Evaluation of Molecular Variability of Isolates of <em>Trypanosoma cruzi</em> in the State of Rio de Janeiro-Brazil

Trypanosoma cruzi, the etiological agent of Chagas disease, presents considerable heterogeneity among populations of isolates within the sylvatic and domestic cycle. This study aims to evaluate the genetic diversity of 14 isolates collected from specimens of Triatoma vitticeps from Triunfo, Conceição de Macabu, and Santa Maria Madalena cities (Rio de Janeiro—Brazil). By using PCR based on the mini-exon gene, all isolates showed a profile characteristic of bands zymodeme III and with a lower intensity characteristic of TcII. To verify possible hybrids among the strains analyzed, the polymorphisms analysis of the MSH2 gene was performed. HhaI restriction enzyme digestion products resulted in characteristic TcII fragments only, demonstrating the absence of hybrids strains. In our attempt to characterize isolation in accordance with the reclassification of T. cruzi into six new groups called DTUs (“discrete typing unit”), we genotyped the mitochondrial cytochrome oxidase subunit two gene, ribosomal RNA gen (24Sα rDNA), and the spliced leader intergenic region (SL-IR). This procedure showed that TcII, TcIII, and TcIV are circulating in this area. This highlights the diversity of parasites infecting specimens of T. vitticeps, emphasizing the habit of wild type and complexity of the region epidemiological study that presents potential mixed populations

Quedas em pacientes em hemodiálise: um estudo piloto prospectivo de 12 meses

Introduction: Complications caused by chronic kidney disease and hemodialysis (HD) increase the risk of falls. Objectives: The primary objective was to assess the incidence rate of falls over 12 months. The secondary objectives were to compare characteristics between patients with a history of falls and without a history of falls, and between fallers and recurrent fallers. Material and Methods: A 12 month longitudinal prospective pilot study was conducted with 43 patients on HD (54.9 ± 8.4 years; 58.1% male), assessed for physical function by the Mini Balance Evaluation Systems Test, Timed Up and Go, Gait Speed ​​Measured over 4m (4-MGS) and 10-repetitions sit-to-stand test, and later, observed for 12 months. The incidence rate was provided in falls/person-year and comparisons between groups were performed by the Student's t-test, Mann-Whitney U test or Chi-square. Results: The incidence rate of falls was 0.27 (IC95%: 0.09–0.45) falls/person-year. Patients with a history of falls (n= 33) had a higher prevalence of hyperparathyroidism (p= 0.024) and lower gait speed compared to those without a history of falls (p= 0.007). Recurrent fallers patients (n= 5) were older (p = 0.043) and had a lower hemoglobin level (p= 0.032) compared to fallers. The 4-MGS had a sensitivity of 80% and specificity of 78.8% to discriminate patients with and without history of falls. Conclusion: The incidence rate of falls was 0.27 falls/person-year, and those with a history of falls have a higher prevalence of hyperparathyroidism and lower gait speed, and recurrent fallers are older and have a lower hemoglobin level. In addition, gait speed was able to discriminate patients with and without a history of falls.Introdução: Complicações causadas pela doença renal cônica e hemodiálise (HD) aumentam o risco de quedas. Objetivos: O objetivo primário foi avaliar a taxa de incidência de quedas em 12 meses. Os objetivos secundários foram comparar as características entre os pacientes com histórico de quedas e sem histórico de quedas, e entre caidores e caidores recorrentes. Material e Métodos: Estudo piloto longitudinal prospectivo de 12 meses conduzido com 43 pacientes em HD (54,9 ± 8,4 anos; 58,1% sexo masculino), avaliados quanto à função física pelo Mini Balance Evaluation Systems Test, Timed Up and Go, Gait Speed Measured over 4m (4-MGS) e teste de sentar e levantar de 10 repetições, e posteriormente, acompanhados durante 12 meses. A taxa de incidência foi fornecida em quedas/pessoa-ano e as comparações entre os grupos realizadas pelos testes t de Student não pareado, Mann-Whitney ou Qui-quadrado. Resultados: A taxa de incidência de quedas foi de 0,27 (IC95%: 0,09-0,45) quedas/pessoa-ano. Os pacientes com histórico de quedas (n= 33) apresentaram maior prevalência de hiperparatireoidismo (p= 0,024) e menor velocidade de marcha comparados aos sem histórico de quedas (p= 0,007). Os pacientes caidores recorrentes (n= 5) foram mais velhos (p= 0,043) e apresentaram menor nível de hemoglobina (p= 0,032) em relação aos caidores.  O 4-MGS apresentou sensibilidade de 80% e especificidade de 78,8% para discriminar pacientes com e sem história de quedas. Conclusão: A incidência de quedas foi de 0,27 quedas/pessoa-ano em pacientes em HD, sendo que aqueles com histórico de quedas possuem maior prevalência de hiperparatireoidismo e menor velocidade de marcha, e caidores recorrentes são mais velhos e possuem menor nível de hemoglobina. Além disso, a velocidade de marcha foi capaz de discriminar pacientes com e sem histórico de quedas

Equilíbrio postural de pacientes em hemodiálise comparados a indivíduos sem doença renal crônica: estudo transversal

Introduction: Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) show several factors that contribute to postural balance impairment and higher risk of falls. Objectives: To compare postural balance between HD patients and subjects without CKD, and to evaluate the factors associated with impairment of postural balance in these patients. Material and methods: A cross-sectional study was conducted, including a group of Hemodialysis patients (HG) (n= 39, 55.1 ± 7.7 years, 53.8% males) and a control group (CG) (n= 39, 55.3 ± 7.5 years, 53.8% male). Participants were submitted to the following evaluations: postural balance (Mini Balance Evaluation Systems Test - Mini-BESTest), functional mobility (Time Up and Go), gait speed (Gait Speed Measured over 4 m), muscle strength (handgrip and sit-to-stand test), and quality of life (36-Item Short Form Survey questionnaire). Results: The HG showed worse postural balance evaluated by Mini-BESTest score [22 (3) vs. 24 (2), p&lt;0.001) when compared to CG. Postural balance was significantly correlated with gait speed (r= 0.381, p= 0.017) and muscle strength evaluated by the sit-to-stand test (r= -0.358, p&lt;0.027). The linear regression showed an association between the postural balance and the gait speed. The multiple R-squared was 0.291 and the adjusted R-squared was 0.231. Conclusion: In the present study, HD patients showed worse postural balance when compared to the subjects without CKD. The postural balance was associated with gait speed in these patients.Introdução: Pacientes com doença renal crônica (DRC) em hemodiálise (HD) apresentam fatores que contribuem para alterações no equilíbrio postural, aumentando o risco de quedas. Objetivo: Comparar o equilíbrio postural de pacientes em HD com indivíduos sem DRC, bem como verificar os fatores associados a alterações do equilíbrio postural nesses pacientes. Material e métodos: Foi realizado estudo transversal que incluiu um grupo de pacientes com DRC em Hemodiálise (GH) (n= 39, 55,1 ± 7,7 anos, 53,8% do gênero masculino) e um grupo controle (GC) com indivíduos sem DRC (n= 39, 55,3 ± 7,5 anos, 53,8% do gênero masculino). Os participantes foram submetidos a avaliações de equilíbrio postural (Mini Balance Evaluation Systems Test – Mini-BESTest), mobilidade funcional (Time Up and Go), velocidade de marcha (Gait Speed Measured over 4m), força muscular (preensão palmar e teste de sentar e levantar de 10 repetições) e qualidade de vida (36-Item Short Form Survey). Resultados: O GH apresentou pior equilíbrio postural avaliado pelo escore do Mini-BESTest [22 (3) vs. 24 (2); p&lt;0,001] quando comparado ao GC. O equilíbrio postural nos pacientes em HD apresentou correlação significante com a velocidade de marcha (r= 0,381; p= 0,017) e a força muscular avaliada pelo teste de sentar e levantar (r= -0,358; p= 0,027). Na regressão linear múltipla foi observada associação do equilíbrio postural com a velocidade de marcha, sendo o coeficiente de determinação múltiplo de 0,291 e o coeficiente de determinação múltiplo ajustado de 0,231. Conclusão: Pacientes em HD apresentaram pior equilíbrio postural quando comparados a indivíduos sem DRC. O equilíbrio postural foi associado à velocidade de marcha nesses pacientes

Factors associated with fear of falling in hemodialysis patients

From PubMed via Jisc Publications RouterItem not available in this repository.Pelagia Koufaki - ORCID: 0000-0002-1406-3729 https://orcid.org/0000-0002-1406-3729Fear of falling (FOF) has important clinical and psychological consequences. This study evaluated the factors associated with FOF in hemodialysis patients and compared with the FOF reported by age-gender matched individuals without chronic kidney disease. This cross sectional study included hemodialysis group (n = 60, 55.4 ± 7.6 years, 55.0% male) and control group (n = 40, 55.1 ± 7.5 years, 52.5% male). FOF was assessed by the Falls Efficacy Scale International (FES-I). Physical function was evaluated using the Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go test, 4-m gait speed, isometric handgrip force and 10-repetition sit-to-stand test. The physical and mental components of quality of life was evaluated by 36-Item Short Form Health Survey. The FES-I score was higher in the hemodialysis group compared to the control group (28.2 ± 9.7 vs. 23.3 ± 5.1, p = 0.020). In addition, the prevalence of individuals with a higher concern about falling was greater in the hemodialysis group (41.7 vs. 17.5%, p = 0.033). Multiple linear regression showed that the FES-I score was associated with the Mini-BESTest score and the physical component summary of quality of life (coefficient of determination of 0.51 and an adjusted coefficient of determination of 0.46). FOF was associated with poor postural balance and reduced physical component of quality of life in patients on hemodialysis and these patients showed higher FOF compared to individuals without chronic kidney disease.Funder: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; Grant(s): 00153pubpu

Genomic epidemiology reveals how restriction measures shaped the SARS-CoV-2 epidemic in Brazil

Abstract Brazil has experienced some of the highest numbers of COVID-19 infections and deaths globally and made Latin America a pandemic epicenter from May 2021. Although SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, important gaps remain in our understanding of local virus transmission dynamics. Here, we describe the genomic epidemiology of SARS-CoV-2 using near-full genomes sampled from 27 Brazilian states and an adjacent country - Paraguay. We show that the early stage of the pandemic in Brazil was characterised by the co-circulation of multiple viral lineages, linked to multiple importations predominantly from Europe, and subsequently characterized by large local transmission clusters. As the epidemic progressed, the absence of effective restriction measures led to the local emergence and international spread of Variants of Concern (VOC) and under monitoring (VUM), including the Gamma (P.1) and Zeta (P.2) variants. In addition, we provide a preliminary genomic overview of the epidemic in Paraguay, showing evidence of importation from Brazil. These data reinforce the need for the implementation of widespread genomic surveillance in South America as a toolkit for pandemic monitoring and providing a means to follow the real-time spread of emerging SARS-CoV-2 variants with possible implications for public health and immunization strategies