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Abstract Sjogren’s Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients.

https://doi.org/10.1186/s42358-022-00248-1

Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjögren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)
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Trevisani, Virginia Fernandes Moça

; Pinheiro, Aysa César

; Fialho, Sonia Cristina de Magalhães Souza

; Fernandes, Marilena Leal Mesquita Silvestre

; Pugliesi, Alisson

; Pasoto, Sandra Gofinet

; Lopes, Maria Lucia Lemos

; Guedes, Lissiane Karine Noronha

; Miyamoto, Samira Tatiyama

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Fidelix, Tania

; Ribeiro, Sandra Lúcia Euzébio

; Brito, Danielle Christinne Soares Egypto de

; Libório-Kimura, Tatiana Nayara

; Santos, Maria Carmen Lopes Ferreira Silva

; Cantali, Diego Ustárroz

; Gennari, Juliana D.’Agostino

; Capobianco, Karina Gatz

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira da

; Rocha Filho, César Ramos

; Oliveira, Fabiola Reis

; Valim, Valeria

Advances in Rheumatology

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2022, Volume 62 elocation 35

Abstract: En | Text: En | PDF: En

Abstract Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients.

https://doi.org/10.1186/s42358-022-00267-y

2021 recommendations of the Brazilian Society of Rheumatology for the gynecological and obstetric care of patients with Sjogren’s syndrome
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Oliveira, Fabiola Reis

; Valim, Valeria

; Pasoto, Sandra Gofinet

; Fernandes, Marilena Leal Mesquita Silvestre

; Lopes, Maria Lucia Lemos

; Souza Fialho, Sonia Cristina de Magalhães

; Pinheiro, Aysa César

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Fidelix, Tania

; Ribeiro, Sandra Lucia Euzébio

; Brito, Danielle Christinne Soares Egypto de

; Libório, Tatiana

; Santos, Maria Carmen Lopes Ferreira Silva

; Tanure, Leandro

; Gennari, Juliana DAgostino

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Rocha Filho, César Ramos

; Miyamoto, Samira Tatiyama

; Guedes, Lissiane Karine Noronha

; Pugliesi, Alisson

; Trevisani, Virginia Fernandes Moça

Advances in Rheumatology

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2021, Volume 61 elocation 54

Abstract: En | Text: En | PDF: En

Abstract Sjogren’s syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided.

https://doi.org/10.1186/s42358-021-00208-1 54 downloads

Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjögren's syndrome (Part I): glandular manifestations (systematic review)
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Trevisani, Virginia Fernandes Moça

; Pasoto, Sandra Gofinet

; Fernandes, Marilena Leal Mesquita Silvestre

; Lopes, Maria Lucia Lemos

; Fialho, Sonia Cristina de Magalhães Souza

; Pinheiro, Aysa César

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Fidelix, Tania

; Ribeiro, Sandra Lucia Euzébio

; Brito, Danielle Christinne Soares Egypto de

; Libório, Tatiana

; Santos, Maria Carmen Lopes Ferreira Silva

; Tanure, Leandro

; Gennari, Juliana D Agostino

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Oliveira, Fabiola Reis

; Sousa, Jaqueline Martins de

; Miyamoto, Samira Tatiyama

; Valim, Valeria

Advances in Rheumatology

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2019, Volume 59 elocation 58

Abstract: En | Text: En | PDF: En

Abstract Background: Primary Sjögren's syndrome (pSS) is a systemic immune-mediated disease whose main characteristic is exocrine gland inflammation and, subsequent reduction in tear and saliva production. A delayed diagnosis is common due to the nonspecific clinical manifestations of disease. The aim of the present study was to develop recommendations for the diagnosis of glandular manifestations of pSS based on evidence and expert opinion. Main body of the abstract: We conducted a systematic literature review to retrieve the best evidence available on the accuracy of diagnostic tests for pSS. We also held two in-person meetings with experts (rheumatologists, pathologists, ophthalmologists and dentists) to establish their level of agreement using the Delphi method. Ultimately, we generated 18 recommendations that aim to facilitate the diagnosis of the glandular manifestations of pSS. Conclusion: The diagnosis of glandular manifestations of pSS is complex and multidisciplinary. It requires specific knowledge in the field of ophthalmology, immunology, pathology and imaging, making it compulsory for the rheumatologist to work with professionals from these different areas in order to improve accuracy and early diagnosis. Glandular dysfunction tests, ANA, RF, Anti-Ro, protein electrophoresis, urinalysis, blood count, C-Reactive protein, complement, testing for syphilis and viruses (HCV, HIV) and SGUS should be investigated when dryness or systemic manifestation are present. Minor salivary gland biopsy is recommended for all anti-Ro negative or incomplete criteria cases.

