A imbricação entre liberdade de expressão e liberdade religiosa e a problemática do discurso de ódio religioso no Estado Constitucional

Analisa a compatibilidade do discurso de ódio religioso com a democracia constitucional e os direitos fundamentais tensionados pela questão, notadamente o direito à liberdade de expressão e o direito à liberdade religiosa. A liberdade de expressão constitui uma conquista de importância central à construção da democracia e a questão atinente à sua eventual restrição sempre suscita controvérsias, tanto pela centralidade desse direito, quanto pelo histórico de censura e controle exercidos sobre as manifestações do indivíduo. A noção de Estado constitucional democrático, na qual ela se encontra inserida, está associada, por seu turno, à pluralidade e ao inclusivismo. Propõe-se, assim, uma análise do discurso de ódio religioso, partindo-se, num primeiro momento, do conteúdo inerente à liberdade de expressão e à liberdade religiosa, para se investigar, em seguida, as posições jusfilosóficas acerca da viabilidade dessas manifestações na esfera pública. Desse contexto, então, soergue-se a questão acerca da possibilidade de se restringir ou não a liberdade de expressão, e, nessa discussão em especial, também a liberdade religiosa, dentro de um Estado constitucional

The role of Kisspeptin in bovine in vitro embryo production

The aim of this study was to investigate the effect of Kisspeptin (Kp) on the medium used in different stages of in vitro production of bovine embryo (IVEP), evaluating cleavage (CR) and blastocyst (BR) rates. The study was divided into three experiments that analyzed, respectively, the action of Kp on in vitro maturation (IVM), in vitro fertilization (IVF), and in vitro culture (IVC) of bovine embryos. In experiment 1, the oocytes were matured in IVM medium and distributed into the following treatments: maturation (IVM Control, n = 102), maturation with addition of 10-7 M Kp (Kp 10-7 IVM, n = 90), and hormone-free maturation luteinizing hormone (LH) and follicle-stimulating hormone (FSH) with the addition of 10-7M Kp (No hormones + Kp 10-7, n = 84), following maturation to normal stages of IVEP. In experiment 2, the oocytes were fertilized in IVF medium, in the following treatments: TALP-FERT without Kp (Control IVF, n = 103) and TALP-FERT with the addition of 10-7M Kp (Kp 10-7 IVF, n = 119), usually following the other steps. Finally, in the third experiment, the oocytes passed through all phases and were divided into IVC in two treatments: SOF medium without Kp (Control IVC, n = 109) and SOF medium with the addition of 10-7M Kp (Kp 10-7, N = 106). The data were analyzed by PROC GLIMMIX of the SAS program. In experiment 1, the means of CR and BR were similar (P > 0.05) between treatments (IVM Control76.47% and 37.25%, Kp 10-7 MIV80% and 33.33%, and No hormones + Kp 10-770.24% and 30.95%, respectively). In experiment 2, the means of CR were similar for the IVF Control and Kp 10-7 IVF groups (P > 0.05), 76.70% and 86.55% respectively. But, the mean of the BR of the group Kp 10-7 IVF was 38.66%, which was higher (P 0.05) were similar between the IVC Control and Kp 10-7 IVC groups (CR 83.50% and 78.30%, and BR 26.60% and 23.60%, respectively). Although at this concentration of 10-7M during IVC no change in embryo production is seen, Kp presents the same performance as both gonadotrophins in oocyte maturation and modulates the fertilization process, providing more blastocysts. With these findings, it can be seen that Kp presents a regulatory action on bovine reproduction, and can be an excellent tool to maximize IVEP indexes

Physicochemical Characterization, Proximate Composition and Fatty Acid Profile of Fruits from Brazilian Northeast Agrobiodiversity

Abstract The objective was to evaluate the physicochemical characteristics, nutritional composition and fatty acid profile of eleven exotic fruits in Brazil Northeast. The fruits, except pequi, presented acid pH, high moisture, low protein, low lipid and low energetic contents. Pequi is highlighted by its high protein content (2.79 g.100 g-1), lipid (13.6 g.100 g-1), carbohydrates (28.71 g.100 g-1), titratable acidity (2.75 g citric acid.100 g-1) and pH (2.54-5.19). Unpeeled and peeled jenipapo presented higher ash composition (1.26-1.38g.100 g-1), soluble solids (20.29-21.17 ºBrix) and carbohydrates (22.55-23.66 g.100 g-1) compared to others fruits. Fourteen fatty acids were quantified and classified as saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids. The concentrations of total fatty acids ranged from 1.92 to 1293.21 mg.100 g-1, being palmitic acid and oleic acid more prevalent. The fruits composition data indicated potential for improvement of diets, food industry and gastronomic market

Desafios emergentes: O impacto da pandemia de COVID-19 na incidência e internações por Diabetes Mellitus

A pandemia de COVID-19 trouxe consigo desafios sem precedentes para a saúde global, afetando não apenas os sistemas de saúde, mas também indivíduos com condições médicas crônicas, como o diabetes mellitus. A interseção entre o diabetes e a pandemia de COVID-19 tem gerado preocupações significativas, exigindo uma análise cuidadosa dos impactos dessa interação na saúde pública e no manejo clínico do diabetes. Dessa forma, O objetivo desse trabalho foi avaliar a influência da pandemia de COVID-19 nas internações causadas por Diabetes mellitus no Brasil, no período de 2019 a 2023. Este é um estudo de séries temporais, que usou dados do Sistema de Informações Hospitalares (SIH) do DATASUS. Essa fonte abrangente oferece uma visão detalhada das internações causadas por Diabetes mellitus no Brasil. Através desse estudo, demostramos uma redução de 5,6% nas internações causadas por diabetes mellitus durante a pandemia, com o sudeste sendo responsável pela maioria das internações e custos hospitalares. Além disso, identificamos que homens, pardos, com idade entre 60 a 69 anos, foram os principais afetados. As informações sobre internações hospitalares causadas pelo diabetes mellitus são cruciais para informar políticas de saúde, melhorar a qualidade dos cuidados e reduzir o ônus pessoal e econômico associado a essa doença crônica. A implementação de estratégias eficazes de prevenção e manejo do diabetes é essencial para reduzir as taxas de hospitalização e melhorar os resultados de saúde para os pacientes afetados

ABORDAGEM DA IMUNOSSUPRESSÃO EM PACIENTES APÓS TRANSPLANTE CARDÍACO: ATUALIZAÇÕES

INTRODUCTION: Patients with advanced heart failure (HF) refractory to optimized clinical and surgical interventions commonly undergo heart transplantation to improve quality of life, survival, and graft functionality. Thus, aiming to reduce rejection episodes, the most widely adopted strategy is the use of immunosuppressive drugs in triple therapy using calcineurin inhibitors, glucocorticoids, and nucleotide synthesis inhibitors. However, the use of these drugs is inherent to adverse effects, such as infection, malignancy, and drug toxicity. OBJECTIVE: To analyze adverse effects secondary to maintenance immunosuppressive therapy after heart transplantation. METHODOLOGY: A careful search of original scientific articles was carried out in the PubMed database between 2018 and 2023, according to the established PRISMA guidelines. The inclusion criteria were original studies, clinical studies, which presented the descriptors in the title or abstract and written in English. RESULTS: After using the inclusion criteria, 35 studies were found. However, only 04 were published. The studies show that the association between Tacrolimus and Everolimus can result in the development of left ventricular hypertrophy (LVH). In addition, the drug tacrolimus can be associated with the appearance of fibrosis, ischemic heart failure and hypomagnesemia. Children and adolescents medicated with prolonged or immediate release Tacrolimus present diarrhea, hypertension and increased creatinine. In addition, studies based on standard therapy with Cyclosporine show the development of deterioration of renal function. CONCLUSION: The use of immunosuppressive drugs is extremely important to avoid graft rejection and increase the individual's survival. However, the use of such drugs can cause adverse effects, which compromise the patient's quality of life. Therefore, it is important to develop further studies, aiming to contribute to the use of these medications and knowledge about potential adverse effects.INTRODUÇÃO:Pacientes com insuficiência cardíaca (IC) avançada, refratária às intervenções clínicas e cirúrgicas otimizadas, são comumente submetidos a transplante cardíaco, tendo em vista a melhoria da qualidade de vida, sobrevida e funcionalidade do enxerto. Dessa forma, visando diminuir os episódios de rejeição, a estratégia mais adotada é a utilização de fármacos imunossupressores em terapia tríplice usando inibidores de calcineurina, glicocorticóides e inibidores da síntese de nucleotídeos. No entanto, a utilização desses fármacos está inerente à efeitos adversos, tais como: infecção, malignidade e toxicidade medicamentosa. OBJETIVO: Analisar efeitos adversos secundários à terapia imunossupressora de manutenção após transplante cardíaco. METODOLOGIA: Realizou-se uma pesquisa criteriosa de artigos científicos originais, na base de dados PubMed, entre 2018 e 2023, segundo as diretrizes estabelecidas do PRISMA. Os critérios de inclusão foram estudos originais, estudos clínicos, que apresentaram os descritores no título ou no resumo e escritos na língua inglesa.RESULTADOS:Após a utilização dos critérios de inclusão, foram achados 35 estudos. No entanto, somente 04 foram publicados. Os estudos mostram que a associação entre Tacrolimus e Everolimus pode resultar no desenvolvimento de hipertrofia ventricular esquerda (HVE). Além disso, o fármaco tacrolimus pode estar associado ao aparecimento de fibrose, insuficiência cardíaca isquêmica e hipomagnesemia. Em crianças e adolescentes medicados com Tacrolimus de liberação prolongada ou imediata apresentam diarreia, hipertensão e aumento da creatinina. Além disso, estudos com base na terapia padrão com Ciclosporina mostram desenvolvimento da deterioração da função renal.CONCLUSÃO: A utilização de fármacos imunossupressores é de extrema importância para evitar a rejeição do enxerto e aumentar a sobrevida do indivíduo. No entanto, a utilização de tais fármacos pode ocasionar efeitos adversos, que comprometem a qualidade de vida do paciente. Dessa maneira, é relevante o desenvolvimento de mais estudos, visando contribuir com a utilização desses medicamentos e o conhecimento acerca dos efeitos adversos potenciai

Temporal patterns of cytokine and injury biomarkers in hospitalized COVID-19 patients treated with methylprednisolone

BackgroundThe novel coronavirus disease 2019 (COVID-19) presents with complex pathophysiological effects in various organ systems. Following the COVID-19, there are shifts in biomarker and cytokine equilibrium associated with altered physiological processes arising from viral damage or aggressive immunological response. We hypothesized that high daily dose methylprednisolone improved the injury biomarkers and serum cytokine profiles in COVID-19 patients.MethodsInjury biomarker and cytokine analysis was performed on 50 SARS-Cov-2 negative controls and 101 hospitalized severe COVID-19 patients: 49 methylprednisolone-treated (MP group) and 52 placebo-treated serum samples. Samples from the treated groups collected on days D1 (pre-treatment) all the groups, D7 (2 days after ending therapy) and D14 were analyzed. Luminex assay quantified the biomarkers HMGB1, FABP3, myoglobin, troponin I and NTproBNP. Immune mediators (CXCL8, CCL2, CXCL9, CXCL10, TNF, IFN-γ, IL-17A, IL-12p70, IL-10, IL-6, IL-4, IL-2, and IL-1β) were quantified using cytometric bead array.ResultsAt pretreatment, the two treatment groups were comparable demographically. At pre-treatment (D1), injury biomarkers (HMGB1, TnI, myoglobin and FABP3) were distinctly elevated. At D7, HMGB1 was significantly higher in the MP group (p=0.0448) compared to the placebo group, while HMGB1 in the placebo group diminished significantly by D14 (p=0.0115). Compared to healthy control samples, several immune mediators (IL-17A, IL-6, IL-10, MIG, MCP-1, and IP-10) were considerably elevated at baseline (all p≤0.05). At D7, MIG and IP-10 of the MP-group were significantly lower than in the placebo-group (p=0.0431, p=0.0069, respectively). Longitudinally, IL-2 (MP-group) and IL-17A (placebo-group) had increased significantly by D14. In placebo group, IL-2 and IL-17A continuously increased, as IL-12p70, IL-10 and IP-10 steadily decreased during follow-up. The MP treated group had IL-2, IFN-γ, IL-17A and IL-12p70 progressively increase while IL-1β and IL-10 gradually decreased towards D14. Moderate to strong positive correlations between chemokines and cytokines were observed on D7 and D14.ConclusionThese findings suggest MP treatment could ameliorate levels of myoglobin and FABP3, but appeared to have no impact on HMGB1, TnI and NTproBNP. In addition, methylprednisolone relieves the COVID-19 induced inflammatory response by diminishing MIG and IP-10 levels. Overall, corticosteroid (methylprednisolone) use in COVID-19 management influences the immunological molecule and injury biomarker profile in COVID-19 patients

Nationwide access to endovascular treatment for acute ischemic stroke in portugal

Publisher Copyright: Copyright Ordem dos M dicos 2021.Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitalspublishersversionpublishe