16 research outputs found
Description of microsporidia in simulids: molecular and morphological characterization of microsporidia in the larvae of Simulium pertinax Kollar (Diptera: Simuliidae)
Introduction Microsporidia constitute the most common black fly pathogens, although the species' diversity, seasonal occurrence and transmission mechanisms remain poorly understood. Infections by this agent are often chronic and non-lethal, but they can cause reduced fecundity and decreased longevity. The objective of this study was to identify microsporidia infecting Simulium (Chirostilbia) pertinax (Kollar, 1832) larvae from Caraguatatuba, State of São Paulo, Brazil, by molecular and morphological characterization. Methods Larvae were collected at a single point in a stream in a rural area of the city and were kept under artificial aeration until analysis. Polydispyrenia spp. infection was characterized by the presence of at least 32 mononuclear spores measuring 6.9 ± 1.0 × 5.0 ± 0.7µm in persistent sporophorous vesicles. Similarly, Amblyospora spp. were characterized by the presence of eight uninucleate spores measuring 4.5 × 3.5µm in sporophorous vesicles. Results The molecular analysis confirmed the presence of microsporidian DNA in the 8 samples (prevalence of 0.51%). Six samples (Brazilian larvae) were related to Polydispyrenia simulii and Caudospora palustris reference sequences but in separate clusters. One sample was clustered with Amblyospora spp. Edhazardia aedis was the positive control taxon. Conclusions Samples identified as Polydispyrenia spp. and Amblyospora spp. were grouped with P. simulii and Amblyospora spp., respectively, corroborating previous results. However, the 16S gene tree showed a considerable distance between the black fly-infecting Amblyospora spp. and the mosquito-infecting spp. This distance suggests that these two groups are not congeneric. Additional genomic region evaluation is necessary to obtain a coherent phylogeny for this group.Instituto Butantan Laboratório de ParasitologiaFundação Oswaldo Cruz Centro de Pesquisa Gonçalo Moniz Laboratório de ImunoparasitologiaUniversidade Federal de São Paulo (UNIFESP) Disciplina de InfectologiaSuperintendência de Controle de Endemias Laboratório de Entomologia MédicaUniversidade Federal de São Paulo (UNIFESP) Disciplina de Gastroenterologia Departamento de MedicinaSuperintendência de Controle de Endemias Laboratório de SimulídeosMosquito and Fly Research Unit United States Department of AgricultureUNIFESP, Disciplina de InfectologiaUNIFESP, Disciplina de Gastroenterologia Depto. de MedicinaSciEL
“Quem ensina também aprende” : a formação pela prática de professores primários na província do Paraná
Resumo Segundo a historiografia da educação brasileira, muitas foram as ações relacionadas aos modos de formar professores primários durante o período imperial. Desses estudos, a maioria se centra na formação de professores atrelada à instituição das escolas normais, entretanto, há uma parcela menor de trabalhos que se propõem a discutir outro aspecto da formação de professores ao longo do século XIX, mais especificamente, a forma como sujeitos que não frequentaram esse espaço institucional (a escola normal), constituíram-se docentes primários. O artigo que aqui se apresenta partilha dessa perspectiva, e volta o olhar para os modos de formação pela prática de professores primários no Paraná na segunda metade do século XIX, por compreender que esse tipo de formação marcou um período em que a instrução pública estava se consolidando em meio a ações, deliberações, dificuldades e tensões, na tentativa de melhorias de sua condição. A pesquisa valeu-se da consulta da legislação educacional do período e de documentos advindos dos sujeitos envolvidos com a instrução pública, naquele momento, disponíveis no acervo do Arquivo Público do Paraná. No cotejamento e análise das fontes, é possível afirmar, que a formação pela prática dos professores primários na província do Paraná se deu no decorrer do desenvolvimento do processo de constituição do magistério primário
Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults
Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We
estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from
1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.
Methods We used data from 3663 population-based studies with 222 million participants that measured height and
weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate
trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children
and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the
individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference)
and obesity (BMI >2 SD above the median).
Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in
11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed
changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and
140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of
underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and
countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior
probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse
was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of
thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a
posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%)
with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and
obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for
both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such
as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged
children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls
in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and
42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents,
the increases in double burden were driven by increases in obesity, and decreases in double burden by declining
underweight or thinness.
Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an
increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy
nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of
underweight while curbing and reversing the increase in obesit
Preventing perioperative hypothermia: an integrative literature review
abstrak Context: During surgery, many patients become hypothermic. Health complications resulting from hypothermia lead to longerhospital stays and increased healthcare costs.Objective: To identify in empirical research results the active warming systems that proved to be most effective in the pre andintraoperative periods to prevent perioperative hypothermia.Methodology: The search was performed using the following keywords: Hypothermia, perioperative nursing, anaesthesia andrewarming. Publications from the last five years (2007-2012), with full text, and written in English, Spanish or Portuguese wereincluded. Articles on pregnant women, neurocritical patients, induced hypothermia and the variables affecting hypothermiawere excluded.Results: A total of 30 articles were obtained, seven of which were selected for analysis.Conclusion: Active warming methods are effective measures for the prevention of hypothermia; the combination of warmingmethods is more effective than an isolated use; and, finally, the forced-air system and circulating water garments proved to bethe most effective active warming methods
Spatial distance and climate determine modularity in a cross-biomes plant–hummingbird interaction network in Brazil
Aim: We examined the effects of space, climate, phylogeny and species traits on module composition in a cross-biomes plant–hummingbird network. Location: Brazil, except Amazonian region. Methods: We compiled 31 local binary plant–hummingbird networks, combining them into one cross-biomes metanetwork. We conducted a modularity analysis and tested the relationship between species’ module membership with traits, geographical location, climatic conditions and range sizes, employing random forest models. We fitted reduced models containing groups of related variables (climatic, spatial, phylogenetic, traits) and combinations of groups to partition the variance explained by these sets into unique and shared components. Results: The Brazilian cross-biomes network was composed of 479 plant and 42 hummingbird species, and showed significant modularity. The resulting six modules conformed well to vegetation domains. Only plant traits, not hummingbird traits, differed between modules, notably plants’ growth form, corolla length, flower shape and colour. Some modules included plant species with very restricted distributions, whereas others encompassed more widespread ones. Widespread hummingbirds were the most connected, both within and between modules, whereas widespread plants were the most connected between modules. Among traits, only nectar concentration had a weak effect on among-module connectivity. Main conclusions: Climate and spatial filters were the main determinants of module composition for hummingbirds and plants, potentially related to resource seasonality, especially for hummingbirds. Historical dispersal-linked contingency, or environmental variations not accounted for by the explanatory factors here evaluated, could also contribute to the spatial component. Phylogeny and morphological traits had no unique effects on the assignment of species to modules. Widespread species showed higher within- and/or among-module connectivity, indicating their key role connecting biomes, and, in the case of hummingbirds, communities within biomes. Our results indicate that biogeography and climate not only determine the variation of modularity in local plant–animal networks, as previously shown, but also affect the cross-biomes network structure. © 2018 John Wiley & Sons Lt
ERICA: prevalências de hipertensão arterial e obesidade em adolescentes brasileiros
OBJECTIVE:To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS: Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and
classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis
and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population.
RESULTS:We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in
the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%.
CONCLUSIONS:ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian
adolescents by 1/5. DESCRIPTORS:Adolescent. Obesity, epidemiology. Hypertension, epidemiology. Cross-Sectional
Studies.OBJETIVO: Estimar as prevalências de hipertensão arterial e obesidade e a fração atribuível populacional de hipertensão arterial devida à obesidade em adolescentes brasileiros. MÉTODOS: Foram avaliados dados dos participantes do Estudo de Riscos Cardiovasculares em Adolescentes, estudo seccional l nacional de base escolar. A amostra foi dividida em 32 estratos geográficos e conglomerados de escolas e turmas, com representatividade nacional, macrorregional e de capitais. Obesidade foi classificada pelo índice de massa corporal segundo idade e sexo. Considerou-se hipertensão arterial a média da pressão arterial sistólica ou diastólica maior ou igual ao percentil 95 da curva de referência. Foram estimadas prevalências e intervalos de confiança de
95% (IC95%) de hipertensão arterial e de obesidade, nacionais e nas macrorregiões do País, por sexo e grupo etário, assim como as frações de hipertensão atribuíveis à obesidade na população. RESULTADOS: Foram avaliados 73.399 estudantes, 55,4% do sexo feminino, com média de idade
14,7 anos (DP = 1,6). A prevalência de hipertensão arterial foi 9,6% (IC95% 9,0-10,3); sendo as mais baixas observadas nas regiões Norte, 8,4% (IC95% 7,7-9,2) e Nordeste, 8,4% (IC95% 7,6-9,2) e a mais alta na região Sul, 12,5% (IC95% 11,0-14,2). A prevalência de obesidade foi 8,4% (IC95% 7,9-8,9), mais
baixa na região Norte e mais alta na Sul. As prevalências de hipertensão arterial e obesidade foram maiores no sexo masculino. Adolescentes com obesidade tiveram prevalência de hipertensão arterial mais elevada, 28,4% (IC95% 25,5-31,2), do que aqueles com sobrepeso, 15,4% (IC95% 13,8-17,0), ou
eutróficos, 6,3% (IC95% 5,6-7,0). A fração de hipertensão arterial atribuível à obesidade foi de 17,8%. CONCLUSÕES: O ERICA foi o primeiro estudo brasileiro com representatividade nacional a estimar a prevalência de hipertensão arterial aferida em adolescentes. A fração da prevalência de hipertensão arterial atribuível à obesidade mostrou que cerca de 1/5 dos hipertensos poderiam
não ser hipertensos se não fossem obesos. DESCRITORES: Adolescente. Obesidade, epidemiologia. Hipertensão, epidemiologia. Prevalência. Estudo Transversal
Embracing Monogenic Parkinson's Disease: The MJFF Global Genetic PD Cohort
BACKGROUND: As gene-targeted therapies are increasingly being developed for Parkinson's disease (PD), identifying and characterizing carriers of specific genetic pathogenic variants is imperative. Only a small fraction of the estimated number of subjects with monogenic PD worldwide are currently represented in the literature and availability of clinical data and clinical trial-ready cohorts is limited. OBJECTIVE: The objectives are to (1) establish an international cohort of affected and unaffected individuals with PD-linked variants; (2) provide harmonized and quality-controlled clinical characterization data for each included individual; and (3) further promote collaboration of researchers in the field of monogenic PD. METHODS: We conducted a worldwide, systematic online survey to collect individual-level data on individuals with PD-linked variants in SNCA, LRRK2 VPS35, PRKN, PINK1, DJ-1, as well as selected pathogenic and risk variants in GBA and corresponding demographic, clinical, and genetic data. All registered cases underwent thorough quality checks, and pathogenicity scoring of the variants and genotype-phenotype relationships were analyzed. RESULTS: We collected 3888 variant carriers for our analyses, reported by 92 centers (42 countries) worldwide. Of the included individuals 3185 had a diagnosis of PD (ie, 1306 LRRK2, 115 SNCA, 23 VPS35 429 PRKN, 75 PINK1, 13 DJ-1, and 1224 GBA) and 703 were unaffected (ie, 328 LRRK2, 32 SNCA, 3 VPS35, 1 PRKN, 1 PINK1, and 338 GBA). In total, we identified 269 different pathogenic variants; 1322 individuals in our cohort (34\%) were indicated as not previously published. CONCLUSIONS: Within the MJFF Global Genetic PD Study Group, we (1) established the largest international cohort of affected and unaffected individuals carrying PD-linked variants; (2) provide harmonized and quality-controlled clinical and genetic data for each included individual; (3) promote collaboration in the field of genetic PD with a view toward clinical and genetic stratification of patients for gene-targeted clinical trials. 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Management practices for postdural puncture headache in obstetrics: a prospective, international, cohort study
© 2020 British Journal of AnaesthesiaBackground: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP