Solitary fibrous tumor of the floor of the mouth

A solitary ?brous tumor (SFT) of the oral cavity is an extremely rare entity. Its diagnosis is complicated because of its diverse morphology and similarity to other mesenchymal diseases. A rare case of SFT involving floor of the mouth is presented. The tumor was well circumscribed and almost spherical, measuring approximately 3 cm in diameter. Patient was submitted to biopsy and histopathologic examination showed a tumor composed of spindle to epithelioid cells showing pale to eosinophilic cytoplasm, oval or elongated nuclei with inconspicuous nucleoli. Tumor cells showed strong positivity for CD34, vimentin and Bcl-2. SFTs may present as a diagnostic challenge. The patient was followed for 8 years without recurrences. SFT is an uncommon disease in maxillofacial region; however it should be considered in the differential diagnosis of spindle cell neoplasms with oral manifestation. Only a few cases have been reported in the floor of mouth. We describe a new case of SFT arising at this location

Non-thyroidal illness syndrome predicts outcome in adult critically ill patients : a systematic review and meta-analysis

We performed a systematic review and meta-analysis to comprehensively determine the prevalence and the prognostic role of non-thyroidal illness syndrome (NTIS) in critically ill patients. We included studies that assessed thyroid function by measuring the serum thyroid hormone (TH) level and in-hospital mortality in adult septic patients. Reviews, case reports, editorials, letters, animal studies, duplicate studies, and studies with irrelevant populations and inappropriate controls were excluded. A total of 6869 patients from 25 studies were included. The median prevalence rate of NTIS was 58% (IQR 33.2-63.7). In univariate analysis, triiodothyronine (T3) and free T3 (FT3) levels in non-survivors were relatively lower than that of survivors (8 studies for T3; standardized mean difference (SMD) 1.16; 95% CI, 0.41-1.92; I2 = 97%; P < 0.01). Free thyroxine (FT4) levels in non-survivors were also lower than that of survivors (12 studies; SMD 0.54; 95% CI, 0.31-0.78; I2 = 83%; P < 0.01). There were no statistically significant differences in thyrotropin levels between non-survivors and survivors. NTIS was independently associated with increased risk of mortality in critically ill patients (odds ratio (OR) = 2.21, 95% CI, 1.64-2.97, I2 = 65% P < 0.01). The results favor the concept that decreased thyroid function might be associated with a worse outcome in critically ill patients. Hence, the measurement of TH could provide prognostic information on mortality in adult patients admitted to ICU

Congenital Zika syndrome is associated with maternal protein malnutrition

Zika virus (ZIKV) infection during pregnancy is associated with a spectrum of developmental impairments known as congenital Zika syndrome (CZS). The prevalence of this syndrome varies across ZIKV endemic regions, suggesting that its occurrence could depend on cofactors. Here, we evaluate the relevance of protein malnutrition for the emergence of CZS. Epidemiological data from the ZIKV outbreak in the Americas suggest a relationship between undernutrition and cases of microcephaly. To experimentally examine this relationship, we use immunocompetent pregnant mice, which were subjected to protein malnutrition and infected with a Brazilian ZIKV strain. We found that the combination of protein restriction and ZIKV infection leads to severe alterations of placental structure and embryonic body growth, with offspring displaying a reduction in neurogenesis and postnatal brain size. RNA-seq analysis reveals gene expression deregulation required for brain development in infected low-protein progeny. These results suggest that maternal protein malnutrition increases susceptibility to CZS.Fil: Barbeito Andrés, Jimena. Universidade Federal do Rio de Janeiro; Brasil. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Pezzuto, Paula. Universidade Federal do Rio de Janeiro; BrasilFil: Higa, Luiza. Universidade Federal do Rio de Janeiro; BrasilFil: Dias, André Alves. Universidade Federal do Rio de Janeiro; BrasilFil: Vasconcelos, Janaina. Universidade Federal do Pará; BrasilFil: Santos, T. M. P.. Universidade Federal do Rio de Janeiro; BrasilFil: Ferreira, Jéssica. Universidade Federal do Rio de Janeiro; BrasilFil: Ferreira, R. O.. Universidade Federal do Rio de Janeiro; BrasilFil: Dutra, F. F.. Universidade Federal do Rio de Janeiro; BrasilFil: Rossi, A. D.. Universidade Federal do Rio de Janeiro; BrasilFil: Barbosa, R. V.. Universidade Federal Do Rio de Janeiro. Centro Nacional de Biologia Estrutural E Bioimagem.; BrasilFil: Amorim, C. K. N.. Evandro Chagas Institute; BrasilFil: de Souza, M. P. C.. Evandro Chagas Institute; BrasilFil: Chimelli, L.. Instituto Estadual do Cérebro Paulo Niemeyer ; BrasilFil: Aguiar, R. S.. Universidade Federal do Rio de Janeiro; BrasilFil: Gonzalez, Paula Natalia. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Lara, F. A.. Oswaldo Cruz Institute; BrasilFil: Castro, M.C.. Harvard University. Harvard School of Public Health; Estados UnidosFil: Molnár, Z.. University of Oxford; Reino UnidoFil: Lopes, R. T.. Universidade Federal do Rio de Janeiro; BrasilFil: Bozza, M. T.. Universidade Federal do Rio de Janeiro; BrasilFil: Vianez, J. L. S. G.. Evandro Chagas Institute; BrasilFil: Barbeito, Claudio Gustavo. Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Cuervo, P.. Oswaldo Cruz Institute; BrasilFil: Bellio, M.. Universidade Federal do Rio de Janeiro; BrasilFil: Tanuri, A.. Universidade Federal do Rio de Janeiro; BrasilFil: Garcez, P. P.. Universidade Federal do Rio de Janeiro; Brasi

Sinais e sintomas, manifestação clínica e diagnóstico do miocárdio não compactado: uma revisão sistemática

O objetivo desta revisão bibliográfica foi relatar o conhecimento atual sobre o miocárdio não compactado e fornecer uma análise crítica sobre as manifestações e os métodos diagnósticos. &nbsp; Para o desenvolvimento dessa pesquisa foi elaborada uma questão norteadora:&nbsp; ‘’Quais são os principais sinais e sintomas da &nbsp;Não Compactação do Ventrículo Esquerdo (NCVE), bem como quais são os métodos utilizados no diagnóstico e qual recurso terapêutico é utilizado na prática clínica? As buscas foram realizadas na base de dados PubMed Central (PMC) . Foram utilizados 5 descritores em combinação com o termo booleano “AND”: Isolated Noncompaction of the Ventricular Myocardium , Thrombosis, Signs and Symptoms, Pathological Conditions e Cardiomyopathies. Dessa forma, encontrados um total de 32 artigos, e que após a aplicação dos critérios de inclusão e exclusão foram selecionados 9 estudos para compor o estudo. A NCVE é caracterizada por insuficiência cardíaca, arritmias e alto risco de eventos embólicos. A prevalência de fibrilação atrial e taquiarritmias ventriculares é notável. O diagnóstico depende de critérios morfológicos específicos, sendo a ecocardiografia transtorácica e a ressonância magnética cardíaca as ferramentas diagnósticas principais. Há variações na identificação da NCVE entre os critérios ecocardiográficos, sugerindo a necessidade de um consenso diagnóstico mais padronizado. A identificação correta da NCVE é essencial para o manejo apropriado dos pacientes, visando reduzir complicações e melhorar a qualidade de vida

Índice de risco cirúrgico e infecção de ferida operatória em puérperas submetidas a cesarianas.

Backgound and Objectives: Considering the use of active surveillance assists in infection identification and the need for studies that use Surgical Risk Index (SRI) for assessment of Surgical Site Infection (SSI) in cesareans, this study aims to determine the incidence of SSI and analyze the applicability of SRI in the prediction of SSI in women in the postpartum period after being submitted to a cesarean section at a university hospital between April 2012 and March of 2013. Methods: Prospective cohort study. Information notifying SSI by active surveillance was collected daily from the medical records. After hospital discharge, the mothers were contacted through telephone calls to identify infection criteria within 30 days after the cesarean. Descriptive and comparative analyses were performed. The chi-square test was used to compare groups. Results: 737 cesareans were performed. Telephone contact was achieved with 507 (68.8%) women up to 30 days postpartum, with loss of follow-up of 230 cases (31.2%). The medical consultation in the post-partum period occurred with 188 (37.08%) women, with whom telephone contact was obtained, on average, 17.28 days (SD=8.39) after delivery. It was verified that 21 patients met the criteria for SSI, with a 4.14% rate. A total of 12 cases (57.1%) were classified as superficial SSI, 5 (23.8%) as deep and 4 (19.1%) as infection of organs and cavities. The SRI and its risk variables were not associated with SSI in patients submitted to cesarean sections. Conclusion: The SRI and the risk variables included in this index were not associated to SSI in patients submitted to cesarean sections. KEYWORDS: Cesarean Section; Surgical Wound Infection; Epidemiological Surveillance; Infection Control; Risk Index; Disease Notification.Justificativa e Objetivos: Tendo em vista que o emprego de vigilância ativa colabora na identificação de infecção e a necessidade de estudos que utilizem o Índice de Risco Cirúrgico (IRC) para avaliação de Infecção de Ferida Cirúrgica (IFC) em cesarianas este estudo objetiva determinar a incidência de IFC e analisar a aplicabilidade do IRC na predição das IFC em puérperas submetidas à cesariana em hospital universitário entre abril de 2012 e março de 2013. Métodos: Estudo de coorte prospectivo concorrente. Informações de notificação das IFC por vigilância ativa foram coletadas diariamente nos prontuários. Após alta hospitalar, as puérperas eram contatadas por ligações telefônicas para identificação de critérios de infecção até 30 dias após a cesariana. Análises descritivas e comparativas foram conduzidas. Para comparação dos grupos foi utilizado teste de Qui-quadrado. Resultados: Foram realizadas 737 cesarianas. Contato telefônico foi conseguido com 507 (68,8%) puérperas até 30 dias pós-parto, com perda de seguimento de 230 casos (31,2%). A consulta médica no puerpério ocorreu em 188 (37,08%) mulheres com quem foi obtido contato telefônico, em média, 17,28 dias (± 8,39) após o parto. Verificou-se que 21 casos preencheram critérios para IFC, taxa de 4,14%. Classificou-se 12 (57,1%) casos como infecção de ferida cirúrgica superficial, 5 (23,8%) como profunda e 4 (19,1%) de órgãos e cavidades. O IRC e suas variáveis de risco não foram associados à IFC em pacientes submetidas a cesarianas. Conclusão: O IRC e as variáveis de risco incluídas nesse índice não foram associados à IFC em pacientes submetidas a cesarianas. DESCRITORES: Cesárea; Infecção da Ferida Operatória; Vigilância epidemiológica; Controle de Infecções; Índice de Risco; Notificação de doenças

The spatial and temporal scales of local dengue virus transmission in natural settings:a retrospective analysis

Background Dengue is a vector-borne disease caused by the dengue virus (DENV). Despite the crucial role of Aedes mosquitoes in DENV transmission, pure vector indices poorly correlate with human infections. Therefore there is great need for a better understanding of the spatial and temporal scales of DENV transmission between mosquitoes and humans. Here, we have systematically monitored the circulation of DENV in individual Aedes spp. mosquitoes and human patients from Caratinga, a dengue endemic city in the state of Minas Gerais, in Southeast Brazil. From these data, we have developed a novel stochastic point process pattern algorithm to identify the spatial and temporal association between DENV infected mosquitoes and human patients. Methods The algorithm comprises of: (i) parameterization of the variogram for the incidence of each DENV serotype in mosquitoes; (ii) identification of the spatial and temporal ranges and variances of DENV incidence in mosquitoes in the proximity of humans infected with dengue; and (iii) analysis of the association between a set of environmental variables and DENV incidence in mosquitoes in the proximity of humans infected with dengue using a spatio-temporal additive, geostatistical linear model. Results DENV serotypes 1 and 3 were the most common virus serotypes detected in both mosquitoes and humans. Using the data on each virus serotype separately, our spatio-temporal analyses indicated that infected humans were located in areas with the highest DENV incidence in mosquitoes, when incidence is calculated within 2.5–3 km and 50 days (credible interval 30–70 days) before onset of symptoms in humans. These measurements are in agreement with expected distances covered by mosquitoes and humans and the time for virus incubation. Finally, DENV incidence in mosquitoes found in the vicinity of infected humans correlated well with the low wind speed, higher air temperature and northerly winds that were more likely to favor vector survival and dispersal in Caratinga. Conclusions We have proposed a new way of modeling bivariate point pattern on the transmission of arthropod-borne pathogens between vector and host when the location of infection in the latter is known. This strategy avoids some of the strong and unrealistic assumptions made by other point-process models. Regarding virus transmission in Caratinga, our model showed a strong and significant association between high DENV incidence in mosquitoes and the onset of symptoms in humans at specific spatial and temporal windows. Together, our results indicate that vector surveillance must be a priority for dengue control. Nevertheless, localized vector control at distances lower than 2.5 km around premises with infected vectors in densely populated areas are not likely to be effective

Avanços na Profilaxia Pós-Exposição ao HIV: Uma Revisão Abrangente de Regimes Terapêuticos e Desenvolvimentos Recentes

This research project aims to conduct a critical analysis of the literature on therapeutic regimens for post-exposure prophylaxis to the human immunodeficiency virus (HIV). The literature review will span the last decade and be carried out on renowned databases such as SciELO, PubMed, LILACS, and Cochrane Library. Using relevant descriptors such as Acquired Immunodeficiency Syndrome (AIDS), prophylaxis, antiretroviral therapy, diagnosis, and treatment, the research will seek observational studies, case-control studies, prospective studies, and government documents. The review aims to provide a comprehensive overview of the technical evolution over time, efficacy, safety, tolerability, and major divergences in post-exposure prophylaxis regimens for HIV. The study is relevant to update healthcare professionals and individuals at risk about the latest practices in this field, contributing to the effective prevention of HIV infection.Este projeto de pesquisa tem como objetivo realizar uma análise crítica da literatura sobre os regimes terapêuticos para a profilaxia pós-exposição ao vírus da imunodeficiência humana (HIV). A revisão bibliográfica abrangerá o período dos últimos dez anos e será conduzida nas bases de dados SciELO, PubMed, LILACS e Cochrane Library. Utilizando descritores relevantes como Síndrome de Imunodeficiência Adquirida (AIDS), prophylaxis, antiretroviral therapy, diagnóstico e tratamento, a pesquisa buscará estudos observacionais, estudos caso-controle, estudos prospectivos e documentos governamentais. A revisão visa fornecer uma visão abrangente sobre a evolução técnica ao longo do tempo, eficácia, segurança, tolerabilidade e principais divergências nos regimes de profilaxia pós-exposição ao HIV. O estudo tem relevância para atualizar profissionais de saúde e indivíduos em risco sobre as práticas mais recentes nesse campo, contribuindo assim para a prevenção efetiva da infecção pelo HIV

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

Diagnóstico diferencial da Síndrome de Takotsubo e infarto agudo do miocárdio: uma revisão sistemática: Differential diagnosis of Takotsubo Syndrome and acute myocardial infarction: a systematic review

A cardiomiopatia de Takotsubo e o infarto agudo do miocárdio compartilham apresentação clínica e risco de morte semelhantes, embora uma das diferenças mais importantes seja a ausência de doença coronariana obstrutiva na cardiomiopatia de Takotsubo. Neste estudo, tem-se como objetivo analisar a literatura disponível avaliando o diagnóstico diferencial entre pacientes com CTT em comparação com pacientes com infarto agudo do miocárdio. Para isso, foi realizada uma revisão sistemática, utilizando-se a Pubmed e a Medline como base de dados. A partir da análise dos estudos e interpretação de suas principais descobertas, concluiu-se que para pacientes com CTT, outras condições e comorbidades, em vez de apenas dislipidemia e/ou outros fatores de risco estabelecidos, sejam responsáveis por um risco de morte comparável ao de IAM. No entanto, as conclusões desse estudo têm várias limitaçõe