https://doi.org/10.1186/s42358-019-0102-8 878 downloads

EXTREME EVENTS, CLIMATE CHANGE AND ADAPTATION IN THE STATE OF SÃO PAULO
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Giulio, Gabriela Marques Di

; Torres, Roger Rodrigues

; Vasconcellos, Maria da Penha

; Braga, Diego R. G. C.

; Mancini, Rosa Maria

; Lemos, Maria Carmen

Ambiente & Sociedade

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2019, Volume 22 elocation e02771

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

Resumo O artigo traz uma análise de dados secundários provenientes do preenchimento de questionários sobre mudanças climáticas e adaptação por agentes municipais que atuam em 332 dos 645 municípios do Estado de São Paulo. Com base em um referencial teórico sobre governança climática urbana, que destaca o papel que os governos locais desempenham na proposição de estratégias para lidar com as mudanças climáticas, o artigo apresenta e discute informações providas pelos agentes municipais sobre a ocorrência de eventos climáticos extremos nos municípios paulistas, os impactos desses eventos, a percepção sobre mudanças climáticas e as ações e respostas. A análise dos dados permite ampliar o conhecimento sobre como o maior estado brasileiro em termos populacionais e econômicos tem avançado no enfrentamento das mudanças climáticas e quais são os principais entraves que dificultam o processo de adaptação das cidades.

Abstract In this paper, we analyze secondary data from surveys focusing on climate change and adaptation in Sao Paulo municipalities. The survey was completed by municipal actors who work in 332 of the 645 municipalities in the State. In this paper, we use a theoretical framework on urban climate governance, which highlights the role that local governments play in proposing strategies to deal with climate change, to present and discuss data related to: 1) the occurrence of extreme climatic events in these municipalities; 2) the impacts of these events; 3) local government actors’ perception about climate change; and 4) local actions and responses. Our analysis of these data significantly contributes to better understanding how cities in the most populous and economically developed state in Brazil perceive, respond and deal with climate change and what critical challenges hamper climate adaptation in these cities.

Resumen El artículo trae el análisis de datos secundarios provenientes del llenado de cuestionarios sobre cambios climáticos y adaptación por agentes municipales que actúan en 332 de los 645 municipios del Estado de São Paulo. Con base en una referencia teórica sobre gobernanza climática urbana, que destaca el papel que los gobiernos locales desempeñan en la proposición de estrategias para lidiar con los cambios climáticos, el artículo presenta y discute informaciones proveídas por los agentes municipales sobre la ocurrencia de eventos climáticos extremos en los municipios paulistas, los impactos de esos eventos, la percepción sobre cambios climáticos y, las acciones y respuestas. El análisis de los datos permite ampliar el conocimiento sobre cómo el mayor estado brasileño en términos poblacionales y económicos ha avanzado en lo enfrentamiento de los cambios climáticos, y qué aspectos críticos dificultan el proceso de adaptación en estas ciudades.

https://doi.org/10.1590/1809-4422asoc0277r1vu19l4ao 2867 downloads

Antibodies anti-trypanosomatides in domestic cats in Paraná: who is at highest risk of infection?
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Matos, Andressa Maria Rorato Nascimento de

; Caldart, Eloiza Teles

; Ferreira, Fernanda Pinto

; Monteiro, Keila Clarine

; Souza, Marielen de

; Brunieri, Déborah Thais Silva Cepelo

; Hilst, Carmen Lúcia Scortecci

; Mascarenhas, Nilva Maria Freres

; Mitsuka-Breganó, Regina

; Freire, Roberta Lemos

; Navarro, Italmar Teodorico

Revista Brasileira de Parasitologia Veterinária

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jun 2018, Volume 27 N. 2 Pages 232 - 236

