A contaminação ou poluição da água, geram diversos fenômenos, um deles é a eutrofização. Em virtude disso, com a finalidade de gestão sustentável dos recursos hídricos, o Índice de Estado Trófico foi ...desenvolvido para possibilitar a classificação das águas de corpos hídricos em diferentes graus de trofia, sendo o sensoriamento remoto uma das ferramentas capazes de determinar tal índice. Dessa forma, o objetivo deste estudo é comparar os níveis tróficos obtidos por meio das análises do sensoriamento remoto com as análises limnológicas de amostras de clorofila “a” em laboratório. A presente pesquisa é composta por três etapas de análises, primeiro serão coletadas amostras de água ao longo de sete pontos da baía de Portel-PA, que por sua vez serão analisadas em laboratório, em seguida, será feita a coleta e o tratamento das imagens de satélite para a predição da clorofila “a”, e então a comparação qualitativa dos valores obtidos com as etapas anteriores através do IET. A aplicação da metodologia permitiu observar que em todos os pontos os valores de IET verificados pelo sensoriamento remoto estão próximos da análise feita em laboratório tendo como classificação predominante entre os pontos a mesotrófica. Logo, análises espaciais como esta, demonstram a importância do sensoriamento remoto como ferramenta para a identificação das áreas de ocorrência de clorofila “a”, contudo, as técnicas de sensoriamento remoto utilizadas neste trabalho, não foram capazes de substituir os trabalhos de campo. Elas apenas permitiram um planejamento e monitoramento remoto mais eficiente das ações a serem realizadas na etapa conclusiva.
Childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has been associated with early-life exposures, including birth by cesarean section (C-section), and a deficit of social exposure ...(first child). These exposures as proxies for microbiome acquisition in infancy are essential to prime the immune system and restrain later dysregulated immune responses that can trigger ALL in susceptible individuals. We tested risk factors pertaining to immune stimulation that may impact BCP-ALL development.
Cases comprised 1,126 children (0-12 years) with ALL (BCP-ALL: 78.5%) from the EMiLI study group in Brazil (2002-2020). Age- and sex-matched controls (n = 2,252) were randomly selected from healthy children whose mothers participated in the National Placental and Umbilical Cord Blood Bank donation. Multiple logistic regression was run fitted and adjusted for selected covariates models.
C-section delivery was associated with increased risk for ALL odds ratio (OR) ALL: 1.10; 95% confidence intervals (CI), 1.04-1.15; ORBCP-ALL: 1.09; 95% CI, 1.03-1.14, as well as being the firstborn child. Interaction analysis showed a significant effect of first birth on the observed C-section associations (P < 0.0001). Indeed, high-risk children, namely, firstborn children delivered via C-section were at increased risk for ALL (OR: 2.33; 95% CI, 2.40-4.84) compared with non-first, vaginally born children. An increased risk was found for firstborn children delivered by C-section and non-breastfed with ALL (ORALL: 2.32; 95% CI, 1.27-4.24; ORBCP-ALL: 2.37; 95% CI, 1.18-4.76).
Our observations are in accord with the prediction that exposures determining microbiome composition and adrenal pathway in infancy contribute to the risk of BCP-ALL.
These findings encourage the exploration of potential preventive interventions. See related commentary by Wiemels and Gallant, p. 292.
•ABLC is effective and well-tolerated for the treatment of invasive fungal infections.•ABLC presented similar rates of safety outcomes when compared L-AMB.•Lipid formulations showed similar safety ...profiles, the same does not apply to D-AMB.•A minimum of 2 weeks of treatment with ABLC should be prioritized.•Standardization of clinical management is necessary to minimize harmful effects.
Data on the real-life use of amphotericin B lipid complex (ABLC) compared with other available formulations are limited. This study aimed to evaluate the effectiveness, tolerability, and safety of different amphotericin B (AMB) intravenously administered in the context of hospital practice for the treatment of invasive fungal infections (IFI) and to provide new insights into the profile of ABLC.
This is a multicenter, retrospective, observational study conducted at 10 tertiary Brazilian hospitals. Patients first exposed to any formulation of AMB for treating endemic and opportunistic IFI who had received at least 2 intravenous doses were screened. Retrospective data (from January 2014 to December 2019) were extracted from the patients’ medical records. Clinical parameters were examined pre- and post-treatment to determine effectiveness; acute infusion-related side effects (IRSE) and drug interruption to determine tolerability; and adverse events, toxicity, and treatment interruption were stated to analyze safety.
Overall, 1879 medical records of patients were identified. The median (interquartile rate) duration of treatment was 14 (7–21) days. The overall success rate (95% confidence interval CI) was 65% (95% CI 60–65). ABLC proved to be effective among AMB formulations with 59% (95% CI 55.6–62.5) within complete response. This was significantly higher in patients who received the drug for a longer period, ≥4 weeks compared to <1 week treatment (P < 0.001). IRSE was observed in 446 (23.7%) patients. Eight cases (1.4%) of severe IRSE in pediatrics and 14 (1.1%) in adults resulted in treatment discontinuation. Regarding safety, 637 (33.9%) patients presented some alteration in creatinine levels during AMB exposure, and 89 (4.74%) had to interrupt or discontinue the drug within the first 14 days of therapy because of renal dysfunction. Overall mortality was 34%.
ABLC is an effective formulation for the treatment of invasive fungal infections, with few adverse events leading to drug discontinuation or lethal outcomes. Furthermore, this real-life study confirmed the comparative safety of AMB lipid formulations versus AMB deoxycholate.
Abstract Background Progressive disseminated histoplasmosis is a significant issue in Latin America, particularly in Brazil, contributing to high mortality rates. Objectives Our objectives were to ...comprehensively describe histoplasmosis treatment with various amphotericin B (AmB) formulations, including mortality rates, adverse effects and risk factors for mortality. Methods This multicentre retrospective cohort study (January 2014–December 2019) evaluated medical records of patients with proven or probable histoplasmosis treated with at least two doses of AmB in seven tertiary medical centres in Brazil. We assessed risk factors associated with death during hospitalization using univariate and multivariate analyses. Results The study included 215 patients, mostly male (n = 158, 73%) with HIV infection (n = 187, 87%), and a median age of 40 years. Only 11 (5%) patients initiated treatment with liposomal amphotericin B (L-AmB). Amphotericin B deoxycholate (D-AmB) was administered to 159 (74%) patients without changes in the treatment. The overall mortality during hospitalization was 23% (50/215). Variables independently associated with mortality were use of D-AmB (OR 4.93) and hospitalization in ICU (OR 9.46). There was a high incidence of anaemia (n = 19, 90%), acute kidney injury (n = 96, 59%), hypokalaemia (n = 73, 55%) and infusion reactions (n = 44, 20%) during treatment. Conclusions We found that D-AmB was the main formulation, which was also associated with a higher mortality rate. Lipid formulations of AmB have become more readily available in the public health system in Brazil. Further studies to evaluate the effectiveness of L-AmB will likely show improvements in the treatment outcomes for patients with disseminated histoplasmosis.
Trace elements were determined in fish and oysters from Sepetiba Bay, Brazil, by total reflection Xray fluorescence using synchrotron radiation (SRTXRF). Cr, Mn, Fe, Ni, Cu, Zn and Se were determined ...in fish muscles and organs and in oyster soft tissue. SRTXRF was shown to be a good tool for the analysis of trace elements from biological tissue samples. Overall, the levels of the analysed metals were higher in oysters than in the fish samples. Metals were not uniformly distributed throughout the body of the analysed fish. The detected concentrations of Cr, Zn and Se were very high in some samples, surpassing the maximum limits established by Brazilian legislation.
O município de Belém está entre os que possuem pior índice de saneamento básico do país, com destaque para o esgotamento sanitário que eleva a carga de poluentes nos corpos receptores, dentre eles o ...rio Guamá. Considerando este cenário onde apenas 13% da população possui coleta de esgoto, a situação requer alerta, pois a história nos revela que a saúde da população está relacionada ao nível de saneamento e ao modo como os recursos hídricos são utilizados. Neste sentido, a pesquisa visou determinar as condições das águas superficiais do rio Guamá, na sub-bacia do baixo Guamá em Belém, com análise de parâmetros microbiológicos e identificar quais fatores têm influenciado nos resultados obtidos. Dados primários foram alcançados mediante coleta de água em 08 pontos da sub-bacia, no trecho de Belém, em período chuvoso e não chuvoso de 2020 para posterior análise da concentração de coliformes termotolerantes - CT. Ademais, dados secundários foram obtidos quanto ao número de notificações das principais doenças de veiculação hídrica e relacionadas à falta de saneamento, através do Datasus entre 2007 a 2017. A análise dos dados pautou-se na comparação dos limites legais da Res. CONAMA 357/05, bem como testes estatísticos. Como resultado, os limites legais (1.000 NMP/100ml) foram ultrapassados em diversos pontos, onde no período menos chuvoso obteve média de 3.799,5 NMP/100ml, alcançando máxima de 12.098 NMP/100ml no ponto 05. No período mais chuvoso, apresentou-se resultados maiores que 24.000 NMP/100ml em todos os pontos. Estatisticamente os CT obtiveram diferença significativa na sazonalidade. Os dados secundários indicam um total de 17.304 notificações das doenças pesquisadas no período analisado, tendo a dengue e leptospirose, relacionadas à falta de saneamento, com maiores incidências. Conclui-se que a capital tem tido reflexo tanto na qualidade do corpo receptor, quanto na saúde da população. Fatores socioambientais nos pontos coletados podem ter relação com a alta concentração resultante de CT encontrada e de doenças em decorrência do saneamento precário.
Este artigo avaliou os aspectos de sustentabilidade social e econômica da coleta extrativa e manejada do fruto de bacuri e das práticas agrícolas realizadas pelos pequenos produtores e coletores da ...Mesorregião Marajó. A pesquisa foi realizada nos Municípios de Soure, Salvaterra, Cachoeira do Arari e Ponta de Pedras. Os procedimentos metodológicos foram baseados numa análise quali-quantitativa. Realizou-se a aplicação de questionários semi-estruturados para 52 pequenos produtores e coletores de bacuri. Os resultados demonstram que 32 (61,5%), 28 (53,8%) e 22 (42,3%) pequenos produtores realizam o cultivo e venda de mandioca, açaí e abacaxi, respectivamente. Essas são as culturas comumente comercializadas pela maioria dos entrevistados, ao longo do período que os bacurizeiros não estão no período de safra. Quanto ao nível de satisfação em relação à venda dos frutos de bacuri, 14 pequenos produtores declararam que a comercialização é pouco satisfatória (27,0%), 11 afirmaram que é razoavelmente satisfatória (21,1%), e 27 consideram a venda muito satisfatória, configurando 51,9% das entrevistas. Portanto, os informantes possuem sistemas agroextrativistas presentes nas suas atividades produtivas, e os aspectos de sustentabilidade social e econômica da dinâmica produtiva e comercial do fruto de bacuri, demonstram a importância dessa cultura na complementação financeira dos pequenos produtores entrevistados, pois, a maioria possui a percepção de que a venda deste produto extrativista gera retorno econômico, que pode ser potencializado por meio do manejo.
Cryptococcosis is traditionally associated with immunocompromised patients but is increasingly being identified in those without the human immunodeficiency virus (HIV) or other immunocompetent ...individuals. We aim to describe the characteristics, mortality, and associated variables with death among hospitalized patients with cryptococcosis in Brazil. This is the first multicenter retrospective cohort study conducted in seven public tertiary Brazilian hospitals. A total of 384 patients were included; the median age was 39 years and 283 (73.7%) were men. In all, 304 HIV-positive were hosts (79.2%), 16 (4.2%) solid organ transplant (SOT), and 64 (16.7%) non-HIV-positive/non-transplant (NHNT). Central nervous system (CNS) cryptococcosis had a significantly higher number across disease categories, with 313 cases (81.5%). A total of 271 (70.6%) patients were discharged and 113 (29.4%) died during hospitalization. In-hospital mortality among HIV-positive, SOT, and NHNT was 30.3% (92/304), 12.5% (2/16), and 29.7% (19/64), respectively. Induction therapy with conventional amphotericin B (AMB) mainly in combination with fluconazole (234; 84.2%) was the most used. Only 80 (22.3%) patients received an AMB lipid formulation: liposomal (n = 35) and lipid complex (n = 45). Most patients who died belong to the CNS cryptococcosis category (83/113; 73.4%) when compared with the others (P = .017). Multivariate analysis showed that age and disseminated cryptococcosis had a higher risk of death (odds ratio OR, 1.03; 95% confidence interval CI, 1.01-1.05; P = .008 and OR, 1.84; 95% CI, 1.01-3.53; P = .048, respectively). Understanding the epidemiology of cryptococcosis in our settings will help to recognize the burden and causes of mortality and identify strategies to improve this scenario.
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