RESUMO As Síndromes Hipertensivas da Gestação (SHG) são uma das principais causas de morbimortalidade materna. Evidências crescentes indicam a associação entre a exposição ao cádmio e a hipertensão arterial na população em geral, mas não as SHG. Afim de investigar esse tema, realizou-se uma revisão sistemática seguindo as diretrizes PRISMA, nas bases de dados BVS/Lilacs, PubMed/Medline e SciELO e no repositório da Universidade de São Paulo (USP) até agosto de 2021. A qualidade metodológica foi avaliada pelo checklist Downs and Black. Selecionaram-se dezenove artigos, sendo treze caso-controle, quatro coortes e dois seccionais. No total, 11.451 participantes foram avaliadas, sendo 1.445 (12,6%) com SHG e, destas, 1.071 (74,1%) com pré-eclâmpsia. Observou-se o ajuste inadequado para confundimento em onze estudos. Dos sete estudos considerados de boa qualidade metodológica, quatro relataram associação positiva e três não a observaram, enquanto somente um estudo observou diferença de média, que foi maior nas gestantes com SHG. Atribuiu-se a divergência dos resultados às diferenças metodológicas e ao ajuste inadequado para os fatores de confusão. Como o cádmio é um metal tóxico que pode levar ao aumento do estresse oxidativo, que desempenha papel importante na fisiopatologia das SHG, estudos adicionais são necessários para elucidar esta associação.

ABSTRACT Hypertensive Disorders of Pregnancy (HDP) are one of the main causes of maternal morbimortality. Strong evidence point to an association between cadmium and hypertension in the general population, but not HDP. A systematic review was carried out to investigate this potential relationship, following PRISMA guidelines, in the BVS/LILACS, PubMed/MEDLINE, and SciELO databases and a repository (University of São Paulo – USP) until August 2021. The methodological quality was assessed using the Downs and Black checklist. Nineteen articles were selected, thirteen of which were case-control, four were cohorts, and two were cross-sectional. A total of 11.451 participants were evaluated, 1.445 (12.6%) with HDP, and of these 1.071 (74.1%) with preeclampsia. The inadequate adjustment for confounding was observed in eleven studies. Out of the seven studies considered good methodological quality, four reported a positive association, and three did not observe it. In contrast, only one observed a mean difference, which was higher in HDP. The inconsistency of the results was attributed to the methodological differences and inadequate adjustment for confounding. As cadmium is a toxic metal that can induce an increase in oxidative stress, which plays an essential role in the pathophysiology of HDP, additional studies are needed to elucidate this association.

ABSTRACT Hypertensive Disorders of Pregnancy (HDP) are one of the main causes of maternal morbimortality. Strong evidence point to an association between cadmium and hypertension in the general population, but not HDP. A systematic review was carried out to investigate this potential relationship, following PRISMA guidelines, in the BVS/LILACS, PubMed/MEDLINE, and SciELO databases and a repository (University of São Paulo – USP) until August 2021. The methodological quality was assessed using the Downs and Black checklist. Nineteen articles were selected, thirteen of which were case-control, four were cohorts, and two were cross-sectional. A total of 11.451 participants were evaluated, 1.445 (12.6%) with HDP, and of these 1.071 (74.1%) with preeclampsia. The inadequate adjustment for confounding was observed in eleven studies. Out of the seven studies considered good methodological quality, four reported a positive association, and three did not observe it. In contrast, only one observed a mean difference, which was higher in HDP. The inconsistency of the results was attributed to the methodological differences and inadequate adjustment for confounding. As cadmium is a toxic metal that can induce an increase in oxidative stress, which plays an essential role in the pathophysiology of HDP, additional studies are needed to elucidate this association.

RESUMO As Síndromes Hipertensivas da Gestação (SHG) são uma das principais causas de morbimortalidade materna. Evidências crescentes indicam a associação entre a exposição ao cádmio e a hipertensão arterial na população em geral, mas não as SHG. Afim de investigar esse tema, realizou-se uma revisão sistemática seguindo as diretrizes PRISMA, nas bases de dados BVS/Lilacs, PubMed/Medline e SciELO e no repositório da Universidade de São Paulo (USP) até agosto de 2021. A qualidade metodológica foi avaliada pelo checklist Downs and Black. Selecionaram-se dezenove artigos, sendo treze caso-controle, quatro coortes e dois seccionais. No total, 11.451 participantes foram avaliadas, sendo 1.445 (12,6%) com SHG e, destas, 1.071 (74,1%) com pré-eclâmpsia. Observou-se o ajuste inadequado para confundimento em onze estudos. Dos sete estudos considerados de boa qualidade metodológica, quatro relataram associação positiva e três não a observaram, enquanto somente um estudo observou diferença de média, que foi maior nas gestantes com SHG. Atribuiu-se a divergência dos resultados às diferenças metodológicas e ao ajuste inadequado para os fatores de confusão. Como o cádmio é um metal tóxico que pode levar ao aumento do estresse oxidativo, que desempenha papel importante na fisiopatologia das SHG, estudos adicionais são necessários para elucidar esta associação.

Bioactive glasses (BG) are versatile materials for various biomedical applications due to their capacity to bond to hard and soft tissues. These materials can be produced with different nominal compositions, such that include fluoride ions. Fluorine-containing-BG (BGF) can be produced by the sol-gel method, and its properties can be changed by altering the synthesis parameters. Here, BGF particle size between 235 nm-390 nm were obtained through sol-gel method assisted by ultrasound energy (BGU) or through mechanical stirring (BGM). The BGM and BGU particles showed highly dispersed spherical shape, moreover BGM are mesoporous and BGU are dense structures, indicating mixing mode can alter mainly the material textural characteristics. All compositions have apatite forming ability, verified by DRX from 14 days in SBF. The results showed CaF2 on the surface of BGF particles, indicating that part of F ions was not incorporated in the material network. The samples did not show any cytotoxicity towards human cells in Cellular Metabolic Activity and Calcein assays. This study showed that mechanical agitation was more efficient to produce mesoporous particles to be applied as carrier of drugs and molecules to the biological environment, so BGM can be used as a more efficient biomaterial for such applications.

Resumo Em meados do século passado, transformações na economia e sociedade brasileira somaram-se para desencadear uma rápida transição demográfica, que se caracterizou pelo aumento de idosos. Assim, presenciou-se um envelhecimento populacional, que foi acompanhado pelo aumento da incidência de doenças crônicas não transmissíveis. Alguns fatores de risco estão bem estabelecidos para o desenvolvimento das doenças crônicas não transmissíveis, como excesso de peso, consumo de tabaco e álcool, alimentação inadequada e inatividade física. Adicionalmente, o comportamento sedentário mostrou-se relacionado a importantes efeitos deletérios à saúde, como, por exemplo, diabetes mellitus tipo 2, obesidade e mortalidade.O estudo teve como objetivo investigar a associação entre tempo sentado e diabetes mellitus em idosos. Estudo transversal, realizado em 24 municípios integrantes da Superintendência Regional de Saúde de Uberaba, MG. Os indivíduos selecionados responderam um questionário estruturado e foram submetidos à avaliação antropométrica. Foram analisados 3.265 idosos. A prevalência de diabetes mellitus foi de 20,0% e a mediana de tempo sentado de 240,00 (P25º=137,14 e P75º=330,00) minutos/dia. A análise de regressão logística ajustada demonstrou que o tempo sentado superior a 330,00 minutos/dia associou-se positivamente com a diabetes mellitus (OR=1,329; IC95%: 1,040-1,700). Pode-se concluir que os idosos que ficam sentados por longos períodos diariamente apresentam maior chance de ter diabetes mellitus quando comparados com aqueles que ficam sentados por menor tempo.

Abstract By the middle of the last century, changes in the Brazilian economy and society triggered a rapid demographic transition characterized by an increased number of older adults in the population. Thus, Brazil has witnessed population aging, which was accompanied by an increased incidence of non-communicable chronic diseases. Some risk factors for the development of the chronic non-communicable diseases have been well established, such as overweight, tobacco and alcohol consumption, inadequate nutrition, and physical inactivity. Additionally, sedentary behavior has been related to significant deleterious effects on health, such as diabetes mellitus type 2, obesity and mortality. The objective of this study was to investigate the association between sitting time and diabetes mellitus in older adults. A cross-sectional study was conducted in 24 municipalities in the Regional Health Superintendence of Uberaba, MG. Selected subjects answered a structured questionnaire and underwent anthropometric assessment. A total of 3,265 elderly subjects, with a median time spent sitting of 240.00 (P25th=137.14 and P75th=330.00) minutes/day and a 20.0% prevalence of diabetes mellitus were detected. Adjusted logistic regression analysis showed that a sitting time of more than 330.00 minutes/day was positively associated with diabetes mellitus (OR=1.351, 95%CI: 1.057-1.729). It was concluded that older adults who daily sit for long periods of time have higher chances of having diabetes compared to those who sit for less time.

Biological nitrogen fixation (BNF) has global economic and environmental importance, but has often not been considered in soybean [Glycine max (L.) Merrill] breeding programs. Knowing the genetic diversity and structure of a population within a germoplasm represent a key step for breeding programs. This study aimed at determining the structure of the population and diversity of soybean with regard to BNF and protein content in grain. In total, 191 accessions were evaluated, including 171 commercial soybean cultivars, developed and released by public institutions and private companies in Brazil, and 20 ancestral lines. The genotypes were chosen to represent four genetic groups: 128 Brazilian public genotypes, 20 exotic, and 43 genotypes from private companies. Soybeans were genotyped with 22 SSR markers, previously described as associated with BNF and protein content. Genetic diversity was evaluated using the DARwin 5.0 software. Population structure was inferred by principal component analysis and by the STRUCTURE software. The accessions were distributed in two groups: one clustering approximately 50 % of the accessions, from Brazilian public and private companies; the other one clustering 45 % of the accessions, including Brazilian, exotic and private germoplasms. Some accessions (5 %) were not grouped in any cluster. Principal component analysis explained 29 % of the total variance and there was a tendency to cluster the accessions into two groups. Similar results were obtained with the STRUCTURE, clearly showing two subpopulations. There is variability for BNF and protein content amongst both modern germoplasms cultivated in Brazil and ancestral lines. This variability could be better explored in soybean breeding programs to improve these traits.

BACKGROUND: The lack of standardization of clinical diagnostic criteria, classification and severity scores of chronic graft-versus-host disease led the National Institutes of Health to propose consensus criteria for the purpose of clinical trials. METHODS: Here we describe a one-day workshop model conducted by the Chronic Graft-versus-Host Disease Brazil-Seattle Consortium Study Group to train investigators interested in participating in multicenter clinical trials in Brazil. Workshop participants included eight transplant physicians, one dermatologist, two dentists, three physical therapists and one psychologist from five institutions. Workshop participants evaluated nine patients with varying degrees of severity of mucocutaneous lesions and other manifestations of the disease followed by a training session to review and discuss the issues encountered with the evaluation and scoring of patients and in the methods used to evaluate grip strength and the 2-minute walk test. RESULTS: Most participants had difficulties in rating the percentage of each type of mucocutaneous lesion and thought 20 minutes was insufficient to evaluate and record the scores of each patient using the National Institutes of Health criteria and other cutaneous assessments. Several specific areas of difficulties encountered by the evaluators were: 1) determining the percentage of erythema in movable and non-movable sclerosis, 2) whether to score all cutaneous findings in a particular area or just the dominant lesion; 3) clarification of the definition of poikiloderma in chronic graft-versus-host disease; 4) discrepant interpretation of the mouth score and 5) clarification on the methodology used for the evaluation of grip strength and the 2-minute walk tests. CONCLUSIONS: Results of this workshop support the need to train investigators participating in clinical trials on chronic graft-versus-host disease.

O sucesso crescente dos transplantes de órgãos sólidos (TOS) e de células tronco-hematopoiéticas (TCTH) e as novas drogas imunossupressoras fizeram dos transplantes a primeira opção terapêutica para muitas doenças que afetam milhares de pessoas em todo o mundo. Também os populosos países em desenvolvimento investiram no crescimento de seus programas de transplante e desde então começaram a vivenciar o impacto das doenças tropicais negligenciadas (DTNs) nestes pacientes. Revisamos os dados da literatura sobre a epidemiologia das DTNs de maior impacto clinico e social que afetam receptores de transplante de países em desenvolvimento, ou que podem representar um risco para receptores de transplante vivendo em outras regiões não afetadas por estas doenças. Tuberculose, hanseníase, doença de Chagas, malaria, leishmaniose, dengue, febre amarela e sarampo são os tópicos incluídos nesta revisão. Além disso, revisamos retrospectivamente a experiência referente ao manejo das DTNs do Serviço de Transplante de Medula Óssea da Fundação Amaral Carvalho, atualmente o maior centro de TCTH alogênico do Brasil.

The rising success rate of solid organ (SOT) and haematopoietic stem cell transplantation (HSCT) and modern immunosuppression make transplants the first therapeutic option for many diseases affecting a considerable number of people worldwide. Consequently, developing countries have also grown their transplant programs and have started to face the impact of neglected tropical diseases (NTDs) in transplant recipients. We reviewed the literature data on the epidemiology of NTDs with greatest disease burden, which have affected transplant recipients in developing countries or may represent a threat to transplant recipients living in other regions. Tuberculosis, Leprosy, Chagas disease, Malaria, Leishmaniasis, Dengue, Yellow fever and Measles are the topics included in this review. In addition, we retrospectively revised the experience concerning the management of NTDs at the HSCT program of Amaral Carvalho Foundation, a public transplant program of the state of São Paulo, Brazil.