Vigilância activa de eventos após vacinação

A vigilância de efeitos indesejáveis após a vacinação é complexa. Existem vários actores de confundimento que podem dar origem a associações espúrias, meramente temporais mas que podem provocar uma percepção do risco alterada e uma consequente desconfiança generalizada acerca do uso das vacinas. Com efeito as vacinas são medicamentos complexos com características únicas cuja vigilância necessita de abordagens metodológicas desenvolvidas para esse propósito. Do exposto se entende que, desde o desenvolvimento da farmacovigilância se tem procurado desenvolver novas metodologias que sejam concomitantes aos Sistemas de Notificação Espontânea que já existem. Neste trabalho propusemo-nos a desenvolver e testar um modelo de vigilância de reacções adversas a vacinas, baseado na auto-declaração pelo utente de eventos ocorridos após a vacinação e testar a capacidade de gerar sinais aplicando cálculos de desproporção a datamining. Para esse efeito foi constituída uma coorte não controlada de utentes vacinados em Centros de Saúde que foram seguidos durante quinze dias. A recolha de eventos adversos a vacinas foi efectuada pelos próprios utentes através de um diário de registo. Os dados recolhidos foram objecto de análise descritiva e análise de data-mining utilizando os cálculos Proportional Reporting Ratio e o Information Component. A metodologia utilizada permitiu gerar um corpo de evidência suficiente para a geração de sinais. Tendo sido gerados quatro sinais. No âmbito do data-mining a utilização do Information Component como método de geração de sinais parece aumentar a eficiência científica ao permitir reduzir o número de ocorrências até detecção de sinal. A informação reportada pelos utentes parece válida como indicador de sinais de reacções adversas não graves, o que permitiu o registo de eventos sem incluir o viés da avaliação da relação causal pelo notificador. Os principais eventos reportados foram eventos adversos locais (62,7%) e febre (31,4%).------------------------------------------ABSTRACT: The monitoring of undesirable effects following vaccination is complex. There are several confounding factors that can lead to merely temporal but spurious associations that can cause a change in the risk perception and a consequent generalized distrust about the safe use of vaccines. Indeed, vaccines are complex drugs with unique characteristics so that its monitoring requires specifically designed methodological approaches. From the above-cited it is understandable that since the development of Pharmacovigilance there has been a drive for the development of new methodologies that are concomitant with Spontaneous Reporting Systems already in place. We proposed to develop and test a new model for vaccine adverse reaction monitoring, based on self-report by users of events following vaccination and to test its capability to generate disproportionality signals applying quantitative methods of signal generation to data-mining. For that effect we set up an uncontrolled cohort of users vaccinated in Healthcare Centers,with a follow-up period of fifteen days. Adverse vaccine events we registered by the users themselves in a paper diary The data was analyzed using descriptive statistics and two quantitative methods of signal generation: Proportional Reporting Ratio and Information Component. themselves in a paper diary The data was analyzed using descriptive statistics and two quantitative methods of signal generation: Proportional Reporting Ratio and Information Component. The methodology we used allowed for the generation of a sufficient body of evidence for signal generation. Four signals were generated. Regarding the data-mining, the use of Information Component as a method for generating disproportionality signals seems to increase scientific efficiency by reducing the number of events needed to signal detection. The information reported by users seems valid as an indicator of non serious adverse vaccine reactions, allowing for the registry of events without the bias of the evaluation of the casual relation by the reporter. The main adverse events reported were injection site reactions (62,7%) and fever (31,4%)

Acompanhamento radiográfico e ultrassonográfico de calcificação distrófica no ligamento sesamoideo oblíquo em cavalo de salto. Seguimento durante 20 meses

Mineralization of the anatomical structures involved in the limb movement of horses has been reported to induce lameness and interfere with athletic performance. A 4-year-old jumping horse in sport activity was reported at Veterinary Hospital of University of São Paulo, with mild lameness and a mineralized oblique distal sesamoidean ligament (ODSL) of the left forelimb, revealed by a purchase radiographic and ultrasound examination. Mineralization is more common in tendons than ligaments. This report calls for attention to these structures when performing image exams, even in mild lameness. Long-term favorable follow-up by ultrasonographic and radiographic examination showed that the severe ligament injury in this case did not decrease the athletic activity until the present day. A mineralização de estruturas anatômicas envolvidas na movimentação dos membros predispõe à claudicação e interfere no desempenho atlético. Foi admitido no Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da USP-SP um equino macho, da raça Brasileiro de Hipismo, com quatro anos de idade e histórico de claudicação leve e ligamento sesamoideo oblíquo distal mineralizado do membro torácico esquerdo, diagnosticado por exame de compra. A mineralização apresenta alta incidência em tendões, sendo em menor proporção nos ligamentos. Esse relato visa atentar à essas estruturas ao se realizar exames rotineiros de imagem, apesar de claudicação leve. O acompanhamento a longo prazo por ultrassonografia e radiografia mostrou que lesões graves de ligamentos, como no presente caso, não diminuíram a atividade atlética até o momento

Pockmarks and fluid migration in the Estremadura Spur, Western Iberian Margin.

A field with more than 70 pockmarks in the Estremadura Spur outer shelf on the Western Iberia margin is the main focus of research of the PES project. High-resolution seismic reflection profiles and multibeam bathymetry allowed the characterization of the seismic sequence of a Pliocene-Quaternary basin as well as the pockmark field therein. The Pliocene-Quaternary basin developed on top of a folded, most probably, Miocene sequence. The pockmarks are found either sealed within the Pliocene-Quaternary sedimentary sequence or as depressions at the seafloor. Besides the pockmarks, several other seismic evidences of fluid migration and shallow gas accumulations are identified on the seismic dataset. No evidences of pockmarks were found below the Pliocene-Quaternary sequence. The seafloor observations with a ROV on three of those pockmarks show that, although several episodes of fluid migration and escape affected this region at present seepage seems to be mainly inactive

Tumor de Frantz em paciente do sexo feminino com diarreia: relato de caso de neoplasia pancreática rara

O tumor pseudopapilar sólido, também conhecido como tumor de Frantz, é um tumor raro do pâncreas. Relatamos o caso de uma paciente de 25 anos com dor abdominal, febre, diarréia e perda de peso.TC de abdome com contraste revelou pâncreas alargado com lesão hipodensa de aparência nodular e calcificações periféricas. Foi decidido realizar pancreatectomia subtotal com linfadenectomia e optou-se pela esplenectomia com biópsia hepática intra-operatória. O anatomopatológico da ressecção cirúrgica do tumor pancreático revelou tumor pseudopapilar sólido compatível com o tumor de Frantz. A imuno-histoquímica confirmou os achados histopatológicos. Ela evoluiu com fístula pancreática e pancreatite resolvida após 15 dias. Atualmente, está sendo acompanhada ambulatorialmente em nosso serviço com remissão completa dos sintomas.Solid pseudopapillary tumor, also known as frantz tumor, is a rare tumor of the pancreas. We report a case of 25-year-old female patient with abdominal pain, fever, diarrhea and weight loss. Contrast abdominal CT showed enlarged pancreas with a hypodense lesion of nodular appearance and peripheral calcifications.It was decided to perform subtotal pancreatectomy with lymphadenectomy, and opted for splenectomy and intraoperative liver biopsy. The pathology of surgical resection of the pancreatic tumor showed solid pseudopapillary tumor compatible with Frantz’s tumor. Immunohistochemistry confirmed histopathological findings. She evolved with pancreatic fistula and pancreatitis resolved after 15 days. Currently, it is being followed up in our service with complete remission of symptoms

E-Cadherin Destabilization Accounts for the Pathogenicity of Missense Mutations in Hereditary Diffuse Gastric Cancer

E-cadherin is critical for the maintenance of tissue architecture due to its role in cell-cell adhesion. E-cadherin mutations are the genetic cause of Hereditary Diffuse Gastric Cancer (HDGC) and missense mutations represent a clinical burden, due to the uncertainty of their pathogenic role. In vitro and in vivo, most mutations lead to loss-of-function, although the causal factor is unknown for the majority. We hypothesized that destabilization could account for the pathogenicity of E-cadherin missense mutations in HDGC, and tested our hypothesis using in silico and in vitro tools. FoldX algorithm was used to calculate the impact of each mutation in E-cadherin native-state stability, and the analysis was complemented with evolutionary conservation, by SIFT. Interestingly, HDGC patients harbouring germline E-cadherin destabilizing mutants present a younger age at diagnosis or death, suggesting that the loss of native-state stability of E-cadherin accounts for the disease phenotype. To elucidate the biological relevance of E-cadherin destabilization in HDGC, we investigated a group of newly identified HDGC-associated mutations (E185V, S232C and L583R), of which L583R is predicted to be destabilizing. We show that this mutation is not functional in vitro, exhibits shorter half-life and is unable to mature, due to premature proteasome-dependent degradation, a phenotype reverted by stabilization with the artificial mutation L583I (structurally tolerated). Herein we report E-cadherin structural models suitable to predict the impact of the majority of cancer-associated missense mutations and we show that E-cadherin destabilization leads to loss-of-function in vitro and increased pathogenicity in vivo

Art déco e indústria: Brasil, décadas de 1930 e 1940

Este artigo analisa as características assumidas pela arquitetura de tendência art déco em construções ligadas à indústria - moradias, igrejas, escolas, clubes, fábricas etc. - erguidas no Brasil nas décadas de 1930 e 1940, investigando o repertório formal utilizado em diferentes tipologias. Faz uma análise mais detalhada das construções criadas pela Companhia Industrial Fiação de Tecidos Goyanna, em Pernambuco, no período entre 1937 e o final da década de 1940. Trata-se de um conjunto notável pela unidade formal, vinculada à linguagem art déco, e pelo emprego de soluções inovadoras em termos de forma e de programa.The aim of this article is to analyze the characteristics of Art Deco tendencies in buildings related to the industry - as houses, churches, schools, clubs, plants etc - in Brazil during the 1930s and 1940s. It studies the formal repertory used in different types of construction and develops a more detailed analysis of a complex of constructions by the firm Companhia Industrial Fiação de Tecidos Goyanna, in the state of Pernambuco, built during the period between 1937 and the end of 1940s. The presented group of constructions is notable for the formal coherence, associated with the Art Deco language, and for the use of innovative program and form solutions

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Em torno da mesa do rei: artefatos, convivialidade e celebração no Rio de Janeiro joanino

Este artigo aborda um aspecto relevante do ritual das refeições na corte de D. João VI, no Rio de Janeiro: a prataria de mesa. Isto é, objetos de luxo destinados a servir e a consumir os alimentos. Com base em um inventário de bens de mesa enviados do Rio de Janeiro para Lisboa junto com o monarca em seu retorno a Portugal, em 1821, este artigo procura refletir sobre as funções e possíveis usos desses objetos, assim como sobre a importância desse universo material para o funcionamento, representação e celebração da Casa Real portuguesa na sua nova sede. O artigo argumenta que a presença e o uso de baixelas de prata de serviço, mas também de grande aparato, nas refeições públicas da família real pode contribuir para se repensar a imagem de uma corte pobre e sem brilho recorrentemente reforçada na historiografia do período joanino.This article discusses a specific issue of the royal dinner's rituals at the Court of Rio de Janeiro: the silver service: some luxury artifacts of different forms specially made to serve and consume food. Based on a inventory of these silver objects and also on a stock of table linen which were shipped to Lisbon, along with the royal family in 1821, The article intend to explore the functions and utilities of those objects at the table, as well as, analyze the importance of this material universe for the functioning, representation and celebration of the Portuguese Royal House in its new headquarters.The article argues that the use and even the exhibition of the banquet silver in public ceremonies may contribute to change a rather depreciative image of poverty the royal court in Brazil, which has being explored by the historiography for more than a hundred years