HELICOBACTER PYLORI INFECTION AND RISK FACTORS IN THE DEVELOPMENT OF GASTRODUODENAL DISEASES IN A POPULATION FROM THE CENTRAL-WEST REGION OF BRAZIL

Resumo: Helicobacter pylori é uma bactéria gram-negativa associada ao desenvolvimento de patologias severas como o adenocarcinoma gástrico. Aproximadamente 50% da população mundial está infectada por este microrganismo. A infecção está associada a fatores socioeconômicos, sociodemográficos e estilo de vida. Em função disso o presente estudo teve o objetivo de avaliar os fatores de risco e patologias gástricas associadas a infecção pela H. pylori. Foram aplicados 117 questionários que contemplavam fatores sociodemográficos, econômicos, sintomatologia e estilo de vida de pacientes submetidos a endoscopia digestiva alta. O diagnóstico foi realizado a partir do exame histopatológico e molecular. A prevalência da infecção foi de 69,2%, sendo 70,4% entre adultos e 79% do sexo feminino. Não foi observada diferença estatística nos níveis educacional, socioeconômico e condições expostas na infância. O hábito de consumir álcool demonstrou significância para a infecção (p=0,049). A sintomatologia mais frequente foi o arroto (p= 0,023). Entre as patologias gástricas, a gastrite foi o desfecho clínico mais encontrado. O conhecimento dos fatores de risco para a infecção bacteriana é de extrema relevância para dar subsídios para implementação de políticas públicas voltadas para a prevenção e erradicação do microrganismo. Palavras-chave: Bactéria. Prevalência. Fatores de risco. Dispepsia.   Abstract: Helicobacter pylori is a gram-negative bacterium associated with the development of severe pathologies such as gastric adenocarcinoma. Approximately 50% of the world population is infected by this microorganism. Infection is associated with socioeconomic, sociodemographic and lifestyle factors. Therefore, the present study had the goal of evaluating the risk factors and gastric pathologies associated with H. pylori infection. A total of 117 questionnaires were used, which included sociodemographic, economic, symptomatology and patient lifestyle factors submitted to upper digestive endoscopy. The diagnosis was done based on histopathological and molecular. The prevalence of infection was 69.2%, being 70.4% among adults and 79% females. No statistical difference was observed in educational, socioeconomic and childhood conditions. The alcohol consumption habit showed significance for the infection (p = 0.049). The most frequent symptomatology was belching (p = 0.023). Among the gastric pathologies, gastritis was the most frequent clinical outcome. The knowledge of the risk factors for bacterial infection is extremely relevant to provide subsidies for the implementation of public policies aimed at the prevention and eradication of the microorganism. Key words: Bacteria. Risk factors. Dyspepsia

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Genetic characterization of natural populations of araticunzeiro (Annona crassiflora Mart.) by cpDNA sequence analysis

Made available in DSpace on 2014-07-29T16:24:21Z (GMT). No. of bitstreams: 1 ANGEL jose.pdf: 1885350 bytes, checksum: 8203e3220392d36d98c1cc30c0439590 (MD5) Previous issue date: 2005-08-30The araticunzeiro (Annona crassiflora Mart.) is a tropical fruit tree species from the Cerrado (Brazilian Savannah) with high economic potential. The strong degradation of the Cerrado, allied to the predatory extractivism that threatens the species, points out to the necessity of development of research to support future conservation programs. With the aim to furnish information about the genetic status of this species and to guide future conservation strategies, 82 individuals from 11 natural populations were submitted to genetic analysis. The coalescent based analysis of the polymorphism present in the trn-L cpDNA allowed the detection of high levels of genetic diversity in the species. In spite of the high level of genetic similarity among different populations the results produced suggested that, , there is an incipient, but statistically significant, increasing differentiation process taking place due to current status of geographical isolation and genetic drift. The genetic differentiation coefficient estimated was equal to 7.3%. The spatial genetic divergence analyses suggested that the genetic distances are not associated to geographical distances between populations, evidencing the absence of current gene flow between adjacent populations. The coalescent based approach allowed the identification of different evolutionary scenes to the investigated populations. Among sampled populations cases from well conserved status to dangerous low levels of genetic diversity were detected. Results obtained by the use of coalescent models to infer the divergence time between populations suggested that natural populations of A. crassiflora were, until recently, part of a great regional continuum. These findings suggest that the low levels of genetic diversity among different populations must be due to the small time since isolation.O araticunzeiro (Annona crassiflora Mart.) é uma espécie de árvore frutífera nativa do bioma Cerrado com elevado potencial de utilização econômica. A forte degradação desse bioma, aliada ao extrativismo predatório a que a espécie vem sendo submetida, justifica a necessidade de desenvolvimento de pesquisas que subsidiem a sua conservação. Objetivando obter informações que indiquem o status genético dessa espécie e orientem futuras estratégias de conservação, 82 indivíduos provenientes de 11 populações naturais foram analisados geneticamente. A análise do polimorfismo presente em seqüências da região trn-L do genoma cloroplastidial e posterior aplicação dos modelos associados à teoria da coalescência permitiram a detecção de elevados níveis de diversidade genética para a espécie. Os resultados obtidos indicam que, embora as populações amostradas tenham demonstrando elevada similaridade genética entre si, há uma incipiente, mas significativa, diferenciação genética entre elas, que tende a aumentar progressivamente devido ao efeito do isolamento geográfico e à força da deriva. O coeficiente de diferenciação genética entre as populações analisadas foi de 7,3%. A análise de divergência entre as populações amostradas não evidenciou a existência de associação significativa dos padrões de diferenciação genética com a distância geográfica entre elas. As informações obtidas pela análise baseada no modelo de coalescência permitiram a identificação de diferentes cenários evolutivos para as populações estudadas. Dentre as populações amostradas, foram identificadas desde populações em bom estado de conservação até populações com baixíssimos níveis de diversidade genética. Os resultados obtidos pela utilização do modelo coalescente para se inferir o tempo de divergência entre as populações sugeriram que as populações se A. crassiflora até há muito pouco tempo se constituíam em um grande contínuo populacional, sendo a baixa diversidade encontrada entre as populações atribuída ao pequeno tempo de divergência entre elas