New records of Niceforo’s big-eared bat, Trinycteris nicefori (Sanborn, 1949) (Chiroptera, Phyllostomidae), from the state of Maranhão, Brazil

Niceforo’s big-eared bat, Trinycteris nicefori (Sanborn, 1949), is a monotypic species which has been recorded in a number of Brazilian states, but has a disjunct distribution in this country. This study presents the first record of T. nicefori in the Brazilian state of Maranhão. The specimens were collected in the municipalities of Godofredo Viana and Cândido Mendes, in fragments of the Amazon forest. One male (forearm: 38.00 mm, weight: 6 g) and one female (39.68 mm, 8 g) specimens were collected. The specimens presented chestnut-colored fur, and a chin with a pair of dermal pads arranged in a V-shape, without a central papilla. The COI gene sequences were plotted in the BOLD Systems platform, which confirmed the morphological identification of the species, with a 99.1% similarity in the male, and 99.4% in the female to existing sequences. This record extends the known distribution of T. nicefori in Brazil by approximately 310 km to the most eastern part of the Amazon Biome

Occurrence of Sturnira tildae De La Torre, 1959 (Chiroptera: Phyllostomidae) in the state of Maranhão, Brazil

The bat genus Sturnira is widely distributed in the Neotropical region, from northwestern Mexico to northern Argentina, and four species occur in Brazil: Sturnira lilium, Sturnira giannae, Sturnira magna, and Sturnira tildae. The present study is the first to record Sturnira tildae in the state of Maranhão, Brazil, based on morphological and molecular diagnoses. The specimen was identified based on its cranial and morphometric traits. The diagnostic traits include discreetly bilobed inner upper incisors with a broad base, lower first and second molars with lingual cusps separated by shallow grooves, and forearm longer than 45 mm. The molecular sequences of Cytochrome C Oxidase Subunit 1 (COI) and 16S rRNA genes confirmed the morphological identification and thus the occurrence of Sturnira tildae in the Amazon biome of Maranhão. This record represents an eastward extension of the known distribution of the species in the Amazonia, to Cândido Mendes, Maranhão, within an area dominated by dense rainforest and influenced by tides

First record of Eumops glaucinus (Wager, 1843) (Chiroptera, Molossidae) to the Brazilian state of Maranhão

The study provides the first record of Eumops glaucinus in the Maranhão state, located in the northern region of Brazil. The collected specimen was a non-lactating adult female, with grayish pelage, broad ears, smooth face, a well-developed and squarish tragus, and elongated snout. The combined analysis of the morphological and molecular data (COI, Cyt b, and rRNA 16S genes) confirmed the occurrence of E. glaucinus in the state of Maranhão. This record extends the known species range area by 660 km easternward from the closest locality, Belém, Pará

Transcriptome-based phylogenomic analysis reveals evidence of ancient hybridization events in the Mepraia genus (Hemiptera: Reduviidae: Triatominae)

IntroductionThe Mepraia genus is composed of three endemic species in Chile, namely Mepraia spinolai, Mepraia gajardoi, and Mepraia parapatrica, all capable of transmitting the causative agent of Chagas disease. Although species divergence within this genus is supported by morphological, molecular, and geological evidence, it has never been validated by genome-wide data.MethodsIn this sense, a pioneering phylogenomic study was conducted using transcriptome data of the three species, aiming to infer robust phylogenies and evaluate the impact of interspecific gene flow on the evolution of these insects. Our transcriptomes were used to robustly infer the phylogenetic relationships, employing multi-species coalescent and supermatrix approaches, as well as to investigate the occurrence of introgression.Results and discussionThe inferred phylogenies support the monophyly of the three described taxa and infer divergence times, although gene trees display high levels of discordance. Our results indicate widespread introgression among Mepraia lineages. Thus, our results support that Mepraia diversification occurred in a short period resulting in reticulate phylogenies and low genetic diversity. Additionally, we obtained evidence of introgression suggesting that ancient hybridization has had a major role in the evolution of the three Mepraia species

A estratificação e o manejo adequado da dor: Stratification and proper pain management

A dor é um potencial de risco para a saúde pública, esta se caracteriza pela experiência multidimensional associada a aspectos físicos e emocionais. A dor alerta o perigo e evita danos orgânicos, mas quando está impossibilita atividades diárias e impacta a qualidade de vida do paciente é classificada como patológica e urge por interferência médica. O seguinte artigo objetivou descrever através da revisão narrativa de literatura os aspectos referentes da dor e o seu manejo adequado. A dor é um amplo complexo que possui a classificação conforme a localização, tipo, intensidade, periodicidade. As categorias referentes a dor são nociceptivas, neuropática, psicogênica. Ademais, as síndromes dolorosas são diversas e podem acometer qualquer sistema do corpo. Ressaltando ser essencial a categorização do máximo possível de informações para conduzir adequadamente ao tratamento destas enfermidades.&nbsp

Consenso brasileiro para o tratamento da esclerose múltipla : Academia Brasileira de Neurologia e Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla

O crescent arsenal terapêutico na esclerose múltipla (EM) tem permitido tratamentos mais efetivos e personalizados, mas a escolha e o manejo das terapias modificadoras da doença (TMDs) tem se tornado cada vez mais complexos. Neste contexto, especialistas do Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla e do Departamento Científico de Neuroimunologia da Academia Brasileira de Neurologia reuniram-se para estabelecer este Consenso Brasileiro para o Tratamento da EM, baseados no entendimento de que neurologistas devem ter a possibilidade de prescrever TMDs para EM de acordo com o que é melhor para cada paciente, com base em evidências e práticas atualizadas. Por meio deste documento, propomos recomendações práticas para o tratamento da EM, com foco principal na escolha e no manejo das TMDs, e revisamos os argumentos que embasam as estratégias de tratamento na EM.The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS

Brazilian Consensus for the Treatment of Multiple Sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis

ABSTRACT The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS

Seminário de Dissertação (2024)

Página da disciplina de Seminário de Dissertação (MPPP, UFPE, 2022) Lista de participantes == https://docs.google.com/spreadsheets/d/1mrULe1y04yPxHUBaF50jhaM1OY8QYJ3zva4N4yvm198/edit#gid=

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable