Relationship between the work developed in maximal and submaximal exercise capacity tests and the degree of airflow obstruction in individuals with Chronic Obstructive Pulmonary Disease

Este estudio tuvo como objetivo investigar la relación de labor desarrollada en dos tests de capacidad de ejercicio, un máximo y otro submáximo, con el grado de obstrucción del flujo aéreo en individuos con Enfermedad Pulmonar Obstructiva Crónica (EPOC). Los 53 individuos con EPOC (29 hombres, 70±9Años, 65±14kg, volumen espiratorio forzado en el primer segundo [VEF1] 38 [31-54]% previsto) tuvieron evaluadas su función pulmonar, a través de espirometría, y capacidad máxima de ejercicio en por el Incremental Shuttle Walking Test (ISWT), y submáxima, por el test de caminata de seis minutos (TC6min). El trabajo desarrollado en los tests fue calculado por el producto de la distancia recorrida con el peso corporal del individuo (P). Para evaluar la contribución del peso en el rendimiento de los tests, los individuos fueron separados en dos grupos : de alto peso (n=32) y bajo peso (n=21). Se observó una correlación del VEF1 con la distancia recorrida en el ISWT y con el ISWT*P (r=0,43 y r=0,49, respectivamente; PObjetivou-se investigar a relação do trabalho desenvolvido em dois testes de capacidade de exercício, um máximo e outro submáximo, com o grau de obstrução ao fluxo aéreo em indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC). 53 indivíduos com DPOC (29 homens, 70±9 anos, 65±14 kg, volume expiratório forçado no primeiro segundo [VEF1] 38[31-54]% previsto) tiveram avaliadas sua função pulmonar, por meio de espirometria, e capacidade de exercício máxima, pelo Incremental Shuttle Walking Test (ISWT), e submáxima, pelo teste de caminhada de seis minutos (TC6min). O trabalho desenvolvido nos testes foi calculado pelo produto da distância percorrida com o peso corporal do indivíduo (P). Para avaliar a contribuição do peso no desempenho dos testes, os indivíduos foram separados em dois grupos: maior peso (n=32), e menor peso (n=21). Observou-se correlação do VEF1 com a distância percorrida no ISWT e com o ISWT*P (r=0,43 e r=0,49, respectivamente; pThe aim of this study was to investigate the relationship between the work in two exercise capacity tests, a maximum and a submaximal exercise, and the level of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD). Fifty-three subjects with COPD (29 men, 70±9 years old, 65±14 kg, forced expiratory volume in the first second [FEV1] 38[31-54]% predicted) had their lung function assessed by spirometry, and maximal and submaximal exercise capacity were evaluated by the Incremental Shuttle Walking test (ISWT) and the 6-Minute Walk Test (6MWT), respectively. The work in the tests was calculated by multiplying the covered distance and the individual's body weight (W). To evaluate the contribution of weight on the developed work, subjects were separated into two groups: higher weight (n=32), and lower weight (n=21). FEV1 correlated with the distance on the ISWT and with the ISWT*W (r=0.43 and r=0.49, respectively;

Results from a Nationwide Study

Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.Introduction: Little is known about how sheltering in place to contain the spread of COVID-19 over extended periods affects individuals’ psychological well-being. This study’s objective was to analyze the factors associated with MSM’s (men who have sex with men) low psychological well-being in the COVID-19 pandemic context. Method: This cross-sectional study was conducted online across Brazil (26 states and federal district) in April and May 2020. The participants were recruited using snowball sampling and Facebook posts. Data were collected using social media and MSM dating apps. We estimated the prevalence, crude prevalence ratio (PR), and the respective confidence intervals (CI95%). Results: The prevalence of low psychological well-being found in the sample was 7.9%. Associated factors were belonging to the youngest group (PR 2.76; CI95% 1.90–4.01), having polyamorous relationships (PR 2.78; CI95% 1.51–5.11), not complying with social isolation measures (PR 6.27; CI95% 4.42–8.87), not using the social media to find partners (PR 1.63; CI95% 1.06–2.53), having multiple sexual partners (PR 1.80; CI95% 1.04–3.11), having reduced the number of partners (PR 2.67; CI95% 1.44–4.95), and group sex (PR 1.82; CI95% 1.23–2.69) Conclusion: The well-being of MSM living in Brazil was negatively affected during the social distancing measures intended to control the spread of COVID-19. The variables that contributed the most to this outcome include social isolation, relationships established with partners, and sexual behavior. Policy Implications: Planning and implementing public policies and actions to promote psychological well-being are needed to improve MSM’s resilience by adopting safe strategies and behavior.publishersversionpublishe

MECANISMOS FISIOPATOLÓGICOS E CONDUTAS TERAPÊUTICAS NA SÍNDROME DO OVÁRIO POLICÍSTICO: UMA REVISÃO BIBLIOGRÁFICA

Introduction: Polycystic Ovary Syndrome (PCOS) is a complex endocrine condition that affects women of reproductive age, presenting a wide range of clinical and metabolic manifestations. Objective: to analyze the pathophysiological mechanisms and therapeutic approaches of PCOS, providing an updated synthesis of the scientific literature. Methodology: This is a bibliographic review, using articles present in the following databases: PubMed, Scopus and SciELO. Original articles and systematic reviews in English and Portuguese published between 2013 and 2024 were included, which addressed pathophysiological mechanisms and therapeutic approaches to PCOS. After analysis, 37 articles were selected to prepare this bibliographic review. Results and Discussion: PCOS is a heterogeneous disease characterized by hyperandrogenism, dysfunctional ovulation and polycystic ovarian morphology, accompanied by metabolic abnormalities such as insulin resistance and obesity. Therapeutic approaches for PCOS range from pharmacological interventions to lifestyle modifications. Pharmacological treatments aim to normalize hormone levels, restore ovulation and improve clinical symptoms, including combined oral contraceptives, antiandrogens and insulin sensitizers such as metformin. Conclusion: PCOS remains a challenging condition for patients and healthcare professionals, given its pathophysiological complexity and diverse clinical manifestations.Introducción: El Síndrome de Ovario Poliquístico (SOP) es una afección endocrina compleja que afecta a mujeres en edad reproductiva, presentando una amplia gama de manifestaciones clínicas y metabólicas. Objetivo: analizar los mecanismos fisiopatológicos y abordajes terapéuticos del SOP, proporcionando una síntesis actualizada de la literatura científica. Metodología: Se trata de una revisión bibliográfica, utilizando artículos presentes en las siguientes bases de datos: PubMed, Scopus y SciELO, se incluyeron artículos originales y revisiones sistemáticas en inglés y portugués publicados entre 2013 y 2024, que abordaron mecanismos fisiopatológicos y abordajes terapéuticos del SOP. Luego del análisis, se seleccionaron 37 artículos para elaborar esta revisión bibliográfica. Resultados y Discusión: El SOP es una enfermedad heterogénea caracterizada por hiperandrogenismo, ovulación disfuncional y morfología de ovario poliquístico, acompañada de anomalías metabólicas como resistencia a la insulina y obesidad. Los enfoques terapéuticos para el síndrome de ovario poliquístico van desde intervenciones farmacológicas hasta modificaciones del estilo de vida. Los tratamientos farmacológicos tienen como objetivo normalizar los niveles hormonales, restaurar la ovulación y mejorar los síntomas clínicos, incluidos anticonceptivos orales combinados, antiandrógenos y sensibilizadores de insulina como la metformina. Conclusión: El síndrome de ovario poliquístico sigue siendo una condición desafiante para pacientes y profesionales de la salud, dada su complejidad fisiopatológica y diversas manifestaciones clínicas.Introdução: A Síndrome do Ovário Policístico (SOP) é uma condição endócrina complexa que afeta mulheres em idade reprodutiva, apresentando uma ampla gama de manifestações clínicas e metabólicas. Objetivo: analisar os mecanismos fisiopatológicos e condutas terapêuticas da SOP, fornecendo uma síntese atualizada da literatura científica. Metodologia: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e SciELO Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2013 e 2024, que abordassem sobre mecanismos fisiopatológicos e condutas terapêuticas da SOP. Após a análise, foram selecionados 37 artigos para a confecção dessa revisão bibliográfica.  Resultados e Discussão: A SOP é uma doença heterogênea caracterizada por hiperandrogenismo, ovulação disfuncional e morfologia dos ovários policísticos, acompanhada de anormalidades metabólicas, como resistência à insulina e obesidade. As abordagens terapêuticas para a SOP variam desde intervenções farmacológicas até modificações no estilo de vida. Os tratamentos farmacológicos visam normalizar os níveis hormonais, restaurar a ovulação e melhorar os sintomas clínicos, incluindo contraceptivos orais combinados, antiandrogênios e sensibilizadores de insulina, como a metformina.. Conclusão: A SOP continua sendo uma condição desafiadora para pacientes e profissionais de saúde, dada a sua complexidade fisiopatológica e as diversas manifestações clínicas.Introdução: A Síndrome do Ovário Policístico (SOP) é uma condição endócrina complexa que afeta mulheres em idade reprodutiva, apresentando uma ampla gama de manifestações clínicas e metabólicas. Objetivo: analisar os mecanismos fisiopatológicos e condutas terapêuticas da SOP, fornecendo uma síntese atualizada da literatura científica. Metodologia: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e SciELO Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2013 e 2024, que abordassem sobre mecanismos fisiopatológicos e condutas terapêuticas da SOP. Após a análise, foram selecionados 37 artigos para a confecção dessa revisão bibliográfica.  Resultados e Discussão: A SOP é uma doença heterogênea caracterizada por hiperandrogenismo, ovulação disfuncional e morfologia dos ovários policísticos, acompanhada de anormalidades metabólicas, como resistência à insulina e obesidade. As abordagens terapêuticas para a SOP variam desde intervenções farmacológicas até modificações no estilo de vida. Os tratamentos farmacológicos visam normalizar os níveis hormonais, restaurar a ovulação e melhorar os sintomas clínicos, incluindo contraceptivos orais combinados, antiandrogênios e sensibilizadores de insulina, como a metformina.. Conclusão: A SOP continua sendo uma condição desafiadora para pacientes e profissionais de saúde, dada a sua complexidade fisiopatológica e as diversas manifestações clínicas

Peginterferon still has a place in the treatment of hepatitis C caused by genotype 3 virus

Despite recent advances in therapy for chronic hepatitis C (CHC), the disease caused by genotype 3 virus (GEN3) is still considered a treatment challenge in certain patient subgroups. The aim of this retrospective study was to evaluate the effectiveness and safety of the peginterferon (Peg-IFN) and ribavirin (RBV) combination treatment for GEN3/CHC patients, and to evaluate sustained virological response (SVR) indicators and early treatment interruption due to serious adverse events (SAE). This was a retrospective observational study of GEN3/CHC patients, co-infected or not by HIV and treated with Peg-IFN/RBV in nine Brazilian healthcare centers. The study sample included 184 GEN3/CHC patients; 70 (38%) were co-infected with HIV. The overall SVR rate was 57.1% (95% CI 50-64). Among co-infected and mono-infected patients, the SVR rate was 51.4% (36/70) and 60.5% (69/114), respectively (p=0.241). Thirty-four (18.5%) patients experienced SAE and interrupted treatment. SVR was negatively associated with the use of Peg-IFN alpha 2b (PR 0.75; 95% CI 0.58-0.99; p=0.045) and to early treatment interruption due to SAE (PR 0.36; 95% CI 0.20-0.68; p=0.001). Early treatment interruption due to SAE was associated with age (PR 1.06; 95% CI 1.02-1.10;

Peginterferon still has a place in the treatment of hepatitis C caused by genotype 3 virus

Despite recent advances in therapy for chronic hepatitis C (CHC), the disease caused by genotype 3 virus (GEN3) is still considered a treatment challenge in certain patient subgroups. The aim of this retrospective study was to evaluate the effectiveness and safety of the peginterferon (Peg-IFN) and ribavirin (RBV) combination treatment for GEN3/CHC patients, and to evaluate sustained virological response (SVR) indicators and early treatment interruption due to serious adverse events (SAE). This was a retrospective observational study of GEN3/CHC patients, co-infected or not by HIV and treated with Peg-IFN/RBV in nine Brazilian healthcare centers. The study sample included 184 GEN3/CHC patients70 (38%) were co-infected with HIV. The overall SVR rate was 57.1% (95% CI 50-64). Among co-infected and mono-infected patients, the SVR rate was 51.4% (36/70) and 60.5% (69/114), respectively (p=0.241). Thirty-four (18.5%) patients experienced SAE and interrupted treatment. SVR was negatively associated with the use of Peg-IFN alpha 2b (PR 0.7595% CI 0.58-0.99p=0.045) and to early treatment interruption due to SAE (PR 0.3695% CI 0.20-0.68p=0.001). Early treatment interruption due to SAE was associated with age (PR 1.0695% CI 1.02-1.10p<0.001) and occurrence of liver cirrhosis (PR 2.0695% CI 1.11-3.83p=0.022). In conclusion, Peg-IFN/RBV might represent an adequate treatment option, mainly in young patients without advanced liver disease or when the use of direct-action drugs is limited to specific patient groups.Univ Sul Santa Catarina, Fac Med, Dept Ciencias Biol & Saude & Ciencias Sociais Apl, Disciplina Doencas Infecciosas, Av Pedra Branca 25, BR-88137270 Palhoca, SC, BrazilUniv Fed Sao Paulo, Disciplina Infectol, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Div Gastroenterol & Hepatol, Sao Paulo, SP, BrazilUniv Fed Estado Rio de Janeiro, Dept Clin Med, Disciplina Gastroenterol, Rio De Janeiro, RJ, BrazilUniv Fed Espirito Santo, Serv Infectol, Vitoria, ES, SpainUniv Sao Paulo, Fac Med Ribeirao Preto, Div Gastroenterol, Ribeirao Preto, SP, BrazilInst Infectol Emilio Ribas, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Dept Doencas Infecciosas & Parasitarias, Sao Paulo, SP, BrazilSecretaria Estadual Saude, Unidade Mista Saude, Unimista 508 509, Brasilia, DF, BrazilUniv Sao Paulo, Inst Med Trop Sao Paulo, Lab Virol, LIM 52, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Disciplina Infectol, Sao Paulo, SP, BrazilWeb of Scienc

Organization and Information in the Fight against Crime: An Evaluation of the Integration of Police Forces in the State of Minas Gerais, Brazil *

Abstract This paper explores the experience of information sharing, coordination, and integration of actions of the Civil and Military Polices in the state of Minas Gerais, Brazil, in the context of the IGESP program. The IGESP is based on the introduction of information management systems and organizational changes akin to those associated with COMPSTAT. All the evidence presented points to a causal effect of the IGESP on crime. The most conservative estimates indicate a reduction of 24% in property crimes and 13% in personal crimes. There is also evidence that the IGESP is associated with improved police response, measured by apprehension of weapons and clearance rates. We present one of the first set of causal estimates -with a clear identification strategy -of the impact of COMPSTAT-like programs. The results suggest that the coordination and informational gains represented by the program may constitute a first-order factor in a successful policy for fighting crime

Hedera helix L.: uma revisão dos recentes estudos de suas propriedades farmacológicas

Objective: To search the literature for recent scientific evidence corroborating the pharmacological properties of H. helix L. Method: This is an integrative literature review. Searches were carried out in the electronic databases: Virtual Health Library (VHL), EMBASE and SciVerse Scopus. The time interval chosen covered 2013 to 2023. Results: A total of 40 articles were found in the VHL database, 27 in Scopus and 8 in Embase. Given the inclusion and exclusion criteria, which answered the guiding question, 13 articles were selected for full analysis. The use of H. helix extract as a herbal medicine is recognised by the National Health Surveillance Agency (ANVISA) under RE No. 4,287 of 23 September 2011, and this therapeutic use as an expectorant and antitussive agent is scientifically validated by scientific publications. Its proven pharmacological activities include: expectorant, antitussive, anticancer, anti-inflammatory, antioxidant, antiangiogenic, neuroprotective and anti-ulcer preventive. Final considerations: In view of the therapeutic importance of H. helix as a promising medicinal plant with a wide range of pharmacological activities, it can be used in various medical applications due to its efficacy and safety.Objetivo: Buscar na literatura quais evidências científicas recentes corroboram para as propriedades farmacológicas da H. helix L. Método: Trata-se de uma revisão integrativa da literatura. Foram realizadas buscas nas bases de dados eletrônicas: Biblioteca Virtual em Saúde (BVS), EMBASE e SciVerse Scopus. O intervalo temporal escolhido abrangeu de 2013 a 2023. Resultados: Um total de 40 artigos foram encontrados na base de dados BVS, 27 na Scopus e 8 na Embase. Diante dos critérios de inclusão e exclusão, que responderam à questão norteadora, foram selecionados 13 artigos para análise integral. O uso do extrato da H. helix, como medicamento fitoterápico, é reconhecido pela Agência Nacional de Vigilância Sanitária (ANVISA) pela RE Nº 4.287, de 23 de setembro de 2011, e este uso terapêutico como agente expectorante e antitussígeno é validado cientificamente por publicações científicas. Dentre as atividades farmacológicas comprovadas, destacam-se: expectorante, antitussígena, anticancerígena, anti-inflamatória, antioxidante, antiangiogênicas, neuroprotetora e antiúlcera preventivo. Considerações finais: Diante da importância terapêutica da H. helix como uma planta medicinal promissora com ampla gama de atividades farmacológicas, podendo ser utilizada em diversas aplicações médicas devido à sua eficácia e segurança

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&lt; 0.05). The polymorphic genotypes (AO and OO) were associated with lower MBL levels (p&lt; 0.05). IL-6 and TNF-α were higher in patients with low MBL and severe COVID-19 (p&lt; 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

Brazilian consortium for the study on renal diseases associated with COVID-19 : a multicentric effort to understand SARS-CoV-2-related nephropathy

Kidney involvement appears to be frequent in coronavirus disease 2019 (COVID-19). Despite this, information concerning renal involvement in COVID-19 is still scarce. Several mechanisms appear to be involved in the complex relationship between the virus and the kidney. Also, different morphological patterns have been described in the kidneys of patients with COVID-19. For some authors, however, this association may be just a coincidence. To investigate this issue, we propose assessing renal morphology associated with COVID-19 at the renal pathology reference center of federal university hospitals in Brazil. Data will come from a consortium involving 17 federal university hospitals belonging to Empresa Brasileira de Serviços Hospitalares (EBSERH) network, as well as some state hospitals and an autopsy center. All biopsies will be sent to the referral center for renal pathology of the EBSERH network. The data will include patients who had coronavirus disease, both alive and deceased, with or without pre-existing kidney disease. Kidney biopsies will be analyzed by light, fluorescence, and electron microscopy. Furthermore, immunohistochemical (IHC) staining for various inflammatory cells (i.e., cells expressing CD3, CD20, CD4, CD8, CD138, CD68, and CD57) as well as angiotensin-converting enzyme 2 (ACE2) will be performed on paraffinized tissue sections. In addition to ultrastructural assays, in situ hybridization (ISH), IHC and reverse transcription-polymerase chain reaction (RT-PCR) will be used to detect Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) in renal tissue. For the patients diagnosed with Collapsing Glomerulopathy, peripheral blood will be collected for apolipoprotein L-1 (APOL1) genotyping. For patients with thrombotic microangiopathy, thrombospondin type 1 motif, member 13 (ADAMTS13), antiphospholipid, and complement panel will be performed. The setting of this study is Brazil, which is second behind the United States in highest confirmed cases and deaths. With this complete approach, we hope to help define the spectrum and impact, whether immediate or long-term, of kidney injury caused by SARS-CoV-2