Nutrition especialization course: inter-professional and multidisciplinary experience

This paper presents a review of the post-graduate course in Nutrition offered at the Medical School of Ribeirão Preto - University of São Paulo, Brazil. The data is available in the archives of the Nutrition Library “Prof. Dutra de Oliveira”, Pharmacy School, São Paulo State University, Campus of Arararquara - SP. Brazil. Results show over 200 students, all of them professionals graduated, attended this program from 1968 at 1994. Its history, objectives and appreciation by the students are reviewed. The main contribuition of the one year curriculum is to bring out the interprofessional and multidisciplinary aspects of the area. The past students are today work in nutrition areas and several are university professors.Este trabalho apresenta uma revisão do Curso de Especialização em Nutrição da Faculdade de Medicina de Ribeirão Preto - USP. Os dados foram obtidos nos arquivos da Biblioteca Especializada em Nutrição “Prof. Dutra de Oliveira”, da Faculdade de Ciências Farmacêuticas da UNESP, campus de Araraquara. Os resultados mostram que cerca de 200 alunos, vindos das mais diferentes áreas profissionais, freqüentaram este curso desde sua implantação, em 1968 até 1994. Aspectos históricos do curso, sua filosofia de ensino, as atividades propostas e as opiniões de seus alunos são apresentados. O curso tem contribuído para a caracterização da nutrição como uma área interprofissional e multidisciplinar. Seus ex-alunos estão atuando hoje em diversas áreas da nutrição, sendo que muitos deles são professores universitários

Lung transplantation waiting list in State of São Paulo: patients’ characteristics and predictors of death

Introdução: Atualmente, a alocação de pulmões no Brasil baseia-se, sobretudo,no tempo de espera em lista (Li) para transplante pulmonar (TxP). Objetivos: (1) Determinar operfi l dos pacientes em Li, e (2) Identifi car preditores de mortalidade em lista (PMLi). Casuísticae métodos: Analisamos os prontuários de 164 pacientes inscritos na Li por nosso serviço,de 2001 até 2008. Os PMLi foram obtidos por uma análise de riscos proporcionais de Cox.Resultados: Os pacientes foram inclusos na Li com 40,9 ± 15,7 anos, sobretudo por enfi sema(24,5%). Diagnóstico de enfi sema ou bronquiectasias (risco relativo [RR]=0,15; p=0,002), tempode tromboplastina parcial ativada > 30 segundos (RR=3,28; p=0,002), albumina plasmática >3,5 g/dl (RR=0,41; p=0,033) e saturação da hemoglobina > 85% (RR=0,44; p=0,031) foramidentifi cados como PMLi. Conclusões: (1) Algumas variáveis podem predizer o risco de morteem Li para TxP; (2) Conhecer as características dos receptores de TxP é essencial para futurasmedidas de aprimoramento dos critérios de alocação de TxP.Introduction: Nowadays, lung allocation in Brazil is based mainly on waitingtime while on list (Li) for lung transplantation (LTx). Objectives: (1) To determine the profi leof the patients on Li; (2) To identify predictors of death on list (PDLi). Casuistic and methods:We analysed medical records of 164 patients inscribed on Li by our service, from 2001 to2008. The PDLi were obtained through Cox proportional hazards analyses. Results: Patientswere included onto Li with mean age of 40,9 ± 15,7 years, maily due to emphysema (24,5%).Diagnosis of emphysema or bronquiectasis (relative risk [RR]=0,15; p=0,002), activated partialthromboplastin time > 30 seconds (RR=3,28; p=0,002), plasma albumin (RR=0,44; p=0,033)and hemoglobin saturation > 85% (RR=0,44; p=0,031) were identifi ed as PDLi. Conclusions: (1)Some variables can predict probability of death on Li; (2) To know LTx recipients’ characteristicsis essential for future actions driven at improving LTx allocation criteria

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

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)