Transplante de pâncreas e rim simultâneo com enxerto renal proveniente de doador vivo

O transplante de pâncreas e rim simultâneo (TPRS) assumiu na última década, importante papel no tratamento dos pacientes diabéticos insulino-dependentes com doença renal em fase terminal. A melhora nos resultados obtidos com esta terapia tornou a indicação deste procedimento mais freqüente, acarretando aumento na lista de receptores e, consequentemente, maior tempo de espera pelo transplante. Com o intuito de reduzir o tempo de espera em lista e associar os benefícios imunológicos e técnicos do transplante realizado com doador-vivo relacionado, alguns centros mundiais passaram a indicar o TPRS com o emprego de enxerto renal proveniente de doador-vivo relacionado. Apresentamos a seguir, o primeiro caso realizado no país desta modalidade de transplante de pâncreas.Simultaneous pancreas-kidney transplant (SPK) assumed in the last decade an important paper in treatment of insulin-dependent diabetic patients with end-stage renal disease. The improvement in the results obtained with this therapy made the indication of this procedure more frequent, causing an increase in the patient’s waiting list and, consequently, a larger waiting time for the transplant. Aiming to reduce the waiting time and to associate technical and imunologic benefits in the transplant accomplished with living related donor, some centers started to indicate SPK using the kidney graft obtained from a living related donor. We present the first case of this modality of pancreas transplant accomplished in Brazil

implication for assessing the risk of arbovirus outbreaks

Funding Information: This work was also supported by the U.S. Centers for Disease Control and Prevention through a cooperative agreement number 5NU14GH001237-03-00. The views expressed in this written publication do not necessarily reflect the official policies of the U.S. Department of Health and Human Services. European Foundation Initiative into Neglected Tropical Disease also supported this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank all community leaders, household heads staff from the provincial health directorates, staff from the Medical Entomology Laboratory from the National Institute of Health, staff from National Malaria Control Programme, and staff from the Laboratório de Transmissores de Hematozoários of the Oswaldo Cruz Institute for their support during field work, laboratory testing and identification of Aedes spp. We also thank José Feriano Américo who produced the maps of this work. Ours special thanks goes to Professor J. Dereck Charlwood who revised the English grammar and typos of the entire manuscript. Consent for publication Our manuscript does not present any individual person's data. Publisher Copyright: © 2018 Abílio et al. http://creativecommons.org/licenses/by/4.0/.Background: Aedes-borne arboviruses have emerged as an important public health problem worldwide and, in Mozambique, the number of cases and its geographical spread have been growing. However, information on the occurrence, distribution and ecology of Aedes aegypti and Ae. albopictus mosquitoes remain poorly known in the country. Methods: Between March and April 2016, a cross-sectional study was conducted in 32 districts in Mozambique to determine the distribution and breeding sites of Ae. aegypti and Ae. albopictus. Larvae and pupae were collected from a total of 2,807 water-holding containers using pipette, dipper, funnel and sweeping procedures, depending on the container type and location. Both outdoor and indoor water-holding containers were inspected. The immature forms were reared to adults and the identifications of the mosquito species was carried out with a stereomicroscope using a taxonomic key. Results: Aedes aegypti was found in every district sampled, while Ae. albopictus was only found in Moatize district, situated in Tete Province in the central part of the country. Six hundred and twenty-eight of 2,807 (22.4%) containers were positive for Ae. aegypti but only one (0.03%) was positive for Ae. albopictus. The Container Index (CI) of Aedes was highest in densely populated suburban areas of the central region (260/604; 43.0%), followed by suburban areas in northern areas (228/617; 36.9%) whilst the lowest proportion was found in urbanized southern areas (140/1586; 8.8%). The highest CI of Aedes was found in used tires (448/1268; 35.3%), cement tanks (20/62; 32.3%) and drums (21/95; 22.1%). Conclusion: Data from our study showed that Ae. aegypti is present nation-wide, since it occurred in every sampled district, whilst Ae. albopictus had a limited distribution. Therefore, the risk of transmission of dengue and chikungunya is likely to have been underestimated in Mozambique. This study highlights the need for the establishment of a national entomological surveillance program for Aedes spp. in Mozambique in order to gain a better understanding about vector bionomics and to support the development of informed effective vector control strategies.publishersversionpublishe

