Iron deficiency anemia in pregnancy: controversies in iron supplementation

O período gestacional está associado a uma série de alterações fisiológicas e anatômicas, tais como mudanças no sistema hematológico, respiratório e cardiovascular. Além das alterações funcionais, a anemia por deficiência de ferro (anemia ferropriva) destaca-se como uma das complicações mais comuns de uma gravidez e dependendo da gravidade, pode acarretar prejuízo para mãe e/ou feto. A administração de ferro para as gestantes, com ou sem diagnóstico prévio de anemia, é uma prática comum na área de obstetrícia. Embora não existam evidências concretas a respeito dos beneficios da suplementa- ção profilática de ferro para as gestantes, esta conduta apresenta-se como um procedimento adequado, visto que reduz a prevalência de anemia ferropriva na gestante e após o parto. Entretanto, há uma série de relatos na literatura que descrevem os aspectos deletérios da reposição indiscriminada de ferro durante a gestação. Neste contexto, pretende-se com essa revisão da literatura apresentar os principais aspectos das alterações hematológicas decorrentes da gravidez, em especial a anemia por deficiência de ferro, mostrar as ventagens e desvantagens da suplementação com ferro, bem como orientar o obstetra em realizar um diagnóstico mais preciso de anemia ferropriva durante a gestação e propor uma alternativa coerente de reposição de ferro para as gestantes, minimizando os riscos indesejáveis do excesso ou deficiência dessa suplementação.The gestational period is associated with a series of physiological and anatomical modifications, such as changes in the hematological, respiratory and cardiovascular system. In addition to functional modifications, anemia due to iron deficiency stands out as one of the most common complications of pregnancy and depending on severity can cause harm to mother and/or fetus. The administration of iron for pregnant women, with or without a previous diagnosis of anemia, is a common practice in obstetrics. Although there’s no evidence about the benefits of prophylactic iron supplementation for pregnant women, this approach appears as an appropriate procedure, since it reduces the prevalence of iron deficiency anemia during pregnancy and after childbirth. However, there are reports in the literature that describe the harmful aspects of indiscriminate use of iron during pregnancy. Thus, this literature review intend to present the main aspects of hematological changes that takes place during pregnancy, particularly iron deficiency anemia, to show advantages and disadvantages of iron supplementation, and to guide the obstetrician to perform a more accurate diagnosis of iron deficiency anemia during pregnancy. This literature also intend to propose a consistent alternative of iron supplementation for pregnant women, minimizing the undesirable risks of excess or deficiency of this supplementation

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Development of gel with Matricaria recutita L. extract for topic application and evaluation of physical-chemical stability and toxicity

Matricaria recutita L. (Asteraceae), better known as chamomile, has been used due to its pharmacological properties. Laboratory-manufactured gels with chamomile extract were developed with the evaluation of the physical-chemical stability, as well as the study of its toxicity. The extractive solution was prepared by maceration with ethyl alcohol 95%. Part of the chamomile extractive ethanolic solution (CEES) was concentrated in rotoevaporator, obtaining a raw chamomile extract (RCE). For the preparation of gels, carbopol 940P, hydroxyethyl cellulose and hydroxypropyl methylcellulose were used with the addition of 3% and 5% chamomile extracts. The stability tests applied to the gels were as such: thermal stress, pH evaluation, viscosity and storage at different temperatures. In the end of the tests it was observed that the carbopol gel was the most stable. The Draize Test was employed as the toxicity test, with no irritation observed; however, on skin that underwent abrasion, some gels caused a little irritation.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Impaired TNF, IL-1β, and IL-17 production and increased susceptibility to Mycobacterium tuberculosis infection in HTLV-1 infected individuals

