Avaliação da qualidade de vida e fotopletismografia em pacientes com insuficiência venosa crônica tratados através de escleroterapia com espuma

Contexto: a escleroterapia com espuma guiada por ultrassom (EGUS) ocupa lugar de destaque no tratamento da insuficiência venosa crônica (IVC), proporcionando melhora clínica e hemodinâmica aos pacientes submetidos ao tratamento. Objetivos: verificar a correlação entre dados obtidos por questionário de qualidade de vida e de sintomas com dados obtidos por fotopletismografia (FPG), antes e depois do tratamento por escleroterapia com espuma guiada por ultrassom (EGUS) da insuficiência venosa crônica (IVC). Métodos: um grupo de 32 pacientes, classificados como C4, C5 e C6, foi submetido à aplicação de questionário de qualidade de vida e sintomas, sendo aferido o tempo de enchimento venoso (TEV) por FPG antes e 45 dias depois do tratamento da IVC através de EGUS. O teste do sinal foi utilizado para análise estatística da melhora dos escores dos questionários e do TEV. O teste de McNemar foi utilizado para avaliação da melhora nos sintomas e do impacto do tratamento nas atividades laborais e sociais dos pacientes. Resultados: houve melhora nos escores dos questionários de qualidade de vida e no TEV, com significância estatística (p<0,0001). Houve melhora estatisticamente significativa nos sintomas: dor, cansaço, edema, queimação, pernas inquietas e latejamento (p<0,0001). Incremento na qualidade laboral e social após o tratamento apresentou melhora estatisticamente significativa (p<0,0001). Não ocorreram complicações maiores ou efeitos adversos nesta série. Conclusões: a EGUS mostrou-se eficaz, com alto índice de satisfação e baixas taxas de complicacões maiores, ratificada pelos escores dos questionários e pelos TEVs aferidos pela FPG.Backgrond: ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment. Objectives: to examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency. Methods: thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy. Results: statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001). Conclusions: as confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications

Arteriovenous fistula after ultrasound guided foam sclerotherapy : case report

A escleroterapia com espuma guiada por ultrassom tem ganhado espaço no tratamento da insuficiência venosa crônica secundária a varizes dos membros inferiores. Trata-se de procedimento ambulatorial, de baixo custo e sem necessidade de afastamento das atividades habituais. Apresenta bons resultados clínicos, especialmente nos estágios mais avançados da doença. Quando bem aplicada, apresenta baixas taxas de complicações maiores. Porém, a técnica apresenta altas taxas de recanalização no médio e longo prazo, e seu mecanismo ainda não é totalmente compreendido. O presente artigo descreve um caso de fístula arteriovenosa em segmento de recanalização de veia safena magna, após escleroterapia com espuma guiada por ultrassom, e identificada por exame ultrassonográfico de vigilância pós-procedimento.Ultrasound-guided foam sclerotherapy has become widespread in the treatment of chronic venous insufficiency secondary to varicose veins. It is a low-cost, outpatient procedure that does not require medical leave. It has demonstrated good clinical results, especially in the more advanced stages of the disease. When employed correctly, it results in low rates of major complications. However, the technique exhibits high recanalization rates over mid and long-term follow up. Additionally, the recanalization mechanism has not yet been explained. This article describes an arteriovenous fistula in a recanalized segment of great saphenous vein previously treated with ultrasound-guided foam sclerotherapy that was detected during post-procedure follow-up with ultrasound

The Genome of Anopheles darlingi, the main neotropical malaria vector

Anopheles darlingi is the principal neotropical malaria vector, responsible for more than a million cases of malaria per year on the American continent. Anopheles darlingi diverged from the African and Asian malaria vectors ∼100 million years ago (mya) and successfully adapted to the New World environment. Here we present an annotated reference A. darlingi genome, sequenced from a wild population of males and females collected in the Brazilian Amazon. A total of 10 481 predicted protein-coding genes were annotated, 72% of which have their closest counterpart in Anopheles gambiae and 21% have highest similarity with other mosquito species. In spite of a long period of divergent evolution, conserved gene synteny was observed between A. darlingi and A. gambiae. More than 10 million single nucleotide polymorphisms and short indels with potential use as genetic markers were identified. Transposable elements correspond to 2.3% of the A. darlingi genome. Genes associated with hematophagy, immunity and insecticide resistance, directly involved in vectorhuman and vectorparasite interactions, were identified and discussed. This study represents the first effort to sequence the genome of a neotropical malaria vector, and opens a new window through which we can contemplate the evolutionary history of anopheline mosquitoes. It also provides valuable information that may lead to novel strategies to reduce malaria transmission on the South American continent. The A. darlingi genome is accessible at www.labinfo.lncc.br/index.php/anopheles- darlingi. © 2013 The Author(s)

The complete genome sequence of Chromobacterium violaceum reveals remarkable and exploitable bacterial adaptability

Chromobacterium violaceum is one of millions of species of free-living microorganisms that populate the soil and water in the extant areas of tropical biodiversity around the world. Its complete genome sequence reveals (i) extensive alternative pathways for energy generation, (ii) ≈500 ORFs for transport-related proteins, (iii) complex and extensive systems for stress adaptation and motility, and (iv) wide-spread utilization of quorum sensing for control of inducible systems, all of which underpin the versatility and adaptability of the organism. The genome also contains extensive but incomplete arrays of ORFs coding for proteins associated with mammalian pathogenicity, possibly involved in the occasional but often fatal cases of human C. violaceum infection. There is, in addition, a series of previously unknown but important enzymes and secondary metabolites including paraquat-inducible proteins, drug and heavy-metal-resistance proteins, multiple chitinases, and proteins for the detoxification of xenobiotics that may have biotechnological applications

