Avaliação dos fatores de risco e diagnóstico para neuropatia autonômica cardíaca em pessoas diabéticas

The aim was to highlight the publications expressed in the world scientific literature on this topic. This is an integrative literature review study that followed the PICo strategy to identify risk factors and diagnoses associated with diabetic neuropathy. The search for articles was performed in three electronic databases: Medline, BVS and SciELO. The descriptors "Diabetic Neuropathies", "Diseases of the Peripheral Nervous System", "Neuralgia", "Risk Factors", "Diabetes Mellitus" were used, the inclusion criteria are full texts, published from 2011 to 2021, in the language English, Portuguese and Spanish and the Boolean AND operator was used. It resulted in 51 articles. Forty-six articles were selected to be read in full and 7 met the criteria of this review. It is concluded that autonomic neuropathy can be reduced with better blood glucose control, and improved lipid and blood pressure levels, avoidance of smoking and excessive alcohol consumption are already recommended for the prevention of other complications of diabetes. The treatment of symptoms includes the use of tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin and opioids.Objetivou-se evidenciar as publicações expressas na literatura cientifica mundial sobre essa temática. Trata-se de um estudo de revisão integrativa da literatura que seguiu a estratégia PICo para identificar os fatores de risco e diagnósticos associados à neuropatia diabética. A busca dos artigos foi realizada em três bases de dados eletrônicas: Medline, BVS e SciELO. Foram utilizados os descritores “Neuropatias Diabéticas”, “Doenças do Sistema Nervoso Periférico”, “Neuralgia”, “Fatores de Risco”, “Diabetes Mellitus”, os critérios de inclusão são textos completos, publicados no período de 2011 a 2021, no idioma inglês, português e espanhol e foi usado o operador booleano AND. Resultou-se em 51 artigos. Quarenta e seis artigos foram selecionados para serem lidos na íntegra e 7 atenderam aos critérios desta revisão. Conclui-se que a neuropatia autonômica pode ser reduzida com melhor controle da glicose no sangue, e a melhora dos índices de lipídios e pressão arterial, evitar o tabagismo e o consumo excessivo de álcool já são recomendados para a prevenção de outras complicações do diabetes. O tratamento dos sintomas inclui uso de antidepressivos tricíclicos, inibidores da recaptação da serotonina e noradrenalina, gabapentina, pregabalina e opioides

Avaliação dos fatores de risco e diagnóstico para neuropatia autonômica cardíaca em pessoas diabéticas

The aim was to highlight the publications expressed in the world scientific literature on this topic. This is an integrative literature review study that followed the PICo strategy to identify risk factors and diagnoses associated with diabetic neuropathy. The search for articles was performed in three electronic databases: Medline, BVS and SciELO. The descriptors "Diabetic Neuropathies", "Diseases of the Peripheral Nervous System", "Neuralgia", "Risk Factors", "Diabetes Mellitus" were used, the inclusion criteria are full texts, published from 2011 to 2021, in the language English, Portuguese and Spanish and the Boolean AND operator was used. It resulted in 51 articles. Forty-six articles were selected to be read in full and 7 met the criteria of this review. It is concluded that autonomic neuropathy can be reduced with better blood glucose control, and improved lipid and blood pressure levels, avoidance of smoking and excessive alcohol consumption are already recommended for the prevention of other complications of diabetes. The treatment of symptoms includes the use of tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin and opioids.Objetivou-se evidenciar as publicações expressas na literatura cientifica mundial sobre essa temática. Trata-se de um estudo de revisão integrativa da literatura que seguiu a estratégia PICo para identificar os fatores de risco e diagnósticos associados à neuropatia diabética. A busca dos artigos foi realizada em três bases de dados eletrônicas: Medline, BVS e SciELO. Foram utilizados os descritores “Neuropatias Diabéticas”, “Doenças do Sistema Nervoso Periférico”, “Neuralgia”, “Fatores de Risco”, “Diabetes Mellitus”, os critérios de inclusão são textos completos, publicados no período de 2011 a 2021, no idioma inglês, português e espanhol e foi usado o operador booleano AND. Resultou-se em 51 artigos. Quarenta e seis artigos foram selecionados para serem lidos na íntegra e 7 atenderam aos critérios desta revisão. Conclui-se que a neuropatia autonômica pode ser reduzida com melhor controle da glicose no sangue, e a melhora dos índices de lipídios e pressão arterial, evitar o tabagismo e o consumo excessivo de álcool já são recomendados para a prevenção de outras complicações do diabetes. O tratamento dos sintomas inclui uso de antidepressivos tricíclicos, inibidores da recaptação da serotonina e noradrenalina, gabapentina, pregabalina e opioides

HIV-related non-Hodgkin lymphomas affecting the oral cavity:a clinicopathologic study of 11 cases

HIV-related non-Hodgkin lymphomas of the oral cavity are rare lesions with aggressive clinical behaviour. The aim of this study is to describe the clinicopathological features of a series of HIV-related oral non-Hodgkin lymphomas. Eleven cases of oral lymphomas affecting HIV-positive patients were retrieved from 2012 to 2019. Clinicopathological features regarding age, sex, tumour location, clinical presentation, laboratory findings, disease stage and follow-up were obtained. Histologic, immunohistochemical and in situ hybridization for EBV detection were done for diagnosis confirmation. Overall survival was estimated by Kaplan?Meier curve. Males predominated, with a mean age of 40.3 years-old. Maxilla and mandible were the mostly affected. Plasmablastic lymphoma and diffuse large B-cell lymphoma not otherwise specified (NOS) were the main histological types. Lesions presented as reddish ulcerated swellings, representing the first sign of AIDS in six cases. Stage IV were common (7 cases) and the mean HIV viral load was 10,557 copies/mL, with a mean of 266 CD4+ cells/mm3, 1,278 CD8+ cells/mm3 and a CD4+/CD8+ ratio of 0.26. Eight patients died of the disease (72.7%). Overall survival revealed that 78.2% of the patients died after 21 months of follow-up. HIV-related oral lymphomas present a poor prognosis usually diagnosed in advanced stages and in our series plasmablastic lymphoma was the most common subtype

Extracellular vesicles in infectious diseases caused by protozoan parasites in buffaloes

Background: Extracellular vesicles (EVs) are small membrane-bound vesicles of growing interest in vetetinary parasitology. The aim of the present report was to provide the first isolation, quantification and protein characterization of EVs from buffalo (Bubalus bubalis) sera infected with Theileria spp. Methods: Infected animals were identified through optical microscopy and PCR. EVs were isolated from buffalo sera by size-exclusion chromatography and characterized using western blotting analysis, nanoparticle tracking analysis and transmission electron microscopy. Subsequently, the proteins from isolated vesicles were characterized by mass spectrometry. Results: EVs from buffalo sera have shown sizes in the 124-140 nm range and 306 proteins were characterized. The protein-protein interaction analysis has evidenced biological processes and molecular function associated with signal transduction, binding, regulation of metabolic processes, transport, catalytic activity and response to acute stress. Five proteins have been shown to be differentially expressed between the control group and that infected with Theileria spp., all acting in the oxidative stress pathway. Conclusions: EVs from buffaloes infected with Theileria spp. were successfully isolated and characterized. This is an advance in the knowledge of host-parasite relationship that contributes to the understanding of host immune response and theileriosis evasion mechanisms. These findings may pave the way for searching new EVs candidate-markers for a better production of safe biological products derived from buffaloes

Effectiveness and safety of first-generation protease inhibitors in real-world patients with hepatitis C virus genotype 1 infection in Brazil: a multicenter study

OBJECTIVE: To evaluate the effectiveness and safety of first-generation protease inhibitors for the treatment of genotype 1 hepatitis C virus-infected patients at Brazilian reference centers. METHODS: This multicenter cross-sectional study included hepatitis C virus genotype 1 monoinfected patients treated with Peg-interferon, ribavirin, and either boceprevir (n=158) or telaprevir (n=557) between July 2013 and April 2014 at 15 reference centers in Brazil. Demographic, clinical, virological, and adverse events data were collected during treatment and follow-up. RESULTS: Of the 715 patients, 59% had cirrhosis and 67.1% were treatment-experienced. Based on intention-to-treat analysis, the overall sustained viral response was 56.6%, with similar effectiveness in both groups (51.9% for boceprevir and 58% for telaprevir, p=0.190). Serious adverse events occurred in 44.2% of patients, and six deaths (0.8%) were recorded. Cirrhotic patients had lower sustained viral response rates than non-cirrhotic patients (46.9% vs. 70.6%, p 465 years, diagnosis of cirrhosis, and abnormal hemoglobin levels/platelet counts prior to treatment were associated with serious adverse events. CONCLUSION: Although serious adverse events rates were higher in this infected population, sustained viral response rates were similar to those reported for other patient cohorts.Univ Sao Paulo, Fac Med, Dept Molestias Infecciosas & Parasitarias, Sao Paulo, SP, BrazilUniv Fed Rio de Janeiro, Rio De Janeiro, RJ, BrazilCtr Referencia & Treinamento DST Aids, Sao Paulo, SP, BrazilCDH, Rio De Janeiro, RJ, BrazilHosp Fed Servidores Estado Rio de Janeiro HFSE, Setor Gastrohepatol, Rio De Janeiro, RJ, BrazilUniv Sao Paulo, Fac Med, Dept Gastroenterol & Hepatol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Disciplina Gastroenterol, EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Disciplina Infectol, Sao Paulo, SP, BrazilUniv Sao Paulo, FMRP, Dept Clin Med, Div Gastroenterol, Sao Paulo, SP, Brazil| Univ Fed do Maranhao UFMA, HUPD, Ctr Pesquisa Clin, Sao Luis, MA, BrazilUniv Fed Estado Rio de Janeiro UNIRIO, Disciplina Clin Med & Gastroenterol, Rio De Janeiro, RJ, BrazilUniv Fed Rio do Grande Sul UFRGS, Dept Med Interna, Porto Alegre, RS, BrazilUniv Fed Espirito Santo, Ambulatorio HIV AIDS Hepatites Virais, Vitoria, ES, BrazilSMS, Ctr Orientacao & Aconselhamento, Foz Do Iguacu, PR, BrazilUniv Estado Rio de Janeiro UERJ, Serv Gastroenterol, Rio De Janeiro, RJ, BrazilIMT, Lab Virol LIM 52, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Disciplina Gastroenterol, EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Disciplina Infectol, Sao Paulo, SP, BrazilWeb of Scienc

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Photobiomodulation reduces the cytokine storm syndrome associated with Covid-19 in the zebrafish model

Although the exact mechanism of the pathogenesis of COVID-19 is not fully understood, oxidative stress and the release of pro-inflammatory cytokines have been highlighted as playing a vital role in the pathogenesis of the disease. In this sense, alternative treatments are needed to reduce the inflammation caused by COVID-19. Therefore, this study aimed to investigate the potential effect of red PBM as an attractive therapy to downregulate the cytokine storm caused by COVID-19 from a zebrafish model. RT-PCR analyses and protein-protein interaction prediction among SARS-CoV-2 and Danio rerio proteins showed that rSpike was responsible for generating systemic inflammatory processes with significantly increased pro-inflammatory (il1b, il6, tnfa, and nfkbiab), oxidative stress (romo1) and energy metabolism (slc2a1a, coa1) mRNA markers, with a pattern like those observed in COVID-19 cases in humans. On the other hand, PBM treatment decreased the mRNA levels of these pro-inflammatory and oxidative stress markers compared with rSpike in various tissues, promoting an anti-inflammatory response. Conversely, PBM promotes cellular and tissue repair of injured tissues and significantly increases the survival rate of rSpike-inoculated individuals. Additionally, metabolomics analysis showed that the most impacted metabolic pathways between PBM and the rSpike-treated groups were related to steroid metabolism, immune system, and lipids metabolism. Together, our findings suggest that the inflammatory process is an incisive feature of COVID-19, and red PBM can be used as a novel therapeutic agent for COVID-19 by regulating the inflammatory response. Nevertheless, the need for more clinical trials remains, and there is a significant gap to overcome before clinical trials.publishedVersio