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Abstract Background: Small cell lung cancer (SCLC) represents 13-15% of all primary lung neoplasms and is characterized by rapid growth rate and development of distant metastases. Objectives: To guide and standardize the treatment of limited disease small cell lung cancer in Mexico based on national and international clinical evidence. Material and methods: This document was developed as a collaboration between the National Cancer Institute and the Mexican Society of Oncology in compliance with international standards. An interdisciplinary group was formed, including medical oncologists, oncological surgeons, thoracic surgeons, radiation oncologists, and methodologists with experience in systematic reviews of the literature and clinical practice guidelines. Results: Consensus recommendations were reached, both by the Delphi method and in remote meetings, for limited SCLC disease resulting from the same number of work questions. The scientific evidence that answers each of these clinical questions was identified and critically evaluated, before being incorporated into the body of evidence of the guide. Conclusion: This guide provides clinical recommendations for the management of limited disease SCLC to contribute to the decision-making process of the clinicians involved with its management in our country, hoping that this will contribute to improving the quality of clinical care in these patients.

Resumen Antecedentes: El cáncer de células pequeñas (CPCP) representa el 13-15% del total de neoplasias primarias de pulmón. Se caracteriza por su rapidez en la tasa de crecimiento y en el desarrollo de metástasis a distancia. Objetivos: Orientar y estandarizar el tratamiento del CPCP, enfermedad limitada, en México, basado en evidencia clínica nacional e internacional. Material y métodos: Este documento se desarrolló como una colaboración entre el Instituto Nacional de Cancerología y la Sociedad Mexicana de Oncología en cumplimiento con estándares internacionales. Se integró un grupo conformado por oncólogos médicos, cirujanos oncólogos, cirujanos de tórax, radio-oncólogos y metodólogos con experiencia en revisiones sistemáticas de la literatura y guías de práctica clínica. Resultados: Se consensuaron, por el método Delphi y en reuniones a distancia, las recomendaciones en CPCP enfermedad limitada, producto de las preguntas de trabajo. Se identificó y evaluó críticamente la evidencia científica que responde a cada una de dichas preguntas clínicas, antes de incorporarla a la guía. Conclusión: Esta guía proporciona recomendaciones clínicas para el manejo de la enfermedad limitada del CPCP y durante el proceso de toma de decisiones de los clínicos involucrados con su manejo en nuestro país para mejorar la calidad de la atención clínica en estos pacientes.

https://doi.org/10.24875/j.gamo.22000121

Qualidade microbiológica de ostras e de águas em manguezais de macromaré da costa amazônica (ilha de São Luís, MA), Brasil
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de Sousa, Claudio Baltazar

; Costa, Francisca Neide

; da Silva Almeida Funo, Izabel Cristina

; Freitas, Arlan Silva

; Barros, Tatiana Magalhães

Engenharia Sanitaria e Ambiental

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2023, Volume 28 elocation e20220051

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

Resumo Com o objetivo de avaliar a qualidade microbiológica de águas e ostras de bancos naturais e ostreiculturas localizados na ilha de São Luís (MA), foram analisadas no período de setembro de 2020 a fevereiro de 2021 60 amostras, sendo 30 de água e 30 de ostras (Crassostrea sp.), coletadas diretamente com os marisqueiros e proprietários de cultivos nos municípios da ilha de São Luís. Para a determinação de coliformes totais e Escherichia coli nas amostras de água, foi utilizado o método rápido Colilert®. A contagem de coliformes totais e termotolerantes em ostras foi realizada pelo método do número mais provável (NMP) e de E. coli por testes bioquímicos (Indol, VM, VP, Citrato). A enumeração de Staphylococcus coagulase positiva ocorreu pelo meio Baird Parker para isolamento e identificação, assim como por testes bioquímicos. A média geométrica do resultado da contagem de E. coli nas amostras de água variou entre 604,3 e 1.130,8 NMP/100 mL, indicando qualidade microbiológica insatisfatória. Quanto às amostras de ostras, oito (26,7%) das 30 amostras estavam impróprias para consumo, sendo quatro (13,3%) contaminadas por Salmonella sp. e E. coli, respectivamente. Segundo a Resolução da Diretoria Colegiada nº 331/19 e a Instrução Normativa nº 60 da Agência Nacional de Vigilância Sanitária, os resultados são preocupantes para a saúde pública, e recomendam-se ações mitigadoras, como o monitoramento regular da qualidade microbiológica da água.

ABSTRACT In order to evaluate the microbiological quality of water and oysters from natural banks and oyster farms located on the Island of São Luís, Maranhão (MA), 60 samples were analyzed from September 2020 to February 2021, 30 of water and 30 of oysters (Crassostrea sp.), collected directly from shellfish farmers and owners of oyster farms in the municipalities of the Island of São Luís, MA. For the determination of total coliforms and Escherichia coli in the water samples the Colilert® rapid method was used. For the enumeration of total and thermotolerant coliforms in oysters the Most Probable Number (MPN) method was used and E. coli by biochemical tests (Indol, MV, VP, Citrate). The enumeration of coagulase positive Staphylococcus was performed using Baird Parker medium for isolation and identification, as well as biochemical tests. The geometric mean result of E. coli counts in the water samples ranged from 604.3 to 1,130.8 MPN/100mL, indicating unsatisfactory microbiological quality. As for the oyster samples, 8 (26.7%) out of 30 samples were unfit for consumption, and 4 (13.3%) were contaminated by Salmonella sp. and E. coli, respectively. According to RDC No. 331/19 and IN No. 60 of ANVISA, the results are worrisome for public health and mitigating actions are recommended, such as regular monitoring of the microbiological quality of the water.

https://doi.org/10.1590/s1413-415220220051

Main and moderated effects of multimorbidity and depressive symptoms on cognition
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de Araujo, Jacyra Azevedo Paiva

; Xavier, Érika Fialho Morais

; Rodrigues, Elisângela da Silva

; Machado, Daiane Borges

; Barreto, Marcos E.

; Kanaan, Richard A.

; Barreto, Mauricio L.

; Castro-de-Araujo, Luis Fernando Silva

Brazilian Journal of Psychiatry

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dec 2022, Volume 44 N. 6 Pages 644 - 649

Abstract: En | Text: En | PDF: En

Objective: Multimorbidity, or the occurrence of two or more chronic conditions, is a global challenge, with implications for mortality, morbidity, disability, and life quality. Psychiatric disorders are common among the chronic diseases that affect patients with multimorbidity. It is still not well understood whether psychiatric symptoms, especially depressive symptoms, moderate the effect of multimorbidity on cognition. Methods: We used a large (n=2,681) dataset to assess whether depressive symptomatology moderates the effect of multimorbidity on cognition using structural equation modelling. Results: It was found that the more depressive symptoms and chronic conditions, the worse the cognitive performance, and the higher the educational level, the better the cognitive performance. We found a significant but weak (0.009; p = 0.04) moderating effect. Conclusion: We have provided the first estimate of the moderating effect of depression on the relation between multimorbidity and cognition, which was small. Although this moderation has been implied by many previous studies, it was never previously estimated.

https://doi.org/10.47626/1516-4446-2022-2601

Evaluación de sustratos y tratamientos para mitigar el estrés hídrico en una plantación de Enterolobium cyclocarpum (Jacq.) Griseb.
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Botello Montoya, Adrián

; Alanís Rodríguez, Eduardo

; Sigala Rodríguez, José Ángel

; Silva García, Jesús Eduardo

; Ruiz Carranza, Luis Daniel

Revista mexicana de ciencias forestales

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dec 2022, Volume 13 N. 74 Pages 77 - 96

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

Abstract Enterolobium cyclocarpum is a multipurpose tree species whose growth and survival in plantations are unknown. The objective was to evaluate the effect of different nursery growing media and auxiliary treatments to mitigate water stress on the performance of E. cyclocarpum plants established in the field. The seeds were sown in three different types of substrates: 1) base mixture (peat, vermiculite and agrolite), 2) aerobic compost and 3) native soil. Each group of plants by type of substrate was divided into four subgroups that were assigned different auxiliary treatment to mitigate water stress: 1) irrigation, 2) hydrogel (2 g plant-1), 3) hydrogel (4 g plant-1) and 4) natural conditions (control). The results indicate that the type of substrate influences the survival and growth of the plants, being native soil the one that promotes higher values. It was found that there is a positive relationship between the diameter of the plants and the probability of survival, this variable being a basic quality indicator of the plants grown in the nursery. The auxiliary treatment of hydric stress significantly affected the growth in diameter and height, being irrigation the one that increased the values, with the exception of the diameter in the base mixture.

Resumen Enterolobium cyclocarpum es una especie arbórea multipropósito cuyo crecimiento y supervivencia en plantaciones se desconoce. El objetivo fue evaluar el efecto de tres medios de crecimiento en vivero y tratamientos auxiliares para mitigar el estrés hídrico en el desempeño de plantas de E. cyclocarpum establecidas en campo. Las semillas se sembraron en tres diferentes tipos de sustrato: 1) mezcla base (turba, vermiculita y agrolita), 2) composta aeróbica, y 3) tierra de monte. Cada grupo de plantas por tipo de sustrato se dividió en cuatro subgrupos a los que se les asignó diferente tratamiento auxiliar para mitigar el estrés hídrico: 1) riego, 2) hidrogel (2 g planta-1), 3) hidrogel (4 g planta-1), y 4) condiciones naturales (testigo). Los resultados indican que el tipo de sustrato influye en la supervivencia y crecimiento de las plantas, siendo la tierra de monte la que promueve mayores valores. La relación entre el diámetro de plantas con la probabilidad de supervivencia fue positiva; esta variable es un indicador de la supervivencia en campo durante los primeros años de la plantación. El tratamiento auxiliar para mitigar el estrés hídrico afectó significativamente el crecimiento en diámetro y altura; el riego aumentó los valores, con excepción del diámetro en mezcla base.

https://doi.org/10.29298/rmcf.v13i74.1272

Normal aortic diameters within the Mexican population and the impact of gender and ethnicity
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Fabiani, Mario A.

; González-Urquijo, Mauricio

; Silva-Platas, Christian

; Carrillo-Martínez, Miguel Á.

; Herrera-Vegas, Diego

; Morelli, Luis

; Vaquero-Puerta, Carlos

; Montero-Baker, Miguel

; Schonholtz, Claudio

; Hinojosa-González, David E.

; Mosquera-Anchorena, Nilo

; Reijnen, Michel

Revista mexicana de angiología

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sep 2022, Volume 50 N. 3 Pages 90 - 95

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

Resumen Antecedentes: Faltan estudios que describan el tamaño normal de la aorta en población mexicana. Objetivos: Analizar las medidas aórticas en pacientes mexicanos y compararlas con pacientes de cinco países diferentes. Métodos: Las medidas de la aorta se dividieron en mexicanos y controles. Se realizó una comparación entre etnias y grupos mediante la prueba de suma de rangos de Mann Whitney. Resultados: El registro incluyó a 166 pacientes, 106 (63.8%) eran de México y 60 (36.1%) en el grupo control. Los pacientes mexicanos tenían diámetros aórticos más pequeños en comparación con el grupo control, a nivel del ostium de la arteria renal derecha, la arteria mesentérica inferior y la bifurcación aórtica. La población hispana tenía diámetros aórticos significativamente más pequeños desde el nivel de la arteria celíaca hasta la bifurcación aórtica. Conclusión: Los diámetros aórticos normales en la población mexicana son menores en comparación con otros países.

Abstract Background: There is a lack of studies describing the normal size of the aorta in Mexican population. Objective: To analyze aortic measurements in Mexican patients and to compared them with patients from five different countries. Methods: Measurements of the aorta were divided in Mexicans and controls. Comparisons between ethnicities and groups were performed using Mann Whitney rank sum test. Results: The registry included 166 patients, 106 (63.8%) were enrolled in Mexico and 60 (36.1%) in the control group. Mexican patients had smaller aortic diameters compared to the control group, at the level of the right renal artery ostium, inferior mesenteric artery, and aortic bifurcation. The Hispanic population had significantly smaller aortic diameters from the level of the celiac artery to the aortic bifurcation. Conclusion: The normal aortic diameters in the Mexican population are smaller compared to other countries.

https://doi.org/10.24875/rma.22000026 2 downloads

Molecular characterization of Encaria inaron (Walker, 1839) naturally associated with Bemisia tabaci (Gennadius, 1889) in Brazil
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Cirino, Thaís Carolina Silva

; Alvarez, Daniel de Lima

; Costa, Valmir Antonio

; Müller, Cristiane

; Watanabe Maranho, Luís Fernando

; De Marchi, Bruno Rossitto

; Bello, Vinicius Henrique

; Sakate, Renate Krause

; de Oliveira, Regiane Cristina

Idesia (Arica)

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mar 2022, Volume 40 N. 1 Pages 95 - 99

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

ABSTRACT: This work is the first record of Encarsia inaron (Walker, 1839) (Hymenoptera: Aphelinidae) parasitizing Bemisia tabaci (Gennadius, 1889) (Hemiptera: Aleyrodidae) on soybeans in Brazil. Morphological and molecular characterizations are provided, in addition to verification of the presence of E. inaron in areas infested by whiteflies, indicating that the wasp can potentially be used in integrated management programs. Additionally to morphological verification, the molecular analysis allowed the identification of some degree of genetic variability in the genome of the parasitoid.

RESUMEN: Este es el primer registro de Encarsia inaron (Walker, 1839) (Hymenoptera: Aphelinidae) parasitando Bemisia tabaci (Gennadius, 1889) (Hemiptera: Aleyrodidae) en soja en Brasil. Se proporcionan caracterizaciones morfológicas y moleculares, además de la verificación de la presencia de E. inaron en áreas infestadas por mosca blanca, lo que indica que la avispa puede potencialmente ser utilizada en programas de manejo integrado. Además de la verificación morfológica, el análisis molecular permitió identificar algún grado de variabilidad genética en el genoma del parasitoide.

80 downloads

Resistência microbiana a medicamentos em uma Instituição de Longa Permanência para Idosos
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Silva, João Luis Almeida da

; Silva, Myria Ribeiro da

; Ferreira, Sônia Maria Isabel Lopes

; Rocha, Roseanne Montargil

; Barbosa, Dulce Aparecida

Acta Paulista de Enfermagem

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2022, Volume 35 elocation eAPE03751

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

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.

Resumen Objetivo Caracterizar los microorganismos y su susceptibilidad antimicrobiana en urocultivos de adultos mayores residentes en una institución de larga estadía. Métodos Estudio observacional transversal con 116 individuos de una institución de larga estadía para adultos mayores de un municipio del sur del estado de Bahia. El estudio fue aprobado por el Comité de Ética de Investigación y se utilizó Consentimiento Informado. Se obtuvieron muestras de orina, con las cuales se realizó análisis de laboratorio tipo I y urocultivo. Se realizaron pruebas de sensibilidad a antimicrobianos según los criterios del European Committee on Antimicrobial Susceptibility Testing. Para el diagnóstico de infección del tracto urinario, se utilizaron los criterios de McGeer. El análisis de datos se obtuvo mediante estadística descriptiva, con frecuencias absolutas y relativas. Resultados La prevalencia de infección del tracto urinario fue del 33,62 %, con predominancia del sexo femenino y edad superior a 80 años. Los uropatógenos fueron: 69,2 % Escherichia coli, 20,6 % Klebsiella pneumoniae y 5,1 % Providencia stuartii y Acinetobacter baumannii. Las cepas de E. coli presentaron susceptibilidad en la mayor parte de los antimicrobianos, en las de K. pneumoniae, la susceptibilidad fue variable. P. stuartii y A. baumannii no presentaron resistencia a carbapenémicos ni a los betalactámicos aztreonam y piperacilina asociados a tazobactam. Conclusión Las cepas más prevalentes y el perfil de susceptibilidad presentaron un patrón parecido al hospitalario, lo que implica la necesidad de que la institución promueva mejores estrategias de control de infecciones e involucre al equipo de enfermería en la gestión de los casos y en la cualificación de la prescripción antimicrobiana para reducir la resistencia bacteriana y los efectos adversos en los adultos mayores.

https://doi.org/10.37689/acta-ape/2022ao03751

Consenso de leucemia mieloide aguda en México
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Arana-Luna, Luara L.

; Alvarado-Ibarra, Martha

; Silva-Michel, Luis G.

; Morales-Maravilla, Adrián

; González-Rubio, María del C.

; Chávez-Aguilar, Lénica A.

; Tena-Iturralde, María Fernanda

; Mojica-Balceras, Liliana

; Zapata-Canto, Nidia

; Galindo-Delgado, Patricia

; Miranda-Madrazo, María Raquel

; Morales-Hernández, Alba E.

; Silva-Vera, Karina

; Grimaldo-Gómez, Flavio A.

; Hernández-Caballero, Álvaro

; Bates-Martin, Ramón A.

; Álvarez-Vera, José L.

; Tepepa-Flores, Fredy

; Teomitzi-Sánchez, Óscar

; Fermín-Caminero, Denisse J.

; Peña-Celaya, José A. de la

; Salazar-Ramírez, Óscar

; Flores-Villegas, Luz V.

; Guerra-Alarcón, Lidia V.

; Leyto-Cruz, Faustino

; Inclán-Alarcón, Sergio I.

; Milán-Salvatierra, Andrea I.

; Ventura-Enríquez, Yanet

; Pérez-Lozano, Uendy

; Báez-Islas, Pamela E.

; Tapia-Enríquez, Ana L.

; Palma-Moreno, Orlando G.

; Aguilar-Luévano, Jocelyn

; Espinosa-Partida, Arturo

; Pérez-Jacobo, Luis F.

; Rojas-Castillejos, Flavio

; Ruiz-Contreras, Josué I.

; Loera-Fragoso, Sergio J.

; Medina-Coral, Jesús E.

; Acosta-Maldonado, Brenda L.

; Soriano-Mercedes, Emely J.

; Saucedo-Montes, Erick E.

; Valero-Saldana, Luis M.

; González-Prieto, Susana G.

; Nava-Villegas, Lorena

; Hernández-Colin, Ana K.

; Hernández-Alcántara, Areli E.

; Zárate-Rodríguez, Pedro A.

; Ignacio-Ibarra, Gregorio

; Meillón-García, Luis A.

; Espinosa-Bautista, Karla A.

; Ledesma de la Cruz, Cindy

; Barbosa-Loría, Diego M.

; García-Castillo, Carolina

; Balderas-Delgado, Carolina

; Cabrera-García, Álvaro

; Pérez-Zúñiga, Juan M.

; Hernández-Ruiz, Eleazar

; Villela-Peña, Atenas

; Gómez Cortés, Sue Cynthia

; Romero-Rodelo, Hilda

; Garzón-Velásquez, Katheryn B.

; Serrano-Hernández, Cristina

; Martínez-Ríos, Annel

; Pedraza-Solís, María Luisa

; Martínez-Coronel, Jorge A.

; Narváez-Davalos, Iris M.

; García-Camacho, Alinka S.

; Merino-Pasaye, Laura E.

; Aguilar-Andrade, Carolina

; Aguirre-Domínguez, Juan A.

; Guzmán-Mera, Pedro G.

; Delgado-de la Rosa, Elizabeth

; Flores López, Perla E.

; González-Aguirre, Lilia L.

; Ramírez-Alfaro, Edgar M.

; Vera-Calderón, Heidi

; Meza-Dávalos, María Lizeth

; Murillo-Cruz, Juan

; Pichardo-Cepín, Yayra M.

; Ramírez-Romero, Eva F.

Gaceta médica de México

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2022, Volume 158 N. spe3 Pages M1 - M51

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

Abstract Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.

resumen está disponible en el texto completo

https://doi.org/10.24875/gmm.m21000597 895 downloads

First record of Eumops glaucinus (Wager, 1843) (Chiroptera, Molossidae) to the Brazilian state of Maranhão
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Cardoso, Fábio Henrique de Souza

; Lima, Amanda Cristiny da Silva

; Costa, Cleison Luis da Silva

; Mendes, Samira Brito

; Olímpio, Ana Priscila Medeiros

; Fraga, Elmary da Costa

; Barros, Maria Claudene

Papéis Avulsos de Zoologia

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2022, Volume 62 elocation e202262064

Abstract: En | Text: En | PDF: En

Abstract The study provides the first record of Eumops glaucinus in the Maranhão state, located in the northern region of Brazil. The collected specimen was a non-lactating adult female, with grayish pelage, broad ears, smooth face, a well-developed and squarish tragus, and elongated snout. The combined analysis of the morphological and molecular data (COI, Cyt b, and rRNA 16S genes) confirmed the occurrence of E. glaucinus in the state of Maranhão. This record extends the known species range area by 660 km easternward from the closest locality, Belém, Pará.

https://doi.org/10.11606/1807-0205/2022.62.064

10.

Validação de um Algoritmo de Inteligência Artificial para a Predição Diagnóstica de Doença Coronariana: Comparação com um Modelo Estatístico Tradicional
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Correia, Luis

; Lopes, Daniel

; Porto, João Vítor

; Lacerda, Yasmin F.

; Correia, Vitor C. A.

; Bagano, Gabriela O.

; Pontes, Bruna S. B.

; Melo, Milton Henrique Vitoria de

; Silva, Thomaz E. A.

; Meireles, André C

Arquivos Brasileiros de Cardiologia

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dec 2021, Volume 117 N. 6 Pages 1061 - 1070

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

Resumo Fundamento: A análise prognóstica multivariada tem sido realizada tradicionalmente por modelos de regressão. No entanto, muitos algoritmos surgiram, capazes de traduzir uma infinidade de padrões em probabilidades. A acurácia dos modelos de inteligência artificial em comparação à de modelos estatísticos tradicionais não foi estabelecida na área médica. Objetivo: Testar a inteligência artificial como um algoritmo preciso na predição de doença coronariana no cenário de dor torácica aguda, e avaliar se seu desempenho é superior a do modelo estatístico tradicional. Métodos: Foi analisada uma amostra consecutiva de 962 pacientes admitidos com dor torácica. Dois modelos probabilísticos de doença coronariana foram construídos com os primeiros 2/3 dos pacientes: um algoritmo machine learning e um modelo logístico tradicional. O desempenho dessas duas estratégias preditivas foi avaliado no último terço de pacientes. O modelo final de regressão logística foi construído somente com variáveis significativas a um nível de significância de 5%. Resultados: A amostra de treinamento tinha idade média de 59 ± 15 anos, 58% do sexo masculino, e uma prevalência de doença coronariana de 52%. O modelo logístico foi composto de nove preditores independentes. O algoritmo machine learning foi composto por todos os candidatos a preditores. Na amostra teste, a área sob a curva ROC para predição de doença coronariana foi de 0,81 (IC95% = 0,77 – 0,86) para o algoritmo machine learning, similar à obtida no modelo logístico (0,82; IC95% = 0,77 – 0,87), p = 0,68. Conclusão: O presente estudo sugere que um modelo machine learning acurado não garante superioridade à um modelo estatístico tradicional

Abstract Background: Multivariate prognostic analysis has been traditionally performed by regression models. However, many algorithms capable of translating an infinity of patterns into probabilities have emerged. The comparative accuracy of artificial intelligence and traditional statistical models has not been established in the medical field. Objective: To test the artificial intelligence as an accurate algorithm for predicting coronary disease in the scenario of acute chest pain and evaluate whether its performance is superior to traditional statistical model. Methods: A consecutive sample of 962 patients admitted with chest pain was analyzed. Two probabilistic models of coronary disease were built using the first two-thirds of patients: a machine learning algorithm and a traditional logistic model. The performance of these two predictive strategies were evaluated in the remaining third of patients. The final logistic regression model had significant variables only, at the 5% significance level. Results: The training sample had an average age of 59 ± 15 years, 58% males, and a 52% prevalence of coronary disease. The logistic model was composed of nine independent predictors. The machine learning algorithm was composed of all candidates for predictors. In the test sample, the area under the ROC curve for prediction of coronary disease was 0.81 (95% CI = 0.77 - 0.86) for the machine learning algorithm, similar to that obtained in logistic model (0.82; 95% CI = 0.77 - 0.87), p = 0.68. Conclusion: The present study suggests that an accurate machine learning prediction tool did not prove to be superior to the statistical model of logistic regression.

https://doi.org/10.36660/abc.20200302 2 downloads

11.

Pathologic findings on ruminant enteric clostridial diseases reveal specificities and differences among iota and iota-like toxins
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Brito, Hélio S.

; Alencar, Fernando C.

; Alburquerque, Benedito

; Silva, Marcos G.

; Félix, Mellanie K.C.

; Mulholland, Daniel S.

; Oliveira, Eugênio E.

; Mariúba, Luis Andre M.

; Santos, Eliane M. S.

; Brandi, Igor V.

; Lobato, Francisco Carlos F.

; Cangussu, Alex S.R.

Revista de Ciencias Agrícolas

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dec 2021, Volume 38 N. 2 Pages 157 - 174

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

RESUMEN La toxina iota (ITX) es una enterotoxina binaria producida como protoxina por Clostridium perfringens (C. perfringens) tipo E que es activada por enzimas proteolíticas en el intestino delgado de los animales infectados. Mediante la despolimerización de los filamentos de actina, la ITX provoca la desorganización del citoesqueleto de las células promoviendo el aumento de la permeabilidad celular. Aquí, realizamos esta revisión con el objetivo de avanzar en la comprensión de las enfermedades entéricas clostridiales causadas por las toxinas de C. perfringens y la especificidad de ITX en las lesiones de la mucosa intestinal. La ITX consta de un componente enzimático (Ia) y un componente de unión (Ib). Examinamos los hallazgos histológicos recientemente publicados sobre los efectos de la ITX y su relación con las enfermedades entéricas intestinales. Histológicamente, se ha observado necrosis hemorrágica y hemorragia multifocal en la mucosa del yeyuno-ileo, el intestino delgado y el abomaso. Aunque el diagnóstico sigue basándose en la presencia de toxinas en el contenido intestinal y en la historia clínica y/o histológica, es importante desarrollar nuevos indicadores enterotóxicos capaces de establecer métodos precisos para diferenciar las acciones de la ITX y de otras toxinas implicadas en el proceso infeccioso de C. perfringens tipo E.

ABSTRACT The iota toxin (ITX) is a binary enterotoxin produced as a protoxin by Clostridium perfringens (C. perfringens) type E that is activated by proteolytic enzymes in the small intestine of infected animals. By depolymerization of the actin filaments, ITX causes cytoskeleton disorganization of cells promoting the increase of the cell permeability. Here, we conducted this review aiming to advance the understanding of enteric clostridial diseases caused by C. perfringens toxins and the specificity of ITX in the intestinal mucosa lesions. ITX consists of an enzymatic component (Ia) and a binding component (Ib). We screened the recently published histological findings of the ITX effects and its relationship with intestinal enteric diseases. Histologically, hemorrhagic necrosis and multifocal hemorrhage have been observed in the jejunum-ileum mucosa, the small intestine, and the abomasum. Although the diagnosis is still based on the presence of toxins in the intestinal contents and the clinical and/or histological history, it is important to develop novel enterotoxemic indicators capable of establishing precise methods for differentiate the actions of ITX and other toxins involved in the infectious process of C. perfringens type E.

https://doi.org/10.22267/rcia.213802.154 41 downloads

12.

The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA

; BACCARO, FABRICIO

; CRONEMBERGER, CECILIA

; HIPÓLITO, JULIANA

; BARROS, CLAUDIA FRANCA

; RODRIGUES, DOMINGOS DE JESUS

; NECKEL-OLIVEIRA, SELVINO

; OVERBECK, GERHARD E.

; DRECHSLER-SANTOS, ELISANDRO RICARDO

; ANJOS, MARCELO RODRIGUES DOS

; FERREGUETTI, ÁTILLA C.

; AKAMA, ALBERTO

; MARTINS, MARLÚCIA BONIFÁCIO

; TOMAS, WALFRIDO MORAES

; SANTOS, SANDRA APARECIDA

; FERREIRA, VANDA LÚCIA

; CUNHA, CATIA NUNES DA

; PENHA, JERRY

; PINHO, JOÃO BATISTA DE

; SALIS, SUZANA MARIA

; DORIA, CAROLINA RODRIGUES DA COSTA

; PILLAR, VALÉRIO D.

; PODGAISKI, LUCIANA R.

; MENIN, MARCELO

; BÍGIO, NARCÍSIO COSTA

; ARAGÓN, SUSAN

; MANZATTO, ANGELO GILBERTO

; VÉLEZ-MARTIN, EDUARDO

; SILVA, ANA CAROLINA BORGES LINS E

; IZZO, THIAGO JUNQUEIRA

; MORTATI, AMANDA FREDERICO

; GIACOMIN, LEANDRO LACERDA

; ALMEIDA, THAÍS ELIAS

; ANDRÉ, THIAGO

; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA

; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA

; MESSIAS, MARILUCE REZENDE

; MARQUES, MARCIA C.M.

; PADIAL, ANDRE ANDRIAN

; MARQUES, RENATO

; BITAR, YOUSZEF O.C.

; SILVEIRA, MARCOS

; MORATO, ELDER FERREIRA

; PAGOTTO, RUBIANI DE CÁSSIA

; STRUSSMANN, CHRISTINE

; MACHADO, RICARDO BOMFIM

; AGUIAR, LUDMILLA MOURA DE SOUZA

; FERNANDES, GERALDO WILSON

; OKI, YUMI

; NOVAIS, SAMUEL

; FERREIRA, GUILHERME BRAGA

; BARBOSA, FLÁVIA RODRIGUES

; OCHOA, ANA C.

; MANGIONE, ANTONIO M.

; GATICA, AILIN

; CARRIZO, MARÍA CELINA

; RETTA, LUCÍA MARTINEZ

; JOFRÉ, LAURA E.

; CASTILLO, LUCIANA L.

; NEME, ANDREA M.

; RUEDA, CARLA

; TOLEDO, JOSÉ JULIO DE

; GRELLE, CARLOS EDUARDO VIVEIROS

; VALE, MARIANA M.

; VIEIRA, MARCUS VINICIUS

; CERQUEIRA, RUI

; HIGASHIKAWA, EMÍLIO MANABU

; MENDONÇA, FERNANDO PEREIRA DE

; GUERREIRO, QUÊZIA LEANDRO DE MOURA

; BANHOS, AUREO

; HERO, JEAN-MARC

; KOBLITZ, RODRIGO

; COLLEVATTI, ROSANE GARCIA

; SILVEIRA, LUÍS FÁBIO

; VASCONCELOS, HERALDO L.

; VIEIRA, CECÍLIA RODRIGUES

; COLLI, GUARINO RINALDI

; CECHIN, SONIA ZANINI

; SANTOS, TIAGO GOMES DOS

; FONTANA, CARLA S.

; JARENKOW, JOÃO A.

; MALABARBA, LUIZ R.

; RUEDA, MARTA P.

; ARAUJO, PUBLIO A.

; PALOMO, LUCAS

; ITURRE, MARTA C.

; BERGALLO, HELENA GODOY

; MAGNUSSON, WILLIAM E.

Anais da Academia Brasileira de Ciências

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2021, Volume 93 N. 2 elocation e20201604

Abstract: En | Text: En | PDF: En

Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.

https://doi.org/10.1590/0001-3765202120201604 1034 downloads

13.

Colistin-resistant Escherichia coli belonging to different sequence types: genetic characterization of isolates responsible for colonization, community- and healthcare-acquired infections
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Paiva, Yrving

; Nagano, Debora Satie

; Cotia, Andre Luis Franco

; Guimarães, Thais

; Martins, Roberta Cristina Ruedas

; Perdigão Neto, Lauro Vieira

; Côrtes, Marina Farrel

; Marchi, Ana Paula

; Corscadden, Louise

; Machado, Anna Silva

; Paula, Alexandre Inácio de

; Franco, Lucas Augusto Moyses

; Neves, Patricia Regina

; Levin, Anna Sara

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e38

Abstract: En | Text: En | PDF: En

ABSTRACT The plasmid-mediated colistin-resistance gene named mcr-1 has been recently described in different countries and it became a public health challenge. Of note, few studies have addressed the spread of Escherichia coli harboring the mcr-1 gene in both, community and hospital settings. A total of seven colistin-resistant E. coli carrying mcr-1, collected from 2016 to 2018, from community (n=4), healthcare-acquired infections (n=2) and colonization (n=1) were identified in three high complexity hospitals in Sao Paulo, Brazil. These colistin-resistant isolates were screened for mcr genes by PCR and all strains were submitted to Whole Genome Sequencing and the conjugation experiment. The seven strains belonged to seven distinct sequence types (ST744, ST131, ST69, ST48, ST354, ST57, ST10), and they differ regarding the resistance profiles. Transference of mcr-1 by conjugation to E. coli strain C600 was possible in five of the seven isolates. The mcr-1 gene was found in plasmid types IncX4 or IncI2. Three of the isolates have ESBL-encoding genes (blaCTX-M-2, n=2; blaCTX-M-8, n=1). We hereby report genetically distinct E. coli isolates, belonging to seven STs, harboring the mcr-1 gene, associated to community and healthcare-acquired infections, and colonization in patients from three hospitals in Sao Paulo. These findings point out for the potential spread of plasmid-mediated colistin-resistance mechanism in E. coli strains in Brazil.

https://doi.org/10.1590/s1678-9946202163038 332 downloads

14.

BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; DIAS, André Roncon

; FORONES, Nora Manoukian

; CARVALHO, Marineide Prudêncio de

; CASTRO, Osvaldo Antonio Prado

; KASSAB, Paulo

; COSTA-JÚNIOR, Wilson Luiz da

; WESTON, Antônio Carlos

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira

; ZeideCharruf, Amir

; Brandalise, André

; Silva, André Maciel da

; Alves, Barlon

; Marins, Carlos Augusto Martinez

; Malheiros, Carlos Alberto

; Leite, Celso Vieira

; Bresciani, Claudio José Caldas

; Szor, Daniel

; Mucerino, Donato Roberto

; Wohnrath, Durval R.

; JirjossIlias, Elias

; Martins Filho, Euclides Dias

; PinatelLopasso, Fabio

; Coimbra, Felipe José Fernandez

; Felippe, Fernando E. Cruz

; Tomasisch, Flávio Daniel Saavedra

; Takeda, Flavio Roberto

; Ishak, Geraldo

; Laporte, Gustavo Andreazza

; Silva, Herbeth José Toledo

; Cecconello, Ivan

; Rodrigues, Joaquim José Gama

; Grande, José Carlos Del

; Lourenço, Laércio Gomes

; Motta, Leonardo Milhomem da

; Ferraz, Leonardo Rocha

; Moreira, Luis Fernando

; Lopes, Luis Roberto

; Toneto, Marcelo Garcia

; Mester, Marcelo

; Rodrigues, Marco Antônio Gonçalves

; Franciss, Maurice Youssef

; AdamiAndreollo, Nelson

; Corletta, Oly Campos

; Yagi, Osmar Kenji

; Malafaia, Osvaldo

; Assumpção, Paulo Pimentel

; Savassi-Rocha, Paulo Roberto

; Colleoni Neto, Ramiro

; Oliveira, Rodrigo Jose de

; AissarSallun, Rubens Antonio

; Weschenfelder, Rui

; Oliveira, Saint Clair Vieira de

; Abreu, Thiago Boechat de

; Castria, Tiago Biachi de

; Ribeiro Junior, Ulysses

; Barra, Williams

; Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 N. 1 elocation e1563

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

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico ABCG (Parte 1) foi recentemente publicado. Nesta ocasião inúmeros especialistas que atuam no tratamento desta doença expressaram suas opiniões diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 2) quanto às indicações de tratamento cirúrgico, técnicas operatórias, extensão de ressecção e terapia combinada. Métodos: Para formulação destas diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO, inicialmente com os seguintes descritores: câncer gástrico, gastrectomia, linfadenectomia, terapia combinada. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 43 declarações presentes neste estudo, 11 (25,6%) foram classificadas com nível de evidência A, 20 (46,5%) B e 12 (27,9%) C. Quanto ao grau de recomendação, 18 (41,9%) declarações obtiveram grau de recomendação 1, 14 (32,6%) 2a, 10 (23,3%) 2b e um (2,3%) 3. Conclusão: O complemento das diretrizes aqui presentes possibilita que cirurgiões e oncologistas que atuam no combate ao câncer gástrico possam oferecer o melhor tratamento possível, de acordo com as condições locais disponíveis.

ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.

https://doi.org/10.1590/0102-672020210001e1563 768 downloads

15.

Nuevos registros de ictiosaurios (Reptilia: Ichthyosauria) del Jurásico Superior en Nuevo León, México
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Reyna-Hernández, Rogelio Antonio

; Silva-Martínez, Luis Encarnación

; Rivera-Sylva, Héctor E.

Boletín de la Sociedad Geológica Mexicana

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2021, Volume 73 N. 1 elocation 00004

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

ABSTRACT The paleontological diversity of Mesozoic marine reptiles in northeastern Mexico shows an extensive fossil record, composed of different orders, including Ichthyosauria, a group with reports in Jurassic formations of the region. This paper presents two specimens collected in Galeana, Nuevo León, comprised by postcranial elements, from the La Caja Formation, of the Upper Jurassic. The mentioned specimens increase the fossil record of the area and contribute to the greater understanding of the fauna and paleoecological diversity of the Paleo-Gulf of Mexico during the Upper Jurassic.

RESUMEN La diversidad paleontológica de reptiles marinos mesozoicos en el noreste de México demuestra un registro fósil considerable, compuesto por distintos órdenes, incluyendo Ichthyosauria, grupo que presenta reportes en formaciones del Jurásico de la región. Este trabajo presenta dos ejemplares colectados en Galeana, Nuevo León; los cuales están constituidos por elementos postcraneales, procedentes de la Formación La Caja, del Jurásico Superior. Estos complementan el registro fósil de la zona y contribuyen al mayor entendimiento de la diversidad faunística y paleoecológica del Paleo-Golfo de México durante el Jurásico Superior.

https://doi.org/10.18268/bsgm2021v73n1a150220 116 downloads

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