Chemical characterization, cytotoxicity, antimicrobial and antioxidant potential of Justicia pectoralis Jacq and Croton jacobinensis Baill extracts

In this research, aqueous and ethanolic extracts from Justicia pectoralis Jacq and Croton Jacobinensis Baill were characterized. The UPLC-QTOF-MSE analysis was performed on the extracts identified, predominantly, flavonoids, tannins and acids. The extracts did not indicate toxicity in human epithelial cells. C. jacobinensis presented a concentration of phenolics 60.5% higher than J. pectoralis in all scenarios evaluated and, for both samples, the hydroalcoholic extract at 70% exhibited the best efficiency in the extraction (14501.3 and 32521.5 mg GAE 100 g-1 for J. pectoralis and C. jacobinensis, respectively). The antioxidant activity presented a positive correlation with the concentration of phenolics, being 1.186,1 and 1.507,9 μM of Trolox for J. pectoralis and C. jacobinensis at 70% of ethanol; however, it was not verified statistical difference between the ethanolic solutions (p < 0.05). The antimicrobial activity of J. pectoralis extracts was highlighted once was the most effective against gram-positive bacteria. The results suggest that both J. pectoralis and C. jacobinensis extracts present the potential to be applied as natural additives due to their antioxidant and antimicrobial activity and safety. Thus, it is suggesting the development of studies that could investigate the interaction of these plant extracts with food matrices is required

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Perfil dos produtores de Guaraná (Paullinia cupana) do município de Alta Floresta-MT

O objetivo deste estudo é conhecer o perfil dos produtores de guaraná do município de Alta Floresta, diante do desafio de promover o desenvolvimento da atividade e atender ao desafio da sustentabilidade da produção familiar. Os resultados indicam que o município hoje não possui informações sobre os produtores e a produção agrícola, sua localização e rentabilidade, além de haver um distanciamento entre os guaranicultores e órgãos de assistência. Em contra partida, os resultados indicam também que o município tem um bom volume de produção, a cultura é uma importante fonte de emprego e renda e que os agricultores familiares são os responsáveis pela produção e que a produção do município é toda entregue a intermediários, sem o processamento mínimo

Isolated systolic hypertension : epidemiology and impact in clinical practice

Objective: To study the frequency, distribution and determinants of isolated systolic hypertension (ISH). Design: Cross-sectional study, in two stages. First, consecutive patients of the Portuguese national health system aged 60 or over were selected (1999). The second stage covered people aged up to 60 years (2000). Setting: Health Centers – primary care (Regional Health Administration - Lisbon). Participants: 3228 patients, 1100 male (439 aged up to 60 years and 661 aged 60 years) and 2128 female (860 aged up to 60 years and 1268 aged 60 years). Measurements: Categories of hypertension. Risk stratification. Cardiovascular morbidity. Predictors of isolated systolic hypertension. Results: The definition and staging of hypertension changed between 1988 and 1997/99 and as a consequence, there has been, in hypertensives, an increase in ISH frequency from 13 % to 44 % (2.4 times greater). This form of hypertension is far more frequent than grades 1 (mild hypertension = 22 %), 2 (moderate hypertension =15 %) or 3 (severe hypertension = 7%). The proportion of hypertensives with ISH increases from 19% in people aged up to 40, to 30 % in the fourth decade, 34 % in the fifth decade, 44 % in the sixth decade, 51 % in the seventh decade, and 57 % in those over 80 years of age. In hypertensives aged up to 50, ISH is more frequent in females. However, in those over age 50 it is predominant in males. ISH represents 60 % and 37 % respectively of untreated and treated hypertensives. Among untreated hypertensives, age was associated with ISH (p<0.001; OR=1.051 and 95 % CI 1.037-1.065). In the over-60 subgroup, the following factors were associated: age (p=0.013; OR=1.048 and 95 % CI 1.010-1.087); gender – male (p=0.004; OR=2.578 and 95 % CI 1.361- 4.881) and height (p=0.044; OR=0.966 and 95% CI 0.933-0.999). Conclusions: Isolated systolic hypertension is the most common form of hypertension and the most often untreated. The constitutional characteristics associated with isolated systolic hypertension in the elderly are age, gender (male) and body mass index (height). The extent of the problem justifies more attention to control of systolic blood pressure, both in research (efficacy) and in clinical practice (effectiveness).Objectivo: Caracterizar a frequência, a distribuição e os factores associados à hipertensão sistólica isolada (HSI). Desenho do estudo: Transversal, realizado em duas fases. Na primeira, foram seleccionados e observados utentes do SNS com idade 60 anos (Ano 1999). A segunda fase destinou-se aos grupos etários com idade <60 anos (Ano 2000). Atendimento: Centros de Saúde (ARS de Lisboa) – cuidados de sáude primários. Participantes: Inquiridos 3228 indivíduos, 1100 do sexo masculino (439 com <60 anos e 661 com idade 60 anos) e 2128 do sexo feminino (860 com <60 anos e 1268 com idade 60 anos). Medições: Categorias/graus de hipertensão. Estratificação de risco. Morbilidade cardiovascular. Factores discriminantes da hipertensão sistólica isolada. Resultados: A mudança dos critérios de definição e classificação da hipertensão arterial, entre 1988 e 1997/99, correspondeu, nos hipertensos, a um aumento na frequência da HSI de 13 % para 44 %. Neste estudo de base populacional, a HSI foi predominante em relação à hipertensão ligeira (22 %), moderada (15%) e grave (7 %). A proporção de hipertensos com HSI aumentou de 19 %, abaixo dos 40 anos, para 30 % na 4.ª década, 34 % na 5.ª década, 44 % na 6.ª década, 51 % na 7.ª década e 57 % a partir da 8.ª década. Até à 5.ª década de vida foi predominante no sexo feminino, mas acima dessa idade foi mais frequente no sexo masculino. No grupo de hipertensos não medicados, a maioria (60%) tinha HSI enquanto no grupo sob terapêutica anti-hipertensiva a sua proporção foi de 37 %. As variáveis que demonstraram uma associação positiva com a HSI, no grupo de hipertensos não medicados, foram a idade (p<0,001; OR=1,051 e IC 95 % 1,037-1,065). No grupo de idade 60 anos, os factores relacionados de modo significativo com HSI foram a idade (p=0,013; OR=1,048 e IC 95 %=1,010-1,087), o sexo masculino (p=0,004; OR= 2,578 e IC 95 %=1,361-4,881) e a altura (p=0,044; OR=0,966 e IC 95 %=0,933-0,999). Conclusões: A hipertensão sistólica isolada é a forma de hipertensão mais frequente na população e menos vezes tratada. As características constitucionais que se associam à hipertensão sistólica isolada são a idade, o sexo e a altura (índice de massa corporal). A dimensão do problema justifica que seja dada mais atenção ao controlo da pressão arterial sistólica, quer na investigação (eficácia e eficiência), quer na prática clínica (efectividade).A investigação teve o patrocínio da Pentafarma, Sociedade Técnico-Medicinal

LABORATÓRIO DE GEOLOGIA, GEOMORFOLOGIA E RECURSOS HÍDRICOS: ESPAÇO DE ENSINO, PESQUISA E EXTENSÃO

O Laboratório de Geologia, Geomorfologia e Recursos Hídricos (LGGRH) do Departamento de Geografia da FCT-UNESP desempenha funções didáticas, de pesquisa e de extensão universitária. Sua existência é concomitante com a existência dos cursos de Geografia e dos Cursos de Licenciatura em Ciências e Estudos Sociais, e antecede a criação da UNESP, no final de 1976, desde sua utilização como “sala de aula de Geologia” e mais tarde, já oficialmente como Laboratório de Geologia, Geomorfologia e Recursos Hídricos, vinculado ao Departamento de Geografia. O espaço também oferece suporte para atividades técnicas e de pesquisa de tanto dos docentes quanto dos acadêmicos de Iniciação Científica, Mestrado e Doutorado que desenvolvem, total ou parcialmente, atividades de mapeamento, análise de dados e procedimentos laboratoriais. Resultado do trabalho dos pesquisadores e alunos, os dados de formação e pesquisa apresentam número expressivos, o que permite inferir também que existe um trabalho coletivo e de qualidade entre os pesquisadores e entre os alunos nos diferentes estratos da produção científica