Sintomas de refluxo relatados por pacientes com asma grave

Introdução: A asma é uma inflamação crônica das vias aéreas caracterizada por Shiperresponsividade brônquica, limitação reversível do fluxo aéreo, sibilância, tosse, dentre outros.  Apresenta diversos fenótipos, alta incidência no mundo e pode estar relacionada   a diversas complicações envolvendo o seu mau controle. O refluxo gastroesofágico tem sido associado a apresentação clínica da asma. A pesar da sua alta frequência na população com asma, estudos buscam se aprofundar na sua etiologia, complicações e sua relação com o controle da doença. Objetivo: Investigar a presença de queixas de refluxo gastroesofágico em pacientes com asma e a relação com o controle da doença. Metodologia: Estudo descritivo, a partir da coleta de dados secundários de questionários sorteados de pacientes com asma grave (GINA, 2002), de ambos os sexos, a cima de 18 anos, acompanhados pelo Programa de Controle da asma e da Rinite Alérgica (ProAr).  Resultados: Total de 40 prontuários, com predominância de pacientes do sexo feminino (85%), com média de idade de 53,18±14,97 anos, entre as faixas de sobrepeso e obesidade (62,5%), com renda de 0 a 2 salários mínimos (95%), com 50% dos indivíduos apresentando ausência de mais de 50 % das unidades dentárias e nível de escolaridade entre o ensino médio e o fundamental (60%). A idade média de diagnóstico da asma foi 19,09 ±19,39. O tempo médio de diagnóstico da asma foi 34,85 ± 19,46. A média dos escores para o QS-DRGE foi de 10,4±7,85 e para o ACQ6 foi de 1,65±1,33. 0). A pontuação do escore QS-DRGE para os indivíduos com asma não controlada foi maior que para os indivíduos com o controlados. A razão de prevalência de queixa de refluxo em pacientes asmáticos foi de 1,35. Coeficiente de Spearman foi de 0,641. Conclusão: refluxo foi frequentemente relatado por pacientes com asma e foi associada à ausência de controle da doença, porém foi encontrada uma fraca correlação entre as variáveis

Small-scale distribution of the mesozooplankton in a tropical insular system

Neste presente trabalho, são apresentadas as flutuações espacial e sazonal da abundância e diversidade do mesozooplâncton, com especial atenção para assembleia de copépodes da área costeira do Arquipélago de Fernando de Noronha (AFN) (3°50'24''S and 32°24'48''W). A amostragem foi realizada durante as estações seca e chuvosa de dois anos consecutivos (julho e dezembro de 2013) e (junho e novembro de 2014). Um total de 37 taxa do mesozooplâncton foram registrados, sendo os copépodes o grupo mais diversificado (15 taxa). A Subclasse Copepoda dominou em ambos os períodos amostrados, com valores de abundância relativa equivalentes a 53% e 86%, respectivamente, nas estações seca e chuvosa. As espécies consideradas abundantes foram: Calanopia americana, Undinula vulgaris, Oithona plumifera e Corycaeus speciosus. A estação chuvosa favoreceu um aumento significativo na abundância do mesozooplâncton e copépodes. No entanto, um baixo valor do índice de diversidade de Shannon-Wiener foi observado para este mesmo período sazonal. Isso foi explicado pelo domínio das espécies C. americana e U. vulgaris na área estudada. Diferença espacial não foi verificada. A assembleia de copépodes apresentou um maior número de espécies consideradas carnívoro-predador de grande importância na teia trófica pelágica, indicadoras de condições oligotróficas e componente de grande porção dos itens alimentares dos peixes. Assim, sugerimos que a área costeira do Arquipélago de Fernando de Noronha é caracterizada por uma comunidade do mesozooplâncton espacialmente homogênea, onde as mudanças observadas estão principalmente relacionadas ao fator sazonal.In the present work, spatial and seasonal fluctuations of the abundance and diversity of mesozooplankton are presented, with special attention being given to copepod assemblages from coastal area of the Fernando de Noronha Archipelago (FNA) (3°50'24''S and 32°24'48''W). Sampling was carried out during the dry and rainy seasons of two consecutive years (July and December 2013) and (June and November 2014). A total of 37 mesozooplankton taxa were recorded, being the copepods the most diversified group (15 taxa). The Subclass Copepoda dominated in both periods sampled, comprising 53% and 86% of the total abundance in the dry and rainy season respectively. The species considered abundant were: Calanopia americana, Undinula vulgaris, Oithona plumifera and Corycaeus speciosus. The rainy season favored a significant increase in the abundance of mesozooplankton and copepods. However, a low value of the Shannon-Wiener diversity index was observed in this same seasonal period. This was explained by the dominance of the species C. americana and U. vulgaris in the studied area. Spatial differences have not been verified. The copepod assemblages was composed mostly by species considered as predator-carnivours of greater importance on the pelagic trophic web, indicators of oligotrophic conditions and components of a major portion of fish food items. Thus, we suggest that a spatially homogeneous mesozooplankton community characterizes the coastal area of Fernando de Noronha Archipelago with variations related mainly to the seasonal factor

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Basin-wide variation in tree hydraulic safety margins predicts the carbon balance of Amazon forests

Funding: Data collection was largely funded by the UK Natural Environment Research Council (NERC) project TREMOR (NE/N004655/1) to D.G., E.G. and O.P., with further funds from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES, finance code 001) to J.V.T. and a University of Leeds Climate Research Bursary Fund to J.V.T. D.G., E.G. and O.P. acknowledge further support from a NERC-funded consortium award (ARBOLES, NE/S011811/1). This paper is an outcome of J.V.T.’s doctoral thesis, which was sponsored by CAPES (GDE 99999.001293/2015-00). J.V.T. was previously supported by the NERC-funded ARBOLES project (NE/S011811/1) and is supported at present by the Swedish Research Council Vetenskapsrådet (grant no. 2019-03758 to R.M.). E.G., O.P. and D.G. acknowledge support from NERC-funded BIORED grant (NE/N012542/1). O.P. acknowledges support from an ERC Advanced Grant and a Royal Society Wolfson Research Merit Award. R.S.O. was supported by a CNPq productivity scholarship, the São Paulo Research Foundation (FAPESP-Microsoft 11/52072-0) and the US Department of Energy, project GoAmazon (FAPESP 2013/50531-2). M.M. acknowledges support from MINECO FUN2FUN (CGL2013-46808-R) and DRESS (CGL2017-89149-C2-1-R). C.S.-M., F.B.V. and P.R.L.B. were financed by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES, finance code 001). C.S.-M. received a scholarship from the Brazilian National Council for Scientific and Technological Development (CNPq 140353/2017-8) and CAPES (science without borders 88881.135316/2016-01). Y.M. acknowledges the Gordon and Betty Moore Foundation and ERC Advanced Investigator Grant (GEM-TRAITS, 321131) for supporting the Global Ecosystems Monitoring (GEM) network (gem.tropicalforests.ox.ac.uk), within which some of the field sites (KEN, TAM and ALP) are nested. The authors thank Brazil–USA Collaborative Research GoAmazon DOE-FAPESP-FAPEAM (FAPESP 2013/50533-5 to L.A.) and National Science Foundation (award DEB-1753973 to L. Alves). They thank Serrapilheira Serra-1709-18983 (to M.H.) and CNPq-PELD/POPA-441443/2016-8 (to L.G.) (P.I. Albertina Lima). They thank all the colleagues and grants mentioned elsewhere [8,36] that established, identified and measured the Amazon forest plots in the RAINFOR network analysed here. The authors particularly thank J. Lyod, S. Almeida, F. Brown, B. Vicenti, N. Silva and L. Alves. This work is an outcome approved Research Project no. 19 from ForestPlots.net, a collaborative initiative developed at the University of Leeds that unites researchers and the monitoring of their permanent plots from the world’s tropical forests [61]. The authros thank A. Levesley, K. Melgaço Ladvocat and G. Pickavance for ForestPlots.net management. They thank Y. Wang and J. Baker, respectively, for their help with the map and with the climatic data. The authors acknowledge the invaluable help of M. Brum for kindly providing the comparison of vulnerability curves based on PAD and on PLC shown in this manuscript. They thank J. Martinez-Vilalta for his comments on an early version of this manuscript. The authors also thank V. Hilares and the Asociación para la Investigación y Desarrollo Integral (AIDER, Puerto Maldonado, Peru); V. Saldaña and Instituto de Investigaciones de la Amazonía Peruana (IIAP) for local field campaign support in Peru; E. Chavez and Noel Kempff Natural History Museum for local field campaign support in Bolivia; ICMBio, INPA/NAPPA/LBA COOMFLONA (Cooperativa mista da Flona Tapajós) and T. I. Bragança-Marituba for the research support.Tropical forests face increasing climate risk1,2, yet our ability to predict their response to climate change is limited by poor understanding of their resistance to water stress. Although xylem embolism resistance thresholds (for example, Ψ50) and hydraulic safety margins (for example, HSM50) are important predictors of drought-induced mortality risk3-5, little is known about how these vary across Earth's largest tropical forest. Here, we present a pan-Amazon, fully standardized hydraulic traits dataset and use it to assess regional variation in drought sensitivity and hydraulic trait ability to predict species distributions and long-term forest biomass accumulation. Parameters Ψ50 and HSM50 vary markedly across the Amazon and are related to average long-term rainfall characteristics. Both Ψ50 and HSM50 influence the biogeographical distribution of Amazon tree species. However, HSM50 was the only significant predictor of observed decadal-scale changes in forest biomass. Old-growth forests with wide HSM50 are gaining more biomass than are low HSM50 forests. We propose that this may be associated with a growth-mortality trade-off whereby trees in forests consisting of fast-growing species take greater hydraulic risks and face greater mortality risk. Moreover, in regions of more pronounced climatic change, we find evidence that forests are losing biomass, suggesting that species in these regions may be operating beyond their hydraulic limits. Continued climate change is likely to further reduce HSM50 in the Amazon6,7, with strong implications for the Amazon carbon sink.Publisher PDFPeer reviewe

A epidemiologia da cardiomiopatia de Takotsubo no Brasil e os principais fatores de risco da cardiomiopatia de Takotsubo: The epidemiology of Takotsubo cardiomyopathy in Brazil and the main risk factors for takotsubo cardiomyopathy

A Cardiomiopatia de Takotsubo (CTT) é uma disfunção cardíaca reversível, a qual está relacionada, diretamente, ao estresse físico ou emocional. Objetiva-se através dessa pesquisa evidenciar os principais fatores de risco da CT. Trata-se de uma revisão sistemática realizada no motor de busca Biblioteca Virtual em Saúde (BVS) na base de dados das “Ciências em Saúde em Geral” (Scielo, Medline, Lilacs). Percebeu-se que que a CT apresenta uma ocorrência maior em mulheres na fase de pós-menopausa, onde são atingidas pelo estresse emocional, bem como a inserção de marcapasso também pode desencadear a doença. Entretanto, a etiologia da CT ainda é marcada por controvérsias, mas há concordância acerca do surgimento da CT estar relacionado com a abundância de catecolaminas circulantes

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Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality