To describe the laboratory parameters and biomarkers of the cytokine storm syndrome associated with severe and fatal COVID-19 cases. A search with standardized descriptors and synonyms was performed ...on November 28.sup.th, 2020 of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, LILACS, and IBECS to identify studies of interest. Grey literature searches and snowballing techniques were additionally utilized to identify yet-unpublished works and related citations. Two review authors independently screened the retrieved titles and abstracts, selected eligible studies for inclusion, extracted data from the included studies, and then assessed the risk of bias using the Newcastle-Ottawa Scale. Eligible studies were those including laboratory parameters-including serum interleukin-6 levels-from mild, moderate, or severe COVID-19 cases. Laboratory parameters, such as interleukin-6, ferritin, hematology, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer, were extracted from the studies. Meta-analyses were conducted using the laboratory data to estimate mean differences with associated 95% confidence intervals. This review points to interleukin-6, ferritin, leukocytes, neutrophils, lymphocytes, platelets, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer as important biomarkers of cytokine storm syndrome. Elevated levels of interleukin-6 and hyperferritinemia should be considered as red flags of systemic inflammation and poor prognosis in COVID-19.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Acceptance of a COVID-19 vaccine in patients with immune-mediated diseases was high.•COVID-19 vaccine acceptance may be hampered by some comorbidities and treatments.•The short duration of trials ...was the main concern behind COVID-19 vaccine hesitancy.
To identify potential predictors of COVID-19 vaccine hesitancy (C19-VH) in adults with immune-mediated inflammatory diseases (IMID).
A total of 1000 IMID patients were enrolled in this web-based cross-sectional study. A standardised and self-administered survey was designed by members of the Brazilian Society of Rheumatology Steering Committee for Infectious and Endemic diseases and distributed to IMID patients spread across Brazil.
Of the 908 (90.8%) respondents eligible for analysis, 744 (81.9%) were willing to get vaccinated against COVID-19. In our multivariable logistic regression model, concurrent malignancy, fibromyalgia, hydroxychloroquine use, and recent corticosteroid pulse therapy were independently associated with higher odds of C19-VH. The short duration of COVID-19 vaccine clinical trials was the main reason for C19-VH.
We identified novel characteristics potentially associated with C19-VH among adults with IMID. Greater awareness on the safety and efficacy of COVID-19 vaccines is needed for both IMID patients and attending physicians.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Wastewater released into the environment without proper treatment contributes to the high prevalence of parasitic infections. We aimed to investigate the occurrence of parasites in sewage ...waters in both rainy and dry seasons in the city of Santana do Ipanema, Brazil. This is a descriptive cross-sectional study carried out between the months of June, July (rainy season) and October (dry season) of 2021. A total of 50 streets were selected by a sample calculation in the Epi Info™ program. From each street, two wastewater samples were collected in both climatic periods. In the laboratory, the water samples were submitted to the Bailenger method with some adaptations and analyzed under an optic microscope. In the rainy season, we detected Strongyloides stercoralis (87.6%; 134), Strongylus spp. (4.6%; 7), hookworms (2.0%; 3) and Iodamoeba butschlii (62.5%; 5), and in the dry season, it was detected S. stercoralis (55.0%; 71), Metastrongylids (19.4%; 25), hookworms (12.4%; 16) and I. butschlii (76.5%; 13). The spatial analysis has shown that most hotspots were associated with S. stercoralis, mainly during periods of intense rainfall and close to river areas. Thus, the city population is subject to infections, especially by helminths regardless of seasonality.
Clade 2.3.4.4b highly pathogenic avian influenza (HPAI) H5N1 virus was detected in the South American sea lions found dead in Santa Catarina, Brazil, in October 2023. Whole genome sequencing and ...comparative phylogenetic analysis were conducted to investigate the origin, genetic diversity, and zoonotic potentials of the H5N1 viruses. The H5N1 viruses belonged to the genotype B3.2 of clade 2.3.4.4b H5N1 virus, which was identified in North America and disseminated to South America. They have acquired new amino acid substitutions related to mammalian host affinity. Our study provides insights into the genetic landscape of HPAI H5N1 viruses in Brazil, highlighting the continuous evolutionary processes contributing to their possible adaptation to mammalian hosts.
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6.
Diagnóstico pré-natal Maria Teresa Vieira Sanseverino; Rejane G. Kessler; Maira G. Burin ...
Clinical and Biomedical Research,
07/2022, Volume:
21, Issue:
3
Journal Article
Peer reviewed
Open access
OBJETIVO: O desenvolvimento de técnicas para diagnosticar as condições genéticas intra-útero foi um grande avanço na genética clínica, mudando a perspectiva reprodutiva de famílias de risco. No ...Hospital de Clínicas de Porto Alegre (HCPA), o programa de diagnóstico pré-natal (DPN) de anomalias congênitas faz parte do Grupo de Medicina Fetal, que é composto por uma equipe multidisciplinar, cuja meta principal é estudar, analisar, diagnosticar e aconselhar as gestantes de alto risco. O trabalho apresentado aqui tem como objetivos revisar os principais procedimentos de diagnóstico pré-natal, descrever a nossa amostra e os exames que são oferecidos às nossas gestantes. MATERIAIS E MÉTODOS: De janeiro de 1989 a julho de 2001, foram cariotipadas 613 gestações, realizadas investigações enzimáticas em 86 casos e em 4 foram realizados estudos moleculares em material fetal. Um total de 1.378 novos casos foram avaliados no ambulatório de DPN do HCPA, de julho de 1993 a julho de 2001, para aconselhamento genético reprodutivo. RESULTADOS: O diagnóstico pré-natal de cromossomopatias realizado no HCPA atingiu uma taxa de crescimento de culturas de 98%, índice semelhante ao dos paísesdesenvolvidos. CONCLUSÕES: O diagnóstico pré-natal é um importante recurso para as famílias com risco de anomalia fetal. Novas técnicas de diagnóstico estão em implantação no HCPA, e poderão contribuir ainda mais para o atendimento dessas famílias. Apresentamos também os aspectos éticos envolvidos e algumas perspectivas futuras na área do diagnóstico pré-natal de anormalidades congênitas.
In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to ...prevent YF. In special situations, such as patients with chronic immune-mediated inflammatory diseases (CIMID), undergoing immunosuppressive therapy, as a higher risk of severe adverse events may occur, assessment of the risk-benefit ratio of the yellow fever vaccine (YFV) should be performed on an individual level. Faced with the scarcity of specific orientation on YFV for this special group of patients, the Brazilian Rheumatology Society (BRS) endorsed a project aiming the development of individualized YFV recommendations for patients with CIMID, guided by questions addressed by both medical professionals and patients, followed an internationally validated methodology (GIN-McMaster Guideline Development). Firstly, a systematic review was carried out and an expert panel formed to take part of the decision process, comprising BRS clinical practitioners, as well as individuals from the Brazilian Dermatology Society (BDS), Brazilian Inflammatory Bowel Diseases Study Group (GEDIIB), and specialists on infectious diseases and vaccination (from Tropical Medicine, Infectious Diseases and Immunizations National Societies); in addition, two representatives of patient groups were included as members of the panel. When the quality of the evidence was low or there was a lack of evidence to determine the recommendations, the decisions were based on the expert opinion panel and a Delphi approach was performed. A recommendation was accepted upon achieving ≥80% agreement among the panel, including the patient representatives. As a result, eight recommendations were developed regarding the safety of YFV in patients with CIMID, considering the immunosuppression degree conferred by the treatment used. It was not possible to establish recommendations on the effectiveness of YFV in these patients as there is no consistent evidence to support these recommendations.
This paper approaches a real need, assessed by clinicians and patient care groups, to address specific questions on the management of YFV in patients with CIMID living or traveling to YF endemic areas, involving specialists from many areas together with patients, and might have global applicability, contributing to and supporting vaccination practices. We recommended a shared decision-making approach on taking or not the YFV.
The stems of Pilocarpus grandiflorus have afforded the new imidazole alkaloid 4,6-dehydro- 1,2,4,5-tetrahydro-2,5-dioxopilocarpine in addition to the 17 known compounds germanicol, β - amiryn, ...ocotillone, stigmast-4-en-3-one, 3β -hydroxy-stigmast-5-en-7-one, 6β -hydroxy-stigmast-4- en-3-one, β -sitosterol, scopoletin, 3-(1’,1’-dimethylallyl)-scopoletin, elisin, dictamine, 4-methoxy-2- quinolone, platydesmine, syringaresinol, syringaldehyde, syringic acid and vanillic acid. Their structures were elucidated on the basis of chemical and spectroscopic evidence. The phenolic compounds vanillic acid and syringaldehyde and the furoquinoline alkaloid platydesmine exhibited antifungal activity against Leucoagaricus gongylophorus, the symbiotic fungus of leaf-cutting ants (Atta sexdens rubropilosa).
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