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Clinical trial, randomized, triple-blind, comparison in consultation healing between standard lower limb dressings and standard dressing with Syzygyum cumini extract

Tese (Doutorado) — Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências Da Saúde, 2022.Objetivo: Testar a eficácia e segurança do curativo de hidrocoloide com extrato de Syzygium cumini a 50% na cicatrização de úlceras venosas e encontrar uma substância que tenha poder de cicatrização, com ação bactericida, anti-inflamatória e cicatrizante, de baixo custo e de baixo risco de reação alérgica para o tratamento de úlceras de estase. Materiais e métodos: Baseado em trabalhos com animais, selecionou-se o extrato de Syzygium cumini. Foi realizado um estudo clínico prospectivo, randomizado, triplo cego e comparativo entre coberturas de hidrocoloide gel com extrato de S. cumini 50% (grupo A) e hidrocoloide gel (grupo B). Em todos os pacientes foi utilizado compressão pelo sistema Circaid® Medi©, ajustados em 40mmhg de compressão. Foram randomizados aleatoriamente 44 pacientes no grupo A e 46 no grupo B, que foram acompanhados no mínimo por 13 semanas a cada 15 dias até a cicatrização completa ou final do estudo. Resultados: No modelo uni variado de regressão Cox, não houve diferença na cicatrização entre os grupos B e A dependendo do tipo de cobertura usado [HR 1,7059; IC (0,7387- 4,0011); p=0,1580]. A área da ferida na V1 (cada 100mm² a mais) mostrou-se com significância estatística na dificuldade de cicatrização [HR 0,9506; IC (0,90955-0,9811); p=0,00865, p<0,05). A cultura positiva para Pseudomonas aeruginosa foi o quesito isolado que maior relevância teve em relação à dificuldade de cicatrização, com uma redução de risco de cicatrização de 88% (IC 95% 47-95%) tendo sua presença uma significância estatística importante [HR 0,1229; IC (0,041777-0,3263); p=0,00005, p<0,0001]. Os outros parâmetros como idade, IMC, tempo de ferida, mostraram tendência a piora na cicatrização, porém não alcançaram P<0,05. Nas análises multivariadas em três modelos diferentes temos que o IMC, o tamanho da ferida em V1 e principalmente a cultura positiva para Pseudomonas aeruginosa tiveram p<0,05. Conclusão: Apesar de ter tido cicatrização superior (77,3% X 73,9%) para o grupo A, não houve diferença estatística no resultado. O tamanho inicial da úlcera, o IMC e, principalmente a contaminação da ferida, em especial pela Pseudomonas aeruginosa, foram decisivos para a cicatrização da lesão. Coberturas sem elementos que efetivamente diminuam a contaminação bacteriana terão dificuldade de apresentar melhora nos índices de cicatrização atual.Objective: Finding a substance with healing power, bactericidal, anti-inflammatory and healing action, low cost and low risk to allergic reaction for the treatment of stasis ulcers. Materials and methods: Based on studies with animals, the extract of Syzygium cumini was selected for wound healing because of its antibacterial, antioxidant, anti-inflammatory, and antiallergic action. A prospective, randomized, double-blind, comparative clinical study was conducted evaluating hydrocolloid gel dressings with 50% of S. cumini extract (Group A) and standard hydrocolloid gel dressings alone (Group B). All patients used compression by the Circaid® system adjusted to 40 mmHg compression. Forty-four patients were randomly randomized in group A and 46 in group B, and all were followed up every 15 days for at least 13 weeks until complete healing or until the end of the study. Results: In a univariate Cox regression model, no difference in healing was reported between groups B and A regarding the type of dressing used [hazard ratio (HR) of 1.7059; 95% confidence interval (CI) of 0.7387–4.0011; and p = 0.1580]. The wound area at the first visit (every 100 mm2 increase) was statistically significant for healing difficulty [HR 0.9506; 95% CI 0.90955–0.9811; p = 0.00865, p < 0.05]. Positive culture for Pseudomonas aeruginosa was the single most relevant factor in relation to the difficulty in healing, with an 88% reduction in the risk of healing (95% CI 47–95%), giving its presence an important statistical significance [HR 0.1229; CI 0.041777–0.3263; p = 0.00005, p < 0.0001]. Other parameters, such as age, body mass index (BMI), and wound time demonstrated a tendency to worsen the healing; however, these parameters did not reach p < 0.05. In multivariate analyses in three different models, BMI, wound size at the first visit, and particularly positive cultures for Pseudomonas aeruginosa had p < 0.05. Conclusion: Although healing was better in group A (77.3% vs. 73.9%), there was no statistically significant difference in the result. The initial size of the ulcer, BMI, and especially the contamination of the wound, particularly by Pseudomonas aeruginosa, are decisive factors for the healing of the lesion. It will be difficult for dressings without substances that effectively reduce bacterial contamination to show any improvement in current healing rates

Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency.METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001).CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications