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

Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

ObjectivesTo assess the ABC2-SPH score in predicting COVID-19 in-hospital mortality, during intensive care unit (ICU) admission, and to compare its performance with other scores (SOFA, SAPS-3, NEWS2, 4C Mortality Score, SOARS, CURB-65, modified CHA2DS2-VASc, and a novel severity score).Materials and methodsConsecutive patients (≥ 18 years) with laboratory-confirmed COVID-19 admitted to ICUs of 25 hospitals, located in 17 Brazilian cities, from October 2020 to March 2022, were included. Overall performance of the scores was evaluated using the Brier score. ABC2-SPH was used as the reference score, and comparisons between ABC2-SPH and the other scores were performed by using the Bonferroni method of correction. The primary outcome was in-hospital mortality.ResultsABC2-SPH had an area under the curve of 0.716 (95% CI 0.693–0.738), significantly higher than CURB-65, SOFA, NEWS2, SOARS, and modified CHA2DS2-VASc scores. There was no statistically significant difference between ABC2-SPH and SAPS-3, 4C Mortality Score, and the novel severity score.ConclusionABC2-SPH was superior to other risk scores, but it still did not demonstrate an excellent predictive ability for mortality in critically ill COVID-19 patients. Our results indicate the need to develop a new score, for this subset of patients

Normas para o uso do Mini-Exame do Estado Mental: adequação do ponto de corte em estudos populacionais (evidências do Projeto Bambuí)

Submitted by Nuzia Santos ([email protected]) on 2013-07-04T16:54:12Z No. of bitstreams: 1 24. CASTRO-COSTA E, FUZIKAWA C.pdf: 206696 bytes, checksum: bfa9725ac845a32b88d654458e7aedff (MD5)Made available in DSpace on 2013-07-04T16:54:12Z (GMT). No. of bitstreams: 1 24. CASTRO-COSTA E, FUZIKAWA C.pdf: 206696 bytes, checksum: bfa9725ac845a32b88d654458e7aedff (MD5) Previous issue date: 2008FAPEMIG, CNPqFederal University of Minas Gerais. Medical School. Public health and Ageing research Group/Oswaldo Cruz Foundation. René Rachou Research Institute. Belo Horizonte MG, Brazil/ Faculty of health and human Ecology. Vespasiano, MG, Brazil/ King’s College london. Institute of Psychiatry. Health Services Research Department. London, UKFederal University of Minas Gerais. Medical School. Public health and Ageing research Group/Oswaldo Cruz Foundation. René Rachou Research Institute. Belo Horizonte MG, BrazilFederal University of Minas Gerais. Medical School. Public health and Ageing research Group/Oswaldo Cruz Foundation. René Rachou Research Institute. Belo Horizonte MG, Brazil / Federal University of Minas Gerais.Medical School. Department of Mental Health. Belo Hori-zonte MG, Brazil.Federal University of Minas Gerais. Medical School. Public health and Ageing research Group/Oswaldo Cruz Foundation. René Rachou Research Institute. Belo Horizonte MG, BrazilFederal University of Minas Gerais. Medical School. Public health and Ageing research Group/Oswaldo Cruz Foundation. René Rachou Research Institute. Belo Horizonte MG, BrazilObjetivo: Estimar a prevalência de déficit cognitivo em uma base populacional de idosos, utilizando-se os diferentes pontos de corte do Mini-Exame do Estado Mental (MEEM) recomendados por autores brasileiros e verificar a distribuição em percentis da pontuação do MEEM na população estudada. Método: Participaram do estudo 1558 (89,4% do total) indivíduos com idade ≥60 anos residentes na cidade de Bambuí, MG, que foram submetidos ao MEEM. Resultados: A prevalência estimada de déficit cognitivo variou de 13,2% a 27,0%, dependendo do ponto de corte utilizado, observando-se grande variação na sua concordância (índices de kappa entre 0,38 e 0,88). O ponto de corte de 13/14 correspondeu ao 5º percentil e o de 21/22, ao quartil inferior da distribuição dos escores do MEEM. Conclusão: Na ausência de pontos de corte comparáveis, a distribuição em percentis é mais adequada para estudos de base populacional de idosos com baixa escolaridadeObjective: To estimate the prevalence of cognitive impairment in an elderly population-based cohort, using several Mini-Mental State Examination (MMSE) cut-off points recommended by Brazilian authors and to examine the percentile distribution of MMSE scores in the study population. Method: A total of 1558 subjects aged ≥60 years (89.4% of the total), living in the city of Bambuí, MG, completed the MMSE and were included in the present study. Results: The estimated prevalences of cognitive impairment varied from 13.2% to 27.0% depending on the cut-off point and agreement varied widely between them (kappa range: 0.38 to 0.88). Cut-off point 13/14 corresponded to the 5 th percentile and 21/22 corresponded to the lower quartile of the MMSE score distribution. Conclusion: In the absence of comparable cut-off points, percentile distributions are more adequate for population-based studies of elderly with low schooling level

Insomnia subtypes and their relationship to excessive daytime sleepiness in Brazilian community-dwelling older adults

