Avaliação da mortalidade associada ao status tireoidiano em uma coorte de pessoas idosas eutireoidianas de ambulatório de geriatria em hospital universitário

Resumo Objetivo Avaliar associações entre a média da tireotropina (TSH) e tiroxina livre (T4L) mantida durante follow-up, e mortalidade em pacientes idosos eutireoidianos definidos de acordo com a faixa de referência específica para a idade (FR-e) do TSH. Método Coorte retrospectiva tipo análise de sobrevivência incluindo pacientes idosos eutireoidianos acompanhados no ambulatório de hospital universitário entre 2010 e 2013. Todos os participantes haviam sido avaliados quanto ao risco de incapacidade funcional como critério para admissão nesse ambulatório. As médias dos valores de TSH e T4L foram calculadas através das dosagens obtidas no período de acompanhamento. Cada FR-e de TSH foi dividida em quatro partes iguais, considerando níveis mais baixos como variável de exposição (≤1,75 mUI/L para <80 e ≤2,0 mUI/L para ≥80 anos). Os níveis de T4L foram dicotomizados em duas categorias (< e ≥1,37 ng/dL). O desfecho foi o tempo até a morte. A regressão de risco proporcional de Cox foi empregada para estimar a hazard ratio (HR) e o intervalo de confiança (IC) de 95% Resultados 285 participantes (73% mulheres, idade média =80,4 anos) seguidos pela mediana de 5,7 anos (IQR =3,7–6,4; máximo =7), sendo que 114 faleceram. Após o modelo final ajustado, a mortalidade esteve associada ao TSH no limite inferior (HR=1,7; IC=1,1–2,7; p=0,016) e ao T4L mais elevado. (HR=2,0; IC=1,0–3,8; p=0,052). Conclusão Níveis médios de T4L mais altos e de TSH mais baixos foram associados ao risco de morte em coorte de idosos eutireoidianos usando FR-e de TSH

First records of Ingoldian fungi from the Brazilian Amazon

Ingoldian fungi play an important ecological role by active participation in the decomposition of submerged leaves in aquatic ecosystems. These fungi produce conidia that are filiform, tetraradiate, multiradiate, scolecoid or sigmoid, which aid in the adaptation and dispersal in freshwater habitats. Despite their important ecological role in freshwater there have been no taxonomic and distributional studies of these fungi in the Brazilian Amazon. The aim of this study was to report new records of Ingoldian fungi to Americas, Brazil and Brazilian Amazon region. The fungal specimens were obtained from natural foam, found on the surface of streams in the “Reserva Ducke” (municipality of Manaus) and the “Balneário Marupiara” (municipality of Presidente Figueiredo) in Amazonas state, Brazil. The foam samples were transferred to slides and completely evaporated at room temperature. Lactic acid was added to the slides and covered using a glass cover slip and sealed with nail polish. Seventeen taxa were recorded. All identified taxa are new records: one new to the Americas (Tricladium curvisporum Descals), three new to Brazil (Condylospora flexuosa Nawawi and Kuthub., C. spumigena Nawawi and Dwayaangam cornuta Descals), and 13 new to the Brazilian Amazon region. Our study provides baseline data on the species composition of Ingoldian fungi from the Brazilian Amazon region, thereby enhancing the knowledge of aquatic mycology in this biodiversity hotspot. Descriptions, illustrations, geographical distribution patterns and comments are presented for all observed species. © 2015, Botanical Society of Sao Paulo

Validation study of obstetric hospitalization data held on the Brazilian National Health System Hospital Information System for maternal morbidity surveillance: Brazil, 2021-2022

ABSTRACT Objective To validate the Brazilian National Health System Hospital Information System (SIH/SUS) for maternal morbidity surveillance. Methods This was a cross-sectional study conducted in 2021/2022, taking as its reference a national study on maternal morbidity (MMG) conducted in 50 public and 28 private hospitals; we compared SIH/SUS and MMG data for hospitalization frequency, reason and type of discharge and calculated sensitivity, specificity, positive and negative likelihood ratios for seven diagnoses and four procedures. Results Hospitalizations identified on SIH/SUS (32,212) corresponded to 95.1% of hospitalizations assessed by MMG (33,867), with lower recording on SIH/SUS (85.5%) for private hospitals [10,036 (SIH/SUS)]; 11,742 (MMG)]; compared to MMG, SIH/SUS had a lower proportion of hospitalizations due to “complications during pregnancy” (9.7% versus 16.5%) as well as under-recording of all diagnoses and procedures assessed, except “ectopic pregnancy”. Conclusion Better recording of diagnoses and procedures on SIH/SUS is essential for its use in maternal morbidity surveillance

Desenvolvimento sustentável em publicações científicas brasileiras: uma revisão sistemática

O conceito de desenvolvimento sustentável vem sendo aprimorado ao longo das últimas décadas. A Organização das Nações Unidas (ONU) estabeleceu um conjunto de 17 objetivos para promover esse modelo de desenvolvimento incluído na Agenda 2030. De que maneira a temática desenvolvimento sustentável vem sendo abordada nos estudos científicos publicados em periódicos brasileiros? De que forma esses estudos relacionam-se com os 17 ODS? Este estudo objetivou demonstrar como o tema desenvolvimento sustentável vem sendo apresentado nos artigos científicos publicados no Brasil, ao longo dos últimos anos, e a relação desses com os ODS. Realizou-se uma revisão sistemática da literatura nos artigos nacionais publicados e depositados na plataforma SciELO, referentes ao período de 2014 a 2018, analisados qualitativamente. Os resultados apontaram uma elevação do caráter interdisciplinar e plural desses estudos, bem como de sua relação com os ODS em atendimento à evolução das demandas ambientais e da sociedade. Conclui-se que, apesar desse aumento de interdisciplinaridade, pluralidade e diversidade, ainda há poucas publicações sobre os temas estudados.The concept of sustainable development has been improved over the last few decades. The United Nations (UN) has established 17 objectives aimed at promoting this development model included in the 2030 Agenda. But how has the theme of sustainable development been addressed in scientific studies published in Brazilian periodicals? And how do these studies relate to the 17 SDG? This article aimed to demonstrate how sustainable development has been explained in scientific articles published in Brazil over the last few years and the relationship of these studies with the SDG. To this end, a systematic review of the literature was carried out in the national articles published and deposited on the SciELO platform, referring to the period from 2014 to 2018, analyzed qualitatively. The results indicated an increase in these studies' interdisciplinary and plural character and their relationship with the SDG in meeting the evolution of environmental and social demands. It is concluded that despite this increase in interdisciplinarity, plurality, and diversity, there are still few publications on the topics studied

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

How many women had abortion provoked in Brazilian capitals? Results of a national survey with the application of hierarchical models using indirect information based on the network of contacts

Made available in DSpace on 2019-01-03T17:45:29Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) natalia_santana.pdf: 2573427 bytes, checksum: 7c7d384c457fd3849220d5e5fb3191d7 (MD5) Previous issue date: 2018Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Introdução: O estudo do aborto provocado é de grande interesse em Saúde Pública, pois sabese que o aborto provocado, muitas vezes, inseguro, representa riscos indevidos para a saúde e a vida das mulheres, assim como gera consequências adversas, sociais e financeiras, para o sistema de saúde público e famílias. Dessa forma, é fundamental conhecer sua magnitude com o maior grau de precisão possível. Objetivo: Estimar o número de mulheres que fizeram abortos (provocados), nos últimos 12 meses anteriores à avaliação, nas 27 capitais brasileiras, com base em modelos hierárquicos, considerando o desenho amostral e a estrutura demográfica da população, além de informações indiretas baseadas na rede social de cada participante aleatoriamente selecionado da população em geral. Materiais e métodos: O presente projeto tem como fonte de dados a base de dados secundários de acesso restrito oriundos de Inquérito domiciliar nas 27 capitais em 2012, como parte de uma ampla Pesquisa Nacional sobre o uso de crack, já concluída. Os indivíduos amostrados aleatoriamente, via amostragem complexa, na população geral das 27 capitais brasileiras no inquérito domiciliar, que contemplou o emprego da metodologia “Network scale-up”, foram questionados sobre uma gama de perguntas. Dentre elas, a pergunta de interesse do presente projeto, foi: “Quantas mulheres você conhece que residem neste município e tiveram aborto provocado nos últimos 12 meses?”. Resultados: Das 13.611.082 mulheres de 15 a 49 anos residentes nas capitais do Brasil, 65.682 mulheres fizeram aborto provocado no período de 2011-2012, resultando numa incidência acumulada de 4,83 para cada 1.000 mulheres de 15 a 49 anos. Em média, as estimativas da incidência acumulada de mulheres que fizeram aborto foram superiores nas capitais das regiões Norte e Nordeste do Brasil, como pode ser visto em Boa Vista (RR) (9,81 IC95%[6,08; 14,60]), Aracaju (SE) (9,26 IC95%[5,66; 14,00]), São Luís (MA) (8,77 IC95%[5,47; 12,95]). No entanto, ao nível de 95% de credibilidade, não houve diferença significativa entre as estimativas nas capitais brasileiras. Conclusão: O abortamento provocado é uma prática recorrente entre as mulheres nas capitais brasileiras. A utilização de metodologias de estimação indireta é preferível em contextos de estigma e eventual criminalização, como mulheres que fizeram aborto nas capitais do Brasil, e o método Network Scale-up apresenta-se como um método promissor para estimar o tamanho de populações de difícil acesso, em diversas áreas do conhecimento, como a Saúde Pública.Introduction: The study about provoked abortion is a major Public Health interest. The provoked abortion, many times unsafe, represents a great risk in health and life for women, as well as generating adverse social and financial consequences for families and public health system. In this way, it is essential to know this magnitude with high accuracy as possible. Objective: The number of women that performed the provoked abortion in the last 12 months prior to the evaluation considering 27 State capitals in Brazil based on hierarchical models, considering the sample design and demographic structure of the population is estimate. In addition, indirect information based on the social network of each participant randomly choose from the population is considered. Materials and methods: The data source used is the secondary database of restricted access from household surveys in the 27 capitals in 2012. This database belongs to the National Survey about smoke crack, already accomplished. The individuals sampled randomly, through complex sampling, in the general population of the 27 Brazilian capitals in the household survey, which included the use of the "Network scale-up" methodology, were asked about a range of questions. The main question of interest in this thesis: "How many women do you know who live in this city and have had abortion in the last 12 months?" Results: From the total of 13,611,082 women aged 15-49 years living in the capitals of Brazil, 65,682 women induced provoked abortion in the period 2011-2012, resulting in a cumulative incidence of 4.83 per 1000 women aged 15-49 years. Cumulative incidence estimates of women that performed provoked abortion are considered high in the regions North and Northeast of Brazil, however, at the 95% level of credibility, there was no significant difference between estimates in Brazilian capitals. Conclusions: The practice of provoked abortion is recurrent among women in Brazilian. The use of indirect estimation methodologies is preferable in contexts of stigma and eventual criminalization, such women that induce an abortion in Brazilian capitals, and the Network Scale-up method is a promising method to estimate the size of populations that are difficult to access, in several areas of knowledge, such as Public Health

Modelo de regressão de Poisson com efeitos aleatórios na detecção de padrões de variação do risco de doenças utilizando o método INLA

O escopo do presente trabalho é demonstrar a utilização de alguns modelos de regressão de Poisson com efeitos aleatórios latentes na deteção de padrões de variação do risco de doenças ou agravos. A inferência será feita sob a ótica bayesiana usando o método INLA implementado no ambiente R. Tal método supera o MCMC em termos de acurácia e tempo computacional para modelos com campos aleatórios gaussianos latentes como por exemplo os espaciais e espaço-temporais. A aplicação aos dados de morbidade hospitalar do SUS e de mortalidade para doençaas do aparelho respiratório no estado do Rio de Janeiro no ano de 2003 exemplifica como modelos com efeitos aleatórios não-estruturados e/ou com estrutura espacial podem tratar a sobredispersão e reduzir a heterogeneidade presente nos dados. No caso dos dados da taxa de internação por doenças respiratórias, o modelo de regressão Poisson com efeitos aleatórios com estrutura espacial se mostrou o mais adequado enquanto para o ajuste da taxa de mortalidade por doenças respiratórias o modelo somente com efeitos aleatórios latentes foi o que mais se adequou. Em ambos modelos nenhuma das covariáveis disponíveis mostrou-se estatisticamente significativa

Telomere biology and telomerase mutations in cirrhotic patients with hepatocellular carcinoma

<div><p>Telomeres are repetitive DNA sequences at linear chromosome termini, protecting chromosomes against end-to-end fusion and damage, providing chromosomal stability. Telomeres shorten with mitotic cellular division, but are maintained in cells with high proliferative capacity by telomerase. Loss-of-function mutations in telomere-maintenance genes are genetic risk factors for cirrhosis development in humans and murine models. Telomerase deficiency provokes accelerated telomere shortening and dysfunction, facilitating genomic instability and oncogenesis. Here we examined whether telomerase mutations and telomere shortening were associated with hepatocellular carcinoma (HCC) secondary to cirrhosis. Telomere length of peripheral blood leukocytes was measured by Southern blot and qPCR in 120 patients with HCC associated with cirrhosis and 261 healthy subjects. HCC patients were screened for telomerase gene variants (in <i>TERT</i> and <i>TERC</i>) by Sanger sequencing. Age-adjusted telomere length was comparable between HCC patients and healthy subjects by both Southern blot and qPCR. Four non-synonymous <i>TERT</i> heterozygous variants were identified in four unrelated patients, resulting in a significantly higher mutation carrier frequency (3.3%) in patients as compared to controls (<i>p</i> = 0.02). Three of the four variants (T726M, A1062T, and V1090M) were previously observed in patients with other telomere diseases (severe aplastic anemia, acute myeloid leukemia, and cirrhosis). A novel <i>TERT</i> variant, A243V, was identified in a 65-year-old male with advanced HCC and cirrhosis secondary to chronic hepatitis C virus (HCV) and alcohol ingestion, but direct assay measurements <i>in vitro</i> did not detect modulation of telomerase enzymatic activity or processivity. In summary, constitutional variants resulting in amino acid changes in the telomerase reverse transcriptase were found in a small proportion of patients with cirrhosis-associated HCC.</p></div

Distribution of age-matched telomere length in healthy subjects and HCC mutated patients.

<p>Healthy subjects (n = 261) are represented as grey circles; patients carrying <i>TERT</i> variants (n = 4) are represented as colored circles. Telomere length given as <b>(A)</b> T/S ratio by qPCR <b>(B)</b> and kilobases (kb) by Southern blot.</p