Water Quality From Gualaxo Do Norte And Carmo Rivers (Minas Gerais, Brazil) After The Fundão Dam Failure

Mining waste is rich in trace elements, which present a high toxic potential and may represent a risk for aquatic ecosystems. The Fundão dam failure, considered the largest environmental disaster in the world, affected 663.2 km of watercourses, including Carmo and Gualaxo do Norte Rivers. The ore tail also affected the riverside communities, destroying villages, killing people and affecting the subsistence farming. To evaluate the influence of the mine tailing wave on the water quality of the Carmo and Gualaxo do Norte Rivers water samples were collected at nine points located in Barra Longa during the rainy season. Physicochemical parameters (conductivity, resistivity, EH, total dissolved solids, pH and temperature) and major, minor and trace elements concentrations (Ba, Co, Cr, Cu, Ni, Sc, Sr, V, Zn, As, Pb, Al, Fe, Mn, Ca, K, Mg and P) were evaluated and compared with previous studies and conformity limits established by a national resolution (CONAMA Resolution N°357/2005). Only conductivity, Fe and Mn presented non-conformity values according to CONAMA Resolution N°357/2005. These results may be related not only to the dam burst but also to the rainy season and non-detectable pollution sources. Furthermore, the decreased levels in the toxic elements in the rivers over time, may be related to its association with sediments in addition to their flux to the Atlantic Ocean. Thus, after nearly six years, the environmental and social impacts are still alive and the minerals dragged to the riverbed could bring cumulative effects for the entire environment what means an uncertain future to the Rio Doce Basin and adjacent coastal zone

Communication of bad news in medical practice: medical perception on facilitators and hinderers

OBJETIVOS: Conhecer a formação de médicos no que diz respeito à comunicação de notícias difíceis e conhecer os dificultadores e facilitadores na prática desse profissional em comunicar notícias difíceis a pacientes e seus familiares. MÉTODOS: Estudo qualitativo descritivo. Coleta de dados realizada em entrevista semiestruturada, com profissionais médicos de uma unidade oncológica. Análise de conteúdo convencional realizada segundo Hsie e Shannon. RESULTADOS Houve diferentes definições do termo notícia difícil pelos entrevistados, e diversos fatores dificultadores e facilitadores para a comunicação dessas notícias. Esses fatores podem ser técnicos e/ou sócio-emocionais. Sujeito a esses fatores, está o próprio sucesso da comunicação, que interfere no tratamento do paciente. CONCLUSÃO: Alguns fatores de influência são inalteráveis, outros são passíveis de mudança ou prevenção. Entre esses, estão a atuação multidisciplinar, uma boa relação médico-paciente e um ambiente adequado para a comunicação. Quando esses fatores são manipulados para uma melhor comunicação, essa é realizada com maiores sucesso e benefício. O preparo prévio para essa comunicação foi unanimemente realçado, justificando uma maior abordagem na formação acadêmica médica sobre esse assunto.OBJECTIVES: to acknowledge the training of physicians regarding the disclosure of bad news and the difficulties and facilitators into the practice of communicating difficult news to patients and families. METHOD: descriptive qualitative study. Data collection was carried out through a semi-structured interview with medical professionals from an oncology unit. Conventional content analysis performed according to hsie and shannon. RESULTS: it was reported a great precariousness in medical education regarding the communication of bad news, being a possible contributor to the difficulties found in the position of communicator. There were different definitions attributed to the term “bad news” by the interviewees and several factors that made it difficult to communicate those news. These factors may be technical and/or socio emotional. Subject to these factors, is the very success of communication, that interferes with the treatment of the patient. CONCLUSION: some influencing factors are non-changeable; others are subject to change or prevention. Among these, are the multidisciplinary work, a good doctor- patient relationship and a suitable environment for communication. When these factors are manipulated for a better communication, it is accomplished with greater success and benefit. The prior preparation for this communication was unanimously highlighted, justifying a greater approach in academic medical education on this subject

Ghrelin expression in human and rat fetal lungs and the effect of ghrelin administration in nitrofen-induced congenital diaphragmatic hernia

Ghrelin is a strong physiologic growth hormone secretagogue that exhibits endocrine and non-endocrine actions. In this study, ghrelin expression in humans and rats was evaluated throughout development of normal and hypoplastic lungs associated with congenital diaphragmatic hernia (CDH). Additionally, the effect of antenatal treatment with ghrelin in the nitrofen-induced CDH rat model was tested. In normal lungs, ghrelin was expressed in the primitive epithelium at early stages of development and decreased in levels of expression with gestational age. In hypoplastic lungs ghrelin was overexpressed in both human and rat CDH fetuses when compared with controls. Exogenous administration of ghrelin to nitrofen-treated dams led to an attenuation of pulmonary hypoplasia of CDH pups. Furthermore, the growth hormone, secretagogue receptor (GHSR1a), could not be amplified from human or rat fetal lungs by RT-PCR. In conclusion, of all the lungs studied so far, the fetal lung is one of the first to express ghrelin during development and might be considered a new source of circulating fetal ghrelin. Overexpression of ghrelin in hypoplastic lungs and the effect of exogenous administration of ghrelin to nitrofen-treated dams strongly suggest a role for ghrelin in mechanisms involved in attenuation of fetal lung hypoplasia, most likely through a GHSR1a-independent pathway

Heme-Induced ROS in Trypanosoma Cruzi Activates CaMKII-Like That Triggers Epimastigote Proliferation. One Helpful Effect of ROS

Heme is a ubiquitous molecule that has a number of physiological roles. The toxic effects of this molecule have been demonstrated in various models, based on both its pro-oxidant nature and through a detergent mechanism. It is estimated that about 10 mM of heme is released during blood digestion in the blood-sucking bug's midgut. The parasite Trypanosoma cruzi, the agent of Chagas' disease, proliferates in the midgut of the insect vector; however, heme metabolism in trypanosomatids remains to be elucidated. Here we provide a mechanistic explanation for the proliferative effects of heme on trypanosomatids. Heme, but not other porphyrins, induced T. cruzi proliferation, and this phenomenon was accompanied by a marked increase in reactive oxygen species (ROS) formation in epimastigotes when monitored by ROS-sensitive fluorescent probes. Heme-induced ROS production was time-and concentration-dependent. In addition, lipid peroxidation and the formation of 4-hydroxy-2-nonenal (4-HNE) adducts with parasite proteins were increased in epimastigotes in the presence of heme. Conversely, the antioxidants urate and GSH reversed the heme-induced ROS. Urate also decreased parasite proliferation. Among several protein kinase inhibitors tested only specific inhibitors of CaMKII, KN93 and Myr-AIP, were able to abolish heme-induced ROS formation in epimastigotes leading to parasite growth impairment. Taken together, these data provide new insight into T. cruzi- insect vector interactions: heme, a molecule from the blood digestion, triggers epimastigote proliferation through a redox-sensitive signalling mechanism

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Tamponamento intrauterino induzido por vácuo para hemorragia pós-parto: uma revisão sistemática

A hemorragia pós-parto (HPP) é uma complicação grave e uma das principais causas de mortalidade materna global, respondendo por aproximadamente 25% de todos os óbitos maternos. A busca por intervenções eficazes e seguras é crítica para melhorar os desfechos maternos. O tamponamento intrauterino induzido por vácuo (VHD) surgiu como uma abordagem promissora, oferecendo potencial para rápido controle do sangramento e redução da necessidade de procedimentos invasivos. Nesse sentido, o presente estudo tem como objetivo analisar a eficácia, segurança e aplicabilidade na prática clínica moderna. Foi realizada uma revisão sistemática da literatura de 2016 a 2024 nas bases de dados PubMed (Medline), Cochrane Library e SciELO. A seleção dos estudos foi baseada em critérios de inclusão e exclusão rigorosos, focando na eficácia, segurança e aplicabilidade do VHD para tratamento da HPP. Três estudos chave foram analisados, com pacientes submetidos ao tratamento com VHD para HPP. Os resultados demonstraram uma taxa de sucesso no tratamento variando de 73% a 94%, com um controle do sangramento alcançado em uma média de 3 minutos. Foi observada uma redução significativa na necessidade de transfusões maciças de sangue e na perda de sangue estimada quando comparado com o tamponamento com balão uterino. Eventos adversos foram relatados, mas todos resolveram-se sem sequelas graves. O tamponamento intrauterino induzido por vácuo apresenta-se como uma opção promissora no tratamento da hemorragia pós-parto, com resultados consistentes indicando eficácia no controle do sangramento e redução na necessidade de transfusões sanguíneas. Embora os resultados sejam encorajadores, mais estudos são necessários para confirmar essas descobertas e explorar plenamente o potencial do VHD na prática clínica. O VHD emerge como uma alternativa eficaz e segura, com potencial para melhorar significativamente os desfechos maternos e reduzir a morbimortalidade associada à HPP

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo