Administração profiláctica de plasma no síndrome hemolítico urémico atípico recorrente

O síndrome hemolítico urémico (SHU) define- se pela ocorrência simultânea de anemia hemolítica microangiopática, trombocitopenia e insuficiência renal aguda. A forma atípica de SHU, ou SHU não associado à toxina shiga like(SHU-não-Stx), ocorre em 10% dos casos na criança e apresenta prognóstico reservado. Os autores apresentam um caso clínico de uma criança com idade actual de cinco anos e oito meses com SHU atípico esporádico, de aparecimento precoce, aos quatro meses de vida, com carácter multirecidivante (seis recidivas). O doseamento sérico do factor H do complemento, a análise molecular dos genes do factor H (SCR 20 — sequenciação, os 19 restantes SCRs e o promotor —SSCP), e da membrane cofactor protein (SCR 1-4, e os 14 exões), a determinação da actividade de ADAMTS 13 e a pesquisa de inibidores foram normais. A biópsia renal revelou lesões glomerulares difusas com tumefecção das células endoteliais e redução dos lúmens capilares. O estudo ultraestrutural evidenciou extensa duplicação das membranas basais das ansas capilares e ausência de depósitos imunes. A doente apresentou boa resposta ao tratamento profiláctico com plasma, efectuado com intervalos de 3 semanas, com ausência de novas recaídas durante os períodos em que efectuou profilaxia (duração total de profilaxia: dois anos e sete meses). Conclui-se que esta forma de tratamento profiláctico se revelou, neste caso, e até à data, segura e eficaz na prevenção das recorrências, pelo que deve ser tida em consideração no tratamento de casos de SHU com perfil recidivante

Learning from the covid-19 outbreaks in long-term care facilities: a systematic review

© The Author(s) 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: The COVID-19 pandemic has devastatingly affected Long-Term Care Facilities (LTCF), exposing aging people, staff members, and visitors. The world has learned through the pandemic and lessons can be taken to adopt effective measures to deal with COVID-19 outbreaks in LTCF. We aimed to systematically review the available evidence on the effect of measures to minimize the risk of transmission of COVID-19 in LTCs during outbreaks since 2021. Methods: The search method was guided by the preferred reporting items for systematic reviews (PRISMA) and the reporting guideline synthesis without meta-analysis (SWiM) in systematic reviews. The search was performed in April 2023. Observational and interventional studies from the databases of PubMed, Web of Science, Scopus, Cochrane Systematic Reviews, CINAHL, and Academic Search were systematically reviewed. We included studies conducted in the LTCF with outbreaks that quantitatively assess the effect of non-pharmacological measures on cases of COVID-19. Two review authors independently reviewed titles for inclusion, extracted data, and undertook the risk of bias according to pre-specified criteria. The quality of studies was analyzed using the Joanna Briggs Institute Critical Appraisal. Results: Thirteen studies were included, with 8442 LTCF experiencing COVID-19 outbreaks and 598 thousand participants (residents and staff members). Prevention and control of COVID-19 infection interventions were grouped into three themes: strategic, tactical, and operational measures. The strategic measures reveal the importance of COVID-19 prevention and control as LTCF structural characteristics, namely the LTCF size, new admissions, infection control surveillance, and architectural structure. At the tactical level, the lack of personal and long staff shifts is related to COVID-19's spread. Operational measures with a favorable effect on preventing COVID-19 transmission are sufficient. Personal protective equipment stock, correct mask use, signaling, social distancing, and resident cohorting. Conclusions: Operational, tactical, and strategic approaches may have a favorable effect on preventing the spread of COVID-19 in LTCFs experiencing outbreaks. Given the heterogeneous nature of the measures, performing a meta-analysis was not possible. Future research should use more robust study designs to explore similar infection control measures in LTCFs during endemic situations with comparable outbreaks. Trial registration: The protocol of this systematic review was registered in PROSPERO (CRD42020214566).info:eu-repo/semantics/publishedVersio

Chemotaxonomic markers in essential oils of hypenia (Mart. ex Benth.) R. Haley

O Cerrado Central brasileiro é considerado o centro de origem e dispersão de Hypenia (Lamiaceae: subtribo Hyptidineae) na América do Sul. O gênero tem sido mantido sem divisão, ou subdividido em duas ou cinco seções taxonômicas, baseadas quase exclusivamente a partir de um conjunto limitado de características florais. Nesta trabalho, uma delimitação química interespecífica é descrita a fim de complementar as análises das características botânicas. Análise multivariada dos óleos essenciais de dez espécies na fase vegetativa suporta a divisão taxonômica do gênero em duas seções. Grupo I incluiu quatro espécies da seção Laxiflorae em edição à H. irregularis, os quais foram caracterizados pelos mais altos percentuais de espatulenol e óxido de cariofileno. Grupo II conteve cinco espécies da seção Densiflorae com x-muuroleno e x-muurolol como constituintes principais. Cadinanos e germacranos/ aromadedranos parecem ser as classes marcadoras quimiotaxonômicas nas seções Densiflorae e Laxiflorae, respectivamente. Além disso, análise de redundância canônica não indicou correlação significante entre fatores edáficos com quimiovariação nos óleos essenciais, sugerindo que em Hypenia os óleos são constituídos por substâncias constitutivas e não induzidas pelo ambiente.Central Brasilian Cerrado is regarded as the center of origin and dispersion of Hypenia (Lamiaceae: subtribe Hyptidineae) in South America. The genus has either remained undivided or been divided into two or seven taxonomic sections, based almost exclusively on a limited range of floral features. Interspecific chemical delimitation to complement analyses of botanical traits is described. Multivariate analysis of essential oils of tem species in the vegetative stage supports the taxonomic division in two sections. Cluster I included four species belonging to section Laxiflorae in addition to H. irregularis, which were characterized by the highest percentages of spathulenol and caryophyllene oxide. Cluster II contained five species belonging to section Densiflorae with x-cadinol, x-muurolene and x-muurolol as major constituents. Cadinanes and germacranes/ aromadendranes seem to be chemotaxonomic markers of sections Densiflorae and Laxiforae, respectively. Furthermore, redundancy analysis revealed no significant correlation between edaphic factors and oil chemovariations, suggesting that Hypenia oils consist of constitutive rather than induced compounds

Stability and adaptability of carioca common bean genotypes in states of the central South Region of Brazil

The purpose of this study was to identify ‘Carioca’ common bean genotypes with high yield adaptability andstability in central South Brazil, based on different analysis methods. The value of cultivation and use (VCU) of 16 genotypeswas evaluated in 26 trials in a randomized complete block design with three replications, in the states of Santa Catarina, SãoPaulo and Paraná, in 2003 and 2004. Grain yield data were subjected to analysis of variance, of stability and adaptability,using the methodologies of Lin and Binns, Annichiarico, Eberhart and Russell, Cruz et al. and AMMI. Several of themethodologies indicated the genotypes BRS Estilo and CNFC 9518 for high yield, high adaptability and high stability. Theyield, stability and adaptability of cultivar Pérola, widely grown in the country, were lower than of the new elite genotypesobtained by the breeding programs

Ocorrência de Cooperia curticei (Giles 1892), Nematoda: Trichostrongylidae) parasita de bovinos em cantagalo estado do Rio de Janeiro

Cooperia curticei (Giles, 1892) (Nematoda: Trichostrongylidae) is reported for the first time, parasitizing the small intestine of cattle in the State of Rio de Janeiro, Brazil. The animals, came from Cantagalo.Relatou-se, pela primeira vez, no Estado do Rio de Janeiro, Brasil, a presença de Cooperia curticei (Giles 1892) (Nematoda: Trichostrongylidae) parasitando o intestino delgado de bovinos procedentes de Cantagalo

3D microsimulation of milkruns and pickers in warehouses using SIMIO

To help the Bosch Car Multimedia Portugal in Ferreiros, Braga to reduce its costs (both in time and space) with its warehouse, a micro simulation model is being developed in Simio. Particularly, the tool needs to be able to model pickers riding milkruns to collect containers of products, from a warehouse, to satisfy the needs of the production lines. In this sense, the storage strategy used on the warehouse, the quantity of requests a picker gets per shift, the time between shifts, the number of types of products, the arrival rate of requests, and the number of milkruns and pickers needs to be adjustable. Additionally, to design the corridors of the warehouse in a configurable way, an Add-in in C#, using the API of Simio, is being developed. Thus, this paper intends to document the first part of the simulation model developed, which consists on the pickers receiving requests and riding their milkruns to collect the respective containers from the warehouse. Five different Simio models compose the main simulation model. Conclusions and future work are discussed.This work has been co-supported by SI I&DT project in joint-promotion nº 36265/2013 (HMIEXCEL - 2013-2015 Project) and by FCT – Fundação para a Ciência e Tecnologia in the scope of the project: PEst-OE/EEI/UI0319/2014

Effect of aging in the perception of health-related quality of life in end-stage renal disease patients under online-hemodiafiltration

This work aimed to evaluate how aging could influence patients' perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient's records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.info:eu-repo/semantics/publishedVersio

Chemotaxonomic significance of volatile constituents in Hypenia (Mart. ex Benth.) R. Harley (Lamiaceae)

A análise multivariada da composição química dos óleos essenciais de treze espécies de Hypenia indicou a presença de dois grupos de óleos em relação às seções botânicas das amostras. O primeiro grupo (grupo I) incluiu as três espécies da seção Densiflorae em adição a H. subrosea e H. aristulata, o qual foi caracterizado pelo maior percentual de a-muurolol (5,85 ± 3,08%). No grupo II, com oito espécies da seção Laxiflorae, os principais constituintes discriminantes foram o (E)-cariofileno (7,09 ± 4,88%), germacreno D (18,1 ± 11,4%) e o biciclogermacreno (6,65  ±   1,19%). Todos os óleos essenciais apresentaram predominantemente sesquiterpenos, tais como espatulenol (4,5-31,6%), óxido de cariofileno (2,2-14,4%) e selin-11-en-4a-ol (0-34,8%). Os agrupamentos foram idênticos quando utilizada a análise multivariada baseada nos esqueletos carbônicos dos constituintes químicos ou de 18 caracteres morfológicos das folhas das espécies.Multivariate analysis of essential oil compositions of thirteen Hypenia species revealed the presence of two taxonomic clusters. Cluster I included three species belonging to section Densiflorae in addition to H. subrosea and H. aristulata, and showed the highest percentages of a-muurolol (5.85  ± 3.08%). In Cluster II, which contained eight species belonging to section Laxiflorae, the major discriminant constituents were (E)-caryophyllene (7.09 ± 4.88%), germacrene D (18.1  ± 11.4%), and bicyclogermacrene (6.65 ± 1.19%). All essential oils showed a predominance of sesquiterpenes, such as spathulenol (4.5-31.6%), caryophyllene oxide (2.2-14.4%) and selin‑-11‑-en-4a-ol (0-34.8%). Furthermore, identical clusters were revealed by multivariate analysis of chemical constituents based on carbon skeletons, as well as on 18 morphological leaf characters of the species studied

Níveis de nitrogênio por fertirrigação e densidade de plantio na cultura do melão em um Vertissolo

This study consisted of one experiment with melon (Cucumis melo L.), carried out in a Vertisol in Juazeiro, BA, Brazil, in 1995, with the objective of evaluating the effects of nitrogen levels through fertirrigation and plant density on fruit yield and quality. The N levels were 0, 80, 130 and 180 kg/ha, combined with row spacings of 2.0 and 1.8 m and 0.20 m between plants within the row, with one or two plants/hole. The source of N was urea applied daily up to 42 days after germination, through drip irrigation. All treatments had a uniform fertilization of 120 kg/ha of P2O5 and 120 kg/ha of K2O. No significant difference was caused by spacing between rows in the studied variables. Eighty kg/ha of N combined with one plant per hole gave a yield of 34.07 ton/ha, being 55,7% of fruit allocated to inside market, not significantly lower than those obtained with the highest N levels in any combination. This same N level gave fruits with 10.22o Brix, significantly higher than the treatment without N and not significantly lower than the other levels. In order to get high number of good fruit for out side market it was necessary to elevate the density to two plants per hole and N level to 130 or 180 kg/ha. Mean weight of fruits increased from 1.008 to 1.705 kg with the increase in the levels of N and the decrease in plant density of two plants per hole to one plant per hole.O trabalho constou de um experimento com melão (Cucumis melo L.), conduzido em um Vertissolo, em Juazeiro, BA, em 1995, com o objetivo de avaliar o efeito de níveis de N por fertirrigação e de densidades de plantio na produtividade e qualidade de fruto. Os níveis de N foram 0, 80, 130 e 180 kg/ha, combinados com os espaçamentos 2,00 e 1,80 m entre linhas e 0,20 m entre plantas, com uma ou duas plantas por cova. A fonte de N foi a uréia, aplicada diariamente até 42 dias após a germinação, por meio da irrigação por gotejamento. Todos os tratamentos receberam uma adubação uniforme de 120 kg/ha de P2O5 e 120 kg/ha de K2 O. Os espaçamentos entre linhas não causaram diferenças significativas em nenhuma variável estudada. O nível de 80 kg/ha de N combinado com uma planta por cova proporcionou uma produtividade de 34,07 t/ha, com 55,7% de frutos próprios para o mercado interno, não-significativamente (P ≤ 0,05) inferior à produtividade obtida com os níveis mais elevados de N em qualquer combinação. Com este mesmo nível, obtiveram-se frutos com 10,22o Brix significativamente (P ≤ 0,05) superior ao do tratamento sem N e não-significativamente inferior ao dos outros níveis. Para se obter uma maior parte de frutos próprios para o mercado externo, foi necessário elevar a densidade para duas plantas por cova e o nível de N para 130 ou 180 kg/ha. O peso médio dos frutos aumentou de 1,008 para 1,705 kg, à medida que foram aumentados os níveis de N ou se diminuiu a densidade de plantio de duas para uma planta por cova

Genetic variation of cork oak a tool for improving regeneration of cork oak woodlands

The European Academies' Science Advisory Council (2017) reports that the Mediterranean forest is already being affected by climate change (IPCC, 2014) and cork oak woodlands are particularly vulnerable to high-end climate scenarios that go above the Paris Agreement 2° C increase in temperature. Since longer, more frequent, and more intense drought periods are expected, stress caused by the expansion of arid and semi-arid climate will affect the species distribution. Consequently, not only established stands may be prone to tree mortality, but also the current reforestation effort may be jeopardized by low survival rates attributed to the use of unsuitable genetic material. It is expected that, through genetic adaptation and/or phenotypic plasticity, cork oak populations may have developed significant differences in fitness and the traits related to it. In this context, provenance and progeny trials are the best resource of material to assess the variability between and within populations from seed sources sampled in a wide range of locations (stands) covering the geographical distribution of the species. Profiting from the multi-locality provenance and progeny trials belonging to a Network, established in 1998, in the initiative frame of FAIR I CT 0202 for the evaluation of genetic resources of cork oak for appropriate use in breeding and gene conservation strategies”, where 35 cork oak populations covering all the natural distribution area are represented. The provenance trials that where set up in different countries are entering now the age of first debarking and this should allow to have first data about the influence of genetics on production by different site qualities. INCREDIBLE project should document this knowledgeFAIR I CT 0202info:eu-repo/semantics/publishedVersio