Submitted by Nuzia Santos ([email protected]) on 2014-11-05T12:56:04Z No. of bitstreams: 1 Insomnia subtypes and their relationship to excessive daytime sleepiness in Brazilian community-dwelling older adults.pdf: 183126 bytes, checksum: be48250a18862d009c3f77870cd86398 (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2014-11-05T13:00:30Z (GMT) No. of bitstreams: 1 Insomnia subtypes and their relationship to excessive daytime sleepiness in Brazilian community-dwelling older adults.pdf: 183126 bytes, checksum: be48250a18862d009c3f77870cd86398 (MD5)Made available in DSpace on 2014-11-05T13:00:30Z (GMT). No. of bitstreams: 1 Insomnia subtypes and their relationship to excessive daytime sleepiness in Brazilian community-dwelling older adults.pdf: 183126 bytes, checksum: be48250a18862d009c3f77870cd86398 (MD5) Previous issue date: 2011Serviço de Seguridade Social dos Servidores do Estado de Minas Gerais. Belo Horizonte, MG, Brazil/Faculdade da Saúde e Ecologia Humana. Vespasiano, MG, Brazil;King’s College London. Institute of Psychiatry. London, UK;Universidade Federal de Minas Gerais. Faculdade de Medicina. Saúde Pública Pesquisa do Envelhicimento/Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil;Serviço de Seguridade Social dos Servidores do Estado de Minas Gerais. Belo Horizonte, MG, Brazil;Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Saúde Mental. Belo Horizonte, BrazilUniversidade Federal de Minas Gerais. Faculdade de Medicina. Saúde Pública Pesquisa do Envelhicimento/Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil;Universidade Federal de Minas Gerais. Faculdade de Medicina. Saúde Pública Pesquisa do Envelhicimento/Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil;King’s College London. Institute of Psychiatry. London, UK/Universidade Federal de Minas Gerais. Faculdade de Medicina. Saúde Pública Pesquisa do Envelhicimento/Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrazilSTUDY OBJECTIVES: To investigate the association between different types of insomnia as exposures and excessive daytime sleepiness (EDS) as a binary outcome in older Brazilian residents. DESIGN: The baseline examination of the Bambuí Health and Ageing Study (BHAS), which is an ongoing population-based prospective cohort study of older adults. SETTING: Bambuí (15,000 inhabitants), a city in the State of Minas Gerais, Southeast Brazil PARTICIPANTS: All residents aged ≥ 60 years were eligible to take part in the BHAS baseline. Of 1742 residents identified who were ≥ 60 years, 1606 (92.2%) were interviewed and received comprehensive examinations of health status. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: EDS was defined as the presence of sleepiness ≥ 3 times per week in the last month, causing any interference in usual activities. All insomnia subtypes were significantly associated with EDS in unadjusted analyses, and these associations were only modestly altered after adjusting incrementally for the other covariates. In a final model, the 3 insomnia subtypes were entered into a fully adjusted model simultaneously to investigate mutual independence, giving prevalence ratios of 1.63 (95% CI 1.14-2.31) for initial insomnia, 2.13 (95% CI 1.48-3.07) for middle insomnia, and 1.36 (95% CI 0.94-1.96) for terminal insomnia. The population attributable fractions for initial, middle, and terminal insomnia on prevalence of EDS were 17.6%, 32.9%, and 9.7%, respectively. CONCLUSIONS: Middle insomnia emerged as the insomnia subtype most strongly associated with EDS. Further research is required to clarify causal pathways underlying this cross-sectional association

Thermal equilibrium of Nellore cattle in tropical conditions: an investigation of circadian pattern

<p>The aim of this study was to evaluate the circadian pattern of the thermal equilibrium of Nellore cattle in a tropical environment. The study was conduct at the Animal Biometeorology Laboratory of the São Paulo State University, Jaboticabal, Brazil (21.25° S, 601 m altitude) in December of 2016. Six Nellore cattle with similar weight, age and body condition were assigned in two Latin Square experimental design (24 classes of hours (1-2h; 3-4h; …; 23 - 24h; 24 -1h) during twelve days). Evaluations were performed with subjects protected from direct solar radiation and rain overnight. Respiratory parameters as percentage of oxygen (O₂; %), carbon dioxide (CO₂; %), water vapor pressure (e{T_E}; kPa) respiratory rate (R_R; breaths min^-1) and ventilation (V_E; L s^-1) were quantified using an indirect calorimetry system; furthermore, hair coat surface (T_S, °C), skin (T_EP, °C) and rectal temperature (T_R, °C) were recorded with thermocouple. Metabolic heat production (q_met), sensible heat flow (q_sens), heat loss from respiratory tract (q_er) and cutaneous evaporation (q_es) were calculated. Air temperature (T_A,°C), relative humidity (R_H, %), partial vapor pressure (e{T_A}, kPa), solar irradiance (G_S, W m⁻²), black globe temperature in shade (T_G,°C), and under direct sunlight (T_GSUN ,°C) were measured at regular one-minute intervals during each day with a portable weather station. Data were analyzed by the least square method. T_AR showed, on average, 9°C of amplitude, with higher value at 13:00 h (30.9 ± 0.2 °C). Average metabolism of 158.43 ± 13.97 W m^-2was observed, presenting highest value of 174.62 ± 2.63 W m^-2 at 11:00 h, during the morning; thenceforth, it was gradually decreasing, and start to increase one hour after feeding time. The sensible heat flow through the body surface was represented, in highest percentage, by long wave radiation. Interestingly, even with the fall of the T_AR at night, we observed lower values for q_rad. q_es was more expressive during the warmer temperatures. The q_er seems to be a mechanism of minor significance for the thermal of Nellore cattle. Under tropical condition, from 21 to 30 °C thermoregulatory responses of Nellore cattle remain stable over the 24 hours when protected from direct solar radiation and rain overnight, which seems to be a good indicative of lower energetics costs for homoeothermic maintenance.</p