Evidence for Host Epigenetic Signatures Arising From Arbovirus Infections: A Systematic Review

Background: Arbovirus infections have steadily become a major pandemic threat. This study aimed at investigating the existence of host epigenetic markers arising from the principal arboviruses infections impacting on human health. We set to systematically review all published evidence describing any epigenetic modifications associated with infections from arboviruses, including, but not limited to, microRNAs, DNA methylation, and histone modifications.Methods: A comprehensive search was conducted using the electronic databases PubMed, Science Direct and Cochrane Library from inception to January 4th, 2018. We included reports describing original in vivo or in vitro studies investigating epigenetic changes related to arbovirus infections in either clinical subjects or human cell lines. Studies investigating epigenetic modifications related to the virus or the arthropod vector were excluded. A narrative synthesis of the findings was conducted, contextualizing comparative evidence from in vitro and in vivo studies.Results: A total of 853 unique references were identified and screened by two independent researchers. Thirty-two studies met the inclusion criteria and were reviewed. The evidence was centered mainly on microRNA and DNA methylation signatures implicated with secondary Dengue fever. Evidence for recent epidemic threats, such as the infections by Zika or Chikungunya viruses is still scant.Conclusions: Major epigenetic alterations found on arboviruses infections were miR-146, miR-30e and the Dicer complex. However, existing studies frequently tested distinct hypotheses resulting in a heterogeneity of methodological approaches. Whilst epigenetic signatures associated with arbovirus infections have been reported, existing studies have largely focused on a small number of diseases, particularly dengue. Validation of epigenetic signatures have an untapped potential, but concerted investigations are certainly required to deliver robust candidates of clinical utility for diagnosis, staging and prognosis of specific arboviral diseases

A depressão no teste das Pirâmides Coloridas de Pfister

O objetivo desse estudo foi investigar o desempenho de pacientes com depressão no teste das Pirâmides Coloridas de Pfister. Foram investigados 19 pacientes com depressão, previamente diagnosticados pela SCID, e seus desempenhos foram comparados com os resultados obtidos com uma amostra de 110 indivíduos não pacientes que participaram de um estudo normativo. Adotou-se como procedimento a versão do Pfister de 24 matizes e a realização de três pirâmides bonitas. Os resultados apontaram para um significativo aumento do verde acompanhado da constância absoluta da cor violeta, bem como a maior incidência de pirâmides cortadas e de formações tendendo a estruturas. A combinação desses indicadores possibilita identificar pacientes com pânico havendo 86,4% de sensibilidade. Tais resultados permitem afirmar que o teste de Pfister pode colaborar para o diagnóstico de depressão, sendo contudo necessários outros recursos para maior segurança diagnóstica.In this study our purpose was to identify the aspects in the Color Pyramid Test of Pfister which may be useful to the assessment of depressive patients. Our sample was composed by 19 participants previously assessed by the SCID as depressives. We used the Pfister's version composed by 24 colors and only the three beautiful pyramids. The results are compared with the performance of 110 no-patients and demonstrates that the high frequency of green, the absolute constancy of violet, the stratified forms with cuts or tendency to structures are significant for the group of patients Our results indicates that the sensibility of Pfister for the diagnosis of depression based on this aspects is about 86,4%. This test can helps satisfactory for the assessment of depression when associated to others techniques. This study contributes to the necessity to verify the possibilities and limitations in the use of this test

Telehealth effectiveness for pre-exposure prophylaxis delivery in Brazilian public services : the Combine! Study

Introduction Pre-exposure prophylaxis (PrEP) delivery based on user needs can enhance PrEP access and impact. We examined whether telehealth for daily oral PrEP delivery could change the indicators of care related to prophylactic use in five Brazilian public HIV clinics (testing centres, outpatient clinics and infectious disease hospitals). Methods Between July 2019 and December 2020, clients on PrEP for at least 6 months could transition to telehealth or stay with in-person follow-up. Clients were clinically monitored until June 2021. A desktop or mobile application was developed, comprising three asynchronous consultations and one annual in-person consultation visit. Predictors influencing telehealth preference and care outcomes were examined. The analysis encompassed intent-to-treat (first choice) and adjustments for sexual practices, schooling, age, duration of PrEP use and PrEP status during the choice period. Results Of 470 users, 52% chose telehealth, with the adjusted odds ratio (aOR) increasing over time for PrEP use (aOR for 25–months of use: 4.90; 95% CI: 1.32–18.25), having discontinued PrEP at the time of the choice (aOR: 2.91; 95% CI: 1.40–6.06) and having health insurance (aOR: 1.91; 95% CI: 1.24–2.94) and decreasing for those who reported higher-risk behaviour (aOR for unprotected anal sex: 0.51; 95% CI: 0.29–0.88). After an average follow-up period of 1.6 years (95% CI: 1.5–1.7), the risk of discontinuing PrEP (not having the medication for more than 90 days) was 34% lower with telehealth (adjusted hazard ratio: 0.66; 95% CI: 0.45–0.97). When adjusted by mixed linear regression, no differences in adherence (measured by mean medication possession rate) were found between in-person and telehealth (p = 0.486) or at pre- and post-telehealth follow-ups (p = 0.245). Sexually transmitted infections increased between the pre-follow-up and post-follow-up choices and were not associated with in-person or telehealth (p = 0.528). No HIV infections were observed. Conclusions Our findings indicate that telehealth for PrEP delivery can enhance service rationalization and reinforce the prevention cascade. This approach reduces prophylaxis interruptions and is mainly preferred by individuals with lower demands for healthcare services

Smp38 MAP Kinase Regulation in Schistosoma mansoni: Roles in Survival, Oviposition, and Protection Against Oxidative Stress

Eukaryotic protein kinases (ePKs) are good medical targets for drug development in different biological systems. ePKs participate in many cellular processes, including the p38 MAPK regulation of homeostasis upon oxidative stress. We propose to assess the role of Smp38 MAPK signaling pathway in Schistosoma mansoni development and protection against oxidative stress, parasite survival, and also to elucidate which target genes have their expression regulated by Smp38 MAPK. After a significant reduction of up to 84% in the transcription level by Smp38 MAPK gene knockdown, no visible phenotypic changes were reported in schistosomula in culture. The development of adult worms was tested in vivo in mice infected with the Smp38 knocked-down schistosomula. It was observed that Smp38 MAPK has an essential role in the transformation and survival of the parasites as a low number of adult worms was recovered. Smp38 knockdown also resulted in decreased egg production, damaged adult worm tegument, and underdeveloped ovaries in females. Furthermore, only ~13% of the eggs produced developed into mature eggs. Our results suggest that inhibition of the Smp38 MAPK activity interfere in parasites protection against reactive oxygen species. Smp38 knockdown in adult worms resulted in 80% reduction in transcription levels on the 10th day, with consequent reduction of 94.4% in oviposition in vitro. In order to search for Smp38 MAPK pathway regulated genes, we used an RNASeq approach and identified 1,154 DEGs in Smp38 knockdown schistosomula. A substantial proportion of DEGs encode proteins with unknown function. The results indicate that Smp38 regulates essential signaling pathways for the establishment of parasite homeostasis, including genes related to antioxidant defense, structural composition of ribosomes, spliceosomes, cytoskeleton, as well as, purine and pyrimidine metabolism pathways. Our data show that the Smp38 MAPK signaling pathway is a critical route for parasite development and may present attractive therapeutic targets for the treatment and control of schistosomiasis

Complicações Pós-Trauma: Gerenciando Edema Cerebral e Hipertensão Intracraniana

Introduction: The interconnection between cerebral edema and intracranial hypertension requires complex and rigorous monitoring, since cerebral edema directly influences the increase in intracranial pressure, resulting in a series of serious symptoms that can vary depending on the extent of the edema and other underlying factors. Objective: Understand complications arising from trauma and how to manage cerebral edema and intracranial pressure. Methodology: The Cochrane, Medline and Pubmed databases were used, searching for articles published between the years 2015 to 2023, in Portuguese or English. Conclusion: The treatment of these post-trauma conditions varies according to the clinical manifestations of each patient, therefore, obtaining an early diagnosis contributes to better monitoring and recovery.Introdução: A interconexão entre edema cerebral e hipertensão intracraniana aborda um acompanhamento complexo e rigoroso, uma vez que o edema cerebral influencia diretamente no aumento da pressão intracraniana, resultando em uma série de sintomas graves que podem variar dependendo da extensão do edema e de outros fatores subjacentes. Objetivo: Compreender as complicações decorrentes de traumas e como gerenciar o edema cerebral e a pressão intracraniana.  Metodologia: Foram utilizadas as bases de dados Cochrane, Medline e Pubmed, buscando artigos publicados entre os anos 2015 a 2023, nos idiomas Português ou Inglês. Conclusão: O tratamento dessas condições pós-trauma varia de acordo com o as manifestações clínicas de cada paciente, por isso, obter o diagnóstico precoce contribui para um melhor monitoramento e recuperação

Cartografia e diplomacia: usos geopolíticos da informação toponímica (1750-1850)

O artigo explora dimensões geopolíticas da toponímia, registradas em documentos cartográficos, desde as reformas empreendidas pelo consulado pombalino em meados do século XVIII, até às primeiras décadas do século XIX, em meio ao processo de afirmação do Estado imperial pós-colonial.This paper explores the geopolitical dimensions of toponymy as registered in cartographic documents dating from the reforms pushed through by the consulate of Marquis of Pombal in the mid 18th century to the early decades of the 19th century, as the post-colonial imperial State established itself

Plantar povoações no território: (re)construindo a urbanização da capitania do Piauí, 1697-1761

The Piauí province´s urbanization has kept up with since late 17th century a complex process dealt among Portuguese Crown, the regal representatives, the network woven by the Casa da Torre and by the resident population in its countryside. What it was content of Rodelas countryside has begun to build with territorial identity since the foundation of first parish in 1697. Structuring itself discontinuously in time and space, the Piauí had reformed in 1758, year of creation of its autonomous government. And had became urban in 1761 when the king D. José I and marquis of Pombal had framed by the royal letter written in June 19 a territory formed by six towns and one city. Thus, this paper purposes to reconstructing the Piauí province according to agents involved in the urbanization processes. It proposes to deconstructing Crown´s polices by means towns strategically placed in territory aiming at control and "remedy" of routine injustices practiced in Piauí´s hinterlands. The method of presenting this reconstruction draws on interconnection between text (manuscript documents) and image (maps and photography) which in their discourses have represented a Piauí as space of experiences apprehended as much in official dimension as inhabitant´s everyday life.A urbanização da capitania do Piauí acompanhou, desde finais do século XVII, um complexo processo negociado entre a Coroa portuguesa, os representantes régios, a rede clientelar urdida pela Casa da Torre e a população residente em seus sertões. O que antes era conteúdo dos sertões de Rodelas passou a construir-se como identidade territorial a partir da fundação da primeira freguesia, em 1697, dedicada a Nossa Senhora da Vitória. Estruturando-se descontinuamente no tempo e no espaço, o Piauí reforma-se em 1758, ano da autonomização do seu governo. E fez-se urbano em 1761, quando D. José I e o marquês de Pombal equacionaram, por meio da carta régia de 19 de junho, um território formado por seis vilas e uma cidade. Nessa direção, o objetivo deste artigo consiste em reconstruir o processo de formação da capitania do Piauí segundo os agentes envolvidos na urbanização do território. Propõe-se descortinar as políticas da Coroa por meio da oficialização de povoações estrategicamente locadas no território visando o controle e o "remédio" das injustiças rotineiras do Piauí. O método de apresentar essa reconstrução vale-se da interconexão entre texto (documentação manuscrita) e imagem (mapas e fotografias), que em suas entrelinhas representam um Piauí como espaço de experiências sentidas tanto na dimensão oficial quanto no cotidiano dos seus moradores