Heart rate assessment after the first dose of Fingolimod

Objective: To evaluate the cardiovascular function of patients who received the first dose of Fingolimod in a health center in the state of Rio Grande do Sul – Brazil. Methods: A retrospective database study, gathering clinical data and patients’ electrocardiograms who received the first dose of Fingolimod 0.5mg at Centro de Diagnóstico Cardiológico from May 2013 to October 2020. Results: From 83 patients evaluated 64 (77.1%) were women. The average age of participants was 36.97 (±11.21) years old. Out of the 22 (26.5%) symptomatic patients, drowsiness was the most common symptom. There was a statistically significant difference (p0.0001) in the heart rate that occurred early from the first hour after taking the medicine and went on to the fifth hour. Regarding systolic blood pressure, there was a difference (p 0.0001) between the measurement before taking the drug and the measurement six hours later. However, there was no difference in systolic pressure every hour between the second hour after drug administration. The same that happened to systolic blood pressure occurred to diastolic blood pressure. There was no statistical correlation between the age group and the analyzed variables. Conclusions: The clinical, hemodynamic, and electrocardiographic changes verified in the study sample were mild and resolved within 6 hours after the dose, which allows the use of this drug to treat MS safely in the analyzed group

Desospitalização: Uma Perspectiva Humanizada em Idosos / Dehospitalization: A Humanized Perspective on the Elderly

O artigo pretende analisar à luz do princípio da dignidade da pessoa humana,  autonomia e do Estatuto do idoso a adoção da desospitalização, na rede privada, em pacientes idosos crônicos com indicação médica para hospital de transição ou home care, como medida de humanização e acolhimento desse enfermo. Por outro lado, o trabalho abordará acerca dos benefícios e os malefícios na internação desse grupo de pessoas. Além disso, outro ponto que será brevemente apontado toca  aos impasses encontrados quando essa proposta é levada à  família, na qual há recusa injustificada de adesão da indicação médica, sob alegação da ausência de autonomia do idoso em razão da idade avançada. Tal argumento esbarra no princípio da autonomia e na tutela jurídica conferida aos anciãos. Outro fator  que revela-se presente na negativa do familiar acerca da indicação de desospitalização, envolve a natureza contratual que está relacionada ao custeio da manutenção do paciente na UTI e a participação do familiar na recepção do paciente. Por fim, a pesquisa apontará a legislação vigente que respalda a desospitalização na rede privada, incluindo, possíveis abandonos de pacientes de longa permanência nos hospitais e os benefícios esperados com a prática da desospitalização como ferramenta da humanização do cuidado em saúde

Caminhos para o Diagnóstico Precoce: Biomarcadores Neurogenéticos na Doença de Alzheimer.

This paper proposes a literature review on neurogenetic biomarkers in Alzheimer's disease (AD), highlighting their fundamental role in early diagnosis and understanding of the disease's pathogenesis. The analysis covers the identification of specific genetic variants, such as those in the TOMM40 gene, and polymorphisms identified through genome-wide association studies (GWAS). Additionally, the differential expression of genes associated with AD in early stages offers a unique opportunity for more effective therapeutic interventions. Despite advances, challenges such as external validation and genetic variability are crucial. The neurogenetic approach represents progress in understanding the genetic heterogeneity in AD, providing a foundation for future research. The abstract highlights the promising implications of neurogenetic biomarkers and emphasizes the importance of ethical and social awareness.Este trabalho propõe uma revisão de literatura sobre biomarcadores neurogenéticos na doença de Alzheimer (DA), destacando seu papel fundamental no diagnóstico precoce e na compreensão da patogênese da doença. A análise abrange a identificação de variantes genéticas específicas, como aquelas no gene TOMM40, e polimorfismos identificados por meio de estudos de associação genômica ampla (GWAS). Além disso, a expressão diferencial de genes associados à DA em estágios iniciais oferece uma oportunidade única para intervenções terapêuticas mais eficazes. Apesar dos avanços, desafios como a validação externa e a variabilidade genética são cruciais. A abordagem neurogenética representa um avanço na compreensão da heterogeneidade genética na DA, fornecendo uma base para pesquisas futuras. O resumo destaca as implicações promissoras dos biomarcadores neurogenéticos e destaca a importância da conscientização ética e social

Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium

OBJECTIVE It has been argued that metabolically healthy obesity (MHO) does not increase cardiovascular disease (CVD) risk. This study examines the association of MHO with carotid intima-media thickness (cIMT), a proxy of CVD risk, in children and adolescents. RESEARCH DESIGN AND METHODS Data were available for 3,497 children and adolescents aged 6–17 years from five population-based cross-sectional studies in Brazil, China, Greece, Italy, and Spain. Weight status categories (normal, overweight, and obese) were defined using BMI cutoffs from the International Obesity Task Force. Metabolic status (defined as "healthy" [no risk factors] or "unhealthy" [one or more risk factors]) was based on four CVD risk factors: elevated blood pressure, elevated triglyceride levels, reduced HDL cholesterol, and elevated fasting glucose. High cIMT was defined as cIMT ≥90th percentile for sex, age, and study population. Logistic regression model was used to examine the association of weight and metabolic status with high cIMT, with adjustment for sex, age, race/ethnicity, and study center. RESULTS In comparison with metabolically healthy normal weight, odds ratios (ORs) for high cIMT were 2.29 (95% CI 1.58–3.32) for metabolically healthy overweight and 3.91 (2.46–6.21) for MHO. ORs for high cIMT were 1.44 (1.03–2.02) for unhealthy normal weight, 3.49 (2.51–4.85) for unhealthy overweight, and 6.96 (5.05–9.61) for unhealthy obesity. CONCLUSIONS Among children and adolescents, cIMT was higher for both MHO and metabolically healthy overweight compared with metabolically healthy normal weight. Our findings reinforce the need for weight control in children and adolescents irrespective of their metabolic status

Abordagens para Prevenção Secundária do Tromboembolismo Pulmonar (TEP): Uma Revisão de Literatura

This literature review aims to investigate contemporary strategies for the secondary prevention of Pulmonary Embolism (PE). The research encompassed recent studies, focusing on anticoagulation, including novel oral anticoagulants, surgical interventions, and advanced diagnostic methods. Emphasizing the importance of personalized treatment considering individual factors, the review underscores the need for additional studies to validate conclusions and inform more robust clinical guidelines. This review contributes to an in-depth understanding of secondary prevention strategies for PE, highlighting the integrated and personalized approach as crucial for optimizing clinical outcomes and reducing PE recurrence.Esta revisão de literatura explora estratégias contemporâneas para a prevenção secundária do Tromboembolismo Pulmonar (TEP). A pesquisa abrangeu estudos recentes, enfocando anticoagulação, incluindo novos anticoagulantes orais, intervenções cirúrgicas, e métodos de diagnóstico avançados. Destaca-se a importância da personalização do tratamento, considerando fatores individuais, enquanto ressalta a necessidade de estudos adicionais para validar conclusões e informar diretrizes clínicas mais sólidas. Esta revisão contribui para uma compreensão aprofundada das estratégias de prevenção secundária do TEP, enfatizando a abordagem integrada e personalizada como crucial para otimizar desfechos clínicos e reduzir recorrências do TEP

Apoptose de neutrófilos : uma implicação na Sepse e na Síndrome da Angústia Respiratória Aguda Secundária à Sepse?

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Apoptose de neutrófilos : uma implicação na Sepse e na Síndrome da Angústia Respiratória Aguda Secundária à Sepse?

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Meningococcal Carriage among Adolescents after Mass Meningococcal C Conjugate Vaccination Campaigns in Salvador, Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-03-29T16:22:45Z No. of bitstreams: 1 Nunes AMPB Meningococcal carriage....pdf: 923065 bytes, checksum: 9fc2970b9ce33ebc15e62e63e01f256c (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-03-29T16:45:08Z (GMT) No. of bitstreams: 1 Nunes AMPB Meningococcal carriage....pdf: 923065 bytes, checksum: 9fc2970b9ce33ebc15e62e63e01f256c (MD5)Made available in DSpace on 2017-03-29T16:45:08Z (GMT). No. of bitstreams: 1 Nunes AMPB Meningococcal carriage....pdf: 923065 bytes, checksum: 9fc2970b9ce33ebc15e62e63e01f256c (MD5) Previous issue date: 2016Ministério da Saúde, Brazil, TC335/2013; Fundação de Amparo à Pesquisa do Estado da Bahia, SUS007/2014.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilUniversidadeUniversidade Federal da Bahia. Escola de Enfermagem. Salvador, BA, BrasilInstituto Adolfo Lutz. Centro de Bacteriologia. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilFaculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo, SP, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilNeisseria meningitidis is a commensal bacterium of the human nasopharynx. In rare cases, it penetrates the mucosa, entering the blood stream and causing various forms of disease. Meningococcal conjugate vaccines can prevent invasive disease not only by direct effect in vaccinated individuals but also by herd protection, preventing acquisition of carriage, which interrupts transmission and leads to protection of unvaccinated persons. In 2010 in Salvador, Brazil, an outbreak of group C meningococcal disease led to a mass meningococcal serogroup C conjugate vaccination drive, targeting those <5 and 10-24 years of age. The present study aimed to estimate the prevalence of and identify factors associated with N. meningitidis carriage among adolescents from Salvador, Brazil, in the post-vaccination period. In spring 2014, we performed a cross-sectional study involving 1,200 public school students aged 11-19 years old. Oropharyngeal swabs were collected to identify N. meningitidis. Of the 59 colonized participants, 36 (61.0%) carried non-groupable N. meningitidis, while genogroup B (11.9%), Y (8.5%), E (6.8%), Z (5.1%), C (3.4%), and W (3.4%) were also detected. The overall prevalence of N. meningitidis carriage was 4.9% (95% confidence interval [CI], 3.6-6.1%); the prevalence of N. meningitidis genogroup C was 0.17% (95% CI, 0.0-0.40%). There was no difference by age. Factors associated with carriage were having only one, shared, bedroom in the household (PR, 2.02; 95% CI, 0.99-4.12, p = 0.05); the mother being the only smoker in the home (PR, 2.48; 95% CI, 1.16-5.29; p = 0.01); and going to pubs/parties more than 5 times/month (PR, 2.61; 95% CI, 1.38-4.92; p = 0.02). Our findings show that the N. meningitidis carriage rate in adolescents from Salvador, Bahia, is low and is potentially influenced by the low prevalence of N. meningitidis genogroup C. However, continued surveillance is important to identify changes in the dynamics of N. meningitidis, including the emergence of diseases due to a non-C serogroup

Molecular characterization of Neisseria meningitidis isolates recovered from 11-19-year-old meningococcal carriers in Salvador, Brazil.

Characterization of meningococci isolated from the pharynx is essential towards understanding the dynamics of meningococcal carriage and disease. Meningococcal isolates, collected from adolescents resident in Salvador, Brazil during 2014, were characterized by multilocus sequence typing, genotyping or whole-genome sequencing. Most were nongroupable (61.0%), followed by genogroups B (11.9%) and Y (8.5%). We identified 34 different sequence types (STs), eight were new STs, distributed among 14 clonal complexes (cc), cc1136 represented 20.3% of the nongroupable isolates. The porA and fetA genotypes included P1.18,25-37 (11.9%), P1.18-1,3 (10.2%); F5-5 (23.7%), F4-66 (16.9%) and F1-7 (13.6%). The porB class 3 protein and the fHbp subfamily A (variants 2 and 3) genotypes were found in 93.0 and 71.0% of the isolates, respectively. NHBA was present in all isolates, and while most lacked NadA (94.9%), we detected the hyperinvasive lineages B:P1.19,15:F5-1:ST-639 (cc32); C:P1.22,14-6:F3-9:ST-3780 (cc103) and W:P1.5,2:F1-1:ST-11 (cc11). This is the first report on the genetic diversity and vaccine antigen prevalence among N. meningitidis carriage isolates in the Northeast of Brazil. This study highlights the need for ongoing characterization of meningococcal isolates following the introduction of vaccines and for determining public health intervention strategies

Epidemiology and molecular characterization of Neisseria lactamica carried in 11-19 years old students in Salvador, Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-04-20T13:16:38Z No. of bitstreams: 1 Moura A Epidemiology and molecular....pdf: 884644 bytes, checksum: dc6ea30f5709b5c69be072dd650883a4 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-04-20T13:27:05Z (GMT) No. of bitstreams: 1 Moura A Epidemiology and molecular....pdf: 884644 bytes, checksum: dc6ea30f5709b5c69be072dd650883a4 (MD5)Made available in DSpace on 2018-04-20T13:27:05Z (GMT). No. of bitstreams: 1 Moura A Epidemiology and molecular....pdf: 884644 bytes, checksum: dc6ea30f5709b5c69be072dd650883a4 (MD5) Previous issue date: 2018Ministério da Saúde, Brazil (grant number TC335/2013), and Fundação de Amparo à Pesquisa do Estado da Bahia (grant number SUS 007/2014).Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilCenters for Disease Control and Prevention. Meningitis and Vaccine Preventable Diseases Branch. Division of Bacterial Diseases. Atlanta GA, USAFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Nacional de Controle de Qualidade em Saúde. Rio de Janeiro, RJ, BrasilSanta Casa de São Paulo. Faculdade de Ciências Médicas. São Paulo, SP, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil / Universidade Federal de Pelotas. Centro de Desenvolvimento Tecnológico. Núcleo de Biotecnologia. Pelotas, RS, BrasilCenters for Disease Control and Prevention. Meningitis and Vaccine Preventable Diseases Branch. Division of Bacterial Diseases. Atlanta GA, USAFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilNeisseria lactamica is a nonpathogenic commensal bacterium that is potentially associated with the development of natural immunity against N. meningitidis. However, the genetic variation present in natural populations of N. lactamica has not been fully investigated. To better understand its epidemiology and genetic variation, we studied N. lactamica carriage in 1200 students aged 11-19 years old in Salvador, Brazil. The carriage prevalence was 4.5% (54/1200), with no statistical difference among sex and age, although we observed a trend towards higher carriage prevalence among 11-year-old individuals. Whole genome sequence analysis revealed a high genetic diversity among the isolates, with the presence of 32 different STs, 28 (87.5%) of which were new. A total of 21/50 (42%) isolates belonged to three different clonal complexes. While none of the isolates contained nadA or fHpb alleles, we detected 21 FetA variants, 20 NhbA variants and two variants of PorB. The data provide detailed information on circulating N. lactamica isolates in adolescents in Brazil and are complementary to studies in other countries