332 research outputs found
Actividades de educação ambiental realizadas pelo CCPA no decorrer da XIII Expedição Científica do Departamento de Biologia – Flores e Corvo 2007
XIII Expedição Científica do Departamento de Biologia - Flores e Corvo 2007.Tendo em conta a crescente importância da educação ambiental para a construção
da cidadania, força motriz de um desenvolvimento sustentável, o Centro de Conservação e Protecção do Ambiente (CCPA) promoveu a realização de diversas actividades de cariz teórico-prático sobre questões ambientais e de valorização do património biológico, junto dos utentes da Ecoteca das Flores e dos alunos da Escola Básica Integrada das Colmeias e da Escola EB 2.3/S de Melgaço, que participaram na XIII Expedição Científica do Departamento de Biologia às ilhas das Flores e Corvo
Safety of oral ivermectin during pregnancy: a systematic review and meta-analysis
Background: About 3·7 billion doses of ivermectin have been distributed in mass drug administration (MDA)
campaigns globally over the past 30 years. At 10–100 times higher than current human doses, ivermectin is a known
teratogen in mammals. During these campaigns with recommended doses, pregnant women might be inadvertently
exposed. We therefore aimed to evaluate the existing evidence for serious and non-serious adverse events after
ivermectin exposure in pregnant women.
Methods: For this systematic review and meta-analysis, we searched relevant databases and trial registry platforms on
July 15, 2018, for randomised controlled trials (RCTs) and observational studies that reported adverse events in
pregnant women. We did not use language or date restrictions. Outcomes of interest were spontaneous abortions,
stillbirths, congenital anomalies, and neonatal death (serious adverse events), as well as maternal morbidity, preterm
births, and low birthweight (adverse events). The risk of bias was assessed using the Newcastle-Ottawa Scale for
observational studies and the Cochrane Risk of Bias Tool for RCTs. We did the meta-analysis of observational studies
and RCTs separately. The quality of evidence was assessed using the GRADE approach. The study protocol is
registered with PROSPERO, protocol CRD42016046914.
Findings: We identified 147 records, of which only five observational studies and one RCT were included for quantitative
analysis; these studies were published between 1990 and 2008, and were done in six African countries. 893 women
with 899 pregancy outcomes were included, of whom 496 pregnant women (500 pregnancy outcomes) received
ivermectin inadvertently during MDA campaigns in the observational studies and 397 pregnant women (399 pregnancy
outcomes) purposely received ivermectin as part of the open-label RCT. No study reported neonatal deaths, maternal
morbidity, preterm births, or low birthweight. It is unclear whether exposure to ivermectin during pregnancy
increases the risk of spontaneous abortions and stillbirths (odds ratio [OR] 1·15 [95% CI 0·75–1·78] with very low
certainty of evidence for the four observational studies and 0·62 [0·18–2·14] with very low certainty of evidence for
the RCT) or congenital anomalies (OR 1·69 [95% CI 0·83–3·41] with very low certainty of evidence for the
five observational studies and 1·10 [0·07–17·65] with very low certainty of evidence for the RCT).
Interpretation: There is insufficient evidence to conclude on the safety profile of ivermectin during pregnancy.
Treatment campaigns should focus additional efforts on preventing inadvertent treatment of pregnant women
Alternative transmission routes in the malaria elimination era: an overview of transfusion-transmitted malaria in the Americas
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Previous issue date: 2017Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Hematologia e Hemoterapia do Amazonas. Manaus, AM, Brasil.Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Fundação de Hematologia e Hemoterapia do Amazonas. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Sem afiliação.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto de Pesquisas Leônidas e Maria Deane. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto de Pesquisas Leônidas e Maria Deane. Manaus, AM, Brasil.Background: Transfusion-transmitted (TT) malaria is an alternative infection route that has gained little attention
from authorities, despite representing a life-threatening condition. There has been no systematic review of this health problem in American countries. The aim of this study was to describe the clinical and epidemiological characteristics of TT malaria in the Americas and identify factors associated with lethality based on the studies published in the literature. Methods: Potentially relevant papers in all languages were retrieved from MEDLINE and LILACS. Additional articles were obtained from reviews and original papers. Publications on screening of candidate blood donors and on surveillance of TT malaria cases were included. Odds ratios with respective 95% confidence intervals (95% CI) were calculated. Epidemiological characteristics of blood donors of TT malaria cases, including a pooled positivity of different tests for malaria diagnosis, were retrieved. Results: A total of 63 publications regarding TT malaria from seven countries were included, from 1971 to 2016. A total of 422 cases of TT malaria were recorded. Most TT malaria cases were in females (62.0%) and 39.5% were in the ≥61 years-old age group. About half of all cases were from Mexico (50.7%), 40.3% from the United States of America (USA) and 6.6% from Brazil. Gyneco-obstetrical conditions (67.3%), surgical procedures (20.6%) and complications from neoplasias (6.1%) were the most common indications of transfusion. Packed red blood cells (RBCs) (50.7%) and whole blood (43.3%) were the blood products mostly associated with TT malaria. Cases were mostly caused by Plasmodium malariae (58.4%), followed by Plasmodium vivax (20.7%) and Plasmodium falciparum (17.9%). A total of 66.6% of cases were diagnosed by microscopy. Incubation period of 2–3 weeks was the most commonly observed (28.6%). Lethality was seen in 5.3% of cases and was associated with living in non-endemic countries, P. falciparum infection and concomitant neoplastic diseases.
Conclusion: There is an important research and knowledge gap regarding the TT malaria burden in Latin American countries where malaria remains endemic. No screening method that is practical, affordable and suitably sensitive is available at blood banks in Latin American countries, where infections with low parasitaemia contribute greatly to transmission. Lethality from TT malaria was not negligible. TT malaria needs to be acknowledged and addressed in areas moving toward elimination
Avaliação funcional pré e pós-programa de exercício físico de pacientes em hemodiálise
Model Study: An experimental study Introduction: Chronic Kidney Disease (CKD) refers to a syndromic diagnosis which leads to a progressive and irreversible loss of renal function. A hemodialysis patient may have limitations in functional capacity, pulmonary function and respiratory musclular strength impacting in quality of life. Objective: To evaluate the effects of an exercise program on pulmonary function, functional capacity, quality of life and pain in patients undergoing hemodialysis. Methodology: The study included 28 patients of both genders, women and men aged between 40 and 60 years undergoing dialysis at the Kidney Institute, Santa Casa de Misericordia in Presidente Prudente-SP. Primary outcomes included respiratory muscular strength measurements assessed by manovacuometry. The functional capacity was evaluated by a six minute walking test. A life quality questionnaire was applied to evaluate quality of life (SF36-KDQOL). Lung function was evaluated by spirometry. Pain was assessed by a visual analogue scale. The exercise program consisted of training 3 times a week for 40 minutes on hemodialysis during eight weeks. At the end of the program all patients were reassessed. Results:There was no significant difference in the values of FVC and FEV1 before and after the exercise program as well as the index Tiffenau. The value of post MIP was significantly higher than the value obtained in the pre program. For variable MEP no significant difference was found. Functional capacity evaluations showed that there were no significant differences (p> 0.05). The evaluation of quality of life, about the domains of specific areas of CKD showed statistical significance when comparing the list of symptoms and problems with overloading of renal disease and professional role. Indicators related to pain were significantly reduced after the program (P <0.05). Discussion: A chronic kidney patient faces complex situations of physical, social and financial aspects. Although no statistically significant results were found in all variables, the study corroborates to others found in the literature, which suggests that an exercise program can be positive for this population. Conclusion: Although lung capacity and functional capacity did not submit changes to the end of the study, reduced levels of pain, fatigue and dyspnea suggest improvement in functional performance after exercise programs.Modelo do estudo: Estudo experimental. Introdução: A Doença Renal Crônica (DRC) refere-se a um diagnóstico sindrômico de perda progressiva e irreversível da função renal. O paciente submetido à hemodiálise pode apresentar limitações na capacidade funcional, função pulmonar e força muscular respiratória, com consequentes prejuízos na qualidade de vida. Objetivo: Avaliar os efeitos de um programa de exercício físico sobre a função pulmonar, capacidade funcional, qualidade de vida e dor, em pacientes que realizam hemodiálise. Metodologia: Participaram do estudo 28 pacientes de ambos os sexos, com idade entre 40 e 60 anos, em programa de hemodiálise no Instituto do Rim da Santa Casa de Misericórdia de Presidente Prudente-SP. A força muscular respiratória foi avaliada pela manovacuometria, a capacidade funcional, pelo TC6', a qualidade de vida, pelo questionário KDQOLSF, a função pulmonar, pela espirometria e a dor, pela EVA. Após as avaliações, os pacientes iniciaram o programa de exercícios, que foi desenvolvido três vezes por semana, durante 40 minutos em hemodiálise, por oito semanas. Ao final do programa, os pacientes foram reavaliados. Resultados: Não houve diferença significativa dos valores da CVF e VEF1 pré e pós-programa de exercícios, assim como do Índice de Tiffenau. O valor da PImax pós-programa foi significativamente maior que o obtido na avaliação pré-programa. Para a variável PEmax, não foi encontrada diferença significativa. As avaliações da capacidade funcional inicial e final não apresentaram diferenças significativas (p>0,05). A avaliação da qualidade de vida, quanto aos domínios das áreas específicas da DRC, mostrou que houve significância estatística, ao comparar a lista de sintomas e problemas com a sobrecarga da DRC e papel profissional. Os indicadores relativos à dor foram reduzidos, após o programa (p<0,05). Discussão: O DRC enfrenta situações complexas de dependência física, social e financeira. Apesar de não apresentar resultados estatisticamente significativos em todas as variáveis avaliadas, este estudo, corroborando outros encontrados na literatura, sugere um programa de exercício físico, com aspectos positivos para essa população. Conclusão: Embora a capacidade pulmonar e a capacidade funcional (TC6') não tenham apresentado alterações ao final do experimento, os níveis reduzidos de dor, cansaço e dispneia sugerem melhora do desempenho funcional, após programas de exercício físico para DRC
Distinct mRNA and protein interactomes highlight functional differentiation of major eIF4F-like complexes from Trypanosoma brucei
Gene expression in pathogenic protozoans of the family Trypanosomatidae has several novel features, including multiple eIF4F-like complexes involved in protein synthesis. The eukaryotic eIF4F complex, formed mainly by eIF4E and eIF4G subunits, is responsible for the canonical selection of mRNAs required for the initiation of mRNA translation. The best-known complexes implicated in translation in trypanosomatids are based on two related pairs of eIF4E and eIF4G subunits (EIF4E3/EIF4G4 and EIF4E4/EIF4G3), whose functional distinctions remain to be fully described. Here, to define interactomes associated with both complexes in Trypanosoma brucei procyclic forms, we performed parallel immunoprecipitation experiments followed by identification of proteins co-precipitated with the four tagged eIF4E and eIF4G subunits. A number of different protein partners, including RNA binding proteins and helicases, specifically co-precipitate with each complex. Highlights with the EIF4E4/EIF4G3 pair include RBP23, PABP1, EIF4AI and the CRK1 kinase. Co-precipitated partners with the EIF4E3/EIF4G4 pair are more diverse and include DRBD2, PABP2 and different zinc-finger proteins and RNA helicases. EIF4E3/EIF4G4 are essential for viability and to better define their role, we further investigated their phenotypes after knockdown. Depletion of either EIF4E3/EIF4G4 mRNAs lead to aberrant morphology with a more direct impact on events associated with cytokinesis. We also sought to identify those mRNAs differentially associated with each complex through CLIP-seq with the two eIF4E subunits. Predominant among EIF4E4-bound transcripts are those encoding ribosomal proteins, absent from those found with EIF4E3, which are generally more diverse. RNAi mediated depletion of EIF4E4, which does not affect proliferation, does not lead to changes in mRNAs or proteins associated with EIF4E3, confirming a lack of redundancy and distinct roles for the two complexes
Frequência e perfil de suscetibilidade aos carbapenêmicos de bastonetes Gram-negativos não fermentadores de glicose isolados de amostras clínicas entre 2007 e 2012
Introdução: Um dos grandes problemas nos serviços de saúde é a ocorrência de infecções relacionadas com assistência à saúde (IRAS) por microrganismos resistentes a vários antimicrobianos. Objetivos: Descrever a frequência e o perfil de suscetibilidade de Pseudomonas aeruginosa e Acinetobacter baumannii aos carbapenêmicos no hospital da Fundação Santa Casa de Franca, São Paulo, Brasil. Métodos: Retrospectivamente, a suscetibilidade de P. aeruginosa e A. baumannii aos carbapenêmicos foi analisada em 304 isolados clínicos entre 2007 e 2012, a partir de um banco de dados do setor de microbiologia do laboratório clínico do hospital da Fundação Santa Casa de Franca, São Paulo, Brasil. Resultados: Das cepas isoladas e identificadas, 236 (5,3%) P. aeruginosa eram suscetíveis a imipenem (2007 - 69,6% a 2012 - 41,7%) e meropenem (2007 - 63,3% a 2012 - 25%). Além disso, todos os 68 (1,7%) isolados de A. baumannii eram suscetíveis aos dois antibióticos. Conclusão: Não foi identificada resistência de A. baumannii aos carbapenêmicos, no entanto houve diminuição da suscetibilidade aos carbapenêmicos no decorrer dos anos para P. aeruginosa.Introduction: One of the major problems in health services is the occurrence of healthcare-associated infections (HAIs) by microorganisms resistant to various antimicrobials. Objectives: To describe the frequency and susceptibility profile of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenems in the hospital from Fundação Santa Casa de Franca, São Paulo, Brazil. Methods: The susceptibility of P. aeruginosa and A. baumannii to carbapenems from 304 clinical isolates between 2007 and 2012 was retrospectively analyzed from a microbiology database at the clinical laboratory of the hospital of Fundação Santa Casa de Franca, São Paulo, Brazil. Results: From isolated and identified strains, 236 (5.3%) P. aeruginosa were susceptible to imipenem (2007 - 69.6% to 2012 - 41.7%) and meropenem (2007 - 63.3% to 2012 - 25%). In addition, all 68 (1.7%) A. baumannii isolates were susceptible to both antibiotics. Conclusion: A. baumannii resistance to carbapenems was not identified; however, there was a decrease in susceptibility to carbapenems over the years for P. aeruginosa
European survey on national harmonization in clinical research
Background: Clinical trials remain key to the development of evidence-based medical practice. However, they are becoming increasingly complex, mainly in a multinational setting. To address these challenges, the European Union (EU) adopted the Clinical Trial Regulation EU No. 536/2014 (CTR). Once in force, the CTR will lead to more consistent rules and simplification of procedures for conducting clinical trials through-out the EU. Existing harmonization initiatives and “research infrastructures” for clinical trials may facilitate this process. This publication offers a snapshot of the current level of harmonization activities in academic clinical research in Europe. Methods: A survey was performed among the member and observer countries of the European Clinical Research Infrastructure Network (ECRIN), using a standardizedpublishersversionpublishe
Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community
Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.We are grateful to patients participating in this study and to Sebastiao L. Brandao Filho for technical assistance.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sector
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