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-04-17T14:26:05Z No. of bitstreams: 1 Carvalho N Impaired TNF, IL-1β, and IL-17 production....pdf: 451498 bytes, checksum: e9f90b8c7ddc7b1109837354dcb2d099 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-04-17T16:21:37Z (GMT) No. of bitstreams: 1 Carvalho N Impaired TNF, IL-1β, and IL-17 production....pdf: 451498 bytes, checksum: e9f90b8c7ddc7b1109837354dcb2d099 (MD5)Made available in DSpace on 2018-04-17T16:21:37Z (GMT). No. of bitstreams: 1 Carvalho N Impaired TNF, IL-1β, and IL-17 production....pdf: 451498 bytes, checksum: e9f90b8c7ddc7b1109837354dcb2d099 (MD5) Previous issue date: 2018CNPq (473459/2012-4), Ministry of Science and Technology (573839/2008-5), CAPES (573839/2008-5), and Maria Emília Pedreira Freire de Carvalho Foundation (160067).Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Laboratório de Pesquisa em Infectologia. Salvador, BA, Brasil / Fundação José Silveira. Instituto Brasileiro para a Investigação da Tuberculose. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Estadual de Feira de Santana. Departamento de Ciências Biológicas. Feira de Santana, BA, Brasil / Ministério de Ciência Tecnologia e Inovação. Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Conselho Nacional de Desenvolvimento Científico e Tecnológico. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Ministério de Ciência Tecnologia e Inovação. Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Conselho Nacional de Desenvolvimento Científico e Tecnológico. Salvador, BA, BrasilIFN-γ and TNF play critical roles in the control of Mycobacterium tuberculosis infection. Despite leading to an exaggerated production of inflammatory cytokines, HTLV-1 infection increases the risk of developing tuberculosis (TB). However, the immune mechanisms accounting for this phenomenon are still unclear. The aim of this study was to evaluate immunological aspects of the HTLV-1/M. tuberculosis co-infection. In this cross-sectional study, the levels of TNF, IL-1β, and IL-17 were determined by ELISA in the supernatants of either unstimulated or tuberculin purified protein derivative (PPD) stimulated peripheral blood mononuclear cells. Cells from HTLV-1 infected individuals produced lower levels of TNF following PPD stimulation compared to unstimulated cells. IL-1β and IL-17 production by cells from HTLV-1/M. tuberculosis co-infected individuals was lower than in cells from patients with TB. Impairment in TNF, IL-1β, and IL-17 production upon stimulation with mycobacterial antigens may contribute to the increased susceptibility to M. tuberculosis infection observed in HTLV-1 infected individuals

Neurological Manifestations in Human T-Cell Lymphotropic Virus Type 1 (HTLV-1)-Infected Individuals Without HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis: A Longitudinal Cohort Study.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-04-12T19:18:25Z No. of bitstreams: 1 Tanajura D Neurological manifestations....pdf: 241499 bytes, checksum: 14df94e3e9b8ce05a3ef2c182ba9615f (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-04-12T19:32:48Z (GMT) No. of bitstreams: 1 Tanajura D Neurological manifestations....pdf: 241499 bytes, checksum: 14df94e3e9b8ce05a3ef2c182ba9615f (MD5)Made available in DSpace on 2016-04-12T19:32:48Z (GMT). No. of bitstreams: 1 Tanajura D Neurological manifestations....pdf: 241499 bytes, checksum: 14df94e3e9b8ce05a3ef2c182ba9615f (MD5) Previous issue date: 2015Universidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / National Institute of Science and Technology of Tropical Diseases. Salvador, BA, Brasil / State University of Bahia. Department of Natural Sciences, Southeast. Vitória da Conquista, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / National Institute of Science and Technology of Tropical Diseases. Salvador, BA, Brasil / State University of Feira de Santana. Department of Biological Sciences. Faira de Santana, BA, BrasilWeill Cornell Medical College. Department of Medicine. New York, New YorkUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / National Institute of Science and Technology of Tropical Diseases. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Ba, BrasilBACKGROUND: Human T-cell lymphotropic virus type 1 (HTLV-1) is the agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), observed in up to 5% of infected individuals. Despite low prevalence, many HTLV-1-infected patients who do not fulfill criteria for HAM/TSP present with neurological complaints related to sensory, motor, urinary, or autonomic manifestations. The aim of this study was to determine the incidence of neurologic manifestations and risk factors associated with these outcomes. METHODS: The incidence of HAM/TSP and new signs and neurologic symptoms were computed in a group of patients enrolled in a cohort study. RESULTS: Of 414 subjects, 76 had definite HAM/TSP, 87 had possible or probable HAM/TSP, and 251 subjects had no neurologic manifestation and were selected for analysis. Definite HAM/TSP developed in 5 (1.47%) patients. Follow-up of at least 3 years was achieved in 51% of patients. The incidence rate was computed in 1000 person-years (206 for hand numbness, 187 for feet numbness, 130 for nocturia, and 127 for urgency). Average incidence rate in neurological exam was 76 for leg hyperreflexia, 53 for leg weakness, and 37 for Babinski sign. In the applied Expanded Disability Status Scale, the incidence rate of worsening 1 point was 134 per 1000 person-years. Kaplan-Meier curves stratified by sex and proviral load showed that females and patients with proviral load >50,000 copies/10(6) peripheral blood mononuclear cells had a higher risk of progression. CONCLUSIONS: Development of neurological symptoms or signs occurred in up to 30% of asymptomatic subjects during 8 years of follow-up