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

Resumo O objetivo desse estudo foi detectar a presença de anticorpos IgG anti-Leishmania spp. e anti-Trypanosoma cruzi em duas populações de gatos domésticos (Felis catus domesticus) do Norte do Paraná encaminhados para castração cirúrgica e determinar quais as características dos animais estudados que podem estar associadas à soropositividade. Amostras de soro de 679 gatos foram analisadas utilizando-se os testes imunoenzimático (ELISA) e a reação de imunofluorescência indireta (RIFI), em série. Associações entre idade, sexo, raça, ano de atendimento e grupo animal foram verificadas usando regressão logística simples. Um percentual de 8,5% (58/679) dos gatos apresentou positividade para Leishmania spp. e 7,6% (51/673) para T. cruzi pelos testes ELISA e RIFI. Gatos mantidos em organizações não governamentais de proteção animal apresentaram maior sororeatividade para Leishmania spp. (p<0.0001). As sorologias reativas para Leishmania spp. e Trypanosoma cruzi mostram que esses agentes estão presentes em gatos domésticos na parte norte do estado do Paraná, bem como, os proprietários de organizações não governamentais de proteção animal podem estar mais expostos à leishmaniose quando comparados com outros proprietários de animais avaliados no presente estudo.

Abstract The aim of this study were to detect antibodies anti-Leishmania spp. and anti-Trypanosoma cruzi in two different populations of domestic cats (Felis catus domesticus) from North Paraná referred for surgical castration and to determine which characteristics of the animals studied may be associated with seropositivity. Serum samples from 679 cats were analyzed using enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence antibody test (IFAT) in series. Associations between age, sex, race, year of care and animal group were verified using the simple logistic regression. Percentage of 8.5% (58/679) of cats were positive for Leishmania spp. and 7.6% (51/673) for T. cruzi by the tests ELISA and IFAT. Animals collected by non-governmental animal protection organizations presented more seropositivity for Leishmania spp. (p<0.0001). Results shown that Leishmania spp. and T. cruzi are present in domestic cats in the northern part of the state of Paraná, as well as, owners of non-governmental animal protection organizations may be more exposed to leishmaniasis when compared to other animal owners evaluated in the present study.

https://doi.org/10.1590/s1984-296120180033 913 downloads

Carcinoma bem diferenciado de tireoide: perfil epidemiológico, resultados cirúrgicos e resposta oncológica.
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Rocha, Ricardo Mai

; Santos, Maria Carmen Lopes Ferreira Siva

; Musso, Carlos

; Santos, Marco Homero de Sá

; de-Almeida, Marcelo Lemos

; Miguel, Gustavo Peixoto Soares

Revista do Colégio Brasileiro de Cirurgiões

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2018, Volume 45 N. 5 elocation e1934

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

RESUMO Objetivo: conhecer o perfil epidemiológico dos pacientes submetidos à cirurgia do carcinoma bem diferenciado da tireoide no Hospital Universitário Cassiano Antônio Moraes da Universidade Federal do Espírito Santo, assim como os resultados oncológicos e as principais complicações pós-operatórias. Métodos: estudo transversal e retrospectivo de pacientes portadores de carcinoma bem diferenciado da tireoide operados no período de janeiro de 2008 a dezembro de 2015. Resultados: no período do estudo, dos 353 pacientes submetidos a tratamento cirúrgico da glândula tireoide, 95 eram portadores de CBDT. O carcinoma papilífero da tireoide foi o mais frequente (91,57%). A tireoidectomia total não associada a esvaziamento cervical foi o procedimento cirúrgico mais frequente (65,26%). As complicações pós-operatórias ocorreram em 6,31% dos pacientes, sendo o hematoma a mais frequente. O tempo médio de seguimento foi de 36,9 meses. A recidiva ocorreu em quatro pacientes (4,21%), sendo locorregional em todos os casos. Os fatores prognósticos analisados, como sexo, idade, tamanho do tumor, acometimento linfonodal, estadiamento, tipo de cirurgia, histologia e iodoterapia complementar não demonstraram significância estatística. Conclusão: o carcinoma papilífero da tireoide foi a neoplasia maligna mais frequente, acometendo o sexo feminino na faixa etária dos 49 anos mais frequentemente. A recidiva locorregional ocorreu em quatro pacientes. O hematoma foi a complicação mais frequente.

ABSTRACT Objective: to know the epidemiological profile of patients undergoing surgery for well-differentiated thyroid carcinoma at the Cassiano Antônio Moraes University Hospital of the Federal University of Espírito Santo, as well as the oncological results and the main postoperative complications. Methods: we conducted a cross-sectional, retrospective study of patients with well-differentiated thyroid carcinoma (WDTC) operated from January 2008 to December 2015. Results: During the study period, 95 of the 353 patients undergoing surgical treatment of the thyroid gland had WDTC. Papillary carcinoma was the most frequent (91.57%). Total thyroidectomy not associated with cervical emptying was the most frequent surgical procedure (65.26%). Postoperative complications occurred in 6.31% of patients, hematoma being the most frequent. The mean follow-up time was 36.9 months. Relapse occurred in four patients (4.21%), being locoregional in all cases. The prognostic factors analyzed, such as gender, age, tumor size, lymph node involvement, staging, type of surgery, histology and complementary iodine therapy did not show statistical significance. Conclusion: papillary carcinoma was the most common thyroid malignant neoplasm, affecting women in the 49-year-old age group more frequently. Loco-regional recurrence occurred in four patients. Hematoma was the most frequent complication.

https://doi.org/10.1590/0100-6991e-20181934 7661 downloads

Adaptação climática: Fronteiras do conhecimento para pensar o contexto brasileiro
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GIULIO, GABRIELA MARQUES DI

; MARTINS, ANA MARIA BEDRAN

; LEMOS, MARIA CARMEN

Estudos Avançados

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dec 2016, Volume 30 N. 88 Pages 25 - 41

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

RESUMO No campo das Dimensões Humanas das Mudanças Climáticas existe um rico debate ancorado particularmente em arcabouços teóricos das ciências sociais sobre como as respostas que emergem para lidar com a questão climática estão intrinsecamente relacionadas a aspectos e configurações locais que interferem, em maior ou menor grau, nos processos adaptativos de diferentes sistemas. Outras possibilidades teórico-analíticas, também focadas em adaptação, vulnerabilidade e capacidade adaptativa, buscam intersecções com a literatura sobre resiliência e desenvolvimento sustentável. Neste artigo, as autoras partem de uma revisão crítica dessas perspectivas para pensar o contexto brasileiro e os processos de ajustamentos necessários para antecipar e responder aos impactos associados às mudanças climáticas nas cidades. A partir de uma reflexão sobre estudos conduzidos em diferentes localidades no país, indica-se a necessidade de um olhar sobre um conjunto de variáveis críticas (e as possíveis associações entre elas) em futuras pesquisas focadas na análise do contexto brasileiro.

ABSTRACT The field of the Human Dimensions of Climate Change there is a rich debate grounded in the theoretical frameworks of the Social Science on how responses to climate change are intrinsically related to local factors and determinants that shape adaptive processes in different systems. Other theoretical-analytical possibilities, also focused on adaptation, vulnerability and adaptive capacity, have sought to explore intersections with the literatures on resilience and sustainable development. In this paper, the authors provide a critical review of these theoretical perspectives, and propose a reflection on the Brazilian context and the adjustment processes needed to anticipate and respond to climate impact in the cities. Drawing on empirical studies in Brazil, the authors of this paper advocate the need for a set of critical variables (and an analysis of possible synergies and tradeoffs amongst them) in future studies focused on analyzing the Brazilian context.

https://doi.org/10.1590/s0103-40142016.30880004 4426 downloads

DIVERSIDAD DE MARIPOSAS DIURNAS (INSECTA: LEPIDÓPTERA) DE UN BOSQUE SUBANDINO, CAJIBÍO, CAUCA
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Vélez Lemos, Diana Marcela

; Gallego-Ropero, María Cristina

; Riascos Forero, Yilton

Boletín Científico. Centro de Museos. Museo de Historia Natural

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jun 2015, Volume 19 N. 1 Pages 263 - 285

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

En el departamento del Cauca aún persisten algunos pequeños fragmentos de bosque subandino. La reserva natural "Raíces de Vida", colegio Carmen de Quintana (Cajibío, Cauca), cuenta con uno de estos fragmentos pero se encuentra influenciado por zonas con propósitos agropecuarios, lo cual hizo urgente la necesidad de investigar su estado para implementar a tiempo estrategias educativas, que ayuden a tomar decisiones en cuanto a su manejo, con este objetivo se realizó un muestreo de la comunidad de lepidópteros diurnos para ser utilizado como parámetro biológico. Con los datos obtenidos de la riqueza y abundancia de los lepidópteros, se realizó un análisis de cómo esta comunidad se encuentra asociada al estado del bosque. Se registró un total de 785 mariposas, distribuidas en 80 especies, pertenecientes a la superfamilia Papilionioidea y representadas por cuatro familias Pieridae, Hesperiidae, Nymphalidae y Lycaenidae. En total se encontraron 14 especies indicadoras de ecosistemas perturbados, entre ellas Leptophobia aripa, Anartia amathea, Euptychia hermes y Phoebis sennae, y del buen estado del bosque especies como Manataria maculata, Pseudohaetera hypaesia, Taygetis chrysogone, Memphis lyceus y Heliconius erato chestertoni. Estos resultados permiten sugerir que este fragmento de bosque se encuentra en un estado sucesional intermedio, lo que hace de este un espacio importante de conservación y educación ambiental.

In the department of Cauca, still remains small fragments sub-Andean forest persist. The nature reserve "Raíces de Vida" (Roots of Life) of the school "Carmen Quintana", at Cajibío (Cauca), has one of these fragments but influenced by areas of agricultural uses. This prompted a need for investigate the actual state in order to define and, if needed, implement educational and management strategies. With this objective in mind, a sampling of diurnal Lepidoptera community (as a biological indicator) was carried out. Analyses of data of richness and abundance of Lepidoptera allowed to defined how this insect community is associated with the state of the forest. A total of 785 butterflies, grouped in 80 species, was recorded. Specimens belong to the superfamily Papilionioidea and represent four families: Pieridae, Hesperiidae, Nymphalidae and Lycaenidae. A total of 14 species, indicators of disturbed ecosystems, include Leptophobia aripa, Anartia amathea, Euptychia hermes and Phoebis sennae. On the other hand, a good forest species like Manataria maculata, Pseudohaetera hypaesia, Taygetis chrysogone, Memphis lyceus and Heliconius erato chestertoni were found. Results suggest that this small forest fragment is under an intermediate successional stage, hence representing an important area for conservation and environmental education strategies.

https://doi.org/10.17151/bccm.2015.19.1.20 1271 downloads

10.

The use of ablative lasers in the treatment of facial melasma
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Morais, Orlando Oliveira de

; Lemos, Érica Freitas Lima

; Sousa, Márcia Carolline dos Santos

; Gomes, Ciro Martins

; Costa, Izelda Maria Carvalho

; Paula, Carmen Déa Ribeiro de

Anais Brasileiros de Dermatologia

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apr 2013, Volume 88 N. 2 Pages 238 - 242

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

O melasma representa desordem pigmentar de difícil tratamento. O presente estudo tem como propósito apresentar ampla revisão da literatura acerca do uso de laser ablativos (Er:YAG e CO2) no tratamento do melasma, estabelecendo o nível de evidência dos estudos publicados até o instante. Um total de 75 pacientes foram envolvidos entre quatro séries de casos (n=39), um ensaio clínico controlado (n=6) e um ensaio clínico controlado e randomizado (n=30). Os estudos acerca do laser de Er:YAG demonstraram melhores resultados com o uso de pulsos de forma quadrada, os quais determinaram menores taxas de hiperpigmentação pós-inflamatória. Ademais, os estudos com laser de CO2 também demonstraram benefício no uso de pulsos curtos com baixa densidade de energia. O uso de cremes despigmentantes no período pós-tratamento se mostrou necessária e efetiva na manutenção de resultados à longo prazo. Os lasers ablativos, por conseguinte, podem representar ferramenta efetiva e de grande utilidade no manejo do melasma. Entretanto, hiperpigmentação pós-inflamatória e dificuldade na manutenção de resultados à longo prazo parecem representar as principais limitações atuais ao seu amplo uso. Por conseguinte, com base nas atuais evidências, o uso de tais tecnologias ainda deve ser restrita à casos de doença recalcitrante. Novos estudos ainda são necessários para o estabelecimento de parâmetros e regimes ideais de tratamento.

Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.

https://doi.org/10.1590/S0365-05962013000200009 13889 downloads

11.

Prevalence of celiac disease among blood donors in São Paulo: the most populated city in Brazil
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Alencar, Marília Lage

; Ortiz-Agostinho, Carmen Lucia

; Nishitokukado, lêda

; Damião, Adérson O.M.C.

; Abrantes-Lemos, Clarice P.

; Leite, André Zonetti de Arruda

; Brito, Thales de

; Chamone, Dalton de Alencar Fischer

; Silva, Maria Elizabeth Rossi da

; Giannella-Neto, Daniel

; Sipahi, Aytan Miranda

Clinics

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sep 2012, Volume 67 N. 9 Pages 1013 - 1018

Abstract: En | Text: En | PDF: En

OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which leads to an immunemediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. São Paulo city is one of the largest cities in the world, with a vast population and an important history of internal migratory flow from other Brazilian regions, as well as immigration from other, primarily European, countries, resulting in significant miscegenation. The aim of the present study was to estimate the prevalence of adults with undiagnosed celiac disease among blood donors of São Paulo by collecting information on the ancestry of the population studied. METHODS: The prevalence of celiac disease was assessed by screening for positive IgA transglutaminase and IgA endomysium antibodies in 4,000 donors (volunteers) in the Fundação Pró-Sangue Blood Center of São Paulo, São Paulo, Brazil. The antibody-positive subjects were asked to undergo a small bowel biopsy. RESULTS: Of the 4,000 subjects, twenty-four had positive tests, although both antibody tests were not always concordant. For example, ten subjects were positive for IgA tissue transglutaminase only. In twenty-one positive patients, duodenal biopsies were performed, and the diagnosis of celiac disease was confirmed in fourteen patients (Marsh criteria modified by Oberhuber). In this group, 67% claimed to have European ancestry, mainly from Italy, Portugal and Spain. CONCLUSION: The prevalence of celiac disease is at least 1:286 among supposedly healthy blood bank volunteers in São Paulo, Brazil.

https://doi.org/10.6061/clinics/2012(09)05 3305 downloads Cited 6 times in SciELO

12.

Inclusão, deliberação e controle: três dimensões dedemocracia nos comitês e consórcios de bacias hidrográficas no Brasil
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Abers, Rebecca Neaera

; Formiga-Johnsson, Rosa Maria

; Frank, Beate

; Keck, Margaret Elizabeth

; Lemos, Maria Carmen

Ambiente & Sociedade

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jun 2009, Volume 12 N. 1 Pages 115 - 132

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

Este trabalho avalia o efeito democratizante da governança participativa na gestão das águas, a partir de uma pesquisa junto a 626 membros de 14 comitês e 4 consórcios de bacias hidrográficas. A noção de democracia é examinada segundo três noções: a) as arenas participativas devem promover a inclusão e combater a dominação das elites; b) a participação deve promover um processo dinâmico capaz de modificar a compreensão dos participantes; e c) as arenas participativas devem garantir maior controle social do Estado. Sugere-se que comitês e consórcios são mais bem sucedidos como espaços deliberativos. Desigualdades sociais afetam, mas não impedem um processo deliberativo.

Based on a survey of 626 committee and consortium members in 18 river basins, this study evaluates the democratizing effect of stakeholder governance in water resources management in Brazil. The term democracy is examined according to three ideas: a) participatory arenas should promote political inclusion and combat elite domination; b) participation must involve a dynamic process of interaction that transforms the understandings of those who participate; c) participatory arenas should guarantee a greater control over the state by the society. The paper suggests that the committees and consortia work better as deliberative spaces. Social inequalities among members affect but do not hinder the deliberative process.

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13.

Frequency of 677C -> T and 1298A -> C polymorphisms in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene in Turner syndrome individuals
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Santos, Kelly

; Lemos-Marini, Sofia H.V.

; Baptista, Maria T.M.

; Bonadia, Luciana Cardoso

; Pinto Júnior, Walter

; Bertuzzo, Carmen Sílvia

Genetics and Molecular Biology

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2006, Volume 29 N. 1 Pages 41 - 44

Abstract: En | Text: En | PDF: En

Turner syndrome (TS) is an interesting model for investigating the association between methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and non-disjunction because of the high frequency of chromosomal mosaicism among patients with this syndrome. We determined the frequencies of MTHFR 677C -> T and 1298A -> C polymorphic mutations in 49 patients with TS and 200 control individuals. The frequency of the 677C -> T allele was 0.39 for patients and 0.29 for controls while that of the 1298A -> C allele was 0.28 for patients and 0.25 for controls. Genotype frequencies were shown to be different in patients and controls (chi2 = 12.143; p = 0.033), and this was attributable to the higher frequency of the C677C -> T /677C -> T genotype among TS patients. In homozygotes, this mutation might have an effect on somatic chromosome disjunction by decreasing MTHFR activity.

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