Presence of functional angiotensin II receptor and angiotensin converting enzyme in the aorta of the snake Bothrops jararaca

AbstractAimAngiotensin II (Ang II) interacts with AT1 and AT2 receptors and, in some vertebrates, with an Ang II binding site showing low affinity for AT1 and AT2 receptor antagonists. This study was carried out to characterize the Ang II receptor, and the presence of an angiotensin-converting enzyme (ACE) in the aorta of the Bothrops jararaca snake.Main methodContraction induced by Ang I or II in aortic ring from the snake was evaluated in the absence or in the presence of ACE-blocker or Ang II antagonists.Key findingsAng II analogs, modified at positions 1 and 5, induced vasoconstriction with differences in their potencies. The relative rank order was: [Asp1, Val5] Ang II=[Asp1, Ile5] Ang II⋙[Asn1, Val5] Ang II. ACE-like activity was detected, as well as an Ang II receptor with low affinity for AT1 and AT2 selective receptor antagonists (pKB values of 5.62±0.23 and 5.08±0.25). A disulfide reducing agent almost abolished the Ang II effect, while an alpha adrenoceptor antagonist, or removing the endothelium, did not modify the Ang II effect. These results indicate that the B. jararaca aorta has an Ang II receptor pharmacologically distinct from AT1 and AT2 receptors, and the vasoconstrictor effect observed is independent of catecholamine or endothelium modulation. ACE and the AT receptor in the aorta of B. jararaca may be part of a tissue renin–angiotensin system.SignificanceThe data contribute to the knowledge of the renin–angiotensin system in vertebrate species, and provide insight into the understanding of snake Ang II receptor characteristics and diversity

Gestão da qualidade: um estudo de caso em um restaurante do Alto Paranaíba com foco na gestão da rotina / Quality management: a case study in a restaurant in Alto Paranaíba with a focus on routine management

O presente trabalho tem o objetivo de alinhar teoria e prática, visando verificar se há a existência de práticas de gestão da qualidade e gestão da rotina, em um bar e restaurante. Para isso foi feito um mapeamento dos processos e micro processos do setor da cozinha do restaurante. Buscando propor melhorias a esses problemas relatados ao grupo. E assim verificando a viabilidade de implementação de abordagens de gestão da qualidade na empresa. Por meio da entrevista com o gerente da empresa, foi possível verificar, que não são executadas praticas das abordagens da gestão da qualidade, identificando assim, falhas no seu processo decorrentes da falta de estoque. Em consequência disso definiu-se um microprocesso prioritário, o processo em questão foi o pedido de matéria-prima feito semanalmente. Analisou-se então as questões necessárias para a aplicação do gerenciamento da rotina em conjunto com o ciclo PDCA

Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil

Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible

Platelet-rich fibrin for wound healing of palatal donor sites of free gingival grafts : systematic review and meta-analysis

Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the c

HIV-1 heterosexual transmission and association with sexually transmitted infections in the era of treatment as prevention

Objectives: HIV-1 heterosexual transmission among individuals on antiretroviral treatment (ART) with undetectable viremia is extremely rare. The aim of this study was to evaluate the risk of sexual HIV-1 transmission and other sexually transmitted infections (STIs) in HIV-1 serodifferent couples while the index partner is on ART. Methods: HIV transmission was evaluated in 200 HIV-1 heterosexual serodifferent couples in a stable relationship (≥3 months). All HIV-positive individuals had been on ART for ≥3 months and had been followed up for a median preceding time of 4.5 years (range 0.3–16 years) at the HIV couples clinic at Hospital Nossa Senhora da Conceição in Porto Alegre, Brazil. Following written informed consent, participants responded to demographic/behavioral questionnaires. Quantitative PCR for HIV RNA, T-cell subsets, and STI testing (syphilis, herpes, human papillomavirus, gonorrhea, and bacterial vaginosis) were performed. Self-collected vaginal swabs were obtained for quantitative HIV genital viral load testing. Results: Among 200 couples, 70% of index partners were female. Five seroconversions were observed; the HIV infection incidence was 2.5% (95% confidence interval 0.8% to 5.7%). Mean plasma viral load results were higher in HIV transmitters compared to non-transmitters (p = 0.02). The presence of STIs was significantly greater in couples who seroconverted (60.0% vs. 13.3%; odds ratio 9.75, 95% confidence interval 1.55–61.2; p = 0.023). The duration of undetectable HIV viremia and presence of STIs were associated with HIV transmission. Conclusions: Undetectable viremia was the main factor associated with non-transmissibility of HIV in this setting

Antiretroviral adherence and virologic suppression in partnered and unpartnered HIV-positive individuals in southern Brazil

Background: An undetectable serum HIV-1 load is key to effectiveness of antiretroviral (ARV) therapy, which depends on adherence to treatment. We evaluated factors possibly associated with ARV adherence and virologic response in HIV-infected heterosexual individuals. Methods: A cross-sectional study was conducted in 200 HIV-1 serodiscordant couples and 100 unpartnered individuals receiving ARV treatment at a tertiary hospital in southern Brazil. All subjects provided written informed consent, answered demographic/behavioral questionnaires through audio computer-assisted self-interviews (ACASI), and collected blood and vaginal samples for biological markers and assessment of sexually transmitted infections (STIs). HIV-negative partners were counseled and tested for HIV-1. Results: The study population mean age was 39.9 years, 53.6% were female, 62.5% were Caucasian, 52.6% had incomplete or complete elementary education, 63.1% resided in Porto Alegre. Demographic, behavioral and biological marker characteristics were similar between couples and single individuals. There was an association between adherence reported on ACASI and an undetectable serum viral load (P<0.0001). Logistic regression analysis demonstrated that single-tablet ARV-regimens were independently associated with adherence (OR = 2.3; 95CI%: 1.2–4.4; P = 0.011) after controlling for age, gender, education, marital status, personal income, ARV regimen, and median time of ARV use. A positive correlation between genital secretion PCR results and serum viral load was significant in the presence of STIs (r = 0.359; P = 0.017). Although HIV PCR detection in vaginal secretions was more frequent in women with detectable viremia (9/51, 17.6%), it was also present in 7 of 157 women with undetectable serum viral loads (4.5%), p = 0.005. Conclusions: ARV single tablet regimens are associated with adherence. Detectable HIV-1 may be present in the genital secretions of women with undetectable viremia which means there is potential for HIV transmission in adherent individuals with serologic suppression

Perinatal characteristics and longer-term outcomes in Brazilian children with confirmed or suspected congenital Zika infection: ZIKAction Paediatric Registry

Background: Despite growing scientific knowledge of Zika virus (ZIKV) infection, questions remain regarding ZIKV infection in pregnancy and congenital ZIKV syndrome (CZS). Methods: The ZIKAction Paediatric Registry is an international registry of children with documented ZIKV exposure in utero and/or with confirmed or suspected CZS. Its aim is to characterize these children (i.e., clinical, radiological, neurodevelopmental features) and describe outcomes, longer-term sequelae and management through retrospective case note review. This analysis described the maternal and perinatal characteristics of children in the Registry’s Bahia arm, assessed their neuroimaging, ophthalmic, hearing and electroencephalography abnormalities by microcephaly classification and reported on hospitalisations. Children born in 2015-2018 and enrolled 2020-2021 in three public health facilities in Salvador were included. Results: Of 129 (57% female) children, 15 (11·6%) had laboratory-confirmed congenital ZIKV infection and 114 (88·4%) suspected CZS. At delivery, 15 (11·6%) were normocephalic, 30 (23·3%) moderately microcephalic, and 84 (65·1%) severely microcephalic. Median birth head circumference z-score was -3·51 [IQR, -4·69,-2·73]. During follow-up, all children had abnormal neuroimaging, 80·3% (94/117) abnormal electroencephalogram, 62·2% (77/120) ophthalmic abnormalities, and 27·4% (34/124) hearing impairment. Microcephaly classification was significantly associated with gestational age, and ophthalmological and electroencephalography abnormalities. Of 125 children with hospitalisation data, 52 (41·6%) had been hospitalised by most recent follow-up, at median age of 15·8 [4·0, 34·4] months; infections were the leading cause. Conclusion: Congenital ZIKV infection is an emerging disease with a varied and incompletely understood spectrum. Continued long-term follow-up is essential to understand longer-term prognosis and to inform future health and educational needs

Ocorrência de Listeria spp. em salame tipo Italiano comercializados em supermercados do bairro de Casa Amarela, Recife-PE

Atualmente, os alimentos prontos para consumo têm se popularizado. Isto se deve ao fato da conveniência e propriedades nutricionais encontradas nesses produtos. Embora sofram processamento tecnológico na fabricação, falhas higiênico-sanitárias podem se tornar um sério risco à saúde do consumidor devido à veiculação de patógenos. Dentre estes, destaca-se o gênero Listeria que tem importância para a indústria de alimentos e saúde pública. Assim, objetivou-se neste estudo a detecção de Listeria spp. em salames tipo Italiano fatiados, embalados a vácuo e comercializados em supermercados do bairro de Casa Amarela, Recife-PE. Foram coletadas 22 amostras de salames tipo Italiano fatiados, embalados a vácuo das três principais marcas brasileiras, estas foram analisadas de acordo com a metodologia da Instrução Normativa de nº62/2003 do Ministério da Agricultura Pecuária e Abastecimento.  Dentre as amostras estudadas foi detectada uma ocorrência de 13,64% (3/22), este dado revela possíveis falhas na elaboração do alimento estudado, além de evidenciar a presença de Listeria spp. em salames tipo Italiano fatiados e embalados a vácuo

Soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares no município de São Paulo, 2020

OBJECTIVE: To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS: A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS: Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4–17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6–20.6) and state (16.2%; 95%CI 14.4–18.2) public school systems compared to the private school system (11.7; 95%CI 10.0–13.7), among black and brown students (18.4%; 95%CI 16.8–20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9–20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION: Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.OBJETIVO: Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS: Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS: A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4–17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6–20,6) e estadual (16,2%; IC95% 14,4–18,2) em relação à rede privada (11,7; IC95% 10,0–13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8–20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9–20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO: A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal