Avaliação do grau de exposição do ser humano ao agente zoonótico Toxoplasma gondii

Toxoplasma gondii é um parasita intracelular obrigatório, pertencente ao filo Apicomplexa, sendo responsável por uma importante zoonose mundial, a toxoplasmose. As principais vias de transmissão são a horizontal, através da ingestão de quistos tecidulares presentes na carne crua ou malpassada, ingestão de oócistos esporulados na água, e nas frutas e vegetais crus ou mal lavados; e a transmissão vertical, por via placentária. Em Portugal, foram reportadas elevadas prevalências em indivíduos com idade superior a 45 anos, revelando uma exposição cumulativa com a idade, e em residentes na região norte (70%), em relação ao sul (35%). Este estudo tem como principal objetivo determinar a seroprevalência de infeção por T. gondii na região Cova da Beira, bem como a existência de potenciais fatores de risco para a infeção, tendo sido analisados para o efeito as seguintes variáveis: meio (rural ou urbano), contato com animais e tipo de alimentação (consumo de carne crua ou malpassada). As amostras de soro de 229 indivíduos, residentes na Cova da Beira, foram analisadas para anticorpos contra T. gondii, com o teste de aglutinação modificado (modified agglutination test - MAT). Foi entregue a todos os participantes um inquérito que recolhia as seguintes informações: sexo, idade, concelho, freguesia, meio (rural ou urbano), convivência com gatos e consumo de carne crua ou malpassada. Os resultados evidenciaram uma seropositividade de cerca de 56,3%, contudo não foi encontrada uma relação estatisticamente significativa entre a seroprevalência encontrada e as variáveis consideradas. Ainda assim, dentro da amostra, foi comprovado um maior número de infetados nos grupos etários mais avançados, sugerindo uma exposição cumulativa a T. gondii com a idade (nos 129 resultados positivos, a média de idades foi 65,02 anos). Dentro do género, foi observada uma maior frequência da infeção em homens (65,3% dos resultados positivos pertenciam a indivíduos do sexo masculino) podendo este valor evidenciar um risco aumentado de seropositividade associado a atividades laborais tipicamente consideradas masculinas.Toxoplasma gondii is an obligate intracellular parasite that belongs to the Apicomplexa phylum, accounting for an important global zoonosis, toxoplasmosis. The main routes of transmission are horizontal, through the ingestion of tissue cysts present in raw or undercooked meat, ingestion of sporulated oocysts in water, and raw or unwashed fruits and vegetables; and vertical transmission, by placental route. In Portugal, high prevalences were reported in individuals older than 45 years, revealing a cumulative exposure with age, and in residents of the north region of the country (70%), when compared with the south (35%). This study aimed to determine the seroprevalence of T. gondii infection in the Cova da Beira region and the existence of potential risk factors for infection, having been analyzed, for this purpose, the following variables: environment (rural or urban), contact with animals and type of food (raw/undercooked meat consumption). Serum samples from 229 individuals, living in the Cova da Beira, were analyzed for antibodies against T. gondii, with the modified agglutination test (MAT). It was delivered to all participants a survey that collected the following information: gender, age, county, parish, environment (rural or urban), having one or more cats (as pets), living with cats and consumption of raw meat or undercooked. The results showed a seropositivity of 56.3%, but there was not a statistically significant relationship between the prevalence found and the variables considered. Still, in the sample, it was demonstrated a higher number of infected in older age groups, suggesting a cumulative exposure to T. gondii with age (the mean age in the positive results was 65,02 years). Within the gender, a higher frequency of infection was observed in men (65.3% of positive results were from males); this value may show an increased risk of seropositivity associated with work activities typically considered male

An atypical case of focal myositis

A 64-year-old woman presented with a 10-day history of painful progressive bilateral temporal and right retroauricular region tumefaction, dysphonia, and a body temperature of 37.5°C. She had been previously prescribed antibiotics assuming an oral infection, with no benefit. She had no other complaints and her past medical history and clinical exam were otherwise unremarkable. Her labs revealed high levels of CRP (11.7 mg/dl), ESR (52 mm/h), creatine kinase (CK 623 U/l), myoglobin (83 U/l), aspartate transaminase (56 U/l) and alanine transaminase (69 U/l). Serologies were negative for Treponema pallidum, human immunodeficiency, hepatitis B and C, and Epstein–Barr viruses; blood cultures and immunological study, including anti-nuclear antibodies and antibodies associated with inflammatory myopathies, were negative. A facial MRI revealed thickening and T2/FLAIR hypersignal of the temporal, masseter, and pterygoid muscles with signal intensification after gadolinium injection, suggesting myositis. A temporal muscle biopsy showed marked lymphocyte infiltration (predominantly lymphocyte T CD3), as well as the marking of multiple fibres with major histocompatibility complex class I products, which supported the diagnosis. Prednisolone 0.5 mg/kg/day (30 mg) was started, with marked clinical improvement and normalization of CRP, ESR, and CK.info:eu-repo/semantics/publishedVersio

The Effect of ACTN3 and VDR Polymorphisms on Skeletal Muscle Performance in Axial Spondyloarthropathies

Funding Information: This study was supported by the funding through project MyoSpA, from iNOVA4 health. PM was supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC). Publisher Copyright: © Copyright © 2021 Pimenta, Mateus, Rodrigues-Manica, Pinheiro-Torres, Neto, Domingues, Lage Crespo, Sardoo, Machado, Branco, Silva and Pimentel-Santos.PBackground: Spondyloarthritis (SpA) are the most common group of chronic inflammatory rheumatic diseases affecting about 1.5% of the adult Caucasian population. Low back pain is the most common symptom. The aetiopathogenesis of SpA is multifactorial, with well-known genetic and environmental contributions. Furthermore, muscle properties might also be involved in the pathophysiological process and these could be modulated by the genetic background. Alpha-actinin-3 (ACTN3) and Vitamin D receptor (VDR) genes are well-known genes related with muscle performance. Our aim was to analyze four SNPs of these genes and to evaluate their influence in axial SpA (axSpA) susceptibility, phenotype and muscle properties. Methods: We performed a pilot study based on case-control approach involving 56 participants: 28 axSpA patients and 28 healthy controls matched by age, gender and levels of physical activity. Clinical, epidemiological and muscle characterization data—muscle physical properties (stiffness, tone, and elasticity), strength, mass, and performance, were collected. Two different muscles were considered for analysis, the Multifidus and Gastrocnemius. Four SNPs of ACTN3 (rs1815739) and VDR (rs2228570, rs731236, and rs7975232), were selected, analyzed and correlated with clinical, epidemiological and muscle characterization data. Results: In total, 51 individuals (27 axSpA patients and 24 matched controls) were eligible for further genetic analysis, 66.7% being male and with a mean age of 36 years. Muscle physical properties, muscle strength and muscle mass were similar in both groups; however, axSpA patients showed a decrease in muscle performance. None of the studied SNPs were associated with disease susceptibility/phenotype, muscle physical properties, muscle strength or muscle mass. However, ACTN3 rs1815739 and VDR rs2228570 were shown to be associated with muscle performance. Conclusion: Our results suggest an association between ACTN3 and VDR polymorphisms and muscle performance in axSpA.publishersversionpublishe

Risk factors for infection, predictors of severe disease, and antibody response to COVID-19 in patients with inflammatory rheumatic diseases in Portugal: a multicenter, nationwide study

Copyright © 2022 Cruz-Machado, Barreira, Bandeira, Veldhoen, Gomes, Serrano, Duarte, Rato, Miguel Fernandes, Garcia, Pinheiro, Bernardes, Madeira, Miguel, Torres, Bento Silva, Pestana, Almeida, Mazeda, Cunha Santos, Pinto, Sousa, Parente, Sequeira, Santos, Fonseca and Romão. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Objective: To identify risk factors for SARS-CoV-2 infection and for severe/critical COVID-19, and to assess the humoral response after COVID-19 in these patients. Methods: Nationwide study of adult patients with inflammatory RMDs prospectively followed in the Rheumatic Diseases Portuguese Register-Reuma.pt-during the first 6 months of the pandemic. We compared patients with COVID-19 with those who did not develop the disease and patients with mild/moderate disease with those exhibiting severe/critical COVID-19. IgG antibodies against SARS-CoV-2 were measured ≥3 months after infection and results were compared with matched controls. Results: 162 cases of COVID-19 were registered in a total of 6,363 appointments. Patients treated with TNF inhibitors (TNFi; OR = 0.160, 95% CI 0.099-0.260, P < 0.001) and tocilizumab (OR 0.147, 95% CI 0.053-0.408, P < 0.001) had reduced odds of infection. Further, TNFi tended to be protective of severe and critical disease. Older age, major comorbidities, and rituximab were associated with an increased risk of infection and worse prognosis. Most patients with inflammatory RMDs (86.2%) developed a robust antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21-81.85, P = 0.005) and tended to be blunted by TNFi (OR 0.17, 95% CI 0.03-1.05; P = 0.057). Conclusions: TNFi and tocilizumab reduced the risk of infection by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with increased risk for infection and worse prognosis, in line with previous reports. Most patients with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease.We acknowledge the generous sharing of the expression constructs by Dr. Florian Krammer, Icahn School of Medicine at Mount Sinai, New York, USA [Development of SARS-CoV-2 reagents was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C] and the protein production by Drs. Paula Alves and Rute Castro at Instituto de Biologia Experimental e Tecnológica (iBET) Oeiras, Portugal as part of the Serology COVID consortium.info:eu-repo/semantics/publishedVersio

