C-reactive protein as an inflammatory marker of acute infections outside intensive care settings: case report and evidence-based literature review

We present the clinical case of a 76-year-old woman with delirium causedby multiple factors, including pneumonia. Although this type of case is quitecommon in clinical practice, it provides us with an opportunity to discusslaboratory testing in this context, with a special focus on the role of C-reactiveprotein (CRP). We present data regarding the requests for determination ofserum CRP levels at the University of São Paulo University Hospital overthe past few years. We also present a review of the medical literature on thetopic, as well as clinical epidemiology concepts related to the impact that CRPtesting has on the medical decision-making process

Women's health in the Brazilian press: analysis of scientific quality in weekly magazines

This cross-sectional study evaluated the scientific quality of informative texts on women's health in nationally circulating magazines and described the topics covered. Over a consecutive 12-month period, texts on women's health were collected from the principal Brazilian weekly current affairs magazines (Veja, Época and IstoÉ). Eighty texts were selected and were independently analyzed by two physicians and two journalists, by means of the Index of Scientific Quality, which had been adapted for use in Portuguese and subjected to pilot testing and retesting. The instrument consisted of eight items that ranged from one to five points and measured applicability, opinion versus fact, validity, scope, precision, coherence, consequence and an overall item. The overall item summarized the other items and its median was used for evaluations. The median scientific quality of the texts, relating to the overall item, was three. This demonstrated that the material published was of moderate nature.Este estudo, de corte transversal, avalia a qualidade científica de textos informativos sobre saúde da mulher em revistas de circulação nacional e descreve os temas abordados. Durante 12 meses consecutivos, foram coletados textos sobre saúde da mulher nas principais revistas semanais brasileiras de atualidades: Veja, Época e Isto É. Foram selecionados oitenta textos, analisados de forma independente por dois médicos e dois jornalistas, por meio do questionário Index Of Scientific Quality, adaptado para o português e submetido a prova-piloto e reteste. O instrumento possui oito itens que variam de um a cinco pontos e medem: a aplicabilidade, opinião versus fato, validade, alcance, precisão, coerência, consequência e um item global, que resume os outros itens e cuja mediana foi considerada para avaliação. A mediana da qualidade científica dos textos referente ao item global foi igual a três, demonstrando caráter moderado em relação às matérias publicadas.Este estudio, de corte transversal, evalúa la calidad científica de textos informativos sobre salud de la mujer en revistas de circulación nacional y describe los temas planteados. Durante 12 meses consecutivos se colectaron textos sobre salud de la mujer en las principales revistas semanales brasileñas de actualidades: Veja, Epoca e Isto é. Se han seleccionado 80 textos analizados de forma independiente por dos médicos y dos periodistas por medio del cuestionario Index of Scientific Quality adaptado al portugués y sometido a prueba piloto y nuevo test. El instrumento consta de ocho items que varían de uno a cinco puntos y miden la aplicación, opinión en relación al hecho, validad, alcance, precisión, coherencia, consecuencia y un item global que resume los otros items y cuya mediana se considera para evaluación. La mediana de la calidad científica de los textos referente al item global fue igual a tres, demostrando caracter moderado en relación a las materias publicadas.071

The role of spray-drying atmosphere on fridericia chica (bonpl.) L.G. Lohmann standardized extract production for wound healing activity

Fridericia chica (Bonpl.) L.G. Lohmann (synonym Arrabidaea chica Verlot) is widely used in Brazilian folk medicine. Considering overcoming pitfalls of scaling up production of plant extracts, herein the effects of N2 atmosphere for extract spray-drying process is reported. Samples were monitored by in vitro antioxidant activity and microbiological evaluation. The drying atmosphere influenced 3-deoxyanthocyanines content when using air as atomizing gas, decreasing carajurin (37.5%) content with concomitant increase in luteolin yield (24.1%). Both drying processes preserved the pharmacological activity. In the cell migration test with HaCaT cells, the extract dried under air flow (5 μg/mL) promoted wound closure by 78% (12 hours) whereas the extract dried using N2 flow promoted 49% (12 hours), with 98% closure (12 hours) for the positive control. The antimicrobial evaluation for Staphylococcus aureus did not differ within drying atmospheres, with MIC (minimum inhibitory concentration) at 0.39 mg/mL. Therefore, the drying process reported herein did not interfere with the biological activity’s outcome.The authors A.L.T.G.R.and M.A.F thank CNPq for research productivity fellowship. The authors also thank the Chemical, Biological, and Agricultural Pluridisciplinary Research Center (CPQBA/Unicamp) for the laboratory infrastructure. Sao Paulo Research Foundation (FAPESP). This work was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil, Financing Code 001) and the National Council for Scientific and Technological Development (CNPq, Brazil, grant numbers # 132448/2016-5, # 132207/2017-6, # 429463/2018-9).Peer reviewe

Classification of haematopoietic and lymphoid tumors: WHO, standardization of nomenclature in Portuguese, 4th edition

INTRODUCTION: The World Health Organization (WHO) classification of hematopoietic and lymphoid tissue (4th edition, 2008) tumors constitutes an updated review of the 3rd edition published in 2001. The translation of the nomenclature used to describe the entities should be clear, precise and uniform so that clinicians, pathologists and researchers involved in the onco-hematopathological area may identify them accurately. OBJECTIVE: With this purpose, the authors present an updated proposal and a terminological standardization in Portuguese based on WHO/2008INTRODUÇÃO: A classificação da Organização Mundial da Saúde (OMS) para os tumores do tecido hematopoético e linfoide (4ª edição, 2008) representa uma revisão atualização da 3ª edição publicada em 2001. A tradução da nomenclatura utilizada para identificar as entidades descritas deve ser clara, precisa e uniforme no sentido de reproduzir de forma correta as diversas entidades clinicopatológicas para clínicos, patologistas e pesquisadores envolvidos na área da onco-hematopatologia. OBJETIVO: Os autores apresentam uma proposta de atualização e padronização terminológica em língua portuguesa, com base na OMS/2008Universidade de São Paulo Faculdade de Medicina Departamento de PatologiaUSP Faculdade de Odontologia Departamento de PatologiaHospital do Câncer A. C. Camargo Departamento de Anatomia PatológicaUniversidade Federal do Rio de Janeiro Departamento de PatologiaUniversidade Estadual de Campinas Faculdade de Ciências Médicas Departamento de Anatomia PatológicaFMUSP Hospital das ClínicasHospital Israelita Albert Einstein Setor de Citogenética Laboratório ClínicoUniversidade Federal de São Paulo (UNIFESP)Fleury Medicina Diagnóstica Laboratório de CitogenéticaSanta Casa de São Paulo Faculdade de Ciências MédicasFMUSP HC Divisão de Anatomia PatológicaUNIFESP Departamento de PatologiaFMUSP Instituto do CoraçãoFMUSP Instituto de Ortopedia e Traumatologia Departamento de PatologiaFleury Medicina DiagnósticaInstituto Adolfo LutzHospital Alemão Oswaldo CruzFCMSCSP Departamento de PatologiaUNIFESP, Depto. de PatologiaSciEL

Primary healthcare and the construction of thematic health networks: what role can they play?

The enhancement of primary healthcare has been a core strategy for the empowerment of the Brazilian Unified Health System (SUS). Recent guidelines issued by OPAS and the Ministry of Health highlight the role it has played as a thematic communication network center, a regulating agent for the access and use of services required for comprehensive healthcare. Sponsored by PPSUS/Fapesp, this study examines the possibilities of the primary healthcare network exercising such a strategic function. Life narratives involving 15 regular users were produced in two cities of ABC Paulista, which have adopted the Family Health Strategy for the organization of their primary healthcare networks. The study presents three main findings: the primary healthcare network serves as an outpost of SUS by producing user values even for high complexity service users; the primary network is perceived is a place for simple care needs; there is shared impotence between users and teams when it comes to the network functioning as the coordinator of care, indicating that it does not possess the technological, operational and organizational material conditions or symbolic conditions (values, meanings, and representations) to be in a central position in the coordination of thematic healthcare networks.O fortalecimento da atenção básica tem sido valorizado como estratégia central para a construção do SUS. Diretrizes recentes emanadas pela OPAS e pelo MS destacam seu papel como centro de comunicação de redes temáticas, como reguladora do acesso e utilização dos serviços necessários para a integralidade do cuidado. O presente estudo, financiado com recursos PPSUS/Fapesp, problematiza as possibilidades da rede básica exercer tal função estratégica. Foram produzidas narrativas de vida de 15 usuários altamente utilizadores de serviços de saúde em dois municípios do ABC paulista, que adotaram a Estratégia de Saúde da Família para organização de suas redes básicas. O estudo apresenta três achados principais: a rede básica funciona como posto avançado do SUS, produzindo valores de uso mesmo para os pacientes utilizadores de serviços de alta complexidade; a rede básica é vista como lugar de coisas simples; há uma impotência compartilhada entre usuários e equipes quando se trata da rede básica funcionar como coordenadora do cuidado, indicando como ela não reúne condições materiais (tecnológicas, operacionais, organizacionais) e simbólicas (valores, significados e representações) de deter a posição central da coordenação das redes temáticas de saúde.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina PreventivaInstituto Superior de Ciências do Trabalho e da Empresa Instituto Universitário de Lisboa Faculdade de Ciências Médicas Departamento de Saúde ColetivaUniversidade Estadual de Campinas Faculdade de Ciências Médicas Departamento de Saúde ColetivaUNIFESP, EPM, Depto. de Medicina PreventivaSciEL

Classification of haematopoietic and lymphoid tumors: WHO, standardization of nomenclature in Portuguese, 4th edition

INTRODUCTION: The World Health Organization (WHO) classification of hematopoietic and lymphoid tissue (4th edition, 2008) tumors constitutes an updated review of the 3rd edition published in 2001. The translation of the nomenclature used to describe the entities should be clear, precise and uniform so that clinicians, pathologists and researchers involved in the onco-hematopathological area may identify them accurately. OBJECTIVE: With this purpose, the authors present an updated proposal and a terminological standardization in Portuguese based on WHO/2008INTRODUÇÃO: A classificação da Organização Mundial da Saúde (OMS) para os tumores do tecido hematopoético e linfoide (4ª edição, 2008) representa uma revisão atualização da 3ª edição publicada em 2001. A tradução da nomenclatura utilizada para identificar as entidades descritas deve ser clara, precisa e uniforme no sentido de reproduzir de forma correta as diversas entidades clinicopatológicas para clínicos, patologistas e pesquisadores envolvidos na área da onco-hematopatologia. OBJETIVO: Os autores apresentam uma proposta de atualização e padronização terminológica em língua portuguesa, com base na OMS/200864364

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

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease