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RESUMO A melatonina (MLT) é um hormônio sintetizado e secretado pela glândula pineal, e que, dentre outras atividades e funções, tem capacidade de estimular a formação e inibir a reabsorção óssea. Objetivo avaliar o efeito da aplicação local do hormônio MLT na neoformação óssea, em defeitos críticos produzidos na calvária de ratos, por meio de análise histomorfométrica, microtomográfica e de biologia molecular, comparando-a com um substituto ósseo de origem xenogênica (Bio-Oss®). Materiais e Método foram utilizados 36 ratos Wistar machos adultos, nos quais foram produzidos dois defeitos críticos de 5,0 mm de diâmetro cada, que receberam diferentes tratamentos alocados de forma randomizada: no grupo controle, os animais tiveram um dos defeitos preenchidos apenas com coágulo sanguíneo (C) e o outro com substituto ósseo xenógeno (Bio-Oss®, BO); no grupo teste, um dos defeitos foi preenchido apenas com MLT e, o outro, recebeu a associação da MLT ao material sintético xenógeno (MLTBO). Todos os animais foram eutanasiados após 30 dias do pós-operatório. As amostras das calotas contendo os defeitos críticos foram coletadas para análises histomorfométricas, microtomográficas e da expressão gênica de colágeno do tipo I (COL-I), osteopontina (OPN) e proteína óssea morfogenética 2 (BMP-2), por meio de PCR em tempo real. Resultados Após análise dos dados pode-se observar que não houve diferença estatística na quantificação de neoformação óssea (p>0.05), porém, melhora qualitativa foi observada na cicatrização, quando a MLT foi utilizada. Quanto aos par®metros microtomográficos, foi observado que com ou sem MLT, o volume ósseo foi significativamente menor na ausência de BO. A espessura (p = 0,590) e número (p = 0,150) de trabéculas não foram significativamente afetados pelo uso da MLT. Quanto à expressão gênica de COL-I, OPMN e BMP-2, não foram observadas diferenças significativas entre os grupos MLT, BO e MLTBO. Conclusão conclui-se que a aplicação tópica de MLT, associada ou não ao BO não afetou quantitativamente a neoformação óssea, porém resultou em uma melhora qualitativa na cicatrização. Adicionalmente, na ausência de BO foi observada menor volume ósseo e menor espessura das trabéculas.

ABSTRACT Melatonin (MLT) is a hormone that can stimulate bone formation and inhibit bone resorption, among other functions. Aim To evaluate the effect on new bone formation of MLT applied locally to critical defects created in the calvaria of rats, compared to the effect of Bio-Oss® xenogeneic bone substitute (BO), by analyzing histomorphometry, microtomography and gene expression. Materials and Method Two critical defects (5.0 mm in diameter) were created in the calvaria of 36 adults male Wistar rats. The rats were divided randomly into two groups: a test group, in which one of the defects was filled with MLT, and the other with MLT with Bio-Oss® (MLTBO), and a control group, in which one of the defects was filled only with the clot (C), and the other with BO. The rats were euthanized 30 days after surgery. Samples of the calvaria containing the critical defects were collected for analysis by histomorphometry, microtomography, and the expression of the genes for type I collagen (COL-I), osteopontin (OPN) and bone morphogenetic protein 2 (BMP-2). Results A qualitative improvement was observed in bone healing when MLT was used, though there was no statistical difference in the quantification of newly formed bone (p>0.05). Micro-CT showed that bone volume was significantly smaller in absence of BO (p=0.006). Bone trabeculae thickness (p=0.590) and number (p=0.150) were not significantly affected by MLT. Regarding the expression of the genes COL-I, OPN and BMP-2, no significant differences were observed between the MLT, BO and MLTBO groups. Conclusion Topical application of MLT resulted in a qualitative improvement in bone healing, although it did not affect bone formation quantitatively. In the absence of BO, less bone volume and less bone trabecular thickness were observed.

https://doi.org/10.54589/aol.37/2/123

Guidelines for Trypanosoma cruzi-HIV Co-infection and other Immunosuppressive Conditions: Diagnosis, Treatment, Monitoring, and Implementation from the International Network of Care and Studies - 2023 cruziHIV cruzi HIV Coinfection Co infection Conditions Diagnosis Treatment Monitoring 202 20 2
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Almeida, Eros Antonio de

; Mendes, Fernanda de Souza Nogueira Sardinha

; Ramos Júnior, Alberto Novaes

; Sousa, Andréa Silvestre de

; Pavan, Tycha Bianca Sabaini

; Mediano, Mauro Felippe Felix

; Ostermayer, Alejandro Luquetti

; Hasslocher-Moreno, Alejandro Marcel

; Britto, Constança Felicia De Paoli de Carvalho

; Novaes, Christina Gallafrio

; Correia, Dalmo

; Santos, Fred Luciano Neves

; Silva, Gilberto Marcelo Sperandio da

; Fernandez, Marisa Liliana

; Lima, Mayara Maia

; Carvalho, Noêmia Barbosa de

; Moreira, Otacílio da Cruz

; Albajar-Viñas, Pedro

; Leite, Ruth Moreira

; Palmeira, Swamy Lima

; Costa, Veruska Maia da

; Yasuda, Maria Aparecida Shikanai

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0549-2023

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/0037-8682-0549-2023

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio

; Rassi Jr, Anis

; Oliveira, Gláucia Maria Moraes

; Correia, Luís Claudio Lemos

; Ramos Júnior, Alberto Novaes

; Luquetti, Alejandro Ostermayer

; Hasslocher-Moreno, Alejandro Marcel

; Sousa, Andréa Silvestre de

; Paola, Angelo Amato Vincenzo de

; Sousa, Antônio Carlos Sobral

; Ribeiro, Antonio Luiz Pinho

; Correia Filho, Dalmo

; Souza, Dilma do Socorro Moraes de

; Cunha-Neto, Edecio

; Ramires, Felix Jose Alvarez

; Bacal, Fernando

; Nunes, Maria do Carmo Pereira

; Martinelli Filho, Martino

; Scanavacca, Maurício Ibrahim

; Saraiva, Roberto Magalhães

; Oliveira Júnior, Wilson Alves de

; Lorga-Filho, Adalberto Menezes

; Guimarães, Adriana de Jesus Benevides de Almeida

; Braga, Adriana Lopes Latado

; Oliveira, Adriana Sarmento de

; Sarabanda, Alvaro Valentim Lima

; Pinto, Ana Yecê das Neves

; Carmo, Andre Assis Lopes do

; Schmidt, Andre

; Costa, Andréa Rodrigues da

; Ianni, Barbara Maria

; Markman Filho, Brivaldo

; Rochitte, Carlos Eduardo

; Macêdo, Carolina Thé

; Mady, Charles

; Chevillard, Christophe

; Virgens, Cláudio Marcelo Bittencourt das

; Castro, Cleudson Nery de

; Britto, Constança Felicia De Paoli de Carvalho

; Pisani, Cristiano

; Rassi, Daniela do Carmo

; Sobral Filho, Dário Celestino

; Almeida, Dirceu Rodrigues de

; Bocchi, Edimar Alcides

; Mesquita, Evandro Tinoco

; Mendes, Fernanda de Souza Nogueira Sardinha

; Gondim, Francisca Tatiana Pereira

; Silva, Gilberto Marcelo Sperandio da

; Peixoto, Giselle de Lima

; Lima, Gustavo Glotz de

; Veloso, Henrique Horta

; Moreira, Henrique Turin

; Lopes, Hugo Bellotti

; Pinto, Ibraim Masciarelli Francisco

; Ferreira, João Marcos Bemfica Barbosa

; Nunes, João Paulo Silva

; Barreto-Filho, José Augusto Soares

; Saraiva, José Francisco Kerr

; Lannes-Vieira, Joseli

; Oliveira, Joselina Luzia Menezes

; Armaganijan, Luciana Vidal

; Martins, Luiz Cláudio

; Sangenis, Luiz Henrique Conde

; Barbosa, Marco Paulo Tomaz

; Almeida-Santos, Marcos Antonio

; Simões, Marcos Vinicius

; Yasuda, Maria Aparecida Shikanai

; Moreira, Maria da Consolação Vieira

; Higuchi, Maria de Lourdes

; Monteiro, Maria Rita de Cassia Costa

; Mediano, Mauro Felippe Felix

; Lima, Mayara Maia

; Oliveira, Maykon Tavares de

; Romano, Minna Moreira Dias

; Araujo, Nadjar Nitz Silva Lociks de

; Medeiros, Paulo de Tarso Jorge

; Alves, Renato Vieira

; Teixeira, Ricardo Alkmim

; Pedrosa, Roberto Coury

; Aras Junior, Roque

; Torres, Rosalia Morais

; Povoa, Rui Manoel dos Santos

; Rassi, Sergio Gabriel

; Alves, Silvia Marinho Martins

; Tavares, Suelene Brito do Nascimento

; Palmeira, Swamy Lima

; Silva Júnior, Telêmaco Luiz da

; Rodrigues, Thiago da Rocha

; Madrini Junior, Vagner

; Brant, Veruska Maia da Costa

; Dutra, Walderez Ornelas

; Dias, João Carlos Pinto

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 6 elocation e20230269

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20230269

[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio Rassi Jr., Anis Moraes Oliveira, Gláucia M. Lemos Correia, Luís Claudio Novaes Ramos Jr., Alberto Hasslocher-Moreno, Alejandro Marcel Luquetti Ostermayer, Alejandro Sousa, Andréa Silvestre de Amato Vincenzo de Paola, Angelo Sobral de Sousa, Antonio Carlos Pinho Ribeiro, Antonio Luiz Correia Filho, Dalmo Moraes de Souza, Dilma do Socorro Cunha-Neto, Edecio J. A. Ramires, Felix Bacal, Fernando Pereira Nunes, Maria do Carmo Martinelli Filho, Martino Ibrahim Scanavacca, Maurício Magalhães Saraiva, Roberto Alves de Oliveira Júnior, Wilson M. Lorga-Filho, Adalberto de Jesus Benevides de Almeida Guimarães, Adriana Lopes Latado Braga, Adriana Sarmento de Oliveira, Adriana V. L. Sarabanda, Alvaro Yecê das Neves Pinto, Ana Assis Lopes do Carmo, André Schmidt, André Costa, Andréa Rodrigues da Ianni, Barbara Maria Markman Filho, Brivaldo Eduardo Rochitte, Carlos Thé Macedo, Carolina Mady, Charles Chevillard, Christophe Bittencourt das Virgens, Cláudio Marcelo Nery de Castro, Cleudson De Paoli de Carvalho Britto, Constança Felícia Pisani, Cristiano do Carmo Rassi, Daniela C. Sobral Filho, Dario Rodrigues Almeida, Dirceu A. Bocchi, Edimar T. Mesquita, Evandro de Souza Nogueira Sardinha Mendes, Fernanda Pereira, Francisca Tatiana Sperandio da Silva, Gilberto Marcelo de Lima Peixoto, Giselle Glotz de Lima, Gustavo H. Veloso, Henrique Turin Moreira, Henrique Bellotti Lopes, Hugo Masciarelli Francisco Pinto, Ibraim Pinto Dias, João Carlos Bemfica, João Marcos Silva-Nunes, João Paulo Soares Barreto-Filho, José Augusto Kerr Saraiva, José Francisco Lannes-Vieira, Joseli Menezes Oliveira, Joselina Luzia V. Armaganijan, Luciana Martins, Luiz Cláudio C. Sangenis, Luiz Henrique Barbosa, Marco Paulo Almeida-Santos, Marcos Antônio Simões, Marcos Vinicius Shikanai-Yasuda, Maria Aparecida Vieira Moreira, Maria da Consolação Higuchi, Maria de Lourdes Costa Monteiro, Maria Rita de Cássia Felix Mediano, Mauro Felippe Maia Lima, Mayara T. Oliveira, Maykon Moreira Dias Romano , Minna Nitz, Nadjar de Tarso Jorge Medeiros, Paulo Vieira Alves, Renato Alkmim Teixeira, Ricardo Coury Pedrosa, Roberto Aras, Roque Morais Torres, Rosália dos Santos Povoa, Rui Manoel Rassi, Sérgio Gabriel Salles Xavier, Sérgio Marinho Martins Alves , Silvia B. N. Tavares, Suelene Lima Palmeira, Swamy da Silva Junior, Telêmaco Luiz da Rocha Rodrigues, Thiago Madrini Junior, Vagner Maia da Costa , Veruska Dutra, Walderez

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Publication date: 2022-10-11

Abstract: En Pt

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp; Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities. nbsp; Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp; The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp; The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp; Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.

Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp; Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;

https://doi.org/10.1590/SciELOPreprints.4820

Chagas disease mortality during the coronavirus disease 2019 pandemic: A Brazilian referral center experience
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Hasslocher-Moreno, Alejandro Marcel

; Saraiva, Roberto Magalhães

; Silva, Gilberto Marcelo Sperandio da

; Xavier, Sergio Salles

; Sousa, Andréa Silvestre de

; Costa, Andrea Rodrigues da

; Mendes, Fernanda de Souza Nogueira Sardinha

; Mediano, Mauro Felippe Felix

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0562-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background We investigated the mortality rates of patients with Chagas disease (CD) during the coronavirus disease 2019 (COVID-19) pandemic and assessed the association between this mortality and CD clinical presentation and comorbidities. Methods: This was an observational retrospective study with clinical data retrieved from medical records. Results: Comorbidities were more prevalent among patients who died from COVID-19 than those who died from other causes. The proportion of patients according to CD clinical presentation was similar between the two groups. Conclusions: The prevalence of comorbidities seems to be related to a poorer prognosis in CD and COVID-19.

https://doi.org/10.1590/0037-8682-0562-2021

Evaluation of the WRF-ARW model during an extreme rainfall event: Subtropical storm Guará
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Kitagawa, Yasmin Kaore Lago

; Nascimento, Erick Giovani Sperandio

; Souza, Noéle Bissoli Perini De

; Zucatelli Junior, Pedro

; Kumar, Prashant

; Albuquerque, Taciana Toledo De Almeida

; Moraes, Marcelo Romeiro De

; Moreira, Davidson Martins

Atmósfera

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2022, Volume 35 N. 4 Pages 651 - 672

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT This study simulates an unusual extreme rainfall event that occurred in Salvador city, Bahia, Brazil, on December 9, 2017, which was named subtropical storm Guará and had precipitation of approximately 24 mm within less than 1 h. Numerical simulations were conducted using the Weather Research and Forecasting (WRF) model over three domains with horizontal resolutions of 9, 3, and 1 km. Different combinations of seven microphysics, three cumulus, and three planetary boundary layer schemes were evaluated based on their ability to simulate the hourly precipitation during this rainfall event. Statistical indices (MB = -0.69; RMSE = 4.11; MAGE = 1.74; r = 0.55; IOA = 0.66; FAC2 = 0.58) and time series plots showed that the most suitable configurations for this weather event were the Mellor-Yamada-Janjić, Grell-Freitas, and Lin formulations for the planetary boundary layer, cumulus, and microphysics schemes, respectively. The results were compared with the data measured at meteorological stations located in Salvador city. The WRF model simulated well the arrival and occurrence of this extreme weather event in a tropical and coastal region, considering that the region already has intense convective characteristics and is constantly influenced by sea breezes, which could interfere in the model results and compromise the performance of the simulations.

RESUMEN El presente estudio simula un evento inusual de lluvia extrema ocurrido en la ciudad de Salvador, Bahía, Brasil, el 9 de diciembre de 2017, que se denominó tormenta subtropical Guará y tuvo una precipitación de aproximadamente 24 mm en menos de 1 h. Se realizaron simulaciones numéricas utilizando el modelo Weather Research and Forecasting (WRF) en tres dominios con resoluciones horizontales de 9, 3 y 1 km. Se evaluaron diferentes combinaciones de siete esquemas de microfísica, tres cumulus y tres capas límites planetarias en función de su capacidad para simular la precipitación horaria durante este evento de lluvia. Los índices estadísticos (MB = -0.69; RMSE = 4.11; MAGE = 1.74; r = 0.55; IOA = 0.66, y FAC2 = 0.58) y los gráficos de series temporales mostraron que las configuraciones más adecuadas para este evento meteorológico fueron las de Mellor-Yamada-Janjić, Grell-Freitas y Lin para los esquemas de capa límite planetaria, cumulus y microfísica, respectivamente. Los resultados se compararon con los datos medidos en las estaciones meteorológicas ubicadas en la ciudad de Salvador. El modelo WRF simuló bien la llegada y ocurrencia de este evento climático extremo en una región tropical y costera, considerando que la región ya tiene características convectivas intensas y está constantemente influenciada por brisas marinas, las cuales podrían interferir con los resultados del modelo y comprometer el desempeño de las simulaciones.

https://doi.org/10.20937/atm.52977 31 downloads

Traditional use of benznidazole with weekly clinical follow-up indicate to be an important approach for the etiologic treatment of Chagas disease followup follow up
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Sperandio da Silva, Gilberto Marcelo

Memórias do Instituto Oswaldo Cruz

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2022, Volume 117 elocation e210034chgsa

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0074-02760210034chgsa

The quest for smooth extubation: I banned air from the ETT cuff for good…
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Ramos, Marcelo Sperandio

Brazilian Journal of Anesthesiology

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dec 2021, Volume 71 N. 6 Pages 673 - 674

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2021.07.031

Temporal changes in the clinical-epidemiological profile of patients with Chagas disease at a referral center in Brazil
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Hasslocher-Moreno, Alejandro Marcel

; Saraiva, Roberto Magalhaes

; Brasil, Pedro Emmanuel Alvarenga Americano do

; Sangenis, Luiz Henrique Conde

; Xavier, Sergio Salles

; Sousa, Andréa Silvestre de

; Sperandio-da-Silva, Gilberto Marcelo

; Mendes, Fernanda de Souza Nogueira Sardinha

; Costa, Andréa Rodrigues da

; Holanda, Marcelo Teixeira de

; Veloso, Henrique Horta

; Mazzoli-Rocha, Flavia

; Carneiro, Fernanda Martins

; Portela, Luciana Fernandes

; Mediano, Mauro Felippe Felix

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0040-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients’ levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.

https://doi.org/10.1590/0037-8682-0040-2021 158 downloads

10.

Functional capacity and rehabilitation strategies in Covid-19 patients: current knowledge and challenges
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Frota, Aline Xavier

; Vieira, Marcelo Carvalho

; Soares, Carla Cristiane Santos

; Silva, Paula Simplício da

; Silva, Gilberto Marcelo Sperandio da

; Mendes, Fernanda de Souza Nogueira Sardinha

; Mazzoli-Rocha, Flavia

; Veloso, Henrique Horta

; Costa, Ananda Dutra da

; Lamas, Cristiane da Cruz

; Valete-Rosalino, Claudia Maria

; Gonçalves, Tatiana Rehder

; Costa, Henrique Silveira

; Rodrigues Junior, Luiz Fernando

; Mediano, Mauro Felippe Felix

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e07892020

Abstract: En | Text: En | PDF: En

Abstract Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.

https://doi.org/10.1590/0037-8682-0789-2020 4144 downloads

11.

Melatonin has a stimulatory effect on osteoblasts by upregulating COL-I and OPN expression/secretion
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Dalla-Costa, Karen

; Yurtsever, Fikriye V

; Penteado, Julia

; Martinez, Elizabeth F

; Sperandio, Marcelo

; Peruzzo, Daiane C

Acta Odontológica Latinoamericana

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sep 2020, Volume 33 N. 2 Pages 125 - 134

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A melatonina (MLT) é uma molécula potencial de sinalização na homeostase do metabolismo ósseo e pode ser um importante mediador da formação e estimulação óssea. O objetivo deste estudo in vitro foi avaliar o efeito da MLT na viabilidade, na expressão do mRNA da proteína e mineralização de células préosteoblásticas. As concentrações de MLT 5, 2,5, 1, 0,1 e 0,01 mM foram testadas em células pré-osteoblásticas da linhagem MC3T3 em comparação ao controle (sem MLT), avaliando a proliferação e a viabilidade celular (C50), expressão gênica (rtPCR) e secreção (Elisa) de Colágeno tipo 1 (COL-I) e osteopontina (OPN) às 24, 48 e 72 horas, além da formação de nódulos minerais por meio do teste vermelho de Alizarina fast red após 10 dias de tratamento. MLT a 5 e 2,5 mM provou ser tóxico (C50). Portanto, as concentrações de 0,01, 0,1 e 1 mM foram utilizadas para as análises subsequentes. A expressão do mRNA da OPN aumentou com MLT a 0,1 mM-1mM, seguida pela secreção aumentada de OPN às 24 e 72 horas em comparação aos demais grupos (p<0,05). O mRNA de COL-I e a secreção de COL-I seguiram o mesmo padrão do OPN a 0,1 mM de MLT em 72 horas de tratamento (p<0,05). Em relação à mineralização, todas as doses de MLT (exceto 1mM) causaram aumento (p<0,05) na formação de nódulos minerais em comparação ao controle. A MLT na concentração entre 0,01mM a 1 mM teve um efeito estimulador sobre os osteoblastos, ao regular positivamente a expressão e secreção de COL-I e OPN, além da mineralização, favorecendo a osteogênese.

ABSTRACT Melatonin (MLT) is a potential signaling molecule in the homeostasis of bone metabolism and may be an important mediator of bone formation and stimulation. The aim of this in vitro study was to evaluate the effect of MLT on the viability, mRNA/protein expression and mineralization of pre-osteoblastic cells. The concentrations 5, 2.5, 1, 0.1 and 0.01 mM MLT were tested on pre-osteoblastic cells (MC3T3) compared to control (no MLT), evaluating proliferation and cell viability (C50), gene expression (RT-PCR) and secretion (ELISA) of COL-I and OPN at 24h, 48h and 72h, and the formation of mineral nodules (alizarin red and fast red) after 10 days of treatment. MLT at 5 and 2.5 mM proved to be cytotoxic (C50), so only 0.01, 0.1 and 1 mM were used for the subsequent analyses. OPN mRNA expression increased with MLT at 0.1 mM - 1 mM, which was followed by increased secretion of OPN both at 24h and 72h compared to the remaining groups (p <0.05). COL-I mRNA and COL-1 secretion followed the same pattern as OPN at 0.1 mM MLT at 72h of treatment (p <0.05). Regarding mineralization, all MLT doses (except 1mM) caused an increase (p <0.05) in the formation of mineral nodules compared to the control. Melatonin at 0.01mM - 1mM had a stimulatory effect on osteoblasts by upregulating COL-I and OPN expression/ secretion and mineralization, thereby fostering osteogenesis.

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12.

Lipoid Proteinosis: A Rare Disease In Pediatric Dentistry
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Lourenço, Alan Grupioni

; Araújo, Vera Cavalcanti

; Passador-Santos, Fabricio

; Sperandio, Marcelo

; Neville, Brad Wesley

; Dorta, Regina Garcia

Brazilian Dental Journal

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apr 2020, Volume 31 N. 2 Pages 186 - 189

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Este relato descreve o processo diagnóstico de uma doença rara em uma criança brasileira do sexo feminino. A paciente, inicialmente com 7 anos de idade, apresentava múltiplos nódulos submucosos esbranquiçados, de consistência fibrosa, no lábio inferior, mas com um laudo patológico inconclusivo. Quando completou 9 anos de idade, ela apresentou exacerbação dos achados clínicos originais, que envolveram o lábio superior, mucosa bucal, língua e frênulo lingual. Além disso, lesões dermatológicas foram observadas nos membros e no rosto da criança, assim como rouquidão. O exame histopatológico da mucosa bucal revelou tecido conjuntivo denso com focos hialinos, que foram positivos com coloração periódica com ácido-Schiff (PAS) e resistente à digestão da diástase. Os achados clínicos e histopatológicos levaram ao diagnóstico de uma doença genética rara com menos de 300 casos relatados - proteinose lipoide. A ressonância magnética revelou depósitos de cálcio em amígdala cerebral e a nasofaringolaringoscopia revelou lesões em cordas vocais. Atualmente, a paciente está estável e em acompanhamento multidisciplinar, mas nenhum tratamento foi recomendado até o momento.

Abstract This report describes the diagnostic process of a rare disorder in a Brazilian female child. The patient presented initially as a 7-year-old with multiple whitish submucosal nodules of a fibrous consistency in the lower lip, but with an inconclusive pathology report. When she turned 9 years of age, she presented with exacerbation of the original clinical findings, which then involved the upper lip, buccal mucosa, tongue and lingual frenulum. In addition, dermatological lesions were noted on the child’s limbs and face, as well as a hoarse voice. Histopathological examination of the buccal mucosa revealed dense connective tissue with hyaline foci, which were positive with periodic acid-Schiff (PAS) staining and resistant to diastase digestion. Clinical and histopathological findings led to the diagnosis of a rare genetic disease with fewer than 300 reported cases - lipoid proteinosis. Magnetic resonance imaging revealed calcium deposits in her amygdaloid region of the brain, and nasopharyngolaryngoscopy revealed lesions in her vocal cords. The patient currently is stable and under multidisciplinary follow-up, but no treatment has been recommended to date.

https://doi.org/10.1590/0103-6440202003054 1069 downloads

13.

Adverse drug events and the associated factors in patients with chronic Chagas disease
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Lopes, Luiza Braz da Cunha

; Pereira, Raquel Rodrigues

; Andrade, Patricia Mello

; Carneiro, Fernanda Martins

; Mediano, Mauro Felippe Felix

; Kilgore, Sophia Isabel Linnemann

; Hasslocher-Moreno, Alejandro Marcel

; Sousa, Andréa Silvestre de

; Oliveira, Manoel Marques Evangelista

; Saraiva, Roberto Magalhães

; Holanda, Marcelo Teixeira de

; Silva, Gilberto Marcelo Sperandio da

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20190443

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Herein, we aimed to identify the factors associated with adverse drug events (ADEs) in chronic Chagas disease (CD) patients. METHODS: We analyzed 320 medical notes from 295 patients. The Naranjo algorithm was applied to determine the cause of ADEs. Mixed effects logistic regression was performed to evaluate the factors associated with ADEs. RESULTS: ADEs were described in 102 medical notes (31.9%). Captopril was most frequently associated with ADEs. Age (RR 0.96; 95%CI 0.94-0.99) and cardiac C/D stages (RR 3.24; 95%CI 1.30-4.58) were the most important clinical factors associated with ADEs. CONCLUSIONS: Close follow-up is warranted for CD patients.

https://doi.org/10.1590/0037-8682-0443-2019 452 downloads

14.

Comprehensive care for patients with Chagas cardiomyopathy during the coronavirus disease pandemic
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Mazzoli-Rocha, Flavia

; Mendes, Fernanda de Souza Nogueira Sardinha

; Silva, Paula Simplicio

; Silva, Gilberto Marcelo Sperandio da

; Mediano, Mauro Felippe Felix

; Sousa, Andréa Silvestre de

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20200353

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0353-2020 340 downloads

15.

H2S in periodontal immune-inflammatory response and bone loss: a study in rats
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Ana J. S., Niederauer

; Renan A. B., Guimarães

; Kepler L. S., Oliveira

; Adalberto R., Pires Jr

; Ana P. D., Demasi

; Heloísa H. A., Ferreira

; Marcelo, Sperandio

; Marcelo H., Napimoga

; Daiane C., Peruzzo

Acta Odontológica Latinoamericana

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dec 2019, Volume 32 N. 3 Pages 164 - 171

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A halitose é altamente prevalente na periodontite e é atribuída principalmente à presença de compostos sulforosos voláteis (CSV), sendo o sulfeto de hidrogênio (H2S) o principal gás relacionado ao mau odor e que pode estar envolvido na patogênese da doença periodontal. O objetivo deste estudo foi avaliar o efeito agudo, intermediário e crônico do H2S na resposta imunoinflamatória e na perda óssea alveolar em ratos, com e sem doença periodontal induzida. Trinta e seis ratos foram divididos em 2 grupos: teste (n = 18), ratos expostos ao H2S (NaHS molécula doadora de H2S) e grupo controle (n = 18), ratos tratados apenas com solução salina (Ctrl). Todos os animais tiveram um dos seus segundos molares inferiores submetidos à colocação de uma ligadura para o desenvolvimento da doença periodontal (DP), em comparação com o dente contralateral saudável (H). Cada grupo foi subdividido em 3 (n = 6), de acordo com o tempo de eutanásia (3h, 5 dias e 14 dias). Os tecidos gengivais foram utilizados para a análise da expressão gênica (IL1, IL6, RANKL, OPG e SOFAT) por PCR em tempo real e as mandíbulas foram analisadas morfometricamente. Análise dos dados demonstrou que a ligadura promoveu perda óssea alveolar, observada principalmente aos 14 dias, tanto no grupo exposto ao H2S quanto no grupo Ctrl. A administração de H2S não resultou em perda óssea adicional. A expressão gênica demonstrou aumento significativo de IL1, IL6, RANKL e SOFAT apenas no grupo CtrlPD (p <0,05). Uma significativa regulação negativa na expressão de OPG foi observada ao longo do tempo no grupo CtrlPD (p <0,05). Podese concluir que o H2S não teve efeito adicional na perda óssea alveolar, na ausência de ligadura. Entretanto, na presença de ligadura, a exposição ao H2S teve um efeito imunorregulatório na expressão de citocinas próinflamatórias e próreabsortivas.

ABSTRACT Halitosis is highly prevalent in periodontitis and attributed mainly to the presence of volatile sulfur compounds (VSC), where hydrogen sulfide (H2S) is the chief culprit in the characteristic malodor of periodontitis and thus may play an active role in its pathogenesis. The aim of this study was to evaluate the effect of H2S in the acute, intermediate and chronic immuneinflammatory host response and alveolar bone loss in vivo by using an animal model of induced periodontal disease. Thirtysix rats were divided into 2 groups: test group (n = 18), rats exposed to H2S (NaHS H2S donor molecule) and control group (n = 18), rats treated with saline only (Ctrl). All animals had one of their lower second molars ligated to induce periodontal disease (PD). The sound contralateral molar was used as control (H). Each group was subdivided into 3 (n = 6), according to followup time (3h, 5 days and 14 days). The gingival tissue was used for mRNA expression analysis (IL1, IL6, RANKL, OPG and SOFAT) by realtime PCR and the mandibles were analyzed morphometrically. Data analysis showed that the ligature promoted alveolar bone loss, observed mainly at 14 days, both in the group exposed to H2S and in the Ctrl group. H2S administration did not result in additional bone loss. Gene expression showed a significant increase in IL1, IL6, RANKL and SOFAT only in the CtrlPD group (p<0.05). A significant downregulation in OPG expression was observed over time in the CtrlPD group (p<0.05). In conclusion, H2S had no effect on alveolar bone loss in the absence of a ligature. In the presence of a ligature, however, exposure to H2S had an immunoregulatory effect on the expression of proinflammatory and proresorptive cytokines.

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