Predictive equations overestimated the resting energy expenditure by indirect calorimetry in adults with sickle cell disease

Background: Traditionally, sickle cell disease (SCD) is associated with hypermetabolism. Despite this, few studies have compared resting energy expenditure (REE) with estimated predictive equations (EPE) in the assessment of adults with SCD. Aims: To compare REE values determined by indirect calorimetry (IC) with EPE in adults with SCD. Patients and Methods: 46 patients over 34 years old who were in the treatment performed a cross-sectional observational study from two reference centers for SCD located in the city of Rio de Janeiro, Brazil. The assess body composition and REE used Dual-energy x-ray absorptiometry and IC, respectively. Blood levels were measured to assess hemolytic and protein markers. For the univariate correlation used the Pearson’s correlation test. The comparison between EPE and REE used the Intraclass Correlation Coefficient and the Bland-Altman analysis. Results: 63% of patients were women, 80.4% of homozygous sickle cell disease genotype, and, 52.2% were black color. The mean age was 50 years old. Weight (r=0.469; p=0,001), lean mass (r=0.631; p=0.000), bone mineral content (r=0.508; p=0.000) and C-reactive protein (r=0.319; p=0.002) correlated positively with the REE. There was no linear correlation between markers of hemolysis such as total bilirubin, direct bilirubin, and lactic dehydrogenase with REE. The REE was overestimated in the EPE when compared to IC (p<0.001). Conclusions: The prediction equations developed for healthy populations are not accurate enough to determine the energy requirements in SCD

Avaliação fisiológica de prematuros na pesagem tradicional e humanizada: estudo quase-experimental

Objetivo: Descrever e comparar os sinais fisiológicos apresentados pelos prematuros na pesagem tradicional e humanizada.Método: Estudo quase-experimental crossover, com amostra de 30 prematuros randomicamente assinalados e alocados no grupo controle (tradicional) e no grupo intervenção (humanizada),no período de março de 2019 a março de 2020, com a coleta de dados gerais, sinais vitais antes e depois dos procedimentos. As análises estatísticas incluíram descrição de frequências relativas e absolutas, medida de tendência central e de dispersão.Resultados: Os prematuros apresentaram menos aumento na frequência cardíaca (53,3%) e respiratória (43%) na verificação da pesagem humanizada do que na tradicional, com 83,3% dos neonatos e 80%,respectivamente.Conclusão: Observou-se que a forma humanizada proporcionou menos instabilidade fisiológica, principalmente nas frequências cardíaca e respiratória, tornando-se necessário estimular discussões sobre a humanização da assistência e realizar essa prática de forma rotineira nas unidades de saúde. Palavras-chave: Recém-nascido prematuro. Peso corporal. Temperatura corporal. Humanização da assistência

EPIDEMIOLOGICAL STUDY OF POST-NEONATAL MORTALITY ASSOCIATED WITH AVOIDABLE CAUSES IN PALMAS, TOCANTINS AND BRAZIL

A mortalidade infantil, em especial a pós neonatal, é um sensível indicador da qualidade de vida de uma população. Objetivou-se apresentar o coeficiente de mortalidade pós neonatal de Palmas, Tocantins e Brasil, no triênio 2014-2016 e expor as principais causas evitáveis desses óbitos. Trata-se de um estudo descritivo exploratório que analisa dados públicos disponibilizados pelo Sistema de Informações sobre Mortalidade (SIM) e Sistema de Informação sobre Nascidos Vivos (SINASC). Os resultados apresentaram como principais fatores vinculados a mortalidade pós neonatal a deficiência no diagnóstico e tratamento, em ações de promoção vinculadas a atenção primária, na atenção ao recém-nascido (RN), a gestação e ao parto, e imunizações. Encontrou-se uma redução significativa da mortalidade em Palmas-TO, o oposto dos panoramas Estadual e Nacional. As taxas de mortalidade apresentaram variações. Palmas e Tocantins aumentaram seu valor de 2014 (1,55/1.000 nascidos vivos (NV) e 2,00/1.000 NV, respectivamente) para 2015 (2,30/1.000 NV e 2,07/1.000 NV, respectivamente) e reduziram de 2015 para 2016 (1,34/1.000 NV e 2,06/1.000 NV, respectivamente); o Brasil reduziu seu valor de 2014 (2,05/1.000 NV) para 2015 (1,88/1.000 NV) e aumentou de 2015 para 2016 (2,21/1000 NV). Foi possível concluir que a capacitação e atualização dos profissionais seriam a chave para maior integração com a comunidade, melhoria nos atendimentos, diagnósticos precisos e atuação precoce nas patologias vinculadas à saúde materno-infantil.Infant mortality, especially post neonatal mortality, is a sensitive indicator of the quality of life of a population. The objective of this study was to present the post-neonatal mortality coefficient of Palmas, Tocantins and Brazil in the 2014-2016 triennium and to present the main avoidable causes of these deaths. It is an exploratory descriptive study that analyzes public data provided by the Mortality Information System (SIM) and the Live Birth Information System (SINASC). The results showed a significative reduction of the mortalities in Palmas-TO, the opposite of the State and National scenarios. Mortality rates presented variations, Palmas and Tocantins increased their value from 2014 (1,55/1000 born lives (BL) and 2,00/1000 BL respectively) to 2015 (2,30/1000 BL and 2,07/1000 BL respectively) and reduced from 2015 to 2016 (1,34/1000 BL and 2,06/1000 BL respectively); Brazil reduced its value from 2014 (2,05/1000 BL) to 2015 (1,88/1000 BL) and increased from 2015 to 2016 (2,21/1000 BL). It was identified that the decline in the absolute number of deaths in Palmas-TO is due to actions of health promotion, diagnosis and treatment and attention to gestation. Thus, the local decline in mortality is linked to early diagnosis, quality of care, access to primary health services and the availability of these services at the national level, associated with integral management mechanisms for maternal and child health

Polymorphisms in the MBL2 gene are associated with the plasma levels of MBL and the cytokines IL-6 and TNF-α in severe COVID-19

IntroductionMannose-binding lectin (MBL) promotes opsonization, favoring phagocytosis and activation of the complement system in response to different microorganisms, and may influence the synthesis of inflammatory cytokines. This study investigated the association of MBL2 gene polymorphisms with the plasma levels of MBL and inflammatory cytokines in COVID-19.MethodsBlood samples from 385 individuals (208 with acute COVID-19 and 117 post-COVID-19) were subjected to real-time PCR genotyping. Plasma measurements of MBL and cytokines were performed by enzyme-linked immunosorbent assay and flow cytometry, respectively.ResultsThe frequencies of the polymorphic MBL2 genotype (OO) and allele (O) were higher in patients with severe COVID-19 (p< 0.05). The polymorphic genotypes (AO and OO) were associated with lower MBL levels (p< 0.05). IL-6 and TNF-α were higher in patients with low MBL and severe COVID-19 (p< 0.05). No association of polymorphisms, MBL levels, or cytokine levels with long COVID was observed.DiscussionThe results suggest that, besides MBL2 polymorphisms promoting a reduction in MBL levels and therefore in its function, they may also contribute to the development of a more intense inflammatory process responsible for the severity of COVID-19

Os impactos do iam para o sistema único de saúde e para o Brasil / The impacts of iam for the unique health system and for Brazil

A partir da década de 1960 vem ocorrendo diminuição das doenças infecto-parasitárias (DIP) e aumento das Doenças Crônicas Não Transmissíveis (DCNT). O Infarto Agudo do Miocárdio (IAM) é a principal causa das Doenças Cardiovasculares (DCV). Dados do Departamento de Informática do Sistema Único de Saúde (DATASUS) de 2013 revelavam que o IAM foi a principal causa de morte por doença cardíaca no Brasil e os especialistas projetam que assim seja nos próximos anos caso medidas não sejam instituídas visando inverter essa curva. Dessa forma, é de importância obter atendimento pré-hospitalar rápido e eficiente reduzindo o tempo entre o início do evento isquêmico e necrose até o tratamento. Por isso, o objetivo deste trabalho é interpretar a prevalência do IAM em relação a regiões, sexo e idade no Brasil e o possível impacto disso nos custos pro sistema único de saúde (SUS). A metodologia utilizada foi uma revisão sistemática da literatura, usando como base de dados Pubmed, Scielo e Google Acadêmico a partir das seguintes palavras-chaves: “IAM”. “incidência” e “prevalência”.

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