Lower insulin-dose adjusted A1c (IDAA1c) is associated with less complications in Individuals with Type 1 Diabetes treated with hematopoetic stem-cell transplantation and conventional therapy

Objective: To evaluate the association between insulin-dose adjusted A1C (IDAA1c) and microvascular complications (MC) and hypoglycemia in a representative Brazilian population of Type 1 diabetes mellitus (T1DM) patients. Research Design and Methods: This was a cross-sectional study based on a previous study, “Microvascular Complications in Type 1 Diabetes: a comparative analysis of patients treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) and conventional medical therapy (CT)”. The 168 patients in that study (144 from CT plus 24 from AHST) were re-subdivided into two groups, according to their IDAA1c values (30 patients had IDAA1c ≤ 9; 138 had IDAA1c > 9). Then, the prevalence of MC (diabetic renal disease, neuropathy, and retinopathy), hypoglycemia (blood glucose <60 mg/dL), and severe hypoglycemic (episode of hypoglycemia that required the assistance of another person to treat) events were compared between the groups. The groups were well-matched on these factors: duration of disease, sex, and age at the time of diagnosis of T1DM. Results: After an average of 8 years after diagnosis, only 6.6% (2/30) of the patients from IDAA1c ≤ 9 group developed any MC, whereas 21.0% (29/138) from the IDAA1c > 9 group had at least one complication (p = 0.044). Regarding hypoglycemic events, the proportion of individuals who reported at least 1 episode of hypoglycemia in the last month was 43.3 and 64.7% from the IDAA1c ≤ 9 and IDAA1c > 9 groups, respectively (p = 0.030). Regarding severe hypoglycemia, the proportion of patients presenting at least one episode in the last month and the rate of episode/patient/month were similar between groups (6.7 vs. 13.2%; p = 0.535; and 0.1/patient/month vs. 0.25/patient/month; p = 0.321). Conclusion: In a representative Brazilian population of T1DM patients, those with IDAA1c ≤ 9 presented a lower frequency of MC, as well as fewer episodes of hypoglycemia, in the month prior to the analysis.publishedVersio

Coinfections in Patients With Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Study

Background: The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection. Methods: We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality. Results: Among 8765 patients (hospitalized or not; median age, 65 years; 47.4% male), 16.6% developed coinfections: 12.1% bacterial, 2.1% viral, 0.9% fungal. An additional 6.4% only had clinical diagnosis of a coinfection. The adjusted risk of any coinfection was positively associated with age \u3e50 years, male sex, cardiovascular, pulmonary, and renal comorbidities, diabetes, hematologic malignancy, multiple malignancies, Eastern Cooperative Oncology Group Performance Status, progressing cancer, recent cytotoxic chemotherapy, and baseline corticosteroids; the adjusted risk of superinfection was positively associated with tocilizumab administration. Among hospitalized patients, high neutrophil count and C-reactive protein were positively associated with bacterial coinfection risk, and high or low neutrophil count with fungal coinfection risk. Adjusted mortality rates were significantly higher among patients with bacterial (odds ratio [OR], 1.61; 95% CI, 1.33-1.95) and fungal (OR, 2.20; 95% CI, 1.28-3.76) coinfections. Conclusions: Viral and fungal coinfections are infrequent among patients with cancer and COVID-19, with the latter associated with very high mortality rates. Clinical and laboratory parameters can be used to guide early empiric antimicrobial therapy, which may improve clinical outcomes

A Política Africana de Cuba: a Guerra Civil Angolana como Marco Inicial

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A Política Africana de Cuba: a Guerra Civil Angolana como Marco Inicial

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A Bioética na política pública do Brasil

Made available in DSpace on 2010-08-23T16:41:10Z (GMT). No. of bitstreams: 3 Marques_Bioetica Politica_1996.pdf: 7763885 bytes, checksum: f95b599bba21fa8c46e9adee9fdbf6ca (MD5) license.txt: 1844 bytes, checksum: 61079d0963e5e8422d16406aa8d73d71 (MD5) Marques_Bioetica Politica_1996.pdf.txt: 10 bytes, checksum: 2c6eb67c8897d916ae47524b1a844d3f (MD5) Previous issue date: 1996Made available in DSpace on 2010-11-04T14:18:03Z (GMT). No. of bitstreams: 3 Marques_Bioetica Politica_1996.pdf.txt: 10 bytes, checksum: 2c6eb67c8897d916ae47524b1a844d3f (MD5) license.txt: 1844 bytes, checksum: 61079d0963e5e8422d16406aa8d73d71 (MD5) Marques_Bioetica Politica_1996.pdf: 7763885 bytes, checksum: f95b599bba21fa8c46e9adee9fdbf6ca (MD5) Previous issue date: 1996Fundação Oswaldo Cruz Mato Grosso do Sul. Campo Grande, MS, Brasil.O artigo focaliza a bioética enquanto tema da política enquanto tema da política pública. Analisa os principais códigos internacionais referentes à ética biomédica e apresenta uma sucinta revisão do trabalho de algumas comissões nacionais de bioética de países desenvolvidos. Concluindo, a autora assinala os aspectos mais relevantes e controvertidos a serem considerados na experiência brasileir

Management, planning and assessment of science and technology policies: time to review?

Made available in DSpace on 2010-08-23T16:41:11Z (GMT). No. of bitstreams: 3 Marques MB_Gestao planejamento avaliacao_1999.pdf: 95096 bytes, checksum: 510b326efc2021aa3f15843d55b874b9 (MD5) license.txt: 1844 bytes, checksum: fe022de49d01e4f49b8c1fc2ed61c65f (MD5) Marques MB_Gestao planejamento avaliacao_1999.pdf.txt: 46318 bytes, checksum: ac2c1e48c0d0fe20eaf090feddaf32e8 (MD5) Previous issue date: 1999Made available in DSpace on 2010-11-04T14:18:08Z (GMT). No. of bitstreams: 3 Marques MB_Gestao planejamento avaliacao_1999.pdf.txt: 46318 bytes, checksum: ac2c1e48c0d0fe20eaf090feddaf32e8 (MD5) license.txt: 1844 bytes, checksum: fe022de49d01e4f49b8c1fc2ed61c65f (MD5) Marques MB_Gestao planejamento avaliacao_1999.pdf: 95096 bytes, checksum: 510b326efc2021aa3f15843d55b874b9 (MD5) Previous issue date: 1999Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Rio de Janeiro, RJ, Brasil.O presente artigo aborda o tema das políticas de ciência e tecnologia e as questões relativas à sua gestão, planejamento e avaliação. Revisa a trajetória da ciência e tecnologia nas cinco últimas décadas deste século, analisando como a ciência voltou-se progressivamente para os mercados e empresas de alta tecnologia, ao mesmo tempo em que cresceria a intervenção do Estado dirigida à integração da ciência e da tecnologia ao conjunto da economia. A seguir, analisa a noção de sistema nacional de inovação e suas relações com o tema das políticas de ciência e tecnologia. O texto finaliza retomando o problema dos limites e dos rumos da ação governamental sobre a ciência e a tecnologia nos países em desenvolvimento e subdesenvolvidosThis article addresses the issue of science and technology policies as well as its management and evaluation. Reviews the trajectory of science and technology during the last five decades of this century and analyses how science has progressively turned to the markets and to high-tech firms, simultaneously to the increase in the governmental intervention steered to integrate science and technology in the whole economy. It also analyses the notion of national innovation system and its relations with the science and technology policies. To conclude, the paper considers the problem of the limits and trends of the governmental action directed to science and technology in developing and underdeveloped countries

Privatização indiscriminada?

Made available in DSpace on 2010-08-23T16:41:12Z (GMT). No. of bitstreams: 3 Marques_Privatização indiscriminada_1994.pdf: 837508 bytes, checksum: 95b4528dd359fd9c26fb5bd817f2be82 (MD5) license.txt: 1842 bytes, checksum: c845e0e9485229cf7df039d595781470 (MD5) Marques_Privatização indiscriminada_1994.pdf.txt: 3 bytes, checksum: 2228e977ebea8966e27929f43e39cb67 (MD5) Previous issue date: 1994Made available in DSpace on 2010-11-04T14:18:02Z (GMT). No. of bitstreams: 3 Marques_Privatização indiscriminada_1994.pdf.txt: 3 bytes, checksum: 2228e977ebea8966e27929f43e39cb67 (MD5) license.txt: 1842 bytes, checksum: c845e0e9485229cf7df039d595781470 (MD5) Marques_Privatização indiscriminada_1994.pdf: 837508 bytes, checksum: 95b4528dd359fd9c26fb5bd817f2be82 (MD5) Previous issue date: 1994Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Rio de Janeiro, RJ, Brasil

The Bioethics Debate in Brazil

Made available in DSpace on 2010-08-23T16:41:12Z (GMT). No. of bitstreams: 3 Marques MB_Bioethics Debate1 _1996.pdf: 103763 bytes, checksum: e5b694e258b2214ec1a470cb9d68db26 (MD5) license.txt: 1844 bytes, checksum: ea4dac67fc644bf4e39e9e2af38a32f9 (MD5) Marques MB_Bioethics Debate1 _1996.pdf.txt: 3 bytes, checksum: 2228e977ebea8966e27929f43e39cb67 (MD5) Previous issue date: 1996Made available in DSpace on 2010-11-04T14:18:04Z (GMT). No. of bitstreams: 3 Marques MB_Bioethics Debate1 _1996.pdf.txt: 3 bytes, checksum: 2228e977ebea8966e27929f43e39cb67 (MD5) license.txt: 1844 bytes, checksum: ea4dac67fc644bf4e39e9e2af38a32f9 (MD5) Marques MB_Bioethics Debate1 _1996.pdf: 103763 bytes, checksum: e5b694e258b2214ec1a470cb9d68db26 (MD5) Previous issue date: 1996Oswaldo Cruz Foundation. Center for Scientific and Technological Information. Rio de Janeiro, RJ, Brazil