REPERCUSSÕES DA DISLIPIDEMIA NA POPULAÇÃO INFANTO-JUVENIL: UMA REVISÃO DE LITERATURA

The scope of the present work is to highlight the repercussions of dyslipidemia in the children and youth population, considering the increase of risk factors in the last decades and its consequences. It was observed that the main pathological implication of dyslipidemia is atherosclerosis and coronary artery disease (CAD), one of the leading causes of death in developed countries and closely linked to genetic and environmental factors, overweight and dietary error. However, in the analyzed articles it was found that the elevation of cholesterol levels correlates with the development of cardiovascular risks during childhood and adolescence, whose repercussions may affect the young adult phase, leading to diseases such as atherosclerosis. It is concluded that the screening of this population and diagnosis through the measurement of the lipid profile are fundamental for the implementation of strategies capable of reducing the incidence of diseases and preventing the occurrence of cardiovascular diseases in the subsequent years of their lives, besides treating, if necessary, through the use of statin drugs or fibrates, depending on the patient's cardiovascular risk and the type of dyslipidemia presented.El objetivo del presente trabajo es evidenciar las repercusiones de la dislipidemia en la población infanto-juvenil, ante el aumento de los factores de riesgo en las últimas décadas y sus consecuencias. Se ha observado que la principal implicación patológica de la dislipidemia es la aterosclerosis y la enfermedad arterial coronaria (EAC), una de las principales causas de muerte en los países desarrollados y que está estrechamente relacionada con factores genéticos y ambientales, el sobrepeso y los errores dietéticos. Sin embargo, en los artículos analizados se encontró que la elevación de los niveles de colesterol se correlaciona con el desarrollo de riesgos cardiovasculares durante la infancia y la adolescencia, cuyas repercusiones pueden afectar a la fase de adulto joven, dando lugar a enfermedades como la aterosclerosis. Se concluye que el cribado de esta población y el diagnóstico a través de la medición del perfil lipídico son fundamentales para la puesta en marcha de estrategias capaces de reducir la incidencia de enfermedades y prevenir la aparición de enfermedades cardiovasculares en los años posteriores de su vida, además de tratar, si es necesario, mediante el uso de fármacos estatinas o fibratos, en función del riesgo cardiovascular del paciente y del tipo de dislipidemia que presente.O escopo do presente trabalho é evidenciar as repercussões da dislipidemia na população infanto-juvenil, tendo em vista o aumento dos fatores de risco nas últimas décadas e suas consequências. Observou-se que a principal implicação patológica das dislipidemias são a aterosclerose e a doença arterial coronariana (DAC), uma das principais causas de morte nos países desenvolvidos e intimamente ligadas a fatores genéticos, ambientais, excesso de peso e erro alimentar. Entretanto, nos artigos analisados constatou-se que a elevação dos níveis de colesterol apresenta correlação com o desenvolvimento de riscos cardiovasculares durante a infância e adolescência, cuja repercussão pode afetar a fase jovem adulta, acarretando doenças como a aterosclerose. Conclui-se que, a triagem desta população e diagnóstico através da dosagem de perfil lipídico são fundamentais para implementação de estratégias capazes de reduzir a incidência de agravos e prevenir a ocorrência de doenças cardiovasculares nos anos sequenciais de suas vidas, além de tratar, caso necessário, através de medicamentos à base de estatinas ou fibratos a depender do risco cardiovascular do paciente e o tipo de dislipidemia apresentado. O escopo do presente trabalho é evidenciar as repercussões da dislipidemia na população infanto-juvenil, tendo em vista o aumento dos fatores de risco nas últimas décadas e suas consequências. Observou-se que a principal implicação patológica das dislipidemias são a aterosclerose e a doença arterial coronariana (DAC), uma das principais causas de morte nos países desenvolvidos e intimamente ligadas a fatores genéticos, ambientais, excesso de peso e erro alimentar. Entretanto, nos artigos analisados constatou-se que a elevação dos níveis de colesterol apresenta correlação com o desenvolvimento de riscos cardiovasculares durante a infância e adolescência, cuja repercussão pode afetar a fase jovem adulta, acarretando doenças como a aterosclerose. Conclui-se que, a triagem desta população e diagnóstico através da dosagem de perfil lipídico são fundamentais para implementação de estratégias capazes de reduzir a incidência de agravos e prevenir a ocorrência de doenças cardiovasculares nos anos sequenciais de suas vidas, além de tratar, caso necessário, através de medicamentos à base de estatinas ou fibratos a depender do risco cardiovascular do paciente e o tipo de dislipidemia apresentado.

REPERCUSSÕES DA DISLIPIDEMIA NA POPULAÇÃO INFANTO-JUVENIL: UMA REVISÃO DE LITERATURA

The scope of the present work is to highlight the repercussions of dyslipidemia in the children and youth population, considering the increase of risk factors in the last decades and its consequences. It was observed that the main pathological implication of dyslipidemia is atherosclerosis and coronary artery disease (CAD), one of the leading causes of death in developed countries and closely linked to genetic and environmental factors, overweight and dietary error. However, in the analyzed articles it was found that the elevation of cholesterol levels correlates with the development of cardiovascular risks during childhood and adolescence, whose repercussions may affect the young adult phase, leading to diseases such as atherosclerosis. It is concluded that the screening of this population and diagnosis through the measurement of the lipid profile are fundamental for the implementation of strategies capable of reducing the incidence of diseases and preventing the occurrence of cardiovascular diseases in the subsequent years of their lives, besides treating, if necessary, through the use of statin drugs or fibrates, depending on the patient's cardiovascular risk and the type of dyslipidemia presented.El objetivo del presente trabajo es evidenciar las repercusiones de la dislipidemia en la población infanto-juvenil, ante el aumento de los factores de riesgo en las últimas décadas y sus consecuencias. Se ha observado que la principal implicación patológica de la dislipidemia es la aterosclerosis y la enfermedad arterial coronaria (EAC), una de las principales causas de muerte en los países desarrollados y que está estrechamente relacionada con factores genéticos y ambientales, el sobrepeso y los errores dietéticos. Sin embargo, en los artículos analizados se encontró que la elevación de los niveles de colesterol se correlaciona con el desarrollo de riesgos cardiovasculares durante la infancia y la adolescencia, cuyas repercusiones pueden afectar a la fase de adulto joven, dando lugar a enfermedades como la aterosclerosis. Se concluye que el cribado de esta población y el diagnóstico a través de la medición del perfil lipídico son fundamentales para la puesta en marcha de estrategias capaces de reducir la incidencia de enfermedades y prevenir la aparición de enfermedades cardiovasculares en los años posteriores de su vida, además de tratar, si es necesario, mediante el uso de fármacos estatinas o fibratos, en función del riesgo cardiovascular del paciente y del tipo de dislipidemia que presente.O escopo do presente trabalho é evidenciar as repercussões da dislipidemia na população infanto-juvenil, tendo em vista o aumento dos fatores de risco nas últimas décadas e suas consequências. Observou-se que a principal implicação patológica das dislipidemias são a aterosclerose e a doença arterial coronariana (DAC), uma das principais causas de morte nos países desenvolvidos e intimamente ligadas a fatores genéticos, ambientais, excesso de peso e erro alimentar. Entretanto, nos artigos analisados constatou-se que a elevação dos níveis de colesterol apresenta correlação com o desenvolvimento de riscos cardiovasculares durante a infância e adolescência, cuja repercussão pode afetar a fase jovem adulta, acarretando doenças como a aterosclerose. Conclui-se que, a triagem desta população e diagnóstico através da dosagem de perfil lipídico são fundamentais para implementação de estratégias capazes de reduzir a incidência de agravos e prevenir a ocorrência de doenças cardiovasculares nos anos sequenciais de suas vidas, além de tratar, caso necessário, através de medicamentos à base de estatinas ou fibratos a depender do risco cardiovascular do paciente e o tipo de dislipidemia apresentado. O escopo do presente trabalho é evidenciar as repercussões da dislipidemia na população infanto-juvenil, tendo em vista o aumento dos fatores de risco nas últimas décadas e suas consequências. Observou-se que a principal implicação patológica das dislipidemias são a aterosclerose e a doença arterial coronariana (DAC), uma das principais causas de morte nos países desenvolvidos e intimamente ligadas a fatores genéticos, ambientais, excesso de peso e erro alimentar. Entretanto, nos artigos analisados constatou-se que a elevação dos níveis de colesterol apresenta correlação com o desenvolvimento de riscos cardiovasculares durante a infância e adolescência, cuja repercussão pode afetar a fase jovem adulta, acarretando doenças como a aterosclerose. Conclui-se que, a triagem desta população e diagnóstico através da dosagem de perfil lipídico são fundamentais para implementação de estratégias capazes de reduzir a incidência de agravos e prevenir a ocorrência de doenças cardiovasculares nos anos sequenciais de suas vidas, além de tratar, caso necessário, através de medicamentos à base de estatinas ou fibratos a depender do risco cardiovascular do paciente e o tipo de dislipidemia apresentado.

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

NS1 Antigenemia and Viraemia Load: Potential Markers of Progression to Dengue Fatal Outcome?

Submitted by Sandra Infurna ([email protected]) on 2018-09-18T15:40:27Z No. of bitstreams: 1 flaviaB_santos_etal_IOC_2018.pdf: 2392586 bytes, checksum: fb1781d3cf9eca6c46eaf0bf0538c74b (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2018-09-18T15:53:05Z (GMT) No. of bitstreams: 1 flaviaB_santos_etal_IOC_2018.pdf: 2392586 bytes, checksum: fb1781d3cf9eca6c46eaf0bf0538c74b (MD5)Made available in DSpace on 2018-09-18T15:53:05Z (GMT). No. of bitstreams: 1 flaviaB_santos_etal_IOC_2018.pdf: 2392586 bytes, checksum: fb1781d3cf9eca6c46eaf0bf0538c74b (MD5) Previous issue date: 2018Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Transmissores de Hematozoários. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Dengue is a worldwide problem characterized by a multifactorial pathogenesis. Considering the viral components, it is known that high viremia or high levels of the secreted nonstructural protein 1 (NS1) may be associated with a more severe disease. We aimed to characterize the NS1 antigenemia and viremia in dengue fatal and non-fatal cases, as potential markers of progression to a fatal outcome. NS1 antigenemia and viremia were determined in Brazilian dengue fatal cases (n = 40) and non-fatal cases (n = 40), representative of the four dengue virus (DENV) serotypes. Overall, the fatal cases presented higher NS1 levels and viremia. Moreover, the fatal cases from secondary infections showed significantly higher NS1 levels than the non-fatal ones. Here, irrespective of the disease outcome, DENV-1 cases presented higher NS1 levels than the other serotypes. However, DENV-2 and DENV-4 fatal cases had higher NS1 antigenemia than the non-fatal cases with the same serotype. The viremia in the fatal cases was higher than in the non-fatal ones, with DENV-3 and DENV-4 presenting higher viral loads. Viral components, such as NS1 and viral RNA, may be factors influencing the disease outcome. However, the host immune status, comorbidities, and access to adequate medical support cannot be ruled out as interfering in the disease outcome

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora