Morais et al. conducted a pioneering study with Brazilian indigenous populations to determine reference values for immunologic cells from healthy adult individuals. The main findings included a ...higher relative median for T lymphocyte subsets in females than males, and T CD3+, T CD4+, and T CD8+ relative values were statistically different when compared with Brazilian populations from other Brazilian regions. The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Demographic and ethnic diversity of the Brazilian population can be associated with quantitative modifications in the immunologic cells of healthy individuals.OBJECTIVEThe establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul.METHODSFlow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question.RESULTSThe relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population.CONCLUSIONTo our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.
In mixed-ploidy populations, newly formed polyploids initially occur at low frequencies when compared to diploids. However, polyploidy may lead to morphological and phenological changes, which ...promote reproductive isolation and favor polyploid establishment and reproductive success. Additionally, previous studies have shown that polyploidy can confer some adaptive advantages to organisms in stressful environments. Here, we investigate variation in reproductive phenology, floral traits and reproductive success between diploid and autotetraploid trees of
Libidibia ferrea
(Mart. Ex Tul.) L.P. Queiroz (Leguminosae) in a mixed tropical urban population, a stressful environment. We assessed ploidy levels, flowering and fruiting phenology, flowering synchrony, floral and reproductive biology, pollination and fruit and seed set. We tested the hypothesis that autotetraploid individuals have a higher frequency of pollinators and higher fruit and seed set per inflorescence (as a proxy of reproductive success) than diploids in an urban green space.
Libidibia ferrea
is a good model to test our hypothesis because it is self-incompatible (i.e. relies on pollinators to set fruits). In the urban ecosystem studied, we found that diploids flowered for 6–7 months/year and autotetraploids for 3–5 months/year. Flowering synchrony was low between and within cytotypes and even though autotetraploids and diploids exhibited some overlap in flowering period, diploids flowered alone for 2–3 months. Autotetraploids had significantly more flowers per inflorescences, larger flowers and larger pollen grains (as expected for polyploids), but also a higher frequency of visits by legitimate pollinators including two exclusive ones, and higher fruit and seed set per inflorescence when compared to diploids, despite having a shorter flowering period. Our findings reveal some advantages for polyploids over their related diploids in a tropical urban green space. Also, our results highlight the need for more studies that seek to understand abiotic mechanisms affecting reproductive output of polyploids in urban ecosystems.
O desafio do manejo da Rinossinusite fúngica Lopes, Aline Albuquerque Moraes; Filho, Alexandre Silveira Borges de Andrade; Michelini, Ana Clara Loschiavo ...
Brazilian Journal of Development,
12/2022, Volume:
8, Issue:
12
Journal Article
As rinossinusites fúngicas (RSF) são um espectro de doenças classificadas segundo os aspectos fisiopatológicos, diferenciando-as em não invasivas e invasivas. Entre as não invasivas, existem a ...rinossinusite aguda saprofítica, bola fúngica e rinossinusite fúngica alérgica. Já em relação às invasivas, existem a forma aguda, forma crônica e a forma crônica granulomatosa. Os bolores e leveduras são os principais fungos responsáveis por ocasionar adoecimento em humanos, entretanto, os bolores, por serem multicelulares e possuírem hifas, são os maiores responsáveis pelas sinusites fúngicas. Dentre os fungos causadores da sinusite, o mais comum ao nível do seio nasal, é o Aspergillus. A patogênese da RSF ainda não é bem definida, mas acredita-se que fatores ambientais, como ambientes úmidos, hospedeiros suscetíveis e uso prolongado de antibióticos corroboram com o curso da doença. A RSF abrange diversos cenários que podem caracterizá-la de acordo com a classificação da doença. Dentre as manifestações clínicas mais frequentes, incluem: congestão, febre, cefaleia, tontura e vômitos. Além destes, também são descritos edema e ou celulite infraorbitária, anosmia, gotejamento pós-nasal, dor facial, vertigem, alterações comportamentais, diplopia e proptose ocular. Todos esses sintomas, somados a uma avaliação minuciosa com a utilização de exames histopatológicos, endoscópicos e de imagem, torna possível o estabelecimento do diagnóstico da RSF. Sendo assim, há diversos tratamentos que podem ser empregados, como antifúngicos, desbridamento cirúrgico, corticosteroides e imunoterapia, entretanto, devem ser individualizados de acordo com cada caso. No geral, as rinossinusites fúngicas alérgicas têm bom prognóstico, enquanto as rinossinusites fúngicas invasivas podem vir a ter o prognóstico mais reservado. Dessa forma, todos os otorrinolaringologistas devem estar familiarizados com as diversas variantes de tal afecção, de forma a oferecer um manejo adequado e bom prognóstico.
Objective: The aim of this study was to compare blood pressure variability (BPV) in two consecutive blood pressure measurements in hypertensive and non-hypertensive patients. Design and method: A ...total of 92 patients from an outpatient clinic underwent two consecutive blood pressure measurements. The first one was using a calibrated aneroid sphygmomanometer and the second the HBP-1100 automatic blood pressure monitor. Auscultatory measurement was simultaneously performed by two trained observers using a dual-head teaching stethoscope and one supervisor who checked if differences between observers were less than or equal to 4 mmHg. Interval between measurements was at least 30 and at most 60 seconds. Blood pressure variability was defined as the standard deviation around the mean of the two systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings. The paired sample t-test was used to determine whether there is a difference between the mean SBP and DBP variability in two observation sets, defined as hypertensive and non-hypertensive patients. Results: A total population of 92 from an outpatient clinic 66.3% female; mean age: 39.18 years; 32.61% hypertensives underwent two consecutive blood pressure measurements in different methods. 184 valid blood pressure measurements were performed. Mean auscultatory SBP and DBP was 114.13 ± 17.95/ 69.48 ± 14.08 mmHg, respectively. Using the oscillometric method, mean SBP and DBP was 119.26 ± 16.94/71.89 ± 14.047 mmHg. Mean SBP difference between the two measurements was 5.13 ± 8.57 and 2.402 ± 6.85. SBP variability in hypertensive patients is statistically significantly higher (p = 0.01), whereas for DBP there is no significant difference (p = .0.78). Blood pressure variability in hypertensive patients with altered body mass index (BMI) was not statistically different (p = 0.30 and p = 0.56 for SBP and DBP, respectively). Conclusions: Increased SBP variability between two measurements was identified in hypertensive patients, regardless of BMI. As blood pressure variability is a recognized risk factor for cardiovascular events, its investigation should be included in the management of hypertensive care even in the interval between two blood pressure measurements.
Introduction
The use of automated blood pressure monitors is recommended by current guidelines; however, the accuracy of the device must be validated according to standardized protocols. Wrist blood ...pressure monitors have been undergoing technical improvements; nonetheless, their reliability is not unanimously recognized. No systematic review to date has analyzed the accuracy of wrist blood pressure monitors according to standardized protocols. This study aims to summarize the evidence on the accuracy of wrist blood pressure monitors in adults.
Methods
Three databases (PubMed, Scopus and SciELO) were searched on 9 September 2019. The PICO (Patient, Intervention, Comparison and Outcome) strategy was used to outline the research question: Do automated wrist blood pressure monitors have accuracy equivalent to mercury sphygmomanometers in adults? Validation studies of wrist blood pressure monitors were included. Two reviewers independently screened abstracts and full texts. Summary data was extracted for each device, including mean difference of systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the monitor and the mercury sphygmomanometer.
Results
The review identified twenty-nine validation studies. Most of them were developed in China (44.82%), followed by Italy (20.68%). The most commonly used validation protocol was from the British Society of Hypertension. The mean difference between the devices and the mercury sphygmomanometers was 0.47 (±5.75) mmHg for SBP and 0.17 (±4.75) mmHg for DBP. The percentage of wrist blood pressure monitors that passed validation protocols was 93.1.
Conclusions
Most automated wrist blood pressure monitors showed accuracy equivalent to the reference standard for blood pressure measurement, with mean differences less than 0.5 mmHg for SBP and 0.2 for DBP. This evidence supports the recommendation to adopt this technology for the measurement of blood pressure in adults. However, wrist blood pressure monitors have patient positioning specificities, which, if not followed, may lead to measurement errors. Therefore, the adoption of these monitors should consider not only their accuracy, but also aspects of patient use and preferences.
Introduction
The development of more accurate algorithms has encouraged the replacement of sphygmomanometers with automatic blood pressure (BP) monitors in adults. From the perspective of health ...professionals, these technologies are advantageous for their practicality and are less susceptible to observer errors, and many devices validated by standardized protocols are available for both clinical and home use. However, adherence to these technologies also depends on patient acceptance. No studies to date have examined patient preference for BP measurement in the Brazilian population, although Brazil has undertaken initiatives to replace auscultatory measurement with oscillometric measurement. This study aims to analyze patient preferences between sphygmomanometers and automatic monitors for BP measurement.
Methods
An analytic study was conducted with 93 subjects in a Brazilian outpatient care facility. A random sampling method was used to select participants. After obtaining informed consent, all subjects had their BP measured using a sphygmomanometer and then an automatic monitor for clinical use, both in a quiet room after 10 minutes rest. A structured interview on discomfort and preferences was then conducted. An unpaired t-test and a chi-square test were used.
Results
The mean age was 39.11 (±14.22) years. Minor discomfort was identified when an automatic monitor was used (2.34 versus 2.52). Confidence was higher with the sphygmomanometers (73.11%), and 60.21 percent preferred this technology. There was no association between gender and preferences (p = 0.88), but an association with age was identified. The average age of subjects who preferred sphygmomanometers was higher compared to those who preferred automatic monitors (p < 0.05).
Conclusions
This study revealed that, although BP measurement using automatic monitors is less uncomfortable, patients rely more on sphygmomanometers. Results show that preference is related to age, as younger people tend to prefer automatic monitors. The findings of this study indicate the need to widely disseminate information regarding the accuracy of automatic monitors among patients, especially older ones, in order to make them part of the decision-making process for replacing sphygmomanometers with automatic monitors.
Abstract
Although numerous studies have shown the relevance of the gut microbiome in several diseases, underlying questions remain concerning the stomach microbiome and the establishment of a causal ...link between the microbiota and the development of gastric diseases, much beyond Helicobacter pylori and Epstein Barr virus. In this study, we aimed to characterize the bacterial composition of the stomach of subjects undergoing upper endoscopy, including gastric cancer (GC) individuals, aiming to identify fluctuations in bacterial populations that might be associated with stomach health. During endoscopic examination at A.C. Camargo Cancer Center (Sao Paulo, Brazil), gastric fluids (GF) were recovered from either GC patients (113) or individuals with gastric-related complaints, such as superficial gastritis (SG; 79), atrophic gastritis (AG; 12), and intestinal metaplasia (IM; 33). For eubacteria identification, the V3-V4 region of the 16S rRNA gene was amplified and paired-end sequenced (Illumina MiSeq). Analyses were carried out using Qiime2 and phyloseq packages. On average, we identified between 14 and 104 OTUs per subject, evidencing the potential of GFs for determining the stomach microbial composition and the interindividual variation. Testing of sample richness between GC and controls showed significant differences between the number of OTUs observed in each group (an average of 44 and 52 OTUs, respectively—Mann-Whitney test, p<0.05) and SG patients had a significantly increased alpha diversity (Shannon, p<0.05) as compared to AG, IM, and GC patients (both intestinal and diffuse subtypes), indicating dysbiosis already in early carcinogenesis steps. Additionally, the prolonged use of proton pump inhibitors or the presence of H. pylori (except for SG) did not seem to interfere with bacterial diversity. Specific genera are enriched in the sample subsets, including a lower presence of Corynebacterium and increased Streptococcus (Linear discriminant analysis Effect Size, LDA score >2) in AG samples as compared to SG patients, which are also increased in the IM, and GC. These results indicate these bacteria to be potentially associated with the stomach dysbiosis that may lead to the carcinogenesis cascade. Besides the regular turnover of the gastric epithelial tissue and pouring of cells onto the gastric cavity, GF certainly contains a high proportion of transient oral-derived bacteria, while stomach-resident microbiota is expected to be in close contact with the gastric epithelia. Preliminary data analyzing the bacterial content of the saliva x GF in a subset of patients showed no significant beta-diversity differences, but both fluids differ significantly from their biopsies’ composition. We are currently performing culturomics and transcriptomics to identify bacteria that are alive in the stomach. As GC is a complex malignancy with limited treatment options, these results may contribute to developing new interventions to treat and to better understand this disease.
Citation Format: Thais F. Bartelli, Gabriela E. Albuquerque, Alexandre Defelicibus, Marianna S. Serpa, Lais L.S. Abrantes, Rodrigo Borges, Felipe Coimbra, Adriane G. Pelosof, Israel T. Silva, Diana N. Nunes, Emmanuel Dias-Neto. Unravelling the gastric microbiome in health and disease: Gastric cancer beyond Helicobacter pylori in a Brazilian cohort abstract. In: Proceedings of the AACR Special Conference on the Microbiome, Viruses, and Cancer; 2020 Feb 21-24; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2020;80(8 Suppl):Abstract nr B09.
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