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Vitreous metastasis from cutaneous melanoma: diagnosis and management melanoma
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Ashkenazy, Noy
; Harbour, J. William
; Dubovy, Sander R
; Albini, Thomas A.
; Sridhar, Jayanth
; Patel, Nish
; Hansen, Eric D.
; Uchiyama, Eduardo
; Rubsamen, Patrick E.
; Correa, Zelia M.
.
RESUMO Objetivo: Descrever os achados clínicos, tratamentos, e desfechos em uma série de pacientes com me tástases vítreas de melanoma cutâneo. Métodos: Série retrospectiva de casos de único centro com intervenção. Pacientes incluídos tiveram seu diagnóstico de MVMC confirmado por biópsia entre 1997 e 2020. Vitrectomia via pars plana com 23 ou 25 gauge foram realizadas para obter espécimens. Esclerotomias foram tratadas com crioterapia em duplo ou triplo congelamento. Injeção intravítrea perioperatória de melfalano (32 ug/0,075 mL) foi administrada quando necessário. Foram relatados acuidade visual, pressão intraocular, resposta terapêutica sistêmica e ocular. Resultados: Cinco olhos de 5 pacientes com metástases vítreas de melanoma cutâneo unilateral foram identificados. Idade média de diagnóstico foi 84 anos (variando de 37-88). Seguimento médio após diagnóstico oftalmológico foi 28 (8,5-36) meses; 1 paciente não teve acompanhamento. Acuidade visual inicial variou de 20/30 a movimentos de mão. Achados clínicos iniciais incluíram infiltração de células pigmentadas e não-pigmentadas no vítreo (5/5), segmento anterior (4/5), e retina (3/5). Quatro pacientes tiveram glaucoma secundário. Tratamento sistêmico incluiu imunoterapia com inibidores da via de sinalização (3 - todos com resposta parcial/completa), quimioterapia sistêmica (2), ressecção cirúrgica (3), e irradiação (2). Intervalo médio entre diagnóstico primário e metástases vítreas foi 2 (2-15) anos. Um paciente teve doença sistêmica ativa simultânea as metástases vítreas. Acuidade visual final variou entre 20/40 e SPL. Tratamento oftalmológico incluiu vitrectomia nos 5 pacientes, melfalano intravítreo em 3 e metotrexato intravítreo em 1. Um paciente precisou de enucleação. A histopatologia revelou invasão celular extensa de melanoma. Conclusões: Metástases vítreas de melanoma cutâneo pode se manifestar como uma infiltração difusa de células pigmentadas e não-pigmentadas no vítreo e erroneamente diagnosticada como uveites. Vitrectomia diagnóstica e quimioterapia intravítrea periódica podem estar indicadas. Objetivo tratamentos Métodos intervenção 199 2020 espécimens congelamento 32 ug0075 ug 0 075 ug/0,07 mL necessário intraocular ocular Resultados identificados 8 variando 3788. 3788 37 88 . 37-88) 8,536 8536 8,5 36 (8,5-36 meses acompanhamento 2030 20 30 20/3 mão nãopigmentadas 5/5, 55 5/5 , (5/5) 4/5, 45 4/5 4 (4/5) 3/5. 35 3/5 (3/5) secundário ( parcial/completa, parcialcompleta parcial/completa parcial completa parcial/completa) 2, (2) 3, (3) 2. 215 15 (2-15 2040 40 20/4 SPL enucleação Conclusões uveites indicadas 19 202 ug007 07 ug/0,0 378 37-88 536 8,53 853 85 8, (8,5-3 203 20/ 5/ (5/5 4/ (4/5 3/ (3/5 (2 21 (2-1 204 ug00 ug/0, 37-8 53 (8,5- (5/ (4/ (3/ (2- ug0 ug/0 37- (8,5 (5 (4 ug/ (8, (8
ABSTRACT Purpose: To report the clinical findings, treatments, and outcomes in a series of patients with vitreous metastasis from cutaneous melanoma. Methods: This single-center, retrospective, interventional case series included patients with biopsy-confirmed vitreous metastasis from cutaneous melanoma diagnosed between 1997 and 2020. Standard 23- or 25-gauge pars plana vitrectomy was performed for diagnostic sampling. Sclerotomies were treated with double or triple freeze-thaw cryotherapy. Perioperative intravitreal injections of melphalan (32 µg/0.075 mL) were administered, when indicated. Visual acuity, intraocular pressure, and systemic and ocular treatment responses were reported. Results: Five eyes of five patients with unilateral vitreous metastasis from cutaneous melanoma were identified. The median age at diagnosis was 84 (range, 37-88) years. The median follow-up after ophthalmic diagnosis was 28 (8.5-36) months; one patient did not have a follow-up. The initial visual acuity ranged from 20/30 to hand motions. Baseline clinical findings included pigmented or non-pigmented cellular infiltration of the vitreous (5/5), anterior segment (4/5), and retina (3/5). Four patients had secondary glaucoma. Systemic therapy included checkpoint inhibitor immunotherapy (n=3, all with partial/complete response), systemic chemotherapy (n=2), surgical resection (n=3), and radiation (n=2). The median time from primary diagnosis to vitreous metastasis was 2 (2-15) years. One patient had an active systemic disease at the time of vitreous metastasis. The final visual acuity ranged from 20/40 to no light perception. Ophthalmic treatment included vitrectomy in all five patients, intravitreal administration of melphalan in three, and intravitreal administration of methotrexate in one. One patient required enucleation, and histopathology revealed extensive invasion by melanoma cells. Conclusions: Vitreous metastasis from cutaneous melanoma can present as a diffuse infiltration of pigmented or non-pigmented cells into the vitreous and may be misdiagnosed as uveitis. Diagnostic pars plana vitrectomy and periodic intravitreal chemotherapy may be indicated. Purpose treatments Methods singlecenter, singlecenter single center, center single-center retrospective biopsyconfirmed biopsy confirmed 199 2020 23 25gauge gauge 25 sampling freezethaw freeze thaw cryotherapy 32 (3 µg0075 µg 0 075 µg/0.07 mL administered indicated pressure reported Results identified 8 range, range (range 3788 37 88 37-88 years followup follow up 8.536 8536 8.5 36 5 (8.5-36 months followup. up. 2030 20 30 20/3 motions nonpigmented non 5/5, 55 5/5 , (5/5) 4/5, 45 4/5 4 (4/5) 3/5. 35 3/5 . 3 (3/5) glaucoma n=3, n3 n (n=3 partialcomplete partial complete response, response response) n=2, n2 n=2 (n=2) n=3 (n=3) n=2. 215 15 (2-15 2040 40 20/4 perception three enucleation Conclusions uveitis 19 202 ( µg007 07 µg/0.0 378 37-8 536 8.53 853 85 8. (8.5-3 203 20/ 5/ (5/5 4/ (4/5 3/ (3/5 (n= n= (n=2 21 1 (2-1 204 µg00 µg/0. 37- 53 (8.5- (5/ (4/ (3/ (n (2- µg0 µg/0 (8.5 (5 (4 (2 µg/ (8. (8
2.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil Brasil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
; Slipinski, Adam
; Linzmeier, Adelita M.
; Calor, Adolfo R.
; Garda, Adrian A.
; Kury, Adriano B.
; Fernandes, Agatha C.S.
; Agudo-Padrón, Aisur I.
; Akama, Alberto
; Silva Neto, Alberto M. da
; Burbano, Alejandro L.
; Menezes, Aleksandra
; Pereira-Colavite, Alessandre
; Anichtchenko, Alexander
; Lees, Alexander C.
; Bezerra, Alexandra M.R.
; Domahovski, Alexandre C.
; Pimenta, Alexandre D.
; Aleixo, Alexandre L.P.
; Marceniuk, Alexandre P.
; Paula, Alexandre S. de
; Somavilla, Alexandre
; Specht, Alexandre
; Camargo, Alexssandro
; Newton, Alfred F.
; Silva, Aline A.S. da
; Santos, Aline B. dos
; Tassi, Aline D.
; Aragão, Allan C.
; Santos, Allan P.M.
; Migotto, Alvaro E.
; Mendes, Amanda C.
; Cunha, Amanda
; Chagas Júnior, Amazonas
; Sousa, Ana A.T. de
; Pavan, Ana C.
; Almeida, Ana C.S.
; Peronti, Ana L.B.G.
; Henriques-Oliveira, Ana L.
; Prudente, Ana L.
; Tourinho, Ana L.
; Pes, Ana M.O.
; Carmignotto, Ana P.
; Wengrat, Ana P.G. da Silva
; Dornellas, Ana P.S.
; Molin, Anamaria Dal
; Puker, Anderson
; Morandini, André C.
; Ferreira, André da S.
; Martins, André L.
; Esteves, André M.
; Fernandes, André S.
; Roza, André S.
; Köhler, Andreas
; Paladini, Andressa
; Andrade, Andrey J. de
; Pinto, Ângelo P.
; Salles, Anna C. de A.
; Gondim, Anne I.
; Amaral, Antonia C.Z.
; Rondón, Antonio A.A.
; Brescovit, Antonio
; Lofego, Antônio C.
; Marques, Antonio C.
; Macedo, Antonio
; Andriolo, Artur
; Henriques, Augusto L.
; Ferreira Júnior, Augusto L.
; Lima, Aurino F. de
; Barros, Ávyla R. de A.
; Brito, Ayrton do R.
; Romera, Bárbara L.V.
; Vasconcelos, Beatriz M.C. de
; Frable, Benjamin W.
; Santos, Bernardo F.
; Ferraz, Bernardo R.
; Rosa, Brunno B.
; Sampaio, Brunno H.L.
; Bellini, Bruno C.
; Clarkson, Bruno
; Oliveira, Bruno G. de
; Corrêa, Caio C.D.
; Martins, Caleb C.
; Castro-Guedes, Camila F. de
; Souto, Camilla
; Bicho, Carla de L.
; Cunha, Carlo M.
; Barboza, Carlos A. de M.
; Lucena, Carlos A.S. de
; Barreto, Carlos
; Santana, Carlos D.C.M. de
; Agne, Carlos E.Q.
; Mielke, Carlos G.C.
; Caetano, Carlos H.S.
; Flechtmann, Carlos H.W.
; Lamas, Carlos J.E.
; Rocha, Carlos
; Mascarenhas, Carolina S.
; Margaría, Cecilia B.
; Waichert, Cecilia
; Digiani, Celina
; Haddad, Célio F.B.
; Azevedo, Celso O.
; Benetti, Cesar J.
; Santos, Charles M.D. dos
; Bartlett, Charles R.
; Bonvicino, Cibele
; Ribeiro-Costa, Cibele S.
; Santos, Cinthya S.G.
; Justino, Cíntia E.L.
; Canedo, Clarissa
; Bonecker, Claudia C.
; Santos, Cláudia P.
; Carvalho, Claudio J.B. de
; Gonçalves, Clayton C.
; Galvão, Cleber
; Costa, Cleide
; Oliveira, Cléo D.C. de
; Schwertner, Cristiano F.
; Andrade, Cristiano L.
; Pereira, Cristiano M.
; Sampaio, Cristiano
; Dias, Cristina de O.
; Lucena, Daercio A. de A.
; Manfio, Daiara
; Amorim, Dalton de S.
; Queiroz, Dalva L. de
; Queiroz, Dalva L. de
; Colpani, Daniara
; Abbate, Daniel
; Aquino, Daniel A.
; Burckhardt, Daniel
; Cavallari, Daniel C.
; Prado, Daniel de C. Schelesky
; Praciano, Daniel L.
; Basílio, Daniel S.
; Bená, Daniela de C.
; Toledo, Daniela G.P. de
; Takiya, Daniela M.
; Fernandes, Daniell R.R.
; Ament, Danilo C.
; Cordeiro, Danilo P.
; Silva, Darliane E.
; Pollock, Darren A.
; Muniz, David B.
; Gibson, David I.
; Nogueira, David S.
; Marques, Dayse W.A.
; Lucatelli, Débora
; Garcia, Deivys M.A.
; Baêta, Délio
; Ferreira, Denise N.M.
; Rueda-Ramírez, Diana
; Fachin, Diego A.
; Souza, Diego de S.
; Rodrigues, Diego F.
; Pádua, Diego G. de
; Barbosa, Diego N.
; Dolibaina, Diego R.
; Amaral, Diogo C.
; Chandler, Donald S.
; Maccagnan, Douglas H.B.
; Caron, Edilson
; Carvalho, Edrielly
; Adriano, Edson A.
; Abreu Júnior, Edson F. de
; Pereira, Edson H.L.
; Viegas, Eduarda F.G.
; Carneiro, Eduardo
; Colley, Eduardo
; Eizirik, Eduardo
; Santos, Eduardo F. dos
; Shimbori, Eduardo M.
; Suárez-Morales, Eduardo
; Arruda, Eliane P. de
; Chiquito, Elisandra A.
; Lima, Élison F.B.
; Castro, Elizeu B. de
; Orlandin, Elton
; Nascimento, Elynton A. do
; Razzolini, Emanuel
; Gama, Emanuel R.R.
; Araujo, Enilma M. de
; Nishiyama, Eric Y.
; Spiessberger, Erich L.
; Santos, Érika C.L. dos
; Contreras, Eugenia F.
; Galati, Eunice A.B.
; Oliveira Junior, Evaldo C. de
; Gallardo, Fabiana
; Hernandes, Fabio A.
; Lansac-Tôha, Fábio A.
; Pitombo, Fabio B.
; Dario, Fabio Di
; Santos, Fábio L. dos
; Mauro, Fabio
; Nascimento, Fabio O. do
; Olmos, Fabio
; Amaral, Fabio R.
; Schunck, Fabio
; Godoi, Fábio S. P. de
; Machado, Fabrizio M.
; Barbo, Fausto E.
; Agrain, Federico A.
; Ribeiro, Felipe B.
; Moreira, Felipe F.F.
; Barbosa, Felipe F.
; Silva, Fenanda S.
; Cavalcanti, Fernanda F.
; Straube, Fernando C.
; Carbayo, Fernando
; Carvalho Filho, Fernando
; Zanella, Fernando C.V.
; Jacinavicius, Fernando de C.
; Farache, Fernando H.A.
; Leivas, Fernando
; Dias, Fernando M.S.
; Mantellato, Fernando
; Vaz-de-Mello, Fernando Z.
; Gudin, Filipe M.
; Albuquerque, Flávio
; Molina, Flavio B.
; Passos, Flávio D.
; Shockley, Floyd W.
; Pinheiro, Francielly F.
; Mello, Francisco de A.G. de
; Nascimento, Francisco E. de L.
; Franco, Francisco L.
; Oliveira, Francisco L. de
; Melo, Francisco T. de V.
; Quijano, Freddy R.B.
; Salles, Frederico F.
; Biffi, Gabriel
; Queiroz, Gabriel C.
; Bizarro, Gabriel L.
; Hrycyna, Gabriela
; Leviski, Gabriela
; Powell, Gareth S.
; Santos, Geane B. dos
; Morse, Geoffrey E.
; Brown, George
; Mattox, George M.T.
; Zimbrão, Geraldo
; Carvalho, Gervásio S.
; Miranda, Gil F.G.
; Moraes, Gilberto J. de
; Lourido, Gilcélia M.
; Neves, Gilmar P.
; Moreira, Gilson R.P.
; Montingelli, Giovanna G.
; Maurício, Giovanni N.
; Marconato, Gláucia
; Lopez, Guilherme E.L.
; Silva, Guilherme L. da
; Muricy, Guilherme
; Brito, Guilherme R.R.
; Garbino, Guilherme S.T.
; Flores, Gustavo E.
; Graciolli, Gustavo
; Libardi, Gustavo S.
; Proctor, Heather C.
; Gil-Santana, Helcio R.
; Varella, Henrique R.
; Escalona, Hermes E.
; Schmitz, Hermes J.
; Rodrigues, Higor D.D.
; Galvão Filho, Hilton de C.
; Quintino, Hingrid Y.S.
; Pinto, Hudson A.
; Rainho, Hugo L.
; Miyahira, Igor C.
; Gonçalves, Igor de S.
; Martins, Inês X.
; Cardoso, Irene A.
; Oliveira, Ismael B. de
; Franz, Ismael
; Fernandes, Itanna O.
; Golfetti, Ivan F.
; S. Campos-Filho, Ivanklin
; Oliveira, Ivo de S.
; Delabie, Jacques H.C.
; Oliveira, Jader de
; Prando, Jadila S.
; Patton, James L.
; Bitencourt, Jamille de A.
; Silva, Janaina M.
; Santos, Jandir C.
; Arruda, Janine O.
; Valderrama, Jefferson S.
; Dalapicolla, Jeronymo
; Oliveira, Jéssica P.
; Hájek, Jiri
; Morselli, João P.
; Narita, João P.
; Martin, João P.I.
; Grazia, Jocélia
; McHugh, Joe
; Cherem, Jorge J.
; Farias Júnior, José A.S.
; Fernandes, Jose A.M.
; Pacheco, José F.
; Birindelli, José L.O.
; Rezende, José M.
; Avendaño, Jose M.
; Duarte, José M. Barbanti
; Ribeiro, José R. Inácio
; Mermudes, José R.M.
; Pujol-Luz, José R.
; Santos, Josenilson R. dos
; Câmara, Josenir T.
; Teixeira, Joyce A.
; Prado, Joyce R. do
; Botero, Juan P.
; Almeida, Julia C.
; Kohler, Julia
; Gonçalves, Julia P.
; Beneti, Julia S.
; Donahue, Julian P.
; Alvim, Juliana
; Almeida, Juliana C.
; Segadilha, Juliana L.
; Wingert, Juliana M.
; Barbosa, Julianna F.
; Ferrer, Juliano
; Santos, Juliano F. dos
; Kuabara, Kamila M.D.
; Nascimento, Karine B.
; Schoeninger, Karine
; Campião, Karla M.
; Soares, Karla
; Zilch, Kássia
; Barão, Kim R.
; Teixeira, Larissa
; Sousa, Laura D. do N.M. de
; Dumas, Leandro L.
; Vieira, Leandro M.
; Azevedo, Leonardo H.G.
; Carvalho, Leonardo S.
; Souza, Leonardo S. de
; Rocha, Leonardo S.G.
; Bernardi, Leopoldo F.O.
; Vieira, Letícia M.
; Johann, Liana
; Salvatierra, Lidianne
; Oliveira, Livia de M.
; Loureiro, Lourdes M.A. El-moor
; Barreto, Luana B.
; Barros, Luana M.
; Lecci, Lucas
; Camargos, Lucas M. de
; Lima, Lucas R.C.
; Almeida, Lucia M.
; Martins, Luciana R.
; Marinoni, Luciane
; Moura, Luciano de A.
; Lima, Luciano
; Naka, Luciano N.
; Miranda, Lucília S.
; Salik, Lucy M.
; Bezerra, Luis E.A.
; Silveira, Luis F.
; Campos, Luiz A.
; Castro, Luiz A.S. de
; Pinho, Luiz C.
; Silveira, Luiz F.L.
; Iniesta, Luiz F.M.
; Tencatt, Luiz F.C.
; Simone, Luiz R.L.
; Malabarba, Luiz R.
; Cruz, Luiza S. da
; Sekerka, Lukas
; Barros, Lurdiana D.
; Santos, Luziany Q.
; Skoracki, Maciej
; Correia, Maira A.
; Uchoa, Manoel A.
; Andrade, Manuella F.G.
; Hermes, Marcel G.
; Miranda, Marcel S.
; Araújo, Marcel S. de
; Monné, Marcela L.
; Labruna, Marcelo B.
; Santis, Marcelo D. de
; Duarte, Marcelo
; Knoff, Marcelo
; Nogueira, Marcelo
; Britto, Marcelo R. de
; Melo, Marcelo R.S. de
; Carvalho, Marcelo R. de
; Tavares, Marcelo T.
; Kitahara, Marcelo V.
; Justo, Marcia C.N.
; Botelho, Marcia J.C.
; Couri, Márcia S.
; Borges-Martins, Márcio
; Felix, Márcio
; Oliveira, Marcio L. de
; Bologna, Marco A.
; Gottschalk, Marco S.
; Tavares, Marcos D.S.
; Lhano, Marcos G.
; Bevilaqua, Marcus
; Santos, Marcus T.T.
; Domingues, Marcus V.
; Sallum, Maria A.M.
; Digiani, María C.
; Santarém, Maria C.A.
; Nascimento, Maria C. do
; Becerril, María de los A.M.
; Santos, Maria E.A. dos
; Passos, Maria I. da S. dos
; Felippe-Bauer, Maria L.
; Cherman, Mariana A.
; Terossi, Mariana
; Bartz, Marie L.C.
; Barbosa, Marina F. de C.
; Loeb, Marina V.
; Cohn-Haft, Mario
; Cupello, Mario
; Martins, Marlúcia B.
; Christofersen, Martin L.
; Bento, Matheus
; Rocha, Matheus dos S.
; Martins, Maurício L.
; Segura, Melissa O.
; Cardenas, Melissa Q.
; Duarte, Mércia E.
; Ivie, Michael A.
; Mincarone, Michael M.
; Borges, Michela
; Monné, Miguel A.
; Casagrande, Mirna M.
; Fernandez, Monica A.
; Piovesan, Mônica
; Menezes, Naércio A.
; Benaim, Natalia P.
; Reategui, Natália S.
; Pedro, Natan C.
; Pecly, Nathalia H.
; Ferreira Júnior, Nelson
; Silva Júnior, Nelson J. da
; Perioto, Nelson W.
; Hamada, Neusa
; Degallier, Nicolas
; Chao, Ning L.
; Ferla, Noeli J.
; Mielke, Olaf H.H.
; Evangelista, Olivia
; Shibatta, Oscar A.
; Oliveira, Otto M.P.
; Albornoz, Pablo C.L.
; Dellapé, Pablo M.
; Gonçalves, Pablo R.
; Shimabukuro, Paloma H.F.
; Grossi, Paschoal
; Rodrigues, Patrícia E. da S.
; Lima, Patricia O.V.
; Velazco, Paul
; Santos, Paula B. dos
; Araújo, Paula B.
; Silva, Paula K.R.
; Riccardi, Paula R.
; Garcia, Paulo C. de A.
; Passos, Paulo G.H.
; Corgosinho, Paulo H.C.
; Lucinda, Paulo
; Costa, Paulo M.S.
; Alves, Paulo P.
; Roth, Paulo R. de O.
; Coelho, Paulo R.S.
; Duarte, Paulo R.M.
; Carvalho, Pedro F. de
; Gnaspini, Pedro
; Souza-Dias, Pedro G.B.
; Linardi, Pedro M.
; Bartholomay, Pedro R.
; Demite, Peterson R.
; Bulirsch, Petr
; Boll, Piter K.
; Pereira, Rachel M.M.
; Silva, Rafael A.P.F.
; Moura, Rafael B. de
; Boldrini, Rafael
; Silva, Rafaela A. da
; Falaschi, Rafaela L.
; Cordeiro, Ralf T.S.
; Mello, Ramon J.C.L.
; Singer, Randal A.
; Querino, Ranyse B.
; Heleodoro, Raphael A.
; Castilho, Raphael de C.
; Constantino, Reginaldo
; Guedes, Reinaldo C.
; Carrenho, Renan
; Gomes, Renata S.
; Gregorin, Renato
; Machado, Renato J.P.
; Bérnils, Renato S.
; Capellari, Renato S.
; Silva, Ricardo B.
; Kawada, Ricardo
; Dias, Ricardo M.
; Siewert, Ricardo
; Brugnera, Ricaro
; Leschen, Richard A.B.
; Constantin, Robert
; Robbins, Robert
; Pinto, Roberta R.
; Reis, Roberto E. dos
; Ramos, Robson T. da C.
; Cavichioli, Rodney R.
; Barros, Rodolfo C. de
; Caires, Rodrigo A.
; Salvador, Rodrigo B.
; Marques, Rodrigo C.
; Araújo, Rodrigo C.
; Araujo, Rodrigo de O.
; Dios, Rodrigo de V.P.
; Johnsson, Rodrigo
; Feitosa, Rodrigo M.
; Hutchings, Roger W.
; Lara, Rogéria I.R.
; Rossi, Rogério V.
; Gerstmeier, Roland
; Ochoa, Ronald
; Hutchings, Rosa S.G.
; Ale-Rocha, Rosaly
; Rocha, Rosana M. da
; Tidon, Rosana
; Brito, Rosangela
; Pellens, Roseli
; Santos, Sabrina R. dos
; Santos, Sandra D. dos
; Paiva, Sandra V.
; Santos, Sandro
; Oliveira, Sarah S. de
; Costa, Sávio C.
; Gardner, Scott L.
; Leal, Sebastián A. Muñoz
; Aloquio, Sergio
; Bonecker, Sergio L.C.
; Bueno, Sergio L. de S.
; Almeida, Sérgio M. de
; Stampar, Sérgio N.
; Andena, Sérgio R.
; Posso, Sergio R.
; Lima, Sheila P.
; Gadelha, Sian de S.
; Thiengo, Silvana C.
; Cohen, Simone C.
; Brandão, Simone N.
; Rosa, Simone P.
; Ribeiro, Síria L.B.
; Letana, Sócrates D.
; Santos, Sonia B. dos
; Andrade, Sonia C.S.
; Dávila, Stephane
; Vaz, Stéphanie
; Peck, Stewart B.
; Christo, Susete W.
; Cunha, Suzan B.Z.
; Gomes, Suzete R.
; Duarte, Tácio
; Madeira-Ott, Taís
; Marques, Taísa
; Roell, Talita
; Lima, Tarcilla C. de
; Sepulveda, Tatiana A.
; Maria, Tatiana F.
; Ruschel, Tatiana P.
; Rodrigues, Thaiana
; Marinho, Thais A.
; Almeida, Thaís M. de
; Miranda, Thaís P.
; Freitas, Thales R.O.
; Pereira, Thalles P.L.
; Zacca, Thamara
; Pacheco, Thaynara L.
; Martins, Thiago F.
; Alvarenga, Thiago M.
; Carvalho, Thiago R. de
; Polizei, Thiago T.S.
; McElrath, Thomas C.
; Henry, Thomas
; Pikart, Tiago G.
; Porto, Tiago J.
; Krolow, Tiago K.
; Carvalho, Tiago P.
; Lotufo, Tito M. da C.
; Caramaschi, Ulisses
; Pinheiro, Ulisses dos S.
; Pardiñas, Ulyses F.J.
; Maia, Valéria C.
; Tavares, Valeria
; Costa, Valmir A.
; Amaral, Vanessa S. do
; Silva, Vera C.
; Wolff, Vera R. dos S.
; Slobodian, Verônica
; Silva, Vinícius B. da
; Espíndola, Vinicius C.
; Costa-Silva, Vinicius da
; Bertaco, Vinicius de A.
; Padula, Vinícius
; Ferreira, Vinicius S.
; Silva, Vitor C.P. da
; Piacentini, Vítor de Q.
; Sandoval-Gómez, Vivian E.
; Trevine, Vivian
; Sousa, Viviane R.
; Sant’Anna, Vivianne B. de
; Mathis, Wayne N.
; Souza, Wesley de O.
; Colombo, Wesley D.
; Tomaszewska, Wioletta
; Wosiacki, Wolmar B.
; Ovando, Ximena M.C.
; Leite, Yuri L.R.
.
ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others. publications problem uptodate up date classifications context exception (CTFB http//fauna.jbrj.gov.br/, httpfaunajbrjgovbr http //fauna.jbrj.gov.br/ , jbrj gov br (http://fauna.jbrj.gov.br/) 2015 Brazil 80 specialists 1 2024 133691 133 691 133,69 125138 125 138 125,13 82.3%, 823 82 3 (82.3% 102000 102 000 102,00 7.69%, 769 7 69 (7.69% 11000 11 11,00 . 3,567 3567 567 (3,56 2,292 2292 2 292 (2,29 1,833 1833 833 (1,83 1,447 1447 447 (1,44 1000 1,00 831 (83 628 (62 606 (60 520 (52 50 users science health biology law anthropology education others http//fauna.jbrj.gov.br/ faunajbrjgovbr //fauna.jbrj.gov.br (http://fauna.jbrj.gov.br/ 201 8 202 13369 13 133,6 12513 12 125,1 82.3% (82.3 10200 10 00 102,0 7.69% 76 6 (7.69 1100 11,0 3,56 356 56 (3,5 2,29 229 29 (2,2 1,83 183 83 (1,8 1,44 144 44 (1,4 100 1,0 (8 62 (6 60 52 (5 5 http//fauna.jbrj.gov.br (http://fauna.jbrj.gov.br 20 1336 133, 1251 125, 82.3 (82. 1020 0 102, 7.69 (7.6 110 11, 3,5 35 (3, 2,2 22 (2, 1,8 18 (1, 1,4 14 4 ( 82. (82 7.6 (7. 3, (3 2, (2 (1 7. (7
3.
From waste cooking oil to oxygen-rich onion-like nanocarbons for the removal of hexavalent chromium from aqueous solutions
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Ntuli, Themba D.
; Sikeyi, Ludwe L.
; Mongwe, Thomas H.
; Mkhari, Orlette
; Coville, Neil J.
; Nxumalo, Edward N.
; Maubane-Nkadimeng, Manoko S.
.
Vegetable cooking oil is used in domestic and commercial kitchens owing to its ability to modify and enhance the taste of the food through the frying process. However, as the oil is used through several frying cycles, it changes colour to dark brown and acquires an unpleasant smell. At this point, the waste oil is usually discarded, thereby finding its way into freshwater streams due to poor disposal and thus becoming an environmental pollutant. To provide an alternative, 'green' route to waste oil disposal, herein we report on the metal-free synthesis of onion-like nanocarbons (OLNCs) made from waste cooking oil via flame pyrolysis. The OLNCs were then applied in the removal of hexavalent chromium ions from aqueous solutions. The as-synthesised OLNCs were found to have similar properties (size, quasi-spherical shape etc.) to those synthesised from pure cooking oils. The Fourier-transform infrared spectroscopy data showed that the OLNCs contained C-O-type moieties which were attributed to the oxygenation process that took place during the cooking process. The OLNCs from waste oil were applied as an adsorbent for Cr(VI) and showed optimal removal conditions at pH = 2, t = 360 min, Co = 10 mg/L and Q0max = 47.62 mg/g, superior to data obtained from OLNCs prepared from pristine cooking oil. The results showed that the OLNCs derived from the waste cooking oil were effective in the removal of hexavalent chromium. Overall, this study shows how to repurpose an environmental pollutant (waste cooking oil) as an effective adsorbent for pollutant (Cr(VI)) removal. SIGNIFICANCE: • Waste cooking oil outperformed olive oil as a starting material for the production of OLNCs for the removal of toxic Cr(VI) from water. • The superior performance of the OLNCs from waste cooking oil was attributed to the higher oxygen content found on their surface and acquired through the cooking process. • Not only are the OLNCs produced from waste cooking oil effective in the removal of Cr(VI), but they can be used multiple times before replacement, which makes them sustainable.
4.
Hemodynamic course during ablation and selective hepatic artery embolization for metastatic liver carcinoid: a retrospective observational study carcinoid
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Vinzant, Nathan J.
; Laporta, Mariana L.
; Sprung, Juraj
; Atwell, Thomas D.
; Reisenauer, Christopher J.
; Welch, Tasha L.
; Schulte, Phillip J.
; Weingarten, Toby N.
.
Abstract Background: Manipulation of carcinoid tumors during ablation or selective hepatic artery embolization (transarterial embolization, TAE) can release vasoactive mediators inducing hemodynamic instability. The main aim of our study was to review hemodynamics and complications related to minimally invasive treatments of liver carcinoids with TAE or ablation. Methods: Electronic medical records of all patients with metastatic liver carcinoid undergoing ablation or TAE from 2003 to 2019 were abstracted. Noted were severe hypotension (mean arterial pressure [MAP] ≤ 55 mmHg), severe hypertension (systolic blood pressure ≥ 180 mmHg), and perioperative complications. Associations of procedure type and pre-procedure octreotide use with intraprocedural hemodynamics were assessed using linear regression. A robust covariance approach using generalized estimating equation method was used to account for multiple observations. Results: A total of 161 patients underwent 98 ablations and 207 TAEs. Severe hypertension was observed in 24 (24.5%) vs. 15 (7.3%), severe hypotension in 56 (57.1%) vs. 6 (2.9%), and cutaneous flushing observed in 2 (2.0%) vs. 48 (23.2%) ablations and TAEs, respectively. After adjusting for preprocedural MAP, ablation was associated with lower intraprocedural MAP compared to TAE (estimate −27 mmHg, 95%CI −30 to −24 mmHg, p < 0.001). Intraprocedural declines in MAP were not affected by preprocedural use of octreotide (p = 0.7 for TAE and p = 0.4 for ablation). Conclusions: Ablation of liver carcinoids was associated with substantial hemodynamic instability, especially hypotension. In contrast, a higher number of TAE patients had cutaneous flushing. Preprocedural use of octreotide was not associated with attenuation of intraprocedural hypotension. Background transarterial instability Methods 200 201 abstracted mean [MAP 5 mmHg , mmHg) systolic 18 preprocedure pre regression observations Results 16 9 20 TAEs 24.5% 245 (24.5% vs 1 7.3%, 73 7.3% 7 3 (7.3%) 57.1% 571 57 (57.1% 2.9%, 29 2.9% (2.9%) 2.0% 0 (2.0% 4 23.2% 232 23 (23.2% respectively estimate 27 −2 95CI CI 95 30 −3 0.001. 0001 0.001 . 001 0.001) 07 0. 04 ablation) Conclusions contrast 24.5 (24.5 7.3 (7.3% 57.1 (57.1 2.9 (2.9% 2.0 (2.0 23.2 (23.2 − 000 0.00 00 24. (24. 7. (7.3 57. (57. 2. (2.9 (2. 23. (23. 0.0 (24 (7. (57 (2 (23 (7 (5 (
5.
A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas
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Page, Matthew J.
; McKenzie, Joanne E.
; Bossuyt, Patrick M.
; Boutron, Isabelle
; Hoffmann, Tammy C.
; Mulrow, Cynthia D.
; Shamseer, Larissa
; Tetzlaff, Jennifer M.
; Akl, Elie A.
; Brennan, Sue E.
; Chou, Roger
; Glanville, Julie
; Grimshaw, Jeremy M.
; Hróbjartsson, Asbjørn
; Lalu, Manoj M.
; Li, Tianjing
; Loder, Elizabeth W.
; Mayo-Wilson, Evan
; McDonald, Steve
; McGuinness, Luke A.
; Stewart, Lesley A.
; Thomas, James
; Tricco, Andrea C.
; Welch, Vivian A.
; Whiting, Penny
; Moher, David
.
ABSTRACT The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
RESUMO A declaração dos Principais Itens para Relatar Revisões Sistemáticas e Meta-análises (PRISMA), publicada em 2009, foi desenvolvida para ajudar revisores sistemáticos a relatar de forma transparente por que a revisão foi feita, os métodos empregados e o que os autores encontraram. Na última década, os avanços na metodologia e terminologia de revisões sistemáticas exigiram a atualização da diretriz. A declaração PRISMA 2020 substitui a declaração de 2009 e inclui novas orientações para relato que refletem os avanços nos métodos para identificar, selecionar, avaliar e sintetizar estudos. A estrutura e apresentação dos itens foram modificadas para facilitar a implementação. Neste artigo, apresentamos a lista de checagem PRISMA 2020 de 27 itens, uma lista de checagem expandida que detalha as recomendações para relato para cada item, a lista de checagem PRISMA 2020 para resumos e os fluxogramas revisados para novas revisões e para atualização de revisões.
RESUMEN La declaración PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), publicada en 2009, se diseñó para ayudar a los autores de revisiones sistemáticas a documentar de manera transparente el porqué de la revisión, qué hicieron los autores y qué encontraron. Durante la última década, ha habido muchos avances en la metodología y terminología de las revisiones sistemáticas, lo que ha requerido una actualización de esta guía. La declaración PRISMA 2020 sustituye a la declaración de 2009 e incluye una nueva guía de presentación de las publicaciones que refleja los avances en los métodos para identificar, seleccionar, evaluar y sintetizar estudios. La estructura y la presentación de los ítems ha sido modificada para facilitar su implementación. En este artículo, presentamos la lista de verificación PRISMA 2020 con 27 ítems, y una lista de verificación ampliada que detalla las recomendaciones en la publicación de cada ítem, la lista de verificación del resumen estructurado PRISMA 2020 y el diagrama de flujo revisado para revisiones sistemáticas.
6.
Trends in renal calculus composition and 24-hour urine analyses in patients with neurologically derived musculoskeletal deficiencies
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Hugar, Lee A.
; Kafka, Ilan
; Fuller, Thomas W.
; Taan, Hassan
; Averch, Timothy D.
; Semins, Michelle J.
.
ABSTRACT Purpose: To better characterize metabolic stone risk in patients with neurologically derived musculoskeletal deficiencies (NDMD) by determining how patient characteristics relate to renal calculus composition and 24-hour urine parameters. Materials and Methods: We performed a retrospective cohort study of adult patients with neurologically derived musculoskeletal deficiencies presenting to our multidisciplinary Kidney Stone Clinic. Patients with a diagnosis of NDMD, at least one 24-hour urine collection, and one chemical stone analysis were included in the analysis. Calculi were classified as primarily metabolic or elevated pH. We assessed in clinical factors, demographics, and urine metabolites for differences between patients who formed primarily metabolic or elevated pH stones. Results: Over a 16-year period, 100 patients with NDMD and nephrolithiasis were identified and 41 met inclusion criteria. Thirty percent (12 / 41) of patients had purely metabolic calculi. Patients with metabolic calculi were significantly more likely to be obese (median body mass index 30.3kg / m2 versus 25.9kg / m2), void spontaneously (75% vs. 6.9%), and have low urine volumes (100% vs. 69%). Patients who formed elevated pH stones were more likely to have positive preoperative urine cultures with urease splitting organisms (58.6% vs. 16.7%) and be hyperoxaluric and hypocitraturic on 24-hour urine analysis (37mg / day and 265mg / day versus 29mg / day and 523mg / day). Conclusions: Among patients with NDMD, metabolic factors may play a more significant role in renal calculus formation than previously believed. There is still a high incidence of carbonate apatite calculi, which could be attributed to bacteriuria. However, obesity, low urine volumes, hypocitraturia, and hyperoxaluria suggest an underrecognized metabolic contribution to stone formation in this population.
https://doi.org/10.1590/s1677-5538.ibju.2018.0531
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7.
A Mall Intercept Survey on Religion and Worldview in the Cape Flats of Cape Town, South Africa
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This study analyzes worldviews and religious beliefs and practices in the Cape Flats area of Cape Town, South Africa, using a mall intercept survey of n=513 visitors to five shopping centers. Variables considered included demographic characteristics, measures of religiosity and religious pluralism, participation in religious activities, and supernaturalism (both related and unrelated to a traditional Christian-Abrahamic worldview). The majority (69.4%) of respondents identifies as Christian, though denominational affiliation is very diverse. The other two prevalent religious affiliations are the African Traditional Religion (16.4%) and Islam (11.7%). Only 1.6% of the respondents self-identified as non-religious, a smaller percentage than has been found in research on Cape Town as a whole or South Africa nationally. The degree of self-reported religiosity, participation in religious activities, and belief in supernatural phenomena are all high. Associations between demographic characteristics and religion and worldview variables are analyzed in detail.
https://doi.org/10.17159/2413-3027/2019/v32n1a3
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8.
A self-assessment study of procedural skills of doctors in peri-urban district hospitals of Gauteng, South Africa
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African Journal of Primary Health Care & Family Medicine
- Journal Metrics
BACKGROUND: Several studies have been carried out on procedural skills of doctors in district hospitals in rural South Africa. However, there is insufficient information about skills of doctors in peri-urban district hospitals. This paper attempts to supplement this vital information.AIM: The aim of the study was to determine self-reported levels of competence in procedural skills of doctors in peri-urban district hospitals and to assess factors influencing this.SETTING: The study was undertaken in three district hospitals in two health districts of Gauteng Province.METHODS: A cross-sectional descriptive study using a self-administered questionnaire was undertaken in three district hospitals in two health districts of Gauteng Province. The questionnaire assessed procedural skills based on district health service delivery requirements for doctors in district hospitals using a modified skill set developed for family medicine training in South AfricaRESULTS: There was a wide range of self-reported competence and experience among doctors for various skill sets. Doctors were generally more competent for procedures in general surgery, medicine, orthopaedics, obstetrics and gynaecology and paediatrics than anaesthesia, ear, nose and throat and ophthalmology. There were statistically significant associations between age and overall anaesthetic competence (p = 0.03); gender and overall competence in surgery (p = 0.03), orthopaedics (p = 0.02) and urology (p = 0.005); years of experience and overall competence in dermatology skills; current hospital and overall competence in anaesthesia (p = 0.01), obstetrics and gynaecology (p = 0.015) and dermatology skills (p = 0.01).CONCLUSION: This was one of the first studies to look at self-reported procedural competence of doctors in a peri-urban setting in South Africa. The results highlight the need for regular skills audits, standardised training and updating of skills of doctors in district hospitals.
https://doi.org/10.4102/phcfm.v11i1.1975
327 downloads
9.
Growing knowledge: an overview of Seed Plant diversity in Brazil
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Zappi, Daniela C.
; Filardi, Fabiana L. Ranzato
; Leitman, Paula
; Souza, Vinícius C.
; Walter, Bruno M.T.
; Pirani, José R.
; Morim, Marli P.
; Queiroz, Luciano P.
; Cavalcanti, Taciana B.
; Mansano, Vidal F.
; Forzza, Rafaela C.
; Abreu, Maria C.
; Acevedo-Rodríguez, Pedro
; Agra, Maria F.
; Almeida Jr., Eduardo B.
; Almeida, Gracineide S.S.
; Almeida, Rafael F.
; Alves, Flávio M.
; Alves, Marccus
; Alves-Araujo, Anderson
; Amaral, Maria C.E.
; Amorim, André M.
; Amorim, Bruno
; Andrade, Ivanilza M.
; Andreata, Regina H.P.
; Andrino, Caroline O.
; Anunciação, Elisete A.
; Aona, Lidyanne Y.S.
; Aranguren, Yani
; Aranha Filho, João L.M.
; Araújo, Andrea O.
; Araújo, Ariclenes A.M.
; Araújo, Diogo
; Arbo, María M.
; Assis, Leandro
; Assis, Marta C.
; Assunção, Vivian A.
; Athiê-Souza, Sarah M.
; Azevedo, Cecilia O.
; Baitello, João B.
; Barberena, Felipe F.V.A.
; Barbosa, Maria R.V.
; Barros, Fábio
; Barros, Lucas A.V.
; Barros, Michel J.F.
; Baumgratz, José F.A.
; Bernacci, Luis C.
; Berry, Paul E.
; Bigio, Narcísio C.
; Biral, Leonardo
; Bittrich, Volker
; Borges, Rafael A.X.
; Bortoluzzi, Roseli L.C.
; Bove, Cláudia P.
; Bovini, Massimo G.
; Braga, João M.A.
; Braz, Denise M.
; Bringel Jr., João B.A.
; Bruniera, Carla P.
; Buturi, Camila V.
; Cabral, Elza
; Cabral, Fernanda N.
; Caddah, Mayara K.
; Caires, Claudenir S.
; Calazans, Luana S.B.
; Calió, Maria F.
; Camargo, Rodrigo A.
; Campbell, Lisa
; Canto-Dorow, Thais S.
; Carauta, Jorge P.P.
; Cardiel, José M.
; Cardoso, Domingos B.O.S.
; Cardoso, Leandro J.T.
; Carneiro, Camila R.
; Carneiro, Cláudia E.
; Carneiro-Torres, Daniela S.
; Carrijo, Tatiana T.
; Caruzo, Maria B.R.
; Carvalho, Maria L.S.
; Carvalho-Silva, Micheline
; Castello, Ana C.D.
; Cavalheiro, Larissa
; Cervi, Armando C.
; Chacon, Roberta G.
; Chautems, Alain
; Chiavegatto, Berenice
; Chukr, Nádia S.
; Coelho, Alexa A.O.P.
; Coelho, Marcus A.N.
; Coelho, Rubens L.G.
; Cordeiro, Inês
; Cordula, Elizabeth
; Cornejo, Xavier
; Côrtes, Ana L.A.
; Costa, Andrea F.
; Costa, Fabiane N.
; Costa, Jorge A.S.
; Costa, Leila C.
; Costa-e-Silva, Maria B.
; Costa-Lima, James L.
; Cota, Maria R.C.
; Couto, Ricardo S.
; Daly, Douglas C.
; De Stefano, Rodrigo D.
; De Toni, Karen
; Dematteis, Massimiliano
; Dettke, Greta A.
; Di Maio, Fernando R.
; Dórea, Marcos C.
; Duarte, Marília C.
; Dutilh, Julie H.A.
; Dutra, Valquíria F.
; Echternacht, Lívia
; Eggers, Lilian
; Esteves, Gerleni
; Ezcurra, Cecilia
; Falcão Junior, Marcus J.A.
; Feres, Fabíola
; Fernandes, José M.
; Ferreira, D.M.C.
; Ferreira, Fabrício M.
; Ferreira, Gabriel E.
; Ferreira, Priscila P.A.
; Ferreira, Silvana C.
; Ferrucci, Maria S.
; Fiaschi, Pedro
; Filgueiras, Tarciso S.
; Firens, Marcela
; Flores, Andreia S.
; Forero, Enrique
; Forster, Wellington
; Fortuna-Perez, Ana P.
; Fortunato, Reneé H.
; Fraga, Cléudio N.
; França, Flávio
; Francener, Augusto
; Freitas, Joelcio
; Freitas, Maria F.
; Fritsch, Peter W.
; Furtado, Samyra G.
; Gaglioti, André L.
; Garcia, Flávia C.P.
; Germano Filho, Pedro
; Giacomin, Leandro
; Gil, André S.B.
; Giulietti, Ana M.
; A.P.Godoy, Silvana
; Goldenberg, Renato
; Gomes da Costa, Géssica A.
; Gomes, Mário
; Gomes-Klein, Vera L.
; Gonçalves, Eduardo Gomes
; Graham, Shirley
; Groppo, Milton
; Guedes, Juliana S.
; Guimarães, Leonardo R.S.
; Guimarães, Paulo J.F.
; Guimarães, Elsie F.
; Gutierrez, Raul
; Harley, Raymond
; Hassemer, Gustavo
; Hattori, Eric K.O.
; Hefler, Sonia M.
; Heiden, Gustavo
; Henderson, Andrew
; Hensold, Nancy
; Hiepko, Paul
; Holanda, Ana S.S.
; Iganci, João R.V.
; Imig, Daniela C.
; Indriunas, Alexandre
; Jacques, Eliane L.
; Jardim, Jomar G.
; Kamer, Hiltje M.
; Kameyama, Cíntia
; Kinoshita, Luiza S.
; Kirizawa, Mizué
; Klitgaard, Bente B.
; Koch, Ingrid
; Koschnitzke, Cristiana
; Krauss, Nathália P.
; Kriebel, Ricardo
; Kuntz, Juliana
; Larocca, João
; Leal, Eduardo S.
; Lewis, Gwilym P.
; Lima, Carla T.
; Lima, Haroldo C.
; Lima, Itamar B.
; Lima, Laíce F.G.
; Lima, Laura C.P.
; Lima, Leticia R.
; Lima, Luís F.P.
; Lima, Rita B.
; Lírio, Elton J.
; Liro, Renata M.
; Lleras, Eduardo
; Lobão, Adriana
; Loeuille, Benoit
; Lohmann, Lúcia G.
; Loiola, Maria I.B.
; Lombardi, Julio A.
; Longhi-Wagner, Hilda M.
; Lopes, Rosana C.
; Lorencini, Tiago S.
; Louzada, Rafael B.
; Lovo, Juliana
; Lozano, Eduardo D.
; Lucas, Eve
; Ludtke, Raquel
; Luz, Christian L.
; Maas, Paul
; Machado, Anderson F.P.
; Macias, Leila
; Maciel, Jefferson R.
; Magenta, Mara A.G.
; Mamede, Maria C.H.
; Manoel, Evelin A.
; Marchioretto, Maria S.
; Marques, Juliana S.
; Marquete, Nilda
; Marquete, Ronaldo
; Martinelli, Gustavo
; Martins da Silva, Regina C.V.
; Martins, Ângela B.
; Martins, Erika R.
; Martins, Márcio L.L.
; Martins, Milena V.
; Martins, Renata C.
; Matias, Ligia Q.
; Maya-L., Carlos A.
; Mayo, Simon
; Mazine, Fiorella
; Medeiros, Debora
; Medeiros, Erika S.
; Medeiros, Herison
; Medeiros, João D.
; Meireles, José E.
; Mello-Silva, Renato
; Melo, Aline
; Melo, André L.
; Melo, Efigênia
; Melo, José I.M.
; Menezes, Cristine G.
; Menini Neto, Luiz
; Mentz, Lilian A.
; Mezzonato, A.C.
; Michelangeli, Fabián A.
; Milward-de-Azevedo, Michaele A.
; Miotto, Silvia T.S.
; Miranda, Vitor F.O.
; Mondin, Cláudio A.
; Monge, Marcelo
; Monteiro, Daniele
; Monteiro, Raquel F.
; Moraes, Marta D.
; Moraes, Pedro L.R.
; Mori, Scott A.
; Mota, Aline C.
; Mota, Nara F.O.
; Moura, Tania M.
; Mulgura, Maria
; Nakajima, Jimi N.
; Nardy, Camila
; Nascimento Júnior, José E.
; Noblick, Larry
; Nunes, Teonildes S.
; O'Leary, Nataly
; Oliveira, Arline S.
; Oliveira, Caetano T.
; Oliveira, Juliana A.
; Oliveira, Luciana S.D.
; Oliveira, Maria L.A.A.
; Oliveira, Regina C.
; Oliveira, Renata S.
; Oliveira, Reyjane P.
; Paixão-Souza, Bruno
; Parra, Lara R.
; Pasini, Eduardo
; Pastore, José F.B.
; Pastore, Mayara
; Paula-Souza, Juliana
; Pederneiras, Leandro C.
; Peixoto, Ariane L.
; Pelissari, Gisela
; Pellegrini, Marco O.O.
; Pennington, Toby
; Perdiz, Ricardo O.
; Pereira, Anna C.M.
; Pereira, Maria S.
; Pereira, Rodrigo A.S.
; Pessoa, Clenia
; Pessoa, Edlley M.
; Pessoa, Maria C.R.
; Pinto, Luiz J.S.
; Pinto, Rafael B.
; Pontes, Tiago A.
; Prance, Ghillean T.
; Proença, Carolyn
; Profice, Sheila R.
; Pscheidt, Allan C.
; Queiroz, George A.
; Queiroz, Rubens T.
; Quinet, Alexandre
; Rainer, Heimo
; Ramos, Eliana
; Rando, Juliana G.
; Rapini, Alessandro
; Reginato, Marcelo
; Reis, Ilka P.
; Reis, Priscila A.
; Ribeiro, André R.O.
; Ribeiro, José E.L.S.
; Riina, Ricarda
; Ritter, Mara R.
; Rivadavia, Fernando
; Rocha, Antônio E.S.
; Rocha, Maria J.R.
; Rodrigues, Izabella M.C.
; Rodrigues, Karina F.
; Rodrigues, Rodrigo S.
; Rodrigues, Rodrigo S.
; Rodrigues, Vinícius T.
; Rodrigues, William
; Romaniuc Neto, Sérgio
; Romão, Gerson O.
; Romero, Rosana
; Roque, Nádia
; Rosa, Patrícia
; Rossi, Lúcia
; Sá, Cyl F.C.
; Saavedra, Mariana M.
; Saka, Mariana
; Sakuragui, Cássia M.
; Salas, Roberto M.
; Sales, Margareth F.
; Salimena, Fatima R.G.
; Sampaio, Daniela
; Sancho, Gisela
; Sano, Paulo T.
; Santos, Alessandra
; Santos, Élide P.
; Santos, Juliana S.
; Santos, Marianna R.
; Santos-Gonçalves, Ana P.
; Santos-Silva, Fernanda
; São-Mateus, Wallace
; Saraiva, Deisy P.
; Saridakis, Dennis P.
; Sartori, Ângela L.B.
; Scalon, Viviane R.
; Schneider, Ângelo
; Sebastiani, Renata
; Secco, Ricardo S.
; Senna, Luisa
; Senna-Valle, Luci
; Shirasuna, Regina T.
; Silva Filho, Pedro J.S.
; Silva, Anádria S.
; Silva, Christian
; Silva, Genilson A.R.
; Silva, Gisele O.
; Silva, Márcia C.R.
; Silva, Marcos J.
; Silva, Marcos J.
; Silva, Otávio L.M.
; Silva, Rafaela A.P.
; Silva, Saura R.
; Silva, Tania R.S.
; Silva-Gonçalves, Kelly C.
; Silva-Luz, Cíntia L.
; Simão-Bianchini, Rosângela
; Simões, André O.
; Simpson, Beryl
; Siniscalchi, Carolina M.
; Siqueira Filho, José A.
; Siqueira, Carlos E.
; Siqueira, Josafá C.
; Smith, Nathan P.
; Snak, Cristiane
; Soares Neto, Raimundo L.
; Soares, Kelen P.
; Soares, Marcos V.B.
; Soares, Maria L.
; Soares, Polyana N.
; Sobral, Marcos
; Sodré, Rodolfo C.
; Somner, Genise V.
; Sothers, Cynthia A.
; Sousa, Danilo J.L.
; Souza, Elnatan B.
; Souza, Élvia R.
; Souza, Marcelo
; Souza, Maria L.D.R.
; Souza-Buturi, Fátima O.
; Spina, Andréa P.
; Stapf, María N.S.
; Stefano, Marina V.
; Stehmann, João R.
; Steinmann, Victor
; Takeuchi, Cátia
; Taylor, Charlotte M.
; Taylor, Nigel P.
; Teles, Aristônio M.
; Temponi, Lívia G.
; Terra-Araujo, Mário H.
; Thode, Veronica
; Thomas, W.Wayt
; Tissot-Squalli, Mara L.
; Torke, Benjamin M.
; Torres, Roseli B.
; Tozzi, Ana M.G.A.
; Trad, Rafaela J.
; Trevisan, Rafael
; Trovó, Marcelo
; Valls, José F.M.
; Vaz, Angela M.S.F.
; Versieux, Leonardo
; Viana, Pedro L.
; Vianna Filho, Marcelo D.M.
; Vieira, Ana O.S.
; Vieira, Diego D.
; Vignoli-Silva, Márcia
; Vilar, Thaisa
; Vinhos, Franklin
; Wallnöfer, Bruno
; Wanderley, Maria G.L.
; Wasshausen, Dieter
; Watanabe, Maurício T.C.
; Weigend, Maximilian
; Welker, Cassiano A.D.
; Woodgyer, Elizabeth
; Xifreda, Cecilia C.
; Yamamoto, Kikyo
; Zanin, Ana
; Zenni, Rafael D.
; Zickel, Carmem S
.
Resumo Um levantamento atualizado das plantas com sementes e análises relevantes acerca desta biodiversidade são apresentados. Este trabalho se iniciou em 2010 com a publicação do Catálogo de Plantas e Fungos e, desde então vem sendo atualizado por mais de 430 especialistas trabalhando online. O Brasil abriga atualmente 32.086 espécies nativas de Angiospermas e 23 espécies nativas de Gimnospermas e estes novos dados mostram um aumento de 3% da riqueza em relação a 2010. A Amazônia é o Domínio Fitogeográfico com o maior número de espécies de Gimnospermas, enquanto que a Floresta Atlântica possui a maior riqueza de Angiospermas. Houve um crescimento considerável no número de espécies e nas taxas de endemismo para a maioria dos Domínios (Caatinga, Cerrado, Floresta Atlântica, Pampa e Pantanal), com exceção da Amazônia que apresentou uma diminuição de 2,5% de endemicidade. Entretanto, a maior parte das plantas com sementes que ocorrem no Brasil (57,4%) é endêmica deste território. A proporção de formas de vida varia de acordo com os diferentes Domínios: árvores são mais expressivas na Amazônia e Floresta Atlântica do que nos outros biomas, ervas são dominantes no Pampa e as lianas apresentam riqueza expressiva na Amazônia, Floresta Atlântica e Pantanal. Este trabalho não só quantifica a biodiversidade brasileira, mas também indica as lacunas de conhecimento e o desafio a ser enfrentado para a conservação desta flora.
Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora.
https://doi.org/10.1590/2175-7860201566411
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10.
The construct validity of the Spanish version of the ABQ using a multi-trait/multi-method approach
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Raedeke, Thomas D.
; Arce, Constantino
; Francisco, Cristina De
; Seoane, Gloria
; Ferraces, María J.
.
This study was designed to evaluate construct validity evidence associated with the Spanish version of the Athlete Burnout Questionnaire (ABQ) using a multi-trait/multi-method (MTMM) approach. The ABQ was administered to a sample of 302 Spanish athletes, along with two other questionnaires including the Maslach Burnout Inventory-General Survey (MBI-GS) and the Depression, Anxiety, Stress Scale (DASS-21), which respectively measure burnout in organizational settings and indicators of ill being including depression, anxiety and stress. A structural equation modeling approach to a MTMM analysis was used. Results revealed by comparative analysis of four models that the Spanish version of ABQ has convergent and internal discriminant validity evident by high correlations between matching burnout subscales across two measures and lower correlations between non-matching dimensions. In addition, the burnout measures exhibited external discriminant validity as the correlations between burnout dimensions were higher than those seen between conceptually related, but unique, constructs.
El objetivo de la presente investigación fue evaluar la validez de constructo de la versión española del Athlete Burnout Questionnaire (ABQ) utilizando la aproximación multi-rasgo/multi-método (MTMM). El ABQ fue administrado a una muestra de 302 deportistas españoles, junto con dos otros cuestionarios, el Maslach Burnout Inventory-General Survey (MBI-GS) y la Escala de Depresión, Ansiedad y Estrés (DASS-21), que miden respectivamente burnout en el contexto organizacional e indicadores de depresión, ansiedad y estrés. El análisis multi-rasgo/multi-método se hizo desde la perspectiva de los modelos de ecuaciones estructurales. Los resultados obtenidos por medio de la comparación entre cuatro modelos revelaron que la versión española del ABQ tiene validez convergente y discriminante interna como lo evidencian las altas correlaciones observadas entre las dimensiones semejantes del burnout medidas por los dos cuestionarios de burnout y las bajas correlaciones observadas entre dimensiones no equivalentes. Además, se ha podido concluir que las medidas de burnout también disponen de validez discriminante externa dado que las correlaciones entre las dimensiones del burnout fueron más altas que las obtenidas entre los constructos únicos conceptualmente relacionados.
https://doi.org/10.6018/analesps.29.3.175831
724 downloads
11.
First fungal genome sequence from Africa: a preliminary analysis
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Wingfield, Brenda D.
; Steenkamp, Emma T.
; Santana, Quentin C.
; Coetzee, Martin P.A.
; Bam, Stefan
; Barnes, Irene
; Beukes, Chrizelle W.
; Yin Chan, Wai
; de Vos, Lieschen
; Fourie, Gerda
; Friend, Melanie
; Gordon, Thomas R.
; Herron, Darryl A.
; Holt, Carson
; Korf, Ian
; Kvas, Marija
; Martin, Simon H.
; Mlonyeni, X. Osmond
; Naidoo, Kershney
; Phasha, Mmatshepho M.
; Postma, Alisa
; Reva, Oleg
; Roos, Heidi
; Simpson, Melissa
; Slinski, Stephanie
; Slippers, Bernard
; Sutherland, Rene
; van der Merwe, Nicolaas A.
; van der Nest, Magriet A.
; Venter, Stephanus N.
; Wilken, Pieter M.
; Yandell, Mark
; Zipfel, Renate
; Wingfield, Mike J.
.
Some of the most significant breakthroughs in the biological sciences this century will emerge from the development of next generation sequencing technologies. The ease of availability of DNA sequence made possible through these new technologies has given researchers opportunities to study organisms in a manner that was not possible with Sanger sequencing. Scientists will, therefore, need to embrace genomics, as well as develop and nurture the human capacity to sequence genomes and utilise the 'tsunami' of data that emerge from genome sequencing. In response to these challenges, we sequenced the genome of Fusarium circinatum, a fungal pathogen of pine that causes pitch canker, a disease of great concern to the South African forestry industry. The sequencing work was conducted in South Africa, making F. circinatum the first eukaryotic organism for which the complete genome has been sequenced locally. Here we report on the process that was followed to sequence, assemble and perform a preliminary characterisation of the genome. Furthermore, details of the computer annotation and manual curation of this genome are presented. The F. circinatum genome was found to be nearly 44 million bases in size, which is similar to that of four other Fusarium genomes that have been sequenced elsewhere. The genome contains just over 15 000 open reading frames, which is less than that of the related species, Fusarium oxysporum, but more than that for Fusarium verticillioides. Amongst the various putative gene clusters identified in F. circinatum, those encoding the secondary metabolites fumosin and fusarin appeared to harbour evidence of gene translocation. It is anticipated that similar comparisons of other loci will provide insights into the genetic basis for pathogenicity of the pitch canker pathogen. Perhaps more importantly, this project has engaged a relatively large group of scientists including students in a significant genome project that is certain to provide a platform for growth in this important area of research in the future.
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12.
Re-evaluating the NO2 hotspot over the South African Highveld
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Lourens, Alexandra S.M.
; Butler, Timothy M.
; Beukes, Johan P.
; van Zyl, Pieter G.
; Beirle, Steffen
; Wagner, Thomas K.
; Heue, Klaus-Peter
; Pienaar, Jacobus J.
; Fourie, Gerhardus D.
; Lawrence, Mark G.
.
Globally, numerous pollution hotspots have been identified using satellite-based instruments. One of these hotspots is the prominent NO2 hotspot over the South African Highveld. The tropospheric NO2 column density of this area is comparable to that observed for central and northern Europe, eastern North America and south-east Asia. The most well-known pollution source in this area is a large array of coal-fired power stations. Upon closer inspection, long-term means of satellite observations also show a smaller area, approximately 100 km west of the Highveld hotspot, with a seemingly less substantial NO2 column density. This area correlates with the geographical location of the Johannesburg-Pretoria conurbation or megacity, one of the 40 largest metropolitan areas in the world. Ground-based measurements indicate that NO2 concentrations in the megacity have diurnal peaks in the early morning and late afternoon, which coincide with peak traffic hours and domestic combustion. During these times, NO2 concentrations in the megacity are higher than those in the Highveld hotspot. These diurnal NO2 peaks in the megacity have generally been overlooked by satellite observations because the satellites have fixed local overpass times that do not coincide with these peak periods. Consequently, the importance of NO2 over the megacity has been underestimated. We examined the diurnal cycles of NO2 ground-based measurements for the two areas - the megacity and the Highveld hotspot - and compared them with the satellite-based NO2 observations. Results show that the Highveld hotspot is accompanied by a second hotspot over the megacity, which is of significance for the more than 10 million people living in this megacity.
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Cited 1 time in SciELO
13.
Chlamydia trachomatis infection and associated risk factors in a low-income marginalized urban population in coastal Peru
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León, Segundo R.
; Konda, Kelika A.
; Klausner, Jeffrey D.
; Jones, Franca R.
; Cáceres, Carlos F.
; Coates, Thomas J.
.
OBJECTIVES: To estimate Chlamydia trachomatis (CT) infection prevalence and associated risk factors among a low-income marginalized urban population in Peru. METHODS: Between April 2003 and April 2005, men and women at high-risk for sexually transmitted infections (STIs) were recruited from low-income urban areas in three coastal cities in Peru (Chiclayo, Lima, and Trujillo). Consenting participants were studied using a sero-epidemiologic survey. Urine and vaginal swabs collected from men and women were evaluated using polymerase chain reaction (PCR) (COBAS® AMPLICOR (CT/NG) Test, Roche Molecular Diagnostics, Branchburg, NJ, USA) for CT. RESULTS: Among the 2 440 participants recruited for the study (2 145 men and 295 women), overall prevalence of CT infection was 6.6% (95% CI, 5.6-7.6%): 5.5% (95% CI, 4.5-6.5%) in men and 14.9% (95% CI, 11.7-27.1%) in women. Chlamydial infection was inversely associated with age and positively associated with HIV infection and dysuria in men. Among women, chlamydial infection was inversely associated with age and positively associated with number of sex partners. CONCLUSIONS: CT infection was common among high-risk men and women in urban coastal Peru. Because chlamydial infection is associated with complications related to female reproduction, including infertility and ectopic pregnancy, interventions to prevent and treat infection and studies to determine the feasibility of population-based screening for CT should be conducted among the high-risk female population.
OBJETIVOS: Estimar la prevalencia de la infección por Chlamydia trachomatis y los factores de riesgo asociados en una población marginal urbana de bajos ingresos de Perú. MÉTODOS: Entre abril de 2003 y abril de 2005 se captaron hombres y mujeres con alto riesgo de contraer infecciones de transmisión sexual, en áreas urbanas de bajos ingresos de tres ciudades costeras de Perú (Chiclayo, Lima y Trujillo). Los participantes que aceptaron colaborar respondieron una encuesta seroepidemiológica y se analizaron muestras de orina de los hombres y exudados vaginales de las mujeres mediante la reacción en cadena de la polimerasa con el sistema para C. trachomatis COBAS® AMPLICOR (Roche Molecular Diagnostics, NJ, EE.UU.) RESULTADOS: En el estudio participaron 2 440 personas (2 145 hombres y 295 mujeres). La prevalencia general de infección por C. trachomatis fue de 6,6% (intervalo de confianza de 95% [IC95%]: 5,6 a 7,6%): 5,5% (IC95%: 4,5 a 6,5%) en hombres y 14,9% (IC95%: 11,7 a 27,1%) en mujeres. La infección por clamidia se asoció inversamente con la edad y directamente con la infección por VIH y la disuria en los hombres. En las mujeres, esta infección se asoció inversamente con la edad y directamente con el número de parejas sexuales. CONCLUSIONES: La infección por C. trachomatis fue frecuente en los hombres y mujeres con alto riesgo en las zonas urbanas costeras de Perú. Como esta infección está asociada con complicaciones que afectan la salud reproductiva de las mujeres, como infertilidad y embarazos ectópicos, se deben realizar intervenciones para prevenir y tratar la infección por C. trachomatis y se deben emprender estudios para determinar la factibilidad del tamizaje general de esta infección en la población femenina de alto riesgo.
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14.
Description of a seven-year prospective study of human papillomavirus infection and cervical neoplasia among 10 000 women in Guanacaste, Costa Rica
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Bratti, M. Concepción
; Rodríguez, Ana C.
; Schiffman, Mark
; Hildesheim, Allan
; Morales, Jorge
; Alfaro, Mario
; Guillén, Diego
; Hutchinson, Martha
; Sherman, Mark E.
; Eklund, Claire
; Schussler, John
; Buckland, Julie
; Morera, Lidia A.
; Cárdenas, Fernando
; Barrantes, Manuel
; Pérez, Elmer
; Cox, Thomas J.
; Burk, Robert D.
; Herrero, Rolando
.
OBJECTIVE:The Guanacaste study ("Guanacaste Project," or GP), was designed to investigate the role of human papillomavirus (HPV) infection and its cofactors in the development of cervical neoplasia and to evaluate new cervical cancer screening technologies. The follow-up phase of the GP was designed to study why a small proportion of women infected with HPV develop cervical intraepithelial neoplasia grade 2 (CIN 2), CIN 3, or cancer (these three together are globally referred to as > CIN 2, that is, CIN 2 or worse). The purpose of this article is to describe this prospective study in detail and to present the preliminary findings regarding the incidence of cervical neoplasia. METHODS: A cohort of 10 049 randomly selected women from 18 to 97 years old from Guanacaste, a province in northwestern Costa Rica, was intensively screened in 1993-1994 and then followed up for seven years after being enrolled. A questionnaire for demographic and risk factors was administered, and a pelvic examination was performed on sexually active women at each follow-up visit in order to obtain samples for screening tests and for research purposes. The final diagnosis given at the end of the enrollment phase categorized women into several groups according to the perceived risk of their developing either high-grade precursors of cancer or cancer. These groups were followed up at different intervals according to the risk of developing > CIN 2. The most active follow-up (every 6-12 months) was concentrated on the women most likely to develop > CIN 2, based on cytology (n= 492). The remainder of the cohort was followed either annually (n= 2 574) or after five to seven years of passive follow-up (n= 3 926). All women with possibly severe lesions detected by any technique were referred to colposcopy for further evaluation and treatment, and they were also censored from the study. Lesions >CIN 2 served as both the censoring outcome and our surrogate for cancer risk. RESULTS: Participation during follow-up was high (near 90%). Suspected > CIN 2 by any screening technique censored 4.6% of women. Most of the women censored because of suspected > CIN 2 came from the large group perceived at entry as being at low risk of developing > CIN 2, but the greatest rates of progression to > CIN 2 were observed among women perceived at entry to be at highest risk of >CIN 2, based on their cytology, virology, or sexual behavior. CONCLUSIONS: The GP is the largest population-based longitudinal cohort for the study of HPV and cervical neoplasia in the world, and its results will hopefully let us soon plan future worldwide prevention strategies. Research projects such as this one require the long-term commitment of a large multidisciplinary team and ample financial resources. The intensive effort and expertise applied in all aspects of this study were key factors in its success as a model of cooperative, interdisciplinary cancer research in Latin America. Quality control played an important role at all times during the study and made it possible to adapt new diagnostic and screening technology to Guanacaste. The systematic follow-up of a population-based group of close to 10 000 women in Guanacaste should permit careful, time-dependent evaluation of factors postulated to be linked to the development of cervical cancer as well as the evaluation of clinical markers of disease progression. The study results that have already been published have validated sensitive screening techniques and have also promoted the use of more affordable screening techniques in resource-poor, developing countries. The GP has also contributed to building knowledge for the search for vaccines against HPV as part of the effort to develop an effective tool to reduce the incidence and mortality of cervical cancer worldwide.
OBJETIVOS: El estudio de cohorte de Guanacaste, o Proyecto Epidemiológico Guanacaste, fue diseñado para investigar el papel que desempeñan la infección por el virus del papiloma humano (VPH) y sus cofactores en el desarrollo de neoplasias cervicouterinas y para evaluar nuevas tecnologías de tamizaje del cáncer del cuello de útero. La fase de seguimiento de este proyecto se diseñó para analizar por qué una pequeña parte de las mujeres infectadas por el VPH desarrollan neoplasias intraepiteliales cervicouterinas (NIC) grados 2 y 3, o cáncer (que en lo adelante se llamarán en conjunto > NIC 2, es decir, NIC 2 o peor). El propósito de este artículo es describir en detalle ese estudio prospectivo y presentar los resultados preliminares relacionados con la incidencia de neoplasias cervicouterinas. MÉTODOS: Se realizó el tamizaje intensivo de una cohorte de 10 049 mujeres de 18 a 97 años de edad seleccionadas aleatoriamente en Guanacaste, provincia del noroeste de Costa Rica, en 1993-1994 con un seguimiento ulterior de siete años. A las participantes se les aplicó un cuestionario para conocer sus características demográficas y sus factores de riesgo, y a las sexualmente activas se les realizó además un examen pélvico en cada una de las visitas de seguimiento, a fin de obtener muestras para las pruebas de tamizaje y la investigación. El diagnóstico obtenido al final de la fase de captación permitió clasificar a las mujeres en varios grupos de acuerdo con el riesgo que presentaban de desarrollar cáncer o alguno de sus precursores de alto grado. Estos grupos tuvieron seguimientos a intervalos diferentes, según su riesgo de desarrollar > NIC 2. El seguimiento más activo (cada 6-12 meses) se concentró en las mujeres con mayores probabilidades de desarrollar > NIC 2, según los resultados citológicos (n = 492). Las mujeres restantes recibieron visitas de seguimiento anualmente (n = 2 574) o después de cinco a siete años de seguimiento pasivo (n = 3 926). A todas las mujeres en quienes se detectaron lesiones que pudieran ser graves, por cualquiera de las técnicas empleadas, se les remitió a una evaluación ulterior mediante colposcopia y a tratamiento médico, y se retiraron del estudio. Las lesiones > NIC 2 se utilizaron como criterio para la salida del estudio y como indicadores indirectos del riesgo de cáncer. RESULTADOS: La participación durante la fase de seguimiento fue alta (cercana al 90%). Cualquier indicio de > NIC 2, según cualquiera de las técnicas de tamizaje, fue motivo para eliminar a 4,6% de las mujeres participantes. La mayor parte de estas mujeres procedían del grupo que al inicio del estudio parecía tener un riesgo bajo de desarrollar > NIC 2, pero el mayor riesgo absoluto de progresión a > NIC 2 a partir de lesiones intraepiteliales escamosas de bajo grado se observó entre las mujeres que al incorporarse al estudio parecían estar en mayor riesgo de > NIC 2 según los resultados citológicos y virológicos y su comportamiento sexual. CONCLUSIONES: El Proyecto Epidemiológico Guanacaste es el estudio de cohorte de base poblacional de neoplasia cervicouterina más grande del mundo y se espera que sus resultados permitan elaborar en un futuro cercano estrategias preventivas en todo el mundo. Proyectos de investigación como este requieren del compromiso a largo plazo de un numeroso equipo multidisciplinario y de considerables recursos financieros. El intenso esfuerzo y la gran pericia demostrados en todas las facetas de este estudio constituyeron factores clave que explican su éxito como modelo de investigación cooperativa interdisciplinaria sobre el cáncer en América Latina. El control de la calidad desempeñó un papel importante en todas las etapas de la investigación y permitió adaptar las nuevas tecnologías de diagnóstico y tamizaje a las condiciones de Guanacaste. El seguimiento sistemático de un grupo poblacional de aproximadamente 10 000 mujeres de Guanacaste debe permitir una evaluación cuidadosa y cronológica de los factores que diversos autores han asociado con el desarrollo de cáncer cervicouterino, así como la evaluación de marcadores clínicos de la progresión de esta enfermedad. En los resultados publicados de este estudio se definen las técnicas de tamizaje más sensibles y se promueve la utilización de técnicas de tamizaje más asequibles para países en desarrollo y con pocos recursos. Este proyecto también ha aportado información útil para la búsqueda de vacunas contra los VPH, como parte de las iniciativas dirigidas a desarrollar vías eficaces para reducir la incidencia del cáncer cervicouterino y la mortalidad que ocasiona en todo el mundo.
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15.
The snail hosts of schistosomiasis: some evolutionary and ecological perspectives in relation to control
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Despite opportunities for radiation provided by spatio-temporal isolation, the basic morphological plan of pulmonate snails has remained conservative. In consequence of the resulting dearth of morphological characters and their plasticity, there is a case for using biochemical characters such as exogenous chemicals released by the snails (e.g. amino acids) and their chemoreception niche as taxonomic aids to classify snails of medical importance. As these same chemicals are used by snails to distinguish conspecifics they could also be used as "environmental antibodies" in controlled release formulations (CRF's) designed to remove target snails in a specific, cost-effective and ecologically acceptable manner. The snails, surface-living bacteria, algae and macrophytic plants are considered as co-evolved, interactive modular systems with strong mutualistic elements. Recently, anthropogenic perturbations such as deforestation, and damming of flowing waters, have benefited these modules whereas others such as river canalization, acid deposition, accumulation of pesticide residues and eutrophication have harmed them. Research is needed to elucidate the factors which limit the growth of snails in primitive habitats, uninfluenced by man, as well as in those subject to harmful anthropogenic factors. The understanding thus gained could be applied to develop cost-effective primary health care strategies to reduce or prevent transmission of schistosomiasis and other water related diseases.
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