Guillain-Barre syndrome related to COVID-19: muscle and nerve biopsy findings

Background: The involvement of the peripheral nervous system (PNS) in COVID-19 is rare and, to date, morphological aspects from muscle and nerve biopsies have not been reported. Here, we describe a case of Guillain-Barré Syndrome (GBS) related to COVID-19 and demonstrate findings from peripheral nerve and skeletal muscle biopsies. A 79-year-old man presented with progressive weakness in both legs over one-week, evolving to both arms and urinary retention within 6 days. Four days earlier, he had a cough, febrile sensation and mild respiratory discomfort. On admission, his was afebrile, and without respiratory distress. A neurological examination disclosed asymmetric proximal weakness, diminished reflexes and no sensitive abnormalities. Three days later, the patient presented with bilateral facial weakness and proximal muscle strength worsened. Deep tendon reflexes and plantar responses were absent. Both superficial and profound sensitivity were decreased. From this point, oxygen saturation worsened, and the patient was placed on mechanical ventilation. CSF testing revealed one cell and protein 185 mg/dl. A chest CT showed the presence of ground-glass opacities and RT-PCR for SARS-CoV-2 was positive. The muscle biopsy revealed moderate neuromyopathic findings with positive expression for MHC-class I, C5b9, CD8 and CD68. The nerve biopsy showed inflammatory infiltrates predominantly with endoneurial compound formed by CD45 and CD68. The patient was treated with Oseltamivir for 9 days followed by IVIG for 5 days and died three days later of septic shock. Discussion: This is the first documented case of GBS associated with COVID-19 with a muscle and nerve anatomopathological study. A systematic review about neurological complications caused by COVID-19 described 11 patients with GBS. The morphological features reported in our patient showed signs of involvement of the immune system, suggesting that direct viral invasion could have played a role in the pathogenesis of peripheral nerve injury. Hereafter, further research will be necessary to understand the triggers for these cells migrating into the peripheral nerve

Probabilidades no Esporte

Este trabalho versa sobre Probabilidades no Esporte, de uma forma, assim o esperamos, acessível. Começamos recordando alguns conceitos gerais sobre o assunto que é bem provável que o leitor já tenha, e tentamos argumentar que eles não funcionam se aplicados a Esportes. Isto nos leva naturalmente a uma discussão sobre o que essencialmente são probabilidades. Exibimos dois diferentes modelos de cálculo 'para Futebol e Fórmula 1' que servem de exemplos para o que foi dito anteriormente no texto. Tentamos convencer o leitor de que a construção de um tal modelo não requer nenhuma habilidade especial e esperamos que estas linhas forneçam o embasamento necessário caso o leitor queira fazer seu próprio modelo.This work is about Probabilities in Sport within a, hopefully, accesible shape. We start by recalling few general concepts on the subject that the reader quite likely have, and try to argue why they do not work if applied to Sports. This naturally leads us to a discusion on what essentially probabilities are. We exhibit two different models of computation 'for Soccer and Formula 1' which stand for examples for what was prioly said in the text. We try to convince the reader that the construction of any such a model requires no special skills and we hope our lines provide the reader with the basic backgrounds in case he is interested in build his own model

Bio-behavioral survey of syphilis in homeless men in Central Brazil: a cross-sectional study

The objective of this study was to investigate the prevalence and factors associated with syphilis in homeless men in Central Brazil. It is a cross-sectional study conducted with 481 individuals attending four therapeutic communities between October and December 2015. A structured interview was conducted to collect sociodemographic data and risk factors for syphilis. Rapid/point-of-care and VDRL tests were performed to determine exposure to syphilis and the presence of active syphilis, respectively. Poisson regression analysis was used to verify the risk factors associated with the outcomes investigated. Of the study participants, 10.2% were reactive to the rapid test, and 5.4% had active syphilis. At the multiple regression analysis, schooling (adjusted prevalence ratio - APR: 0.89; p = 0.005), history of genital ulcer (APR: 2.59; p = 0.002), STI history (APR: 1.97; p = 0.042), and sexual intercourse under drug effects (APR: 1.60; p = 0.022) were independent factors associated with lifetime syphilis. Also, history of genital ulcer (APR: 2.19; p = 0.019), STI history (APR: 1.74; p = 0.033) and number of sexual partners in the last year (APR: 1.02; p = 0.044) were associated with active syphilis. The prevalence of syphilis among homeless men was rather high, confirming the vulnerability of this group to this infection. These results emphasize the need for educational intervention, improvement of risk reduction programs, availability of diagnostic tests, especially the rapid test, and treatment

Efficacy of treatment of class II furcation lesions using membrane associated with bone grafting in mandibular molars compared to membrane only: a systematic review and meta-analysis.

Objective: The objective of the present systematic review and meta-analysis was to compare treatment with membrane associated with bone grafting and treatment exclusively with membrane in the approach of Class II furcation defects in mandibular molars. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were conducted in five databases (PubMed, Web of Science, Scopus, Ovid, and Lilacs), in Septem-ber 2021, without restriction regarding publication year or language. Studies comparing membranes associated with bone grafting and membranes exclusively in the treatment of Class II furcation lesions were included. Cross-sectional, case-control studies, and reviews were excluded. Study selection, data extraction, and risk of bias assessment (MINORS) were performed by two review authors. The certainty of the evidence (GRADE) was evaluated and meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. Results: Four hundred eighty-six references were iden-tified and four studies were included. Greater reduction in probing depth [MD = 0.32 (CI = 0.09, 0.56)] and greater clinical attachment level gain [MD = 0.41 (CI = 0.24, 0.57)] were observed when membrane and bone grafting were used. The risk of bias of included studies was low. Conclusions: This present systematic review and meta-analysis demonstrated that treatment of Class II furcation defects in mandibular molars using membrane and bone grafing is significantly more efficacious than treatment with the exclusive use of membrane

Transexualidade, identidade de gênero e sindicato: algumas perspectivas/ Transsexuality, gender identity and union: some perspectives

Analisar a diversidade de gênero no Brasil além de uma questão de compreender os fenômenos sociais é uma questão de preservação da vida de algumas pessoas. Quando se trabalha a existência das pessoas transexuais, fica muito claro o contexto de exclusão e violência sofridos. Tem-se verdadeiro genocídio de transexuais no Brasil, e muito pouco é feito pelas instituições, de modo geral, sobre o tema. E é nesse contexto, que o presente trabalho se propõe a problematizar a atuação dos sindicatos, enquanto verdadeiros espaços de debate e luta, historicamente construídos e compreendidos frente a situação das pessoas transexuais. Busca-se a contextualização das vivências diversas no Brasil e a leitura da diversidade diante da atuação sindical atual

Fequency distribution of HLA DQ2 and DQ8 in celiac patients and first-degree relatives in Recife, northeastern Brazil

AIMS: The aim of this study was to evaluate the frequencies of the HLA genotypes DQ2 and DQ8 and the alleles A1*05, A1*0201, B1*0201 and B1*0302 in individuals with celiac disease in Recife, northeastern Brazil. METHODS: HLA DQ2 and DQ8 genotyping was performed for 73 individuals with celiac disease and 126 first-degree relatives with negative transglutaminase serology. The alleles DQA1*05, DQA1*0201, DQB1*02 and DQB1*0302 were identified by sequencing using specific primers and the EU-DQ kit from the Eurospital Laboratory, Trieste, Italy and double-checked by the All Set SPP kit (Dynal). RESULTS: Among the 73 cases, 50 (68.5%) had the genotype DQ2, 13 (17.8%) had DQ8, 5 (6.8%) had DQ2 and DQ8, and 5 did not have any of these genotypes. Among the 5 negative individuals, four had the B1*02 allele and one did not have any of the alleles studied. B1*02 was the most frequent allele in both groups (94% in the patients and 89% in the control relatives). CONCLUSIONS: In this study, celiac disease was associated with the genotypes DQ2 and DQ8. DQ2 predominated, but the distribution of the frequencies was different from what has been found in European populations and was closer to what has been found in the Americas. The high frequencies of the HLA genotypes DQ2 and DQ8 that were found in first-degree relatives would make it difficult to use these HLA genotypes for routine diagnosis of celiac disease in this group

Increased risk of dizziness in human immunodeficiency virus-infected patients taking zidovudine and efavirenz combination: a Brazilian cohort study.

Abstract Objectives Neuropsychiatric adverse effects (NPAE) related to efavirenz, mainly dizziness, is detrimental to human immunodeficiency virus (HIV) treatment. Our study aims at evaluating if zidovudine use potentiates the risk of dizziness related to efavirenz when used together and whether there are significant differences in over time distribution of this NPAE and others relatively frequents regarding efavirenz regimen without zidovudine. Methods Human immunodeficiency virus-infected patients under efavirenz-containing different therapy were enrolled. A retrospective analysis of official medical records was accomplished to collect clinical data regarding NPAE occurrence and severity. Univariate statistic and statistical model based on survival analyses were performed. Key findings One hundred sixty-two patients were included, of these seventy-seven (47.5%) had NPAE reported, such as dizziness (more frequent), depression and insomnia. Univariate statistical analysis demonstrated that the combined use of efavirenz with zidovudine increased the NPAE risk (OR: 2.5; P-value: 0.008), mainly dizziness risk (OR: 3.5; P-value: 0.009) and survival analysis showed that such combination is associated with dizziness occurrence faster (HR: 2.9; P-value: 0.02). Conclusions The results may contribute to clarify the dizziness occurrence dynamics in therapy with efavirenz and zidovudine by identifying susceptibilities and assisting in the choice of combined antiretroviral therapy

Perfil das internações por condições sensíveis à atenção primária relacionadas à cobertura da estratégia saúde da família em Anápolis-go, de 2001 a 2017

Objetivo: o estudo visa descrever e analisar a relação entre a cobertura da Estratégia Saúde da Família (ESF) e as Internações por Condições Sensíveis à Atenção Primária (ICSAP) em Anápolis no período de 2001 a 2017. Métodos: Estudo ecológico, descritivo e analítico. Considerou-se ICSAP ocorridas em Anápolis, no período de 2001 a 2017, analisando as referidas variáveis e suas interrelações. Os dados foram extraídos do Sistema de Informação Hospitalar (SIH/SUS) e do Sistema de Informação da Atenção Básica (SIAB). Foram ainda analisados por medidas de tendência central. As internações foram definidas por meio da Lista Brasileira de Internações por Condições Sensíveis à Atenção Primária. Resultados: A cobertura da ESF aumentou 5 vezes enquanto as ICSAP reduziram em 3 vezes em relação ao ano 2001. As etiologias mais prevalentes das ICSAP foram: Pneumonia, Gastroenterocolites, Asma, Insuficiência Cardíaca, Angina. O valor “r” atribuído à relação das afecções e as ESF foram negativos enquanto que apenas a pneumonia apresentou r=+0,37. A correlação entre ICSAP e ESF foi de -0,7, enquanto as Internações por Causas Não sensíveis à Atenção Primária (N-ICSAP) foi de +0,26. As gastroenterocolites representaram 76,26% das ICSAP. Angina e Insuficiência cardíaca predominaram em maiores de 60 anos. Asma representou 57,66% das internações em até 9 anos, enquanto a pneumonia mostrou-se prevalente em todas as faixas etárias. As mulheres internam cerca de 8 vezes mais que homens. Conclusões: O estudo concluiu que existe uma relação inversamente proporcional das ESF com as ICSAP no município de Anápolis

Comparação de dados meteorológicos obtidos por estação convencional e automática e estimativa da evapotranspiração de referência em Imperatriz/MA

O uso de dados meteorológicos na agricultura tem grande importância na previsão da evapotranspiração e projeção de cenários futuros, sendo necessário precisão nas estações de coletas desses dados. O estudo objetivou comparar os dados meteorológicos obtidos na estação convencional em relação aqueles obtidos na estação automática, bem como estimar a evapotranspiração de referência (E|To) pelo método de Penman-Monteith. Para alcançar tais objetivos, dados diários de temperatura máxima, mínima, umidade relativa máxima e mínima, velocidade do vento e radiação solar foram adquiridos de dois tipos de estação meteorológicas: uma convencional (EMC) e outra automática (EMA), pertencentes à rede de estações do Instituto Nacional de Meteorologia (INMET) ambas localizadas no município de Imperatriz/MA. Para comparação dos dados bem como da evapotranspiração obtida a partir desses dados, utilizou-se a análise de regressão linear e determinou-se o coeficiente de determinação (R²). Além disso, utilizou-se também a porcentagem relativa dos dados obtidos na EMC em relação aos dados obtidos na EMA (superestimativa/subestimativa) (%), o índice de concordância de Willmott (d), o coeficiente de correlação (r) e o coeficiente de confiança (c) proposto por Camargo e Sentelhas. Os resultados deste estudo mostraram que as estações apresentam divergências relativamente grandes quanto aos dados de temperatura máxima, temperatura mínima, velocidade do vento e radiação solar, sendo necessária a calibração do sensor da estação convencional. A temperatura média e a umidade relativa média do ar foram semelhantes apresentando a melhor correlação entre a EMC e EMA. A evapotranspiração de referência pelo método de Penman Monteith apresentou classificação muito alta segundo a classificação de Cohen, quanto ao coeficiente de correlação e desempenho sofrível pela classificação de Camargo e Sentelhas

Copaiba Oil-Resin Treatment Is Neuroprotective and Reduces Neutrophil Recruitment and Microglia Activation after Motor Cortex Excitotoxic Injury

The oil-resin of Copaifera reticulata Ducke is used in the Brazilian folk medicine as an anti-inflammatory and healing agent. However, there are no investigations on the possible anti-inflammatory and neuroprotective roles of copaiba oil-resin (COR) after neural disorders. We have investigated the anti-inflammatory and neuroprotective effects of COR following an acute damage to the motor cortex of adult rats. Animals were injected with the neurotoxin N-Methyl-D-Aspartate (NMDA) (n = 10) and treated with a single dose of COR (400 mg/kg, i.p.) soon after surgery (Group 1) or with two daily doses (200 mg/kg, i.p.) during 3 days (Group 2) alter injury. Control animals were treated with vehicle only. COR treatment induced tissue preservation and decreased the recruitment of neutrophils and microglial activation in the injury site compared to vehicle animals. The results suggest that COR treatment induces neuroprotection by modulating inflammatory response following an acute damage to the central nervous system