Soroprevalência de hepatite B e hepatite C em Monte Negro, Rondônia, Região Amazônica Ocidental Brasileira

PURPOSE: This study was carried out in Monte Negro (state of Rondônia), a village in the Brazilian western Amazon region, where a University of São Paulo Medical School program for medical student training in rural assistance took place. It aimed to determine the prevalence of hepatitis B virus and hepatitis C virus, to investigate risk factors for infection, and to evaluate the State immunization program against hepatitis B virus in the region. METHODS: The study is a cross-sectional seroprevalence survey, comprising 267 volunteers who answered a comprehensive questionnaire and had blood samples collected, which were analyzed in São Paulo for the presence of antibodies against hepatitis B virus (Hbs Ag, anti-Hbs, and anti-Hbc) and hepatitis C virus using commercial kits. Data were stored in a specific data bank, and the association between seropositivity and potential risk factors was analyzed by means of uni-, bi-, and multi-variate analysis, considering ±5%. RESULTS: The seroprevalence of hepatitis B virus was 61.79% and of hepatitis C virus was 0.38%. Statistical analysis on the data bank showed that the prevalence of hepatitis B virus rose significantly with age, especially after adolescence. Infection was higher in those coming from outside the state of Rondônia. Exposure to vaccination against hepatitis B virus was higher in younger individuals and in those who were born in Rondônia. CONCLUSION: Monte Negro is a highly endemic region for hepatitis B virus but not for hepatitis C virus. Our results also provide indirect evidence indicating a significant improvement in the immunization program in Rondônia in recent years.OBJETIVOS: O presente estudo foi realizado em Monte Negro, Rondônia, Amazônia Oriental, onde um projeto de acadêmicos de Medicina da Universidade de São Paulo promoveu assistência médica à população rural. O objetivo foi determinar a soroprevalência de Hepatite B e Hepatite C, investigar os fatores de risco para sua infecção e avaliar o status imunológico vacinal contra Hepatite B nesta região. MÉTODOS: O estudo é uma pesquisa de corte transversal de soroprevalência, compreendendo 267 voluntários que tiveram suas amostras sanguíneas coletadas após preenchimento de um questionário. As amostras foram analisadas em São Paulo usando kits comerciais pesquisando anticorpos contra Hepatite B (AgHBs, Anti-HBs e Anti-HBc) e Hepatite C . Um banco de dados montado através do questionário foi analisado em relação aos resultados sorológicos com testes uni-, bi-, e multivariado, considerando ± = 5%. RESULTADOS: A soroprevalência do VHB encontrada foi de 61.79% e do Hepatite C, 0.38%. A análise dos possíveis fatores de risco mostrou que a prevalência de Hepatite B aumenta com a idade, especialmente após a adolescência, além de ser maior em aqueles nascidos em Rondônia. A exposição à vacinação contra Hepatite B foi maior em indivíduos jovens e aqueles nascidos em Rondônia. CONCLUSÃO: Monte Negro é uma região altamente endêmica para Hepatite B , mas não para Hepatite C . Ademais, os resultados obtidos evidenciam uma significativa melhora no programa de imunizações em Rondônia nos anos recentes

Influence of the dental topical application of a nisin-biogel in the oral microbiome of dogs: a pilot study

Research Areas: Science & Technology - Other TopicsPeriodontal disease (PD) is one of the most widespread inflammatory diseases in dogs. This disease is initiated by a polymicrobial biofilm in the teeth surface (dental plaque), leading to a local inflammatory response, with gingivitis and/or several degrees of periodontitis. For instance, the prevention of bacterial dental plaque formation and its removal are essential steps in PD control. Recent research revealed that the antimicrobial peptide nisin incorporated in the delivery system guar gum (biogel) can inhibit and eradicate bacteria from canine dental plaque, being a promising compound for prevention of PD onset in dogs. However, no information is available regarding its effect on the dog's oral microbiome. In this pilot study, the influence of the nisin-biogel on the diversity of canine oral microbiome was evaluated using next generation sequencing (NGS), aiming to access the viability of nisin-biogel to be used in long-term experiment in dogs. Composite toothbrushing samples of the supragingival plaque from two dogs were collected at three timepoints: T1-before any application of the nisin-biogel to the animals' teeth surface; T2-one hour after one application of the nisin-biogel; and T3-one hour after a total of three applications of the nisin-biogel, each 48 hours. After that, microbial profiling was performed by NGS of the V3V4 16s rRNA region. After only one application of the nisin-biogel to the oral cavity of dogs, a statistically significant reduction in microbial diversity was observed (T2) as well as a reduction of some bacterial species potentially related with distinct stages of PD, when compared with samples collected before any application (T1). However, after a total of three nisin-biogel applications (T3), a recovery of the microbial diversity was detected. In conclusion, the nisin-biogel may influence the canine oral microbiome. A reduction in some bacterial species potentially related with distinct stages of PD was observed. This pilot study will help to design a controlled in vivo clinical trial to evaluate nisin-biogel effect on dental plaque progression and canine periodontal indices evolution in a long-term application period.info:eu-repo/semantics/publishedVersio

Primary central nervous system lymphoma

O linfoma primário do sistema nervoso central (LPSNC) é um linfoma extralinfonodal que, ao diagnóstico, encontra-se restrito ao parênquima cerebral, às meninges e/ou cordão espinhal e/ou olhos. Sua incidência triplicou nas últimas três décadas para 0,4 casos por 100.000 habitantes, representando 4% dos tumores do sistema nervoso central (SNC). Embora pacientes infectados pelo HIV tenham 3.600 vezes maior risco para o desenvolvimento do LPSNC, a incidência não aumentou apenas neste grupo de pessoas. Dados sugerem reduções da incidência de LPSNC em pacientes infectados após a introdução de drogas anti-retrovirais. Cerca de 90% dos casos de LPSNC são classificados como linfoma difuso de grandes células B, 10% têm envolvimento ocular e 10% são HIV positivos. A apresentação clínica depende da localização tumoral, prevalecendo os sintomas neurológicos em detrimento aos sistêmicos. Os exames de tomografia computadorizada (TC) e ressonância nuclear magnética (RNM) são essenciais para o diagnóstico, porém o exame confirmatório deve ser o anatomopatológico. O estadiamento deve ser feito com exames de imagem e biópsia de medula óssea (BMO) bilateral. Os principais fatores de mau prognóstico são: performance status do paciente acima de 1, idade superior a 60 anos, DHL elevada, hiperproteinorraquia e acometimento de área cerebral não hemisférica. Alguns fatores de prognóstico biológicos também podem influenciar na sobrevida, a exemplo da expressão de Bcl-6, que confere melhor prognóstico. O tratamento de escolha é a combinação de quimioterapia contendo altas doses de metotrexate e radioterapia (RDT). Devido às altas taxas de neurotoxicidade associada à RDT, seu uso tem ficado mais restrito aos pacientes idosos, e os recidivados ou refratários.Primary Central Nervous System lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma in the brain, leptomeninges, spinal cord or eyes. The incidence of PCNSL increased approximately three-fold in the last decades. Nowadays, it represents 0.4 case per 100,000 people and accounts for 4% of all primary brain tumors. Although individuals infected with HIV have a 3,600-fold increased risk of developing PCNSL compared with the general population, the incidence has not increased only in AIDS group. Recent data suggest that the incidence of PCNSL declined in the AIDS group after the introduction of anti-retroviral drugs. Around 90% of PCNSL cases are classified as diffuse large B-cell lymphoma, 10% involve the eyes and 10% of patients are HIV positive. The clinical presentation depends on the location of the tumor with neurological rather than systemic symptoms. Computed tomography (CT) and magnetic resonance imaging (RMI) are essential in diagnosis, however the gold standard is tumor biopsy. Staging should be made with imaging and bilateral biopsy of bone marrow. The main poor prognosic parameters are performance status greater than 1, age older than 60 years, elevated DHL, high liquor protein concentration and tumor located within the deep regions of the brain. BCL-6 expression identified in the tumor confers a better prognosis. Currently, a combined therapy with high doses of methotrexate and whole-brain radiotherapy is the therapy of choice. Nowever, whole-brain radiotherapy should be carefully analyzed because neurotoxity is a frequent problem in the elderly and in relapsed and refractory patients

Smart testing and critical care bed sharing for COVID-19 control

During the early months of the current COVID-19 pandemic, social-distancing measures effectively slowed disease transmission in many countries in Europe and Asia, but the same benefits have not been observed in some developing countries such as Brazil. In part, this is due to a failure to organise systematic testing campaigns at nationwide or even regional levels. To gain effective control of the pandemic, decision-makers in developing countries, particularly those with large populations, must overcome difficulties posed by an unequal distribution of wealth combined with low daily testing capacities. The economic infrastructure of the country, often concentrated in a few cities, forces workers to travel from commuter cities and rural areas, which induces strong nonlinear effects on disease transmission. In the present study, we develop a smart testing strategy to identify geographic regions where COVID-19 testing could most effectively be deployed to limit further disease transmission. The strategy uses readily available anonymised mobility and demographic data integrated with intensive care unit (ICU) occupancy data and city-specific social-distancing measures. Taking into account the heterogeneity of ICU bed occupancy in differing regions and the stages of disease evolution, we use a data-driven study of the Brazilian state of Sao Paulo as an example to show that smart testing strategies can rapidly limit transmission while reducing the need for social-distancing measures, thus returning life to a so-called new normal, even when testing capacity is limited

Impact of dwell time on vertical transportation through discrete simulation in SIMIO

This work has the objective of simulating an elevator system, using SIMIO software. Firstly, two different approaches, and its implementation, will be explained and compared: Vehicle vs. Entity. After selecting the Entity-approach, due to its more flexible processes and the limitations of the Vehicle-approach, it will be used to conduct the simulation experiments. The purpose is to evaluate the impact of dwell time - time in which the elevator remains stopped, allowing for clients to enter and exit - in the performance of the system. That will be achieved analysing the impact on the total time - spent by clients from placing a call until reaching its destination - number of clients inside the system and waiting for the elevator, waiting time, elevator occupation and number of elevator movements. The analysis of the results indicates that, for the properties defined, the best time for the elevator to stay with its doors open is around 10 seconds.This work has been supported by FCT – Fundação para a Ciência e Tecnologia in the scope of the project: PEst-OE/EEI/UI0319/2014 (ALGORITMI).info:eu-repo/semantics/publishedVersio

Analysis of an elevator system using discrete event simulation: case study

This paper documents the work conducted to simulate an elevator system, using SIMIO software. The modelled system represents a case study that was analyzed in a hospital at Braga, Portugal. A previ-ous work on the same case study concluded that the best dwell time configuration would be around 10 seconds, however it did not consider the impact of different client demand on the elevator system. In this sense, this paper analyses the impact of both parameters on the performance of the system. This will be achieved by analyzing the impact on the total time spent by clients in the system, the number of clients inside the system, and waiting for the elevator, waiting time, average elevator occupation and number of elevator movements. Conclusions and future work agenda were discussed in the conclusions section.This work has been supported by FCT -Fundacao para a Ciencia e Tecnologia in the scope of the project: PEstOE/EEI/UI0319/2014 (ALGORITMI)

At the crossroads of performance and pedagogy : a prospective review

Este texto é uma versão ampliada e revista de Teaching is performance, de 1994, no qual eu propunha um marco conceitual para mapear as interseções generativas entre educação libertadora e o emergente paradigma da performance crítica. Essa revisão situa aquele ensaio nas inovações teóricas e metodológicas contemporâneas em pedagogia da performance e utiliza uma nova poética da escrita performativa como método que representa a pesquisa educacional influenciada pela performanceThis text is an expanded and revised version of Teaching is performance (1994), in which I proposed a conceptual framework for mapping the generative intersections between liberatory education and the emerging critical performance paradigm. This revision resituates that essay within contemporary theoretical and methodological innovations in performative pedagogy, while deploying the new poetics of performative writing as a method representing performance-inflected educational research