Serological and molecular characterization of hepatitis B virus infection in chronic kidney disease patients from Rio de Janeiro, Brazil

ABSTRACT Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) are more vulnerable to blood-borne viral infections due to frequent invasive procedures. Hepatitis B virus (HBV) infection in this cohort of patients has been a matter of concern worldwide. The objective of this cross-sectional study was to evaluate the frequency of serological markers for hepatitis B, and the occurrence of overt and occult HBV infection (OBI) and its molecular characterization in serum samples from 644 CKD patients in HD units located in Rio de Janeiro, Brazil, from 2013 to 2017. HBV DNA was investigated in HBsAg reactive and "anti-HBc alone" samples to determine infecting genotypes and genetic relatedness between sequences. The prevalence of serological markers HBsAg+, anti-HBc alone, anti-HBc+/anti-HBs+, anti-HBs+, anti-HBc/anti-HBs/HBsAg were 5.9%, 2.8%, 30.7%, 26.6%, 34.0%, respectively. HBV DNA was detected in 39.5% (15/38) of the HBsAg+ and in 5/18 (27.8%) of the "anti-HBc alone" individuals, indicating a high prevalence of OBI within this group. We found a higher prevalence of HBV/A1 (65%), followed by HBV/D3 (20%), and HBV/A2 (15%). Bayesian MCC tree with a highly supported clade, genetic distance comparison, and identical nucleotide sequences suggested a nosocomial spread of HBV in some units. The high prevalence of HBV infection and low number of individuals immune to infection reinforces the need for vaccination in this group. The presence of closely related strains in the same HD unit reinforces the importance of continuous improvement of safety control measures and laboratory surveillance of serological markers to prevent the risk of infection and transmission of HBV.

High prevalence of insulin resistance among Brazilian chronic hepatitis C patients

ABSTRACT Objective: This study aims to estimate the prevalence of insulin resistance (IR) among chronic hepatitis C (CHC) patients and their related laboratory and demographic data. Subjects and methods: In this study, non-diabetic CHC patients referred to Viral Hepatitis Ambulatories from Rio de Janeiro (Brazil) donated blood samples. Insulin was measured using a chemiluminescence immunoassay. IR was determined by HOMA-IR, where HOMA-IR > 2 was defined as IR. Results: A total of 214 CHC patients were recruited (123 females aged 53.6 years ± 10.9 years). IR was present in 133 patients (62.1%) and was associated in bivariate analysis to higher mean values of age (p = 0.040), triglycerides (p = 0.032), glucose (p = 0.000), insulin (p = 0.000), waist circumference (p = 0.001), and body mass index (p = 0.007); however, none of these variables were significant in the multivariate analysis. Conclusions: The high prevalence of IR was observed among CHC patients, and there was no difference in clinical or laboratory parameters when both groups were compared in the multivariate analysis. This high IR prevalence could lead to a high risk for development of cardiovascular disease and metabolic disorders.

Percepção da morte pelo paciente oncológico ao longo do desenvolvimento / Perception of death by oncologycal patient along its development

O propósito deste estudo é empreender uma revisão não-sistemática da literatura dedicada à percepção da morte e do morrer na perspectiva do paciente oncológico, de acordo com as diferentes fases do ciclo vital. Os resultados mostram que, na criança, a percepção da morte modifica-se conforme se desenvolvem o pensamento e a linguagem. No adulto, a concepção da morte depende muito da experiência física e psicológica por que se está passando. Por fim, no idoso a morte é mais bem aceita e sua percepção depende sobretudo da satisfação previamente auferida com a vida. Diante disso, a literatura ressalta que a percepção da morte é ainda uma experiência eminentemente individual e que, por isso, deve ser considerada a percepção subjetiva de cada paciente oncológico. Concluindo, as reflexões deste estudo enfatizam as transformações da percepção da morte ao longo do desenvolvimento, sustentando a noção da presença da morte como parte integrante da vida.

The purpose of this study is to undertake a non-systematic revision of the bibliography dedicated to the perception of the experiences of 'the coming death and dying' in the perspective of the oncologycal patient, in accordance with the different phases of lifespan. The results show that, in children, the perception of death is modified gradually as the thought and the language develops. In adults, the conception of death depends on their physical and psychological experience. Finally, in elderly people the death is better accepted and its perception depends on the satisfaction previously gained during the lifespan. Bearing that in mind, specialized bibliography emphasizes that the perception of the coming death is still an eminently individual experience, therefore, the subjectivity of each oncologycal patient should be considered. Concluding, this study intends to emphasize the transformations in the perception of the coming death, during the illness development, coping with the presence of death as an integrating part of life.

El propósito de este estudio es emprender una revisión no-sistemática de la literatura dedicada a la percepción de la muerte y del morir en la perspectiva del paciente oncológico, según las diferentes fases del ciclo vital. Los resultados muestran que, en el niño, la percepción de la muerte se modifica conforme se desarrollan el pensamiento y el lenguaje. En el adulto, la concepción de la muerte depende mucho de la experiencia física y psicológica por la que está pasando. Por fin, en el anciano la muerte es mejor aceptada y su percepción depende sobretodo de la satisfacción previamente obtenida con la vida. Delante de eso, la literatura resalta que la percepción de la muerte es aún una experiencia eminentemente individual, y que, a causa de eso, debe ser considerada la percepción subjetiva de cada paciente oncológico. Concluyendo, las reflexiones de este estudio enfatizan las transformaciones de la percepción de la muerte a lo largo del desarrollo, sosteniendo la noción de la presencia de la muerte como parte integrante de la vida.

Preference of goldfish (Carassius auratus) for dark places

Visando determinar a preferência por ambientes claros ou escuros, peixes dourados (Carassius auratus) foram submetidos a um teste num aquário em que podiam sair de um compartimento central indo seja para um compartimento preto, seja para um compartimento branco. Registrou-se (1) o primeiro compartimento escolhido,(2) a freqüência de entradas em cada compartimento, e (3) o tempo gasto neles. Os resultados mostram que, nas condições experimentais, C. auratus tem preferência significativa pelo escuro, uma característica relevante para o desenvolvimento de um modelo experimental de ansiedade com esta espécie