Determination of vitamin A in the milk of donor mothers from the human milk bank (hmb) in Manaus/AM: Effect of processing

This study treats a transversal, descriptive, observational and analytical study with the objective of determining the Vitamin A chemical content in Human Maternal Milk (HMM) of 50 donor mothers from the Ana Braga Maternity Human Milk Bank (HMB), in Manaus, Amazonas. Samples were collected weekly and maintained frozen until pasteurization. Analyses of retinol and β-carotene in human milk were undertaken before and after the treatment (pasteurization), chromatographic method. Aliquots of approximately 5 mL of milk were taken from each sample. The babies included in the study were weight > 2500g. The Vitamin A concentration in the milk, before and after the processing, was found to be insufficient for that required (46.57 ± 6.28 µg/dL and 31.55 ± 8.29 µg/dL respectively) for children who feed exclusively on HMB milk, notably premature babies, whose Vitamin A requirements are greater and whose capacity for ingesting milk is lower than that of fully born babies. The loss of Vitamin A through processing was, in this study, 32.51%. To guarantee hepatic reserves and protect against deficiencies, it would be necessary that the vitamin A concentration in the milk be higher than 80 µg/dL.Esse estudo teve como objetivo determinar os teores de vitamina A no Leite Humano Materno (LHM), de 50 mães doadoras do Banco de Leite Humano (BLH), da Maternidade Ana Braga, em Manaus-AM. As amostras foram coletadas semanalmente e mantidas congeladas até a pasteurização. As análises de retinol e β-caroteno no leite humano foram realizadas antes e após o tratamento (pasteurização), mediante o método cromatográfico. Foram retiradas alíquotas de 5 mL aproximadamente de leite de cada amostra. Os pesos dos bebês ao nascer das mães doadoras de leite incluídos no estudo foram > 2500g. A concentração de vitamina A no leite tanto antes quanto após o processamento, não foram suficientes para suprir o requerimento (46,75 ± 6,28 μg/dL e 31,55 ± 8,29 μg/dL, respectivamente), de crianças que se alimentam exclusivamente do leite do BLH, notadamente as pré-termo, cujos requerimentos de vitamina A são maiores e a capacidade de ingerir leite é menor do que os nascidos a termo. A perda de vitamina A pelo processamento, em nosso estudo foi de 32,51%. Para garantir a formação de reservas hepáticas e a proteção contra deficiência de vitamina A, seriam necessárias concentrações dessa vitamina no leite superiores a 80 μg/dL

Recurrent respiratory papillomatosis: clinical characteristics and viral genotyping in a Brazilian population

This study presents 25 cases of recurrent respiratory papillomatosis (RRP) that occurred in Sao Luis, Maranhao State, Northeast region, Brazil, between January 2007 and December 2018. Sociodemographic and clinical profile of patients as well as human papillomavirus (HPV) infection status were evaluated. Clinical and histopathological data were collected from the patients’ medical records. For the HPV infection analysis, DNA was extracted and subjected to amplification by a nested polymerase chain reaction. Viral genotyping was performed by automated sequencing. The median age of patients was 12.40 ± 12.6. years, and the juvenile form of the disease (68%) was the predominant form of disease. Female participants were predominant (60%), and they were from cities located in the interior of the State (60%). The most common clinical manifestation was dysphonia; recurrence was observed in most cases (56%), and tracheostomy was necessary in seven patients (26.9%). When comparing the RRP forms, patients in the juvenile-RRP group had higher recurrence rates and need of tracheostomy than those in the adult-RRP group. The viral genotyping analysis revealed that 47.8% of patients had low-risk HPVs, whereas 13.1% had high-risk HPVs, and in 39.1% of patients the viral genotype was not obtained. HPV-6 was the most prevalent type and Juvenile-RRP was more prevalent in our population. HPV was present at a high rate, and HPV-6 was the predominant genotype. This study serves as the basis for further studies to be conducted in the Brazilian population. Our findings aid the better understanding of RRP, possibly suggesting some prognostic factors associated with the disease aggressiveness

Elaboração de Informes Técnicos sobre o uso de medicamentos na COVID-19: um trabalho colaborativo de Centros de Informações sobre Medicamentos do Brasil

Introduction: There is an urgency to have drugs capable of treating COVID-19. However, there are still shortages of studies and difficulties in accessing secure information. Drug Information Centers (DIC) operate in the production and dissemination of quality, objective, and timely information, based on the best scientific evidence. Objective: To describe the collaborative experience of preparing Technical Notes (TN) and Drugs Alerts (DA) on the use of medicines at COVID-19, carried out by members of DICs in Brazil. Method: This is an experience report of a descriptive and analytical type, with a qualitative approach. The profile of the participating DICs and their professionals were initially analyzed, and then the method adopted for conducting the work from March to June 2020 was presented. Results: Four DICs from the Northeast of Brazil participated in this experience, that of the Federal University of Vale São Francisco, the Federal University of Sergipe Lagarto campus, the Federal University of Ceará and the DIC of the Regional Pharmacy Council of Bahia. The stages of the TN development process were: 1) Definition of the TN objectives; 2) Selection of themes; 3) Search for information; 4) Construction process and description of the TNs; 5) Review and 6) Publication of TNs. Four TNs were produced, on antihypertensive and non-steroidal anti-inflammatory drugs; hydroxychloroquine or chloroquine; ivermectin and, vitamin D, in addition, a DA about ivermectin and your potential to cause neurotoxicity. Conclusions: The experience of this collaborative work demonstrates that DICs are playing an important role in combating the pandemic by the new coronavirus and infodemic, promoting quality information, based on the best evidence.Introdução: Há uma urgência em se ter medicamentos capazes de tratar a COVID-19, mas existe ainda carência de estudos e dificuldades no acesso a informações seguras. Os Centros de Informações sobre Medicamentos (CIM) atuam na produção e difusão de informações de qualidade, baseadas nas melhores evidências científicas. Objetivo: Descrever a experiência colaborativa da elaboração de notas técnicas (NT) e de alerta de medicamento (AM) sobre a utilização de medicamentos na COVID-19, realizada por membros de CIM do Brasil. Método: Trata-se de um relato de experiência do tipo descritivo e analítico, com abordagem qualitativa. Foi analisado inicialmente o perfil dos CIM participantes e de seus profissionais envolvidos, e então apresentado o método adotado para a condução do trabalho, que foi realizado entre março a junho de 2020. Resultados: Participaram quatro CIM do Nordeste brasileiro: o da Universidade Federal do Vale do São Francisco, o da Universidade Federal de Sergipe, campus Lagarto, o da Universidade Federal do Ceará e o CIM do Conselho Regional de Farmácia da Bahia. As etapas do processo de desenvolvimento dos documentos técnicos foram: 1) Definição dos objetivos; 2) Seleção dos temas; 3) Busca de informação; 4) Processo de construção e descrição; 5) Revisão e 6) Publicização. Foram produzidas quatro NT e um AM. Conclusões: A experiência deste trabalho colaborativo demonstra que os CIM estão exercendo relevante papel no combate a pandemia pelo novo coronavírus e a infodemia, promovendo informação de qualidade, baseada nas melhores evidências

Growth patterns in early childhood: Better trajectories in Afro-Ecuadorians independent of sex and socioeconomic factors.

The first years of life are the most dynamic period for childhood growth. There are limited data available on growth patterns of infants and children living in rural Latin America. The aim of this study was to describe the growth patterns from birth to 5years in children living in a rural District of tropical coastal Ecuador using data from a birth cohort of 2404 neonates. We hypothesize that there would be growth differences according to ethnicity and sex. Evaluations were conducted at birth or until 2weeks of age and at 7, 13, 24, 36 and 60months during clinic and home visits. Individual growth trajectories for weight-for-age, height-for-age and weight/height-for-age Z-scores were estimated using multilevel models. Girls were lighter and shorter than boys at birth. However, Afro-Ecuadorian children (versus mestizo or indigenous) were longer/taller and heavier throughout the first 5years of life and had greater mean trajectories for HAZ and WAZ independent of sex and socioeconomic factors. Our data indicate that ethnicity is a determinant of growth trajectories during the first 5years of life independent of socioeconomic factors in a birth cohort conducted in a rural region of Latin America

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19 : first results of ReumaCoV Brasil registry

Objectives To evaluate risk factors associated with unfavourable outcomes: emergency care, hospitalisation, admission to intensive care unit (ICU), mechanical ventilation and death in patients with immune-mediated rheumatic disease (IMRD) and COVID-19. Methods Analysis of the first 8 weeks of observational multicentre prospective cohort study (ReumaCoV Brasil register). Patients with IMRD and COVID-19 according to the Ministry of Health criteria were classified as eligible for the study. Results 334 participants were enrolled, a majority of them women, with a median age of 45 years; systemic lupus erythematosus (32.9%) was the most frequent IMRD. Emergency care was required in 160 patients, 33.0% were hospitalised, 15.0% were admitted to the ICU and 10.5% underwent mechanical ventilation; 28 patients (8.4%) died. In the multivariate adjustment model for emergency care, diabetes (prevalence ratio, PR 1.38; 95% CI 1.11 to 1.73; p=0.004), kidney disease (PR 1.36; 95% CI 1.05 to 1.77; p=0.020), oral glucocorticoids (GC) (PR 1.49; 95% CI 1.21 to 1.85; p50 years (PR 1.89; 95% CI 1.26 to 2.85; p=0.002), no use of tumour necrosis factor inhibitor (TNFi) (PR 2.51;95% CI 1.16 to 5.45; p=0.004) and methylprednisolone pulse therapy (PR 2.50; 95% CI 1.59 to 3.92; p<0.001); for ICU admission, oral GC (PR 2.24; 95% CI 1.36 to 3.71; p<0.001) and pulse therapy with methylprednisolone (PR 1.65; 95% CI 1.00 to 2.68; p<0.043); the two variables associated with death were pulse therapy with methylprednisolone or cyclophosphamide (PR 2.86; 95% CI 1.59 to 5.14; p<0.018). Conclusions Age >50 years and immunosuppression with GC and cyclophosphamide were associated with unfavourable outcomes of COVID-19. Treatment with TNFi may have been protective, perhaps leading to the COVID-19 inflammatory process

Transtorno bipolar em crianças: análise de relato de caso 2018-2023

O transtorno bipolar em crianças é uma realidade clínica que demanda atenção especializada. A compreensão dos sintomas, fatores de risco, prevalência e desafios diagnósticos é fundamental para proporcionar intervenções precoces e adequadas, visando melhorar a qualidade de vida desses jovens e reduzir o impacto a longo prazo dessa condição psiquiátrica. Trata-se de um estudo cujo objetivo foi objetivo revisar relatos de caso publicados entre 2018 e 2023 sobre transtorno bipolar em crianças, identificando o estado da arte desses estudos. Para isso, se realizou uma revisão sistemática de literatura utilizando as bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SCIELO). Com a análise e interpretação qualitativa dos resultados, a principal conclusão deste estudo é que o transtorno bipolar na infância é uma condição complexa, manifestando-se com comportamentos consistentes com o Transtorno de Conduta e sendo influenciado por fatores ambientais, familiares e genéticos. O tratamento eficaz requer uma abordagem multidisciplinar, integrando intervenções farmacológicas e não farmacológicas, personalizadas conforme as necessidades individuais. A supervisão familiar é crucial para a adesão ao tratamento, mas reconhece-se a necessidade contínua de pesquisa para aprimorar as estratégias terapêuticas diante da diversidade de casos

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio