Pandemonium During the Pandemic: What is the Role of Health and Science Professionals?

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Pandemônio Durante a Pandemia: Qual o Papel dos Profissionais da Saúde e a Ciência?

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Correlação do Escore de Oxford Modificado com as Medidas Perineométricas em Pacientes Incontinentes

Introdução: diversas técnicas foram propostas para avaliação da musculatura do assoalho pélvico, porém, nenhum método mostrou-se capaz de medir as duas funções desses músculos: elevação e força de compressão. Na rotina de avaliação clínica é comumente empregada a palpação vaginal e, especialmente, o escore de Oxford modificado; entretanto, alguns trabalhos questionam a sensibilidade da escala de Oxford e sua correlação com medidas objetivas de força de contração muscular.Objetivo: neste estudo, propõe-se correlacionar as variáveis medidas na perineometria com o escore de Oxford modificado.Métodos: foram incluídas no estudo 45 pacientes com incontinência urinária que procuraram o ambulatório de Uroginecologia do Hospital de Clínicas de Porto Alegre. As pacientes foram submetidas à palpação vaginal, realizada por uma fisioterapeuta treinada na escala de Oxford, e a medição da força de compressão da musculatura pélvica por meio de balonete conectado a transdutor de pressão. As duas avaliações foram realizadas no mesmo dia.  Resultados: encontrou-se correlação significativa (

Hepatitis C in Brazil: lessons learned with boceprevir and telaprevir

In 2012, the first-generation protease inhibitors telaprevir (TVR) and boceprevir (BOC) were introduced in the Brazilian health system for treatment of chronic hepatitis C, after their approval by the National Committee for Health Technology Incorporation (CONITEC). However, these medicines were discontinued in 2015. The short period of use in therapy and their high cost require a discussion about the consequences for patients and for the health system of the early incorporation of new therapies. The article presents a qualitative analysis of the incorporation process of both medications in Brazil and the results of a multicenter study that included patients treated with BOC or TVR between January 2011 and December 2015 in five Brazilian cities. The study included 855 patients (BOC: n=247) and (TVR: n=608). The document analysis showed that CONITEC’s decision to incorporate BOC and TVR was based on results of phase III clinical trials that compared sustained virologic response (SVR) rates of patients treated with BOC and TVR with rates of those that received placebo. However, these studies included a low percentage of cirrhotic patients. The SVR rates observed in this multicenter study were worse than clinical trials pointed out (BOC: 45.6%; TVR: 51.8%), but similar to those achieved with previously adopted therapies. The discontinuation rate due to adverse events was (BOC: 15.4%; TVR: 12.7%). Based on these unsatisfactory results, the study brings a discussion that goes beyond the therapy outcomes, exploring the incorporation of these high-cost medicines and the related decision-making process, contributing to future decisions in medicine policies and in the treatment of chronic hepatitis C

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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withdrawn 2017 hrs ehra ecas aphrs solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation

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The Diverse Calpain Family in Trypanosomatidae: Functional Proteins Devoid of Proteolytic Activity?

Calpains are calcium-dependent cysteine peptidases that were originally described in mammals and, thereafter, their homologues were identified in almost all known living organisms. The deregulated activity of these peptidases is associated with several pathologies and, consequently, huge efforts have been made to identify selective inhibitors. Trypanosomatids, responsible for life-threatening human diseases, possess a large and diverse family of calpain sequences in their genomes. Considering that the current therapy to treat trypanosomatid diseases is limited to a handful of drugs that suffer from unacceptable toxicity, tough administration routes, like parenteral, and increasing treatment failures, a repurposed approach with calpain inhibitors could be a shortcut to successful chemotherapy. However, there is a general lack of knowledge about calpain functions in these parasites and, currently, the proteolytic activity of these proteins is still an open question. Here, we highlight the current research and perspectives on trypanosomatid calpains, overview calpain description in these organisms, and explore the potential of targeting the calpain system as a therapeutic strategy. This review gathers the current knowledge about this fascinating family of peptidases as well as insights into the puzzle: are we unable to measure calpain activity in trypanosomatids, or are the functions of these proteins devoid of proteolytic activity in these parasites

Chagas Disease Control—Many Approaches to Prospect

Chagas disease is an emerging and neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi, estimated to infect 8 to 10 million people worldwide, according to the World Health Organization [...