Evaluación de la infección por Strongyloides stercoralis en pacientes con HTLV-1

Introduction: Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis (S. stercoralis) infection with low therapeutic response. Objective: To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1, who were seen at a Reference Center for HTLV-1 (CHTLV), in Salvador, Bahia, Brazil. Materials and methods: This was a cross-sectional study conducted with 178 HTLV-1-infected individuals, treated at the HTLV specialized center between January 2014 and December 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed by an in house Enzyme Lynked-Immunosorbent Assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot. Results: The frequency of S. stercoralis infection was 3.4% (6/178). Moreover, individuals infected with S. stercoralis from rural area (50.0%; 3/6), also showed S. stercoralis hyperinfection (> 3,000 larvae/gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178). Conclusions: HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.Introducción. Los individuos infectados por el virus linfotrópico T humano tipo 1 (HTLV-1) pueden presentar formas graves y diseminadas de infección por Strongyloides stercoralis (S. stercoralis) con baja respuesta terapéutica. Objetivo. Investigar la infección por S. stercoralis y la seroprevalencia de IgG anti-S. stercoralis en individuos infectados por HTLV-1, que fueron atendidos en un Centro de Referencia para HTLV-1 (CHTLV), en Salvador, Bahía, Brasil. Materiales y métodos. Estudio transversal realizado con 178 individuos infectados por HTLV-1, atendidos en el centro especializado de HTLV entre enero de 2014 y diciembre de 2018. El diagnóstico parasitológico de S. stercoralis se realizó mediante métodos de Hoffman, Pons y Janer, cultivo en placa de agar y Baermann-Morais. La detección de IgG anti-S. stercoralis se realizó mediante un ensayo de inmunoabsorción enzimática (ELISA) casero. La infección por HTLV-1 se diagnosticó usando un ELISA comercial y se confirmó mediante transferencia Western. Resultados. La frecuencia de infección por S. stercoralis fue del 3,4% (6/178). Además, los individuos infectados por S. stercoralis de la zona rural (50,0%; 3/6) también mostraron hiperinfección por S. stercoralis (> 3.000 larvas / gramo de heces). La frecuencia de anticuerpos IgG anti-S. stercoralis fue del 20,8% (37/178). Conclusiones. las personas infectadas por HTLV-1 que viven en condiciones sanitarias precarias son más propensas a desarrollar formas graves de infección por S. stercoralis. Teniendo en cuenta la alta susceptibilidad y el resultado desfavorable de la infección en estos individuos, se debe considerar el diagnóstico serológico de S. stercoralis para administrar el tratamiento

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data