The association of diabetes, subclinical hypothyroidism and carotid intima-media thickness: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil)

Introduction: The association of diabetes with subclinical thyroid diseases may increase the risk of cardiovascular diseases. We analyzed the association of subclinical hypothyroidism, diabetes, and both diseases with carotid Intima-Media Thickness (cIMT) as a surrogate maker for early cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Cross-sectional analysis with data from the 3rd visit (2017‒2019). Linear regression models were used to evaluate the association of subclinical hypothyroidism, diabetes and of both diseases with a cIMT presented as Beta (95% Confidence Interval ‒ 95% CI) without adjustment, with adjustment for sociodemographic variables (Model 1) and multivariable adjustment (Model 1 more cardiovascular risk factors). We also used logistic regression models to analyze the Odds Ratio (OR) and 95% CI for the association of both diseases using cIMT > P75%. Results: After the exclusion of patients with previous cardiovascular disease, 5,077 participants with no diseases, 1578 with diabetes, 662 with subclinical hypothyroidism, and 234 with both diseases were included in the analysis. Linear regression models showed an association of cIMT with only diabetes (β = 0.019; 95% CI 0.012 to 0.027; p < 0.0001) and subclinical hypothyroidism more diabetes (β = 0.03; 95% CI 0.010‒0.047, p < 0.0001). The logistic regression model reported an association between diabetes and CIMT higher than P75% (OR = 1.49, 95% CI 1.30‒1.71). No interaction between diabetes and subclinical hypothyroidism was detected using cIMT respectively as a continuous (p = 0.29) or as a categorical variable (p = 0.92). Discussion: Diabetes was associated with higher cIMT values. However, no additive effect of subclinical hypothyroidism associated with diabetes over cIMT was detected

The magnitude of syphilis: from prevalence to vertical transmission

Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State

Brazilian Plasmodium falciparum isolates: investigation of candidate polymorphisms for artemisinin resistance before introduction of artemisinin-based combination therapy

<p>Abstract</p> <p>Background</p> <p>This study was performed to better understand the genetic diversity of known polymorphisms in <it>pfatpase6 </it>and <it>pfmdr1 </it>genes before the introduction of ACT in Brazil, in order to get a genotypic snapshot of <it>Plasmodium falciparum </it>parasites that may be used as baseline reference for future studies.</p> <p>Methods</p> <p>Parasites from <it>P. falciparum </it>samples collected in 2002, 2004 and 2006-2007 were genotyped using PCR and DNA sequencing at codons 86, 130, 184, 1034, 1042, 1109 and 1246 for <it>pfmdr1 </it>gene, and 243, 263, 402, 431, 623, 630, 639, 683, 716, 776, 769 and 771 for <it>pfatpase6 </it>gene.</p> <p>Results</p> <p>A <it>pfmdr1 </it>haplotype NEF/CDVY was found in 97% of the samples. In the case of <it>pfatpase6</it>, four haplotypes, wild-type (37%), 630 S (35%), 402 V (5%) and double-mutant 630 S + 402 V (23%), were detected.</p> <p>Conclusion</p> <p>Although some polymorphism in <it>pfmdr1 </it>and <it>pfatpase6 </it>were verified, no reported haplotypes in both genes that may mediate altered response to ACT was detected before the introduction of this therapy in Brazil. Thus, the haplotypes herein described can be very useful as a baseline reference of <it>P. falciparum </it>populations without ACT drug pressure.</p

Randomized double-blind clinical trial of a new human epoetin versus a commercially available formula for anemia control in patients on hemodialysis

OBJECTIVES: Anemia is a common complication among chronic kidney disease patients on hemodialysis, occurring mostly due to erythropoietin deficiency. This randomized noninferiority trial sought to compare the efficacy and safety of a new epoetin formulation developed by Bio-Manguinhos, a biologics manufacturer affiliated with the Brazilian government, with those of a commercially available product currently used in Brazil (a biosimilar epoetin formulation). METHODS: The sample size needed to enable demonstration of noninferiority with a statistical power of 85% for a between-group difference in hemoglobin levels of no more than 1.5 g/dL was calculated. In total, 74 patients were randomly assigned to receive the epoetin formulation from Bio-Manguinhos (n = 36) or the biosimilar epoetin formulation (n = 38) in a double-blind fashion. The inclusion criteria were current epoetin therapy and stable hemoglobin levels for at least 3 months prior to the study. The primary and secondary outcomes were mean monthly hemoglobin levels and safety, respectively. The dose was calculated according to international criteria and adjusted monthly in both groups according to hemoglobin levels and at the assistant physicians' discretion. Iron storage was estimated at baseline and once monthly. Clinicaltrials.gov: NCT01184495. RESULTS: The study was conducted for 6 months after randomization. The mean baseline hemoglobin levels were 10.9±1.2 and 10.96±1.2 g/dL (p = 0.89) in the Bio-Manguinhos epoetin and biosimilar epoetin groups, respectively. During the study period, there was no significant change in hemoglobin levels in either group (p = 0.055, ANOVA). The epoetin from Bio-Manguinhos was slightly superior in the last 3 months of follow-up. The adverse event profiles of the two formulations were also similar. CONCLUSIONS: The epoetin formulations tested in this study are equivalent in efficacy and safety

Análise e Acompanhamento da Execução de Soluções de Melhoria de Conforto Térmico na Reabilitação de Edifícios

O presente relatório inserido na Unidade Curricular de DIPRE do Mestrado em Engenharia Civil – Ramo de Construções, do Instituto Superior de Engenharia do Porto e desenvolvido no âmbito do estágio curricular realizado na empresa Porto Vivo, SRU, tem como objetivo descrever as atividades realizadas durante o período de estágio, no Núcleo de Gestão de Obras, tais como o acompanhamento das Operações de Reabilitação e Realojamento no Morro da Sé, participações em reuniões de obra com empreiteiros e projetistas, realização de vistorias para determinar o nível de conservação dos edifícios. Irá ainda ser abordado um caso de estudo relativo ao comportamento térmico da fração autónoma de um edifício em reabilitação, utilizando como base o Regulamento de Desempenho Energético dos Edifícios de Habitação (REH). Por último, as conclusões finais do estágio, a apreciação das atividades desenvolvidas, a sua importância para o estagiário a nível pessoal e profissional e ainda as ilações referentes ao caso de estudo.As part of DIPRE class of Civil Engineering’s – Construction Business - Master Course at Instituto Superior de Engenharia do Porto, the present report was developed under the internship held at Porto Vivo – SRU, it aims to describe the activities performed under the internship period, at Núcleo de Gestão de Obras the tasks of the monitoring of the rehabilitation and resettlement operations of Morro da Sé, participation of site meetings with contractors and designer managers and undertaken of surveys to determine the building’s conservation level. It will also be discussed a study case, related with the thermal behavior of an autonomous fraction from a building undertaking rehabilitation works, based on Regulamento de Desempenho Energético dos Edifícios de Habitação (REH). At last, it will be presented the internship’s final conclusions, the assessments of developed activities and its importance for the trainee at a personal and professional level as well as the conclusions from the study case

Cruce de saberes en el Club Corazones del Retiro

Exploracuátic@s es un proyecto de extensión universitaria acreditado por la Universidad Nacional de La Plata, que realiza actividades para niños y adolescentes en dos Centros Comunitarios de Extensión Universitaria (CCEU) de la UNLP desde octubre 2015: Corazones del Retiro y Sacachispa (La Plata).Facultad de Informátic