Risco de infecção pelo Mycobacterium tuberculosis entre alunos da Faculdade de Medicina da Universidade Federal do Rio de Janeiro Risk for Mycobacterium tuberculosis infection among medical students at the Universidade Federal do Rio de Janeiro Faculdade de Medicina

INTRODUÇÃO: Até o momento raros estudos prospectivos na América Latina demonstraram que estudantes de Medicina estão sob mais alto risco de apresentar conversão tuberculínica do que a população em geral (1,3%). OBJETIVO: Descrever a incidência acumulada de conversão tuberculínica e o risco relativo para tuberculose infecção entre estudante de Medicina. MÉTODO: Em 1.998, uma coorte prospectiva foi iniciada entre estudantes da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, negativos ao teste tuberculínico (<10 mm) realizado em dois tempos no ano anterior. Esses estudantes foram re-testados no ano seguinte ao primeiro teste. Os estudantes têm dois níveis de treinamento: períodos básicos (sem contato com pacientes) e períodos profissionais (com contato com pacientes). Foi usado um questionário padronizado para avaliação das características sócio-demográficas, vacinação pelo BCG (remota e recente) e exposição potencial ao Mycobacterium tuberculosis. Completaram o estudo 72% dos estudantes (414/575). RESULTADOS: Dos 414 participantes do estudo, 16 (3,9%, IC 95% 1,06% a 12,1%) apresentaram conversão tuberculínica, ou seja, a incidência acumulada de conversão foi de 3,9%. Osalunos dos períodos profissionais apresentaram um risco quatro vezes maior de infecção pelo Mycobacterium tuberculosis quando comparados com os dos períodos básicos. CONCLUSÃO: É alta a taxa de conversão tuberculínica entre alunos da Faculdade de Medicina da Universidade Federal do Rio de Janeiro.<br>INTRODUCTION: There have been few Latin American studies investigating the fact that the rate of tuberculosis (TB) infection among medical students is higher than the 1.3% rate seen in the population at large. OBJECTIVE: To describe the cumulative incidence and the relative risk for TB infection among medical students. METHOD: In 1998, a prospective cohort study was conducted involving medical students at the Universidade Federal do Rio de Janeiro Faculdade de Medicina who tested negative (induration <10 mm) on the tuberculin skin test (TST). Students were tested using the two-step TST method and were retested one year later. The students tested were at two different stages in their training: pre-clinical (no contact with patients) and final year (contact with patients). Information about demographic characteristics, BCG vaccination history, and instances of potential exposure to Mycobacterium tuberculosis were obtained using a standardized questionnaire. Of the 575 students initially enrolled, 72% (414) completed the study. RESULTS: The TSTs of 16 (3.9%) of the 414 students converted, representing a cumulative incidence of 3.9% (95% confidence interval = 1.06 to 12.1). Senior medical students were at an almost fourfold higher risk for M. tuberculosis infection than were those in pre-clinical training. CONCLUSION: The risk for TST conversion is very high in this population

ACE activity is modulated by the enzyme alpha-galactosidase A

Fabry disease is a multisystem X-linked disorder resulting from alpha-galactosidase A (alpha-GalA) gene mutations leading to the accumulation of globotriaosylceramide mainly in endothelium compromising heart, kidney, and brain. in Fabry patients, progressive renal failure is frequently treated with angiotensin I-converting enzyme (ACE) inhibitors. We were interested in the possible interactions between ACE inhibitors therapy and the only causative therapy for Fabry disease, the enzyme replacement therapy (ERT) using recombinant human alpha-GalA (rh alpha-GalA). Our results suggest that ACE activity was significantly inhibited in plasma of Fabry patients and the blood pressure level decreased just after ERT (at the end of the rh alpha-GalA infusion). Interestingly, 2 weeks later, ACE activity was significantly upregulated and the plasma levels of angiotensin II increased in the patients treated with rh alpha-GalA following the elevations of ACE activity. the same inhibitory effect on ACE activity was also observed in rats after rh alpha-GalA infusion. Furthermore, ACE activity in CHO cells transfected with the human ACE was inhibited dose and time-dependently by rh alpha-GalA. in vitro, the incubation of plasma from healthy volunteers with rh alpha-GalA significantly reduced ACE activity. Finally, rh alpha-GalA also inhibited ACE activity and released galactose residues from purified rabbit lung ACE dose-dependently. in summary, our results suggest that rh alpha-GalA interacts with ACE and inhibits its activity, possibly by removing the galactose residues from the enzyme. This modulation might have profound impact on the clinical outcome of Fabry patients treated with rh alpha-GalA.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Deutsche Akademische Austauschdienst (DAAD/PROBRAL)Deutsche ForschungsgemeinschaftUniversidade Federal de São Paulo, Dept Biophys, Escola Paulista Med, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biosci, BR-04023062 São Paulo, BrazilMax Delbruck Ctr Mol Med MDC, D-13125 Berlin, GermanyGenzyme Brasil, Personalized Genet Hlth, São Paulo, BrazilUniv Fed Minas Gerais, Dept Physiol & Biophys, Belo Horizonte, MG, BrazilFed Univ Grande Dourados, Sch Environm & Biol Sci, Dourados, MS, BrazilUniversidade Federal de São Paulo, Dept Med, Div Nephrol, BR-04023062 São Paulo, BrazilHosp Sao Vicente de Paulo, Dept Nephrol, Passo Fundo, BrazilUniversidade Federal de São Paulo, Dept Biophys, Escola Paulista Med, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biosci, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Nephrol, BR-04023062 São Paulo, BrazilFAPESP: 2008/06676-8CAPES: 239/06Deutsche Forschungsgemeinschaft: BA 1374/16-1CAPES: 33009015001Web of Scienc

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora