inmortalidad del ser humano, utilizando el cuestionamiento, basado en el análisis fáctico, que lleva al lector a debates entre la ética y la moral, teniendo como ámbito la duda, como lugar de reflexiones empíricas y humanitarias. SANDEL, Michael J.: Contra a perfeição: Ética na era da engenharia genética; tradução de Ana Carolina Mesquita. 3ª ed. Rio de Janeiro: Ed. Civilização Brasileira, 2018; 160 páginas. Tradução de: The Case Against Perfection: Ethics in the Age of Genetic Engineering (2007) ISBN: 978-85-200-1207-

Edición genética

El presente estudio tiene como objetivo los avances tecnológicos en el campo de la ingeniería genética. Describe los impactos en la sociedad mundial contemporánea de las ediciones genéticas, especialmente la técnica Clustered Regularly Interspaced Short Palindromic Repeat – CRISPR-CAS9, a través de metodología exploratoria y revisión bibliográfica. Por lo tanto, trata de señalar el límite determinante entre la ética y la violación de los Derechos Humanos, un tema recurrente en los estudios de Bioética

Análise de conhecimentos e hábitos de hidratação de corredores de rua no município do Rio de Janeiro

The aim of this study was to analyze the knowledge and hydration habits of recreational road runners of 5 and 10 km in Rio de Janeiro city. This was a survey-type descriptive cross-sectional study. The sample consisted of 28 individuals, 18 men (age: 38.06 ± 13.39 years) and 10 women (age: 34.00 ± 6.55 years), road runners in Rio de Janeiro city, with minimum training frequency of three times a week. The data were collected through an adapted questionnaire, with questions about training characteristics, hydration habits and the importance of hydration. The questionnaire responses showed that 35.7% of the study participants have the habit of running for over two years, however, 53.6% of the participants did not seek guidance on the best way to hydrate. Most (61.5%) of those who received information about hydration resorted to a Physical Education teacher, although 64.3% of the sample run without the guidance of this professional and 10.7% are still unaware of some importance of hydration. Hydration of individuals occurs predominantly after the training (87%) and competitions (86.7%) with moderately cold liquids (57.1%), with isotonic (39.3%) and with water (100%). However, 39.3% of respondents are concerned about the hydration only in the summer. We conclude that runners surveyed hydrate with a certain frequency after the activities, but do not understand the importance of this action. Physical Education teacher is the most sought professional for information about hydrationO objetivo do estudo foi analisar conhecimentos e hábitos de hidratação de corredores de rua de 5 e 10 km no município do Rio de Janeiro. O trabalho caracteriza-se como um estudo descritivo, de corte transversal do tipo Survey. A amostra foi composta por 28 indivíduos, 18 homens (idade: 38,06 ± 13,39 anos) e 10 mulheres (idade: 34,00 ± 6,55 anos), corredores de rua da cidade do Rio de Janeiro, com frequência de treinamento mínima de três vezes por semana. Os dados foram coletados através de um questionário adaptado, composto de perguntas sobre características do treinamento, hábitos de hidratação e importância da hidratação. As respostas do questionário mostraram que 35,7% dos sujeitos do estudo têm o hábito de correr há mais de dois anos, porém 53,6% dos participantes não buscaram orientações quanto a melhor maneira de se hidratar. A maioria (61,5%) dos que buscaram informações sobre a hidratação recorreram a um profissional de Educação Física, apesar de 64,3% da amostra correr sem a orientação deste profissional e 10,7% ainda desconhecer alguma importância de se hidratar. A hidratação dos indivíduos se dá predominantemente após os treinos (87%) e competições (86,7%) com líquidos moderadamente gelados (57,1%) e isotônicos (39,3%) em conjunto com a água (100%). Todavia, 39,3% dos participantes se preocupam com a hidratação apenas no verão. Conclui-se que os corredores pesquisados se hidratam com certa frequência após as atividades, porém não entendem a importância dessa ação. O profissional de Educação Física é o profissional mais procurado para informar sobre a hidratação

Determination and comparison of time under tension required to perform 8, 10 and 12-RM loads in the bench press exercise

Study aim: To determine and compare the time under tension (TUT) required to perform 8, 10 and 12 repetition maximum (RM) loads in the bench press exercise