LISINA DIGESTÍVEL PARA MARRÃS NO TERÇO FINAL DA GESTAÇÃO

Objetivou-se verificar com esse trabalho se o aumento do nível de lisina digestível na dieta de marrãs, fornecidas a partir do 75º dia de gestação até o parto influencia o desempenho reprodutivo das matrizes, especialmente sobre o peso dos leitões e a uniformidade do lote e avaliar a condição corporal das fêmeas para a segunda cobertura. Foram utilizadas 6 marrãs da linhagem Fertilis 20 (Genetiporc), alojadas em baias individuais de alvenaria, sem acesso a piquetes, com pé-direito de 2,5m, com telhado em duas águas e telha de barro tipo francesa. As matrizes receberam o mesmo tratamento até 75º dia de gestação. Os animais foram distribuídos em delineamento experimental de blocos inteiramente casualizados, com dois tratamentos: 0,63 e 0,78% de lisina digestível na ração, com três repetições. As rações experimentais foram elaboradas com milho e farelo de soja como ingredientes principais e foram formuladas para atender as exigências nutricionais de marrãs, exceto lisina. As matrizes receberam alimentação “ad libitum” até a fase gestacional na qual se iniciou o experimento. No período experimental, o arraçoamento foi realizado duas vezes ao dia (de manhã e a tarde), totalizando aproximadamente 3,4 kg. As rações, sobras e os animais foram pesados para determinação do ganho de peso médio diário (GPD), do consumo médio de ração diário (CRD). As matrizes foram pesadas após a confirmação de gestação (21 dias após a cobertura), aos 75 dias de gestação, no parto e na desmama dos leitões. Os leitões foram pesados ao nascer e à desmama, realizada aos 21 dias de idade, para determinação do desempenho da leitegada. Foi avaliada a perda de peso da porca durante o período de lactação. Os dados obtidos foram submetidos à análise de variância. Não foi detectado efeito (p>0,05) da elevação do nível de lisina digestível da ração de 0,62 para 0,78% sobre nenhum dos parâmetros avaliados. O aumento do nível de lisina digestível não influenciou o desempenho reprodutivo das marrãs ou da leitegada

Spatial Evaluation and Modeling of Dengue Seroprevalence and Vector Density in Rio de Janeiro, Brazil

Dengue is a major public health problem in many tropical regions of the world, including Brazil, where Aedes aegypti is the main vector. We present a household study that combines data on dengue fever seroprevalence, recent dengue infection, and vector density, in three neighborhoods of Rio de Janeiro, Brazil, during its most devastating dengue epidemic to date. This integrated entomological–serological survey showed evidence of silent transmission even during a severe epidemic. Also, past exposure to dengue virus was highly associated with age and living in areas of high movement of individuals and social/commercial activity. No association was observed between household infestation index and risk of dengue infection in these areas. Our findings are discussed in the light of current theories regarding transmission thresholds and relative role of mosquitoes and humans as vectors of dengue viruses

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Trajetórias da Educomunicação nas Políticas Públicas e a Formação de seus Profissionais

Esta obra é composta com os trabalhos apresentados no primeiro subtema, TRAJETÓRIA – Educação para a Comunicação como Política pública, nas perspectivas da Educomunicação e da Mídia-Educação, do II Congresso Internacional de Comunicação e Educação. Os artigos pretendem propiciar trocas de informações e produzir reflexões com os leitores sobre os caminhos percorridos, e ainda a percorrer, tendo como meta a expansão e a legitimação das práticas educomunicativas e/ou mídia-educativas como política pública para o atendimento à formação de crianças, adolescentes, jovens e adultos, no Brasil e no mundo

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake