Neglected hepatitis D / 中华检验医学杂志

Hepatitis D virus (HDV) is a defective virus that requires hepatitis B surface antigen (HBsAg) to replicate. HDV infection is prevalent worldwide, but the number of HDV infections varies in different regions of the world, and there is no exact global prevalence data for hepatitis D. China belongs to an area with low prevalence of anti-HDV. However, the positive rates of anti-HDV are relatively high in Inner Mongolia Autonomous Region and Xinjiang Uygur Autonomous Region. compared to HBV monoinfection chronic HBV/HDV coinfection progresses more rapidly and frequently to cirrhosis,liver decompensation and hepatocellular carcinoma. Anti-HBV nucleotide analogues (NAs) that inhibit HBV replication are ineffective in controlling HDV infection. The newly approved drug Burweipeptide (BLV) has demonstrated good safety and efficacy in the treatment of chronic hepatitis D, and no drug-resistant mutations have been found so far.

Cohort studies in public health practice and their significance / 上海预防医学

Cohort studies play an important role in elucidating the association between risk factors and diseases， and are widely used in etiology research， the assessment of disease prognosis， understanding the natural history of diseases， and the surveillance following the market release of new drugs. The data produced by cohort studies possess great scientific value and can provide essential evidence for public health practice. A well-conceived scientific design is a prerequisite to conducting a cohort study， and the design should focus on aspects such as sample size， selection of exposed and non-exposed populations， follow-up procedures， outcome assessments， research duration， and the choice of analytical indicators and methods. Cohort studies have become an important way to obtain scientific evidence. Internationally renowned population-based cohorts， such as China Kadoorie biobank and the Framingham heart study cohort， have provided a wealth of scientifically valuable evidence for promoting human health. The quality of data produced by a cohort study is extremely important， and a cohort study should continuously incorporate new technologies and methods to provide objective， accurate， and reliable means to determine exposure and outcomes， as well as control for bias. Cohort studies have great potential for application and will continue to provide abundant high-quality scientific evidence for the development of strategies and measures to enhance human health.

Cohort profile: follow-up of a household cohort throughout five epidemic waves of SARS-CoV-2 in Rio de Janeiro, Brazil / Perfil da coorte: acompanhamento de uma coorte domiciliar ao longo de cinco ondas epidêmicas de SARS-CoV-2 no Rio de Janeiro, Brasil / Perfil de la cohorte: seguimiento de una cohorte de hogares durante cinco olas epidémicas de SARS-CoV-2 en Río de Janeiro, Brasil

Abstract: Since May 2020, we have been conducting a comprehensive study to understand the natural history of SARS-CoV-2 infection in Rio de Janeiro, Brazil. Our focus has been on following families, systematically collecting respiratory tract swabs and blood samples, monitoring symptoms, and gathering data on vaccine status. This paper aims to describe the household cohort across five epidemic waves of SARS-CoV-2, providing an overview of the collected data and a description of the epidemiological, clinical, and immunological characteristics and incidence of SARS-CoV-2 infection. Our cohort includes 691 participants from 189 households. During the five epidemic waves, we detected 606 infections. The incidence density of SARS-CoV-2 infection ranged from 4 (Delta) to 56 (B.1.1.33) per 1,000 person-week, with a peak in wave B.1.1.33 in all age groups. The seroprevalence of SARS-CoV-2 antibodies (IgG anti spike protein) varied from 37%, in the pre-VoC period, to 99%, in the Omicron period, progressively increasing after each wave in a similar manner regardless of age. As we have monitored the cohort continuously since the beginning of the pandemic, we were able to collect data across different scenarios according to the predominant lineage in circulation. Via active monitoring of families, we were able to carry out an epidemiological surveillance on SARS-CoV-2, including its variants, persistence of symptoms, and changes in immunity over time in the population, contributing to knowledge of the natural history of SARS-CoV-2 infection.

Resumo: Desde maio de 2020, temos conduzido um estudo abrangente para entender a história natural da infecção por SARS-CoV-2 no Rio de Janeiro, Brasil. Nosso foco tem sido acompanhar as famílias das quais coletamos sistematicamente amostras de sangue e do trato respiratório, monitoramos os sintomas e reunimos dados sobre o status de vacinação. Este artigo tem como objetivo descrever a coorte de domicílios ao longo de cinco ondas epidêmicas de SARS-CoV-2, fornecendo uma visão geral dos dados coletados e uma descrição das características epidemiológicas, clínicas e imunológicas e da incidência da infecção por SARS-CoV-2. Nossa coorte inclui 691 participantes de 189 domicílios. Ao longo das cinco ondas epidêmicas, detectamos 606 infecções. A densidade de incidência da infecção por SARS-CoV-2 variou de 4 (Delta) a 56 (B.1.1.33) a cada 1.000 pessoas por semana e foi mais alta na onda B.1.1.33 em todas as faixas etárias. A soroprevalência de anticorpos contra o SARS-CoV-2 (proteína IgG anti-spike) variou de 37% no período pré-VoC a 99% no período Omicron e aumentou onda após onda de maneira semelhante, independentemente da idade dos participantes. Como monitoramos a coorte continuamente desde o início da pandemia, pudemos coletar dados em diferentes cenários, de acordo com a cepa predominante em circulação. Por meio do monitoramento ativo das famílias, conseguimos conduzir uma vigilância epidemiológica do SARS-CoV-2, de suas variantes, da persistência dos sintomas e das mudanças na imunidade da população ao longo do tempo, contribuindo para o conhecimento da história natural da infecção pelo SARS-CoV-2.

Resumen: Desde mayo de 2020 se realiza un estudio exhaustivo con el fin de estimar el curso natural de la infección por SARS-CoV-2 en Río de Janeiro, Brasil. Se aplica un seguimiento a las familias en el cual se recolectan sistemáticamente muestras de sangre y de las vías respiratorias, se controlan los síntomas y se recogen datos sobre el estado de vacunación. Este artículo tiene como objetivo describir la cohorte de hogares durante cinco olas epidémicas de SARS-CoV-2, y proporcionar una visión general de los datos recopilados y una descripción de las características epidemiológicas, clínicas e inmunológicas, y de la incidencia de la infección por SARS-CoV-2. La cohorte incluyó a 691 participantes de 189 hogares. A lo largo de las cinco olas epidémicas, se detectaron 606 infecciones. La densidad de incidencia de la infección por SARS-CoV-2 varió de 4 (Delta) a 56 (B.1.1.33) por cada 1.000 personas por semana, y fue más alta en la ola B.1.1.33 en todos los grupos de edad. La seroprevalencia de anticuerpos contra el SARS-CoV-2 (proteína IgG antipico) varió del 37% en el período anti-VOC al 99% en el período Ómicron y aumentó ola tras ola de manera similar, independientemente de la edad de los participantes. El monitoreo continuo de la cohorte desde el comienzo de la pandemia permitió recopilar datos en diferentes escenarios según la cepa predominante en circulación. A partir del monitoreo activo de las familias, se realizó una vigilancia epidemiológica del SARS-CoV-2, sus variantes, la persistencia de los síntomas y los cambios en la inmunidad de la población a lo largo del tiempo, contribuyendo al conocimiento del curso natural de la infección por SARS-CoV-2.

Aspectos electroclínicos de la epilepsia temporal mesial / Neuropsychological risk in temporal lobe epilepsy

Introducción: La epilepsia del lóbulo temporal mesial se considera la más frecuente de las epilepsias focales, con signos y síntomas característicos que ayudan a definir su diagnóstico. Contenidos: Dentro de su historia natural, las crisis pueden iniciar en los primeros años de vida, usualmente como episodios febriles con un periodo de remisión, para reaparecer en la adolescencia o en el adulto joven. La presentación electroencefalográfica tiene un patrón característico, con aparición de puntas y ondas agudas interictales en la región temporal anterior, por lo general unilaterales, y con actividad ictal generalmente theta en la misma localización. La causa más frecuente es la esclerosis del hipocampo. El tratamiento con medicamentos anticrisis puede controlar la epilepsia, aunque algunos casos pueden evolucionar a la farmacorresistencia, en la cual la cirugía de epilepsia está indicada, y tiene buenos resultados. Conclusiones: Esta revisión se centra en la descripción de las características electroclínicas de la epilepsia temporal mesial, para hacer un diagnóstico temprano e iniciar un tratamiento adecuado, a efectos de lograr un mejor pronóstico y una mejor calidad de vida para los pacientes con epilepsia y sus familiares.

Introduction: Mesial temporal lobe epilepsy is considered the most common of the focal epilepsies, with characteristic signs and symptoms that help define its diagnosis. Contents: In the natural history of the disease, seizures can begin in the first years of life, usually as febrile seizures with a period of remission, to reappear in adolescence or in the young adult. The electroencephalographic presentation has a characteristic pattern with the appearance of interictal sharp waves and spikes in the anterior temporal region, usually unilateral, and with generally theta ictal activity in the same location. The most common cause is hippocampal sclerosis. Treatment with antiseizure medication can control epilepsy. However, in some cases evolution of drug resistance can occur, leading to epilepsy surgery as the most appropriate treatment, based on its good results. Conclusions: This review focuses on the description of the electroclinical characteristics of temporal mesial epilepsy, in order to make an early diagnosis and adequate treatment, thus providing a better prognosis and quality of life for patients with epilepsy and their families.

Un caso de leucismo en el Juil de Jamapa, Rhamdia laticauda (Siluriformes, Heptapteridae) en el noreste del estado de Oaxaca, México

Se reporta la primera observación de un espécimen leucístico en el Juil de Jamapa, Rhamdia laticauda en el noreste del estado de Oaxaca. En un estudio ictiológico de la Reserva de la Biosfera Tehuacán-Cuicatlán en el río Xiquila de la cuenca alta del río Papaloapan, el pez se capturó con pesca eléctrica y se fotografió. El bagre vivo mostró una reducción de pigmentos en la piel, manchas blancas y ojos negros normales. Esto contribuye al conocimiento de la variabilidad intraespecífica y la historia natural de R. laticauda. Se discuten las causas potenciales de esta anomalía de color.

Here, we report the first observation of a leucistic specimen in the Rock catfish, Rhamdia laticauda in the Northeast of Oaxaca, Mexico. We caught the specimen by electric fishing and then photographed during an ichthyological survey carried out in the Tehuacán-Cuicatlán Biosphere Reserve in the Xiquila River of the upper Papaloapan River basin. The live catfish showed a lack of pigment in the skin, white spots, and normal eye color. This information contributes to the knowledge about intraspecific variability and natural history of R. laticauda. We discuss the potential causes of this color anomaly.

Debates on the natural history of chronic hepatitis B virus infection during the update of Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2022 Version) / 临床肝胆病杂志

This article introduces the debates on the natural history of chronic hepatitis B virus (HBV) infection during the update of Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2022 Version), including nomenclature and definition, HBV infection, HBV DNA threshold for patients in the immune-tolerant phase, indeterminate phase and natural history, clinical diagnosis and natural history, and HBV DNA threshold for patients in the inactive phase.

O Gabinete de Curiosidades da Universidade de Coimbra: uma proposta museológica e científica / The Cabinet of Curiosities at the University of Coimbra: a museological and scientific initiative

Resumo Os gabinetes de curiosidades constituem a origem do museu moderno. Na utopia da Wunderkammer existe a aspiração à convivência entre arte e ciência. Como docente do novo Curso de Philosofia Natural da Universidade de Coimbra (1772), Portugal contratou o naturalista italiano Domingos Vandelli, que transportou consigo uma coleção, com objetos do seu gabinete em Pádua, à qual anexou uma outra coleção, recolhida em Portugal (1764-1768), repositório ainda não tributário do paradigma naturalista de Lineu. É com fundamento na descrição dessas duas coleções que defendemos a relevante proposta - para a ciência e para a museologia - do Gabinete de Curiosidades do Museu da Ciência da Universidade de Coimbra, inaugurado em maio de 2022.

Abstract Cabinets of curiosities are the origin of modern museums. The utopia these Wunderkammer contain also includes aspirations for art and science to coexist. The Italian naturalist Domingos Vandelli was contracted as an instructor for the new course in natural philosophy at the University of Coimbra (1772), and brought objects from his own cabinet in Padua; he combined these with another collection mounted in Portugal (1764-1768), which did not yet conform to Linneus's naturalistic paradigm. Based on descriptions of these two collections, we defend the important initiative underway at the Cabinet of Curiosities at the University of Coimbra's Museum of Science, which was inaugurated in May 2022.

Hígado graso (parte 1): aspectos generales, epidemiología, fisiopatología e historia natural / Non-alcoholic fatty liver disease part 1: general aspects, epidemiology. pathophysiology and natural history

Resumen El hígado graso no alcohólico (NAFLD) se define por la presencia de grasa o esteatosis en los hepatocitos y abarca un espectro que va desde la esteatosis simple, pasa por la esteatohepatitis no alcohólica (NASH) con inflamación y fibrosis, y finaliza en la cirrosis. Se considera una prevalencia mundial global cercana al 25% en la población general y se diagnóstica entre los 40 y 50 años, con variaciones respecto al sexo predominante y con diferencias étnicas (la población hispana es la más afectada). El hígado graso está asociado al síndrome metabólico (SM), y la obesidad se considera el principal factor de riesgo con su presencia y con su progresión. El hígado graso es un trastorno complejo y muy heterogéneo en su fisiopatología, que resulta de la interacción de múltiples elementos: factores genéticos, epigenéticos, ambientales, culturales, entre otros. Todo ello en conjunto lleva a incremento paulatino de grasa hepática, resistencia a la insulina y alteraciones hormonales y de la microbiota intestinal, lo que genera un daño hepatocelular a través de la formación de radicales libres de oxígeno y activación de la fibrogénesis hepática. La historia natural del hígado graso es dinámica: los pacientes con esteatosis simple tienen bajo riesgo de progresión a cirrosis, mientras que en los pacientes con NASH este riesgo se aumenta; sin embargo, el proceso puede ser reversible y algunas personas tendrán una mejoría espontánea. La fibrosis parece ser el determinante de la mortalidad global y de los desenlaces asociados a la enfermedad hepática; se considera que en todos los pacientes la fibrosis empeora una etapa cada 14 años y en NASH empeora en una etapa cada 7 años. Estudios previos concluyen que aproximadamente 20% de los casos de esteatosis simple progresan a NASH y que, de ellos, aproximadamente el 20% progresan a cirrosis, con presencia de hepatocarcinoma (HCC) en el 5% a 10% de ellos.

Abstract Fatty liver or NAFLD is defined by the presence of fat or steatosis in hepatocytes and covers a spectrum that goes from simple steatosis, through steatohepatitis (NASH), with inflammation and fibrosis and ending in cirrhosis. It is considered a global world prevalence close to 25% in the general population and is diagnosed between 40 and 50 years, with variations regarding the predominant sex and with ethnic differences, affecting more the Hispanic population. Fatty liver is associated with metabolic syndrome (MS), and obesity is considered the main risk factor for its presence and progression. Fatty liver is a complex and very heterogeneous disorder in its pathophysiology, resulting from the interaction of multiple elements, genetic, epigenetic, environmental, cultural factors, etc. All this together leads to an accumulation of hepatic fat, insulin resistance, hormonal and intestinal microbiota alterations, generating hepatocellular damage through the formation of free oxygen radicals and activation of hepatic fibrogenesis. The natural history of fatty liver is dynamic, patients with simple steatosis have a low risk of progression to cirrhosis, in patients with NASH this risk is increased, however, the process may be reversible, and some people will have spontaneous improvement. Fibrosis seems to be the determinant of overall mortality and outcomes associated with liver disease, it is considered that in all patients fibrosis worsens one stage every 14 years, in NASH it worsens one stage every seven years. Previous studies conclude that approximately 20% of cases of simple steatosis progress to NASH and that approximately 20% of them progress to cirrhosis, with the presence of hepatocellular carcinoma (HCC) in 5 to 10% of them.

Seropositivity of COVID-19 Among Healthy Voluntary Blood Donors and Its Association with Blood Groups: A Reflection of Burden of Asymptomatic COVID-19 Cases in The District of South Gujarat

Introduction: First case of COVID-19 in the district was reported on 19th March 2020, thereby increas-ing exponentially, presenting with various symptoms to having few or no symptoms, posing challenge to prevent disease transmission by being a significant source of infection. This study conducted to assess relationship between COVID-19 infection within blood groups and burden of reported cases in the dis-trict to seropositivity among donors. Methodology: This is a prospective observational study from second largest blood bank of south Guja-rat, catering to a population of seven million, 4916 donors from the month of August 2020 to May 2021 participated in the study. Observations: Seropositivity was found to be 54.6%, with higher prevalence (68.63%) among female compared to male (54.45%), there was no statistical difference among age groups & RH groups, blood group AB was found to have highest seropositivity followed by A, B and O group. First time donors sero-positivity was higher compared to frequent donors among the study participants. Seropositivity among donors was positively corelated with RTPCR Positivity rate reported in the district. Conclusions: Looking at similar trend of active surveillance and its correlation to blood bank positivity, we urge policy makers to strengthen hospital-based surveillance for real time insights.

Breeding biology of Hooded Gnateater Conopophaga roberti Hellmayr, 1905 (Aves: Conopophagidae) / Biologia reprodutiva de Conopophaga roberti Hellmayr, 1905 (Aves: Conopophagidae)

Abstract The Hooded Gnateater Conopophaga roberti Hellmayr, 1905 is an insectivorous understory passeriform with discrete behavior, whose reproductive attributes are poorly-known. In the present study, we describe the reproductive biology of the species and the growth pattern of the nestlings, based on observations conducted in remnants of the Cerrado savanna in eastern Maranhão state, in Brazil. The nests were identified during active searches conducted between June, 2018 and March, 2021. A total of 22 nests were found over the course of three breeding seasons. The cup-shaped nests were supported by small branches and were constructed at a mean height of 40.6 ± 16.1 cm (N = 21) above the ground. The nests were 23.1 ± 3.9 cm in length and 14.1 ± 1.6 cm in width (N = 21). The eggs were beige in color, with irregular brown mottling only at the rounded end of the egg, which had a mean length of 21.3 ± 0.8 mm, width of 17.2 ± 0.8 mm, and mass of 3.1 ± 0.1 g (N = 23). Hatchlings are completely naked and weigh 3.1 ± 0.2 g (N = 7), and when they abandon the nest, they have yet to reach full adult size, with the total length being 65.4% of that of the adult, the wing, 65.4%, the head, 73.9%, the culmen, 74.2%, the body mass, 73.3%, and the tarsus, 89.0% that of the adult. The growth curves are sigmoidal and all the coefficients of determination are at least 0.96, with the body length having the highest value (R2 = 0.98). During the breeding season, the adult pair emitted alarm calls constantly when observers were in the vicinity of the nest. On a number of occasions, members of the breeding pair were observed moving away from the nest as it was approached by observers, while engaging in broken-wing display. The nest architecture, the color of the eggs, and the behaviors presented by this gnateater were similar to those described for other Conopophaga. With this work we contributed to improve the knowledge on the breeding behavior of this poorly know group of understory insectivorous birds.

Resumo O chupa-dente-de-capuz Conopophaga roberti Hellmayr, 1905 é um passeriforme insetívoro de subbosque, de comportamento discreto e cujos atributos reprodutivos são pouco conhecidos. Aqui descrevemos a biologia reprodutiva da espécie e o padrão de desenvolvimento dos ninhegos, com base em observações realizadas em remanescentes de Cerrado no leste do Maranhão, Brasil. Os ninhos foram localizados por busca ativa entre junho de 2018 e março de 2021. Um total de 22 ninhos foram encontrados ao longo de três estações reprodutivas. Os ninhos, em forma de taça, foram sustentados por pequenos galhos e construídos a uma altura média de 40,6 ± 16,1 cm (N = 21) acima do solo. Mediram 23,1 ± 3,9 cm de comprimento por 14,1 ± 1,6 cm de largura. Os ovos são branco-amarelados e mediram 21,3 ± 0,8 mm por 17,2 ± 0,8 mm, com massa de 3,1 ± 0,1 g (N = 23). Ao eclodir, os ninhegos estão completamente nus e pesaram 3,1 ± 0,2 g (N = 7). Abandonam o ninho antes de atingirem o tamanho dos adultos, sendo o comprimento total equivalente a 65,4% do adulto, a asa 65,4%, a cabeça 73,9%, o cúlmen 74,2%, a massa corporal 73,3% e o tarso 89%. As curvas de crescimento apresentaram padrão sigmóide e todos os coeficientes de determinação foram maior ou igual a 0,96, sendo o comprimento do corpo o valor mais alto (R2 = 0.98). Durante o período reprodutivo, o casal adulto emitia alertas constantemente quando os observadores se aproximavam dos ninhos. Em diversas ocasiões foi observado o comportamento de defesa de "asa quebrada" pelo casal reprodutor. A arquitetura do ninho, a cor dos ovos e os comportamentos apresentados por Conopophaga roberti se assemelham aos descritos para outras espécies do gênero. Com este trabalho, melhoramos o conhecimento sobre a biologia reprodutiva deste grupo de aves insetívoras de sub-bosque pouco conhecido.