Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Exploração de recursos florestais não madeireiros pelos Mẽbêngôkre-Kayapó da aldeia Las Casas - terra indígena Las Casas, no sudeste do Pará: aspectos biológicos, sociais e econômicos relevantes para a sustentabilidade da comercialização

This thesis analyzes the different types of non-timber forest products use on Indigenous Land Las Casas, as well as the importance of them to Mẽbêngôkre people of village Las Casas subsistence. Besides that, the thesis describes the use and the ways that the products and the community of Las Casas follow through market. The research was a combination of interdisciplinary methods and techniques of biological sciences, and human sciences, finally using techniques of ethnobotany, and geographic information systems. To understand the current context of the use of non-timber forest products and the integration into the market, it was conducted an analyzes of the history of occupation of Indigenous Land Las Casas, the dynamics of the use of land through the processing of Landsat satellite images, and the different types of soil were described by Mẽbêngôkre-Kayapó village of Las Casas occupation, also with the plants and resources used, that is the traditional economy of this people. I also analyzed the different forms of relationship of Mẽbêngôkre Kayapó with the surrounding society and how these influenced the market integration and different economic activities, highlighting in Las Casas to entering the market through Mẽkunhêre and Me à yry Las Casas projects. I found that the Indigenous Land Las Casas presents a dynamic use of the land guided by deforestation events and recovery of deforested areas. In this way, the Kayapó people recognize and classify different types of land use between that stand out savannas and forests, and disturbed areas resulting from the occupation by squatters in the area, for the establishment of cattle ranches. The classification of land use by Kayapó people from Las Casas was compatible to that obtained by the satellite Landsat-8, yet the Kayapó differentiate occupations that the image cannot be recognized, as are babaçuais, pequizais, barns, fields and humid areas. In these territories, the Kayapó people hunt, fish, and cultivate their traditional way fields. Among the plant species used for their livelihoods, identify and explore at least 95 useful species distributed in 36 families and 72 botanicals genera. For these species were raised 21 different uses grouped into eight categories of use. The species that were highlighted uses for subsistence and production of material culture belong to the family Arecaceae (Attalea speciosa Mart., Mauritia flexuosa L.f., Oenocarpus distichus Mart) e Caryocaraceae (Caryocar brasiliense A.St.-Hil.) and Caryocaraceae (Caryocar brasiliense A.St.-Hil.). These species are managed by them and are part of resource exchange network between villages, which ensures the circulation of different crop varieties, and raw materials used in the production of objects intended for ritual life and commercialization. Finally, for the commercialization in a sustainable manner the fruits of babassu and pequi, would be necessary to develop management plans for both species. In this way, the activity that provides more income opportunities is the commercialization of handicrafts. Even so, there are still aspects that should be improved. Especially in Ngonh-rôrô-kre association and community organization.CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorEsta tese analisa os diferentes tipos de usos de produtos florestais não madeireiros na Terra Indígena Las Casas, assim como também a importância destes na subsistência do povo Mẽbêngôkre da aldeia Las Casas, a utilização e os caminhos que estes e a comunidade de Las Casas seguem através da comercialização. A pesquisa consistiu numa combinação de métodos e técnicas interdisciplinares das ciências biológicas, assim como também das ciências humanas, servindo-se finalmente de técnicas da etnobotânica, e sistemas de informação geográfica. Para entender o contexto atual do uso de produtos florestais não madeireiros e a inserção no mercado, se analisa o histórico de ocupação da Terra Indígena Las Casas, a dinâmica do uso da terra a através do processamento de imagens de satélite Landsat, e os diferentes tipos de ocupação solo descritos pelos Mẽbêngôkre-Kayapó da aldeia Las Casas, assim como também as plantas e recursos que utiliza, em fim a economia tradicional deste povo. Se analisaram também as diferentes formas de relação dos Mẽbêngõkre-Kayapó com a sociedade envolvente e como estas influenciaram na inserção ao mercado e em diferentes atividades econômicas, dando destaque em Las Casas à inserção no mercado através dos projetos Mẽkunhêre e Me à yry Las Casas. A Terra Indígena Las Casas apresenta uma dinâmica de uso da terra guiada por eventos de desmatamento e recuperação das áreas desmatadas. Desta maneira, os Kayapó reconhecem e classificam diferentes tipos de ocupação do solo entre as que se destacam formações savânicas e florestais, e áreas antrópicas resultantes da ocupação por posseiros da região, para o estabelecimento de fazendas de gado. A classificação dos usos do solo pelos Kayapó de Las Casas é compatível à obtida através da imagem de satélite Landsat-8, mesmo assim, os Kayapó diferenciam ocupações que na imagem não podem ser reconhecidas, como são babaçuais, pequizais, capoeiras, roças e zonas úmidas de Cerrado. Nestes territórios caçam, pesca, cultivam suas roças de maneira tradicional. Entre as espécies vegetais utilizadas na sua subsistência, identificam e exploram pelo menos 95 espécies úteis distribuídas em 36 famílias e 72 gêneros botânicos. Para estas espécies foram levantados 21 usos diferentes agrupados em oito categorias de uso. As espécies que tiveram usos destacados para a subsistência e a produção de cultura material pertencem à família Arecaceae (babaçu, buriti, bacaba) e Caryocaraceae (pequí). Estas espécies são manejadas por eles e fazem parte da rede de troca de recursos entre aldeias, a qual garante a circulação de diferentes variedades de espécies cultivadas, e matérias-primas utilizadas na produção de objetos destinados à vida ritual e à comercialização. Finalmente se conclui que para a comercialização de maneira sustentável dos frutos de babaçu e pequi, seria necessária a criação de planos de manejo para ambas as espécies. Desta maneira a atividade que mais oferece oportunidades de geração de renda é a comercialização de artesanato. Mesmo assim, ainda há aspectos que devem ser melhorados, principalmente na organização da comunidade e da associação Ngonh-rôrô-kre

Objetos indígenas para o mercado: produção, intercâmbio, comércio e suas transformações. Experiências Ka’apor e Mebêngôkre-Kayapó

Resumo Para muitos povos indígenas da Amazônia, a comercialização de objetos da sua cultura material se apresenta como uma importante possibilidade de geração de renda. Especialistas na arte e muitas famílias das aldeias dedicam parte do seu tempo a elaborar objetos especificamente para este fim. São diversas as práticas e os significados envolvidos na produção e no intercâmbio (monetário ou não) desses objetos. Ao mesmo tempo, são constantes as demandas de articulação ao mercado em nível regional e nacional, encontrando-se ainda muitas dificuldades para abrir espaço à produção artesanal indígena. Considerando os contextos etnográficos dos povos indígenas Ka’apor (Terra Indígena Alto Turiaçú, Maranhão) e Mebêngôkre-Kayapó (Terras Indígenas Las Casas e Kayapó, Pará), discutem-se os processos de produção, intercâmbio e comercialização de objetos indígenas e a relação com a lógica do mercado. Examinam-se também as interpretações e os posicionamentos indígenas sobre esses aspectos e os possíveis efeitos dos aspectos jurídicos que se propõem a revalorizar e proteger os conhecimentos e o patrimônio indígena e o meio ambiente provedor das matérias-primas, considerando os impactos sobre as próprias iniciativas indígenas no momento de se inserir nos mercados

Evaluación de la ingesta del extracto acuoso de rosmarinus officinalis sobre il-10 en pacientes con dm2

La IL-10 es una citocina anti-inflamatoria, cuya principal función es detener el daño a los órganos y tejidos; jugando un importante papel en enfermedades infecciosas, inflamatorias, autoinmunes y metabólicas. Actualmente, se conoce que la concentración serológica de IL-10 se encuentra disminuida en los pacientes con Diabetes Mellitus tipo 2 (DM2) en comparación con los individuos control, situación que agrava y promueve las complicaciones clínicas. Existen diversas terapias inmunomoduladoras de origen herbolario que mejoran los parámetros inflamatorios de esta enfermedad. Recientemente, se ha descrito que el Rosmarinus officinalis tiene propiedades anti-inflamatorias tanto in vitro como in vivo. Objetivo: Cuantificar las concentraciones de IL-10 antes y a los 90 días de la terapia complementaria con extracto acuoso de Rosmarinus officinalis en pacientes con DM2. Materiales y métodos: Se seleccionaron 17 muestras de la Seroteca del Laboratorio de Etnofarmacología de la Universidad Autónoma de Zacatecas, obtenidas de pacientes DM2 que estuvieron bajo tratamiento con metformina y/o glibenclamida a los cuales se les adicionó la terapia complementaria con el extracto acuoso de Rosmarinus officinalis a una dosis de 2g/litro/día durante 90 días. La cuantificación de IL-10 se realizó mediante el kit de ELISA de acuerdo a las indicaciones del fabricante. Resultados: Las concentraciones serológicas de IL-10 en los pacientes con DM2 después de la ingesta del extracto acuoso de Rosmarinus officinalis incrementaron de forma no estadística, (110.8 ± 27.38pg/mL a 131.3 (75 – 356.3) pg/mL; p=0.546). Conclusiones: A pesar que no se encontró una diferencia significativa antes y después de la terapia complementaria, sí, se observó una tendencia al incremento sobre las concentraciones serológicas de IL-10, sugiriendo un efecto inmunomodulador del extracto acuso de Rosmarinus officinalis en pacientes con DM2

Estudios multidisciplinarios en Ciencias de la Salud

Es una distinción, como miembro de la Comisión del Programa del Doctorado en Ciencias de la Salud de la Universidad Autónoma del Estado de México, presentar el libro titulado Estudios multidisciplinarios en Ciencias de la Salud, en el que distinguidos y reconocidos investigadores, entusiastas y comprometidos alumnos del programa nos dan a conocer los resultados de sus proyectos de investigación, trabajos que forman parte de los requisitos para acceder al grado de doctor. Entre las razones que invitan a la lectura del libro destaca su contenido conformado con la participación de autores en cuatro áreas en el campo de la salud: Odontología, Ciencias Médicas y Nutrición, Ciencias de la Conducta, y Enfermería y Obstetricia, quienes contribuyen a incrementar el acervo del conocimiento en cada área, en favor de la ciencia, la tecnología, y la salud física y mental de la población.Universidad Autónoma del Estado de México

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit