17 research outputs found

    COVID-19 outcomes in people living with HIV: Peering through the waves

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    Objective: To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods: This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results: Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions: Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group

    Sensitivity of South American tropical forests to an extreme climate anomaly

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    The tropical forest carbon sink is known to be drought sensitive, but it is unclear which forests are the most vulnerable to extreme events. Forests with hotter and drier baseline conditions may be protected by prior adaptation, or more vulnerable because they operate closer to physiological limits. Here we report that forests in drier South American climates experienced the greatest impacts of the 2015–2016 El Niño, indicating greater vulnerability to extreme temperatures and drought. The long-term, ground-measured tree-by-tree responses of 123 forest plots across tropical South America show that the biomass carbon sink ceased during the event with carbon balance becoming indistinguishable from zero (−0.02 ± 0.37 Mg C ha −1 per year). However, intact tropical South American forests overall were no more sensitive to the extreme 2015–2016 El Niño than to previous less intense events, remaining a key defence against climate change as long as they are protected

    Isolamento e cultivo in vitro do agente etiológico da Doença de Jorge Lobo: morfologia, fisiologia e genoma de Candida loboi sp. nov

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    Jorge Lobo’s disease is a chronic granulomatous infection developing after traumatic implantation of the fungus in the skin. It presents with nodular, verrucous or keloid-like lesions mainly on legs and ears. The highest prevalence is at Amazon Region and it has been considered an emergent disease, presenting new cases on other continents in both, humans and dolphins. Little is known about L. loboi, and the absence of in vitro culture impairs the correct characterization of the fungus. This work had as the main goal to isolate, culture and characterize strains of the etiological agent of Jorge Lobo´s disease, obtained from patients attended at the Dr Marcello Candia Reference Unit in Sanitary Dermatology of the State of Pará, in Marituba, Pará, Brazil. During many years 23 patients were diagnosed and followed by our team. Most of them were male farmers, with age varying from 14 to 80 years-old. After biopsy of the lesion for confirming the diagnosis, the patients initiated treatment and the material was processed with dispase II at liquid medium RPMI, 37º C, 5% CO2 for 1-2 weeks to isolate yeast cells from human tissue. After 2-6 months in the medium, we observed fragmentation of mother cells and the presence of new yeast cells with diameter varying from 1 to 7μm. From that moment, it was possible to grow the strains in different liquid or solid mediums at 37º C or RT, where creamy, whitish cerebriform, sometimes hairy colonies were observed. Cells from those strains were analyzed by different techniques of optical and electron microscopy, biochemistry and genetics, ending with the description of the genome of one patient just after isolation of the fungal cells from the lesional skin, defining the following taxonomic identification: Eukaryota; Fungi; Dikarya; Ascomycota; Saccharomycotina; Saccharomycetes; Saccharomycetales; Debaryomycetaceae; Candida/Lodderomyces clade; Candida; Candida sp. LDI48194. The peculiar clinical presentation associated to unique morphological, physiological and genetic characteristics that do not permit the definition of a known species indicate that the etiological agent of Jorge Lobo’s disease is a new species, for which we propose to use the name Candida loboi.CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorCNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoFAPESPA - Fundação Amazônia de Amparo a Estudos e PesquisasFADESP - Fundação de Amparo e Desenvolvimento da PesquisaA Doença de Jorge Lobo é uma infecção crônica, granulomatosa, que se desenvolve após a implantação traumática do fungo na pele. Manifesta-se com lesões nodulares, verrucosas e/ou queloidiformes, localizadas principalmente nos membros inferiores e pavilhões auriculares. Doença prevalente na região Amazônica e, atualmente considerada como emergente, com casos novos em outros continentes em humanos e golfinhos. Pouco se conhece sobre o agente etiológico da doença de Jorge Lobo, principalmente pela impossibilidade do cultivo in vitro, dificultando a caracterização correta do agente. Este trabalho teve como objetivo isolar, cultivar e caracterizar cepas do agente etiológico da doença de Jorge Lobo provenientes de pacientes atendidos na Unidade de Referência em Dermatologia Sanitária do Estado do Pará Dr. Marcello Candia, Marituba no estado do Pará. Durante alguns anos foram acompanhados 23 pacientes, a maioria lavradores do sexo masculino, entre 14 e 80 anos de idade, com material biológico coletado por raspado dérmico e biópsia, para confirmação do diagnóstico pelo exame micológico direto e histopatologia, com posterior tratamento. O material biológico coletado foi processado para o isolamento, com a obtenção de células leveduriformes características do agente etiológico da doença de Jorge Lobo após 7 a 14 dias em meio RPMI com a enzima dispase II. Depois de 2 a 6 meses em RPMI (5% CO2, 37ºC) observamos a fragmentação das células-mãe provenientes das lesões e a presença de células leveduriformes, variando de 1 a 7 μm de diâmetro. A partir deste momento, foi possível manter as cepas do agente etiológico da doença de Jorge Lobo em meio líquido RPMI ou em ágar Sabouraud-dextrose à temperatura ambiente, onde formaram colônias pastosas, branco-acastanhadas, cerebriformes, por vezes lanuginosas. Células destas cepas foram analisadas por diferentes técnicas de microscopia óptica e eletrônica, bioquímicas e genéticas, culminando com a descrição do genoma da cepa de um paciente, logo após o isolamento enzimático e antes da diferenciação em cultura, definindo aseguinte identificação taxonômica:Eukaryota; Fungi; Dikarya; Ascomycota; Saccharomycotina; Saccharomycetes; Saccharomycetales; Debaryomycetaceae; Candida/Lodderomyces clade; Candida; Candida sp. LDI48194. A apresentação de características clínicas peculiares, associada a aspectos morfológicos únicos, propriedades fisiológicas e genéticas, que não permitem a definição de uma espécie já identificada, indicam que o agente da doença de Jorge Lobo é, na realidade, uma nova espécie, para a qual propomos a nomenclatura de Candida loboi

    Immunochemical, pathogenic and molecular characteristics of wild Paracoccidioides brasiliensis

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    A paracoccidioidomicose (PCM) e uma micose profundade causada pelo fungo termo-dimorfico P. brasiliensis. O habitat natural do fungo ainda e desconhecido e acredita-se que viva saprofiticamente no solo. Estudos mostram sua presenca em visceras de morcegos, de tatus, em fezes de pinguim e no solo. Nao has estudos imunoquimicos, sorologicos, de patogenicidade e moleculares utilizando apenas isolados selvagens de P. brasiliensis. Este trabalho fornece estas informacoes atraves do estudo de 10 isolados. Confirmamos que esses isolados eram realmente de P. brasiliensis por, PCR usando o primer do gene da gp43 obtido do isolado B-339. Os exoantigenos obtidos a partir destes isolados foram testados em ensaios sorologicos tais como imunodifusao, ELISA e Western blot. Os isolados produtores de gp43 foram mais reativos. Por RAPD verificamos que esses isolados selvagens apresentam polimorfismo no DNA. Aspectos de virulencia dos isolados produtores e nao produtores de gp43 foram analisados por, UFC de orgaos de camundongos suscetiveis infectados' e, nao encontramos diferencas entre os dois gruposBV UNIFESP: Teses e dissertaçõe

    Resumos em andamento - Direito

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    Resumos em andamento - Direit

    Resumos em andamento - Direito

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    Resumos em andamento - Direit

    Sensitivity of South American tropical forests to an extreme climate anomaly

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    NERC Knowledge Exchange Fellowship (NE/V018760/1) to E.N.H.C.The tropical forest carbon sink is known to be drought sensitive, but it is unclear which forests are the most vulnerable to extreme events. Forests with hotter and drier baseline conditions may be protected by prior adaptation, or more vulnerable because they operate closer to physiological limits. Here we report that forests in drier South American climates experienced the greatest impacts of the 2015–2016 El Niño, indicating greater vulnerability to extreme temperatures and drought. The long-term, ground-measured tree-by-tree responses of 123 forest plots across tropical South America show that the biomass carbon sink ceased during the event with carbon balance becoming indistinguishable from zero (−0.02 ± 0.37 Mg C ha−1 per year). However, intact tropical South American forests overall were no more sensitive to the extreme 2015–2016 El Niño than to previous less intense events, remaining a key defence against climate change as long as they are protected.Publisher PDFPeer reviewe
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