Relationship of irisin expression with metabolic alterations and cardiovascular risk in type 2 diabetes mellitus: a preliminary study

SUMMARY OBJECTIVE: The aim of this study was to investigate the role of irisin in type 2 diabetes mellitus and its association with metabolic alterations and obesity. METHODS: A cross-sectional case-control study was conducted on participants treated at Centro Universitário FMABC between August 2018 and July 2019, by comparing a control group (n=14) with type 2 diabetes mellitus patients (n=16). The control group consisted of participants aged above 21 years with no chronic diseases, diabetes, smoking, or illicit drug use. The type 2 diabetes mellitus group included patients aged above 21 years, who were diagnosed with type 2 diabetes for at least 5 years (glycated hemoglobin>7%). Exclusion criteria were not willing to continue, recent hospitalization, and failure to meet inclusion criteria. Biochemical parameters included blood glucose, glycated hemoglobin, plasma irisin levels, and irisin gene expression in peripheral blood. RESULTS: Type 2 diabetes mellitus patients exhibited significantly higher plasma glucose levels [143 (40) vs. 92 (13) mg/dL, *p<0.05] and glycated hemoglobin levels [7.1% (1.6) vs. 5.6% (0.5), *p<0.05] compared to the control group. Irisin gene expression in type 2 diabetes mellitus patients was lower 0.02288 (0.08050) than the control group 8.506e-006 (1.412e-005) (p=0.06). Correlation analysis revealed a positive association between irisin expression and body mass index in type 2 diabetes mellitus (Rho=0.5221, 95%CI -0.058 to 0.838, p=0.06), while plasma irisin showed a negative correlation with body mass index (Rho=-0.656, 95%CI -0.836 to 0.215, p=0.03). No significant correlations were found between plasma glucose or glycated hemoglobin levels and irisin expression. CONCLUSION: The data suggests that body mass index directly influences plasma irisin levels and the regulation of irisin gene expression, possibly linking irisin to adiposity changes observed in obesity-related type 2 diabetes mellitus.

Relationship of irisin expression with metabolic alterations and cardiovascular risk in type 2 diabetes mellitus: a preliminary study.

OBJECTIVE: The aim of this study was to investigate the role of irisin in type 2 diabetes mellitus and its association with metabolic alterations and obesity. METHODS: A cross-sectional case-control study was conducted on participants treated at Centro Universitário FMABC between August 2018 and July 2019, by comparing a control group (n=14) with type 2 diabetes mellitus patients (n=16). The control group consisted of participants aged above 21 years with no chronic diseases, diabetes, smoking, or illicit drug use. The type 2 diabetes mellitus group included patients aged above 21 years, who were diagnosed with type 2 diabetes for at least 5 years (glycated hemoglobin>7%). Exclusion criteria were not willing to continue, recent hospitalization, and failure to meet inclusion criteria. Biochemical parameters included blood glucose, glycated hemoglobin, plasma irisin levels, and irisin gene expression in peripheral blood. RESULTS: Type 2 diabetes mellitus patients exhibited significantly higher plasma glucose levels [143 (40) vs. 92 (13) mg/dL, *p<0.05] and glycated hemoglobin levels [7.1% (1.6) vs. 5.6% (0.5), *p<0.05] compared to the control group. Irisin gene expression in type 2 diabetes mellitus patients was lower 0.02288 (0.08050) than the control group 8.506e-006 (1.412e-005) (p=0.06). Correlation analysis revealed a positive association between irisin expression and body mass index in type 2 diabetes mellitus (Rho=0.5221, 95%CI -0.058 to 0.838, p=0.06), while plasma irisin showed a negative correlation with body mass index (Rho=-0.656, 95%CI -0.836 to 0.215, p=0.03). No significant correlations were found between plasma glucose or glycated hemoglobin levels and irisin expression. CONCLUSION: The data suggests that body mass index directly influences plasma irisin levels and the regulation of irisin gene expression, possibly linking irisin to adiposity changes observed in obesity-related type 2 diabetes mellitus.

Survivin expression as a prognostic marker for breast cancer

SUMMARY OBJECTIVE: Due to the speed of development observed in breast cancer, several studies aimed at discovering new biomarkers have been carried out in order to arrive at an early diagnosis. As survivin plays a fundamental role in the evasion of apoptosis in tumor cells, the aim of this study was to verify the expression profile of the survivin gene in paraffin-embedded breast tumor samples and associate it with the clinical characteristics of the patients. METHODS: This is a cross-sectional study, for which 100 tumor samples were obtained from cancer patients treated throughout the year 2019 at Instituto de Mama do Cariri (Juazeiro do Norte, in the state of Ceará). This study included women over 30 years old who had confirmed breast cancer through anatomopathological examination but excluded those with non-neoplastic breast comorbidities, other neoplasms, or chronic diseases. Survivin gene expression was assessed by quantitative polymerase chain reaction. RESULTS: The expression of survivin is associated with the lack of expression of estrogen (p=0.027) and progesterone (p>0.0005) receptors. It means that survivin expression is higher in patients in which labeling was absent for estrogen receptor and progesterone receptor. CONCLUSION: Our data reinforce that survivin expression is higher in estrogen receptor-patients, thus representing an additional prognostic tool.

The effects of the Covid-19 pandemic on eye-related emergency visits / Efeitos da pandemia da Covid-19 em atendimentos de emergência ocular

ABSTRACT Objective To evaluate the effects of the Covid-19 pandemic on the profile of emergency eye-related visits and compare the findings with the same period before the pandemic. Methods Cross-sectional study performed during one year at a reference eye hospital. Cases registered at the emergency Municipal Hospital Complex of Santo Andre, Brazil, between March, 2019 and February, 2020 were included in the study as the Pre-pandemic group. Cases registered between March, 2020 and February, 2021 were included as the Pandemic group. Cases were classified according to the International Classification of Diseases ICD-10 and Related Health Problems. Results There was a decrease of 52.1% in the emergency eye care visits during the pandemic period (n=9,198) when compared to the pre-pandemic period (n=19,220), with significant reductions in nonspecific cases (-98.1%), postoperative visits (-67.0%), disorders of the conjunctiva (-54.1%), tear film (-49.4%) and refraction (-85.6%) during the pandemic period. Conditions such as retina disorders (+202.7%), sclera disorders (+76.2%), orbit disorders (+20.2%), glaucoma (+66.6%) and trauma (+19.4%) have shown increased rates, as well as those related to eyelids (+186.9%), cornea (+33.4%), uvea (+40.2%), and herpes (+55.3%). Conclusion A drastic reduction in the number of eye-related emergency visits was observed during the Covid-19 pandemic, outlining a new profile of care, with higher frequency of sight-threatening conditions and lower frequency of contagious and non-specific diagnosis.

RESUMO Objetivo Avaliar os efeitos da pandemia da Covid-19 no perfil dos atendimentos oftalmológicos de emergência e comparar os achados com os do período anterior à pandemia. Métodos Estudo transversal realizado ao longo de 1 ano em um hospital oftalmológico de referência. Casos registrados no Complexo Hospitalar Municipal de Emergências de Santo André (SP, Brasil) entre março de 2019 e fevereiro de 2020 foram incluídos no estudo como Grupo Pré-Pandemia. Os casos registrados entre março de 2020 e fevereiro de 2021 foram incluídos no Grupo Pandemia. Os casos foram classificados de acordo com a Classificação Internacional de Doenças e Problemas Relacionados à Saúde. Resultados Houve redução de 52,1% no número de atendimentos oftalmológicos de emergência durante o período pandêmico (n=9.198) quando comparado ao pré-pandêmico (n=19.220), com reduções significativas em casos inespecíficos (-98,1%), visitas pós-operatórias (-67,0%), distúrbios da conjuntiva (-54,1%), filme lacrimal (-49,4%) e refração (-85,6%) durante o período de pandemia. Condições como distúrbios da retina (+202,7%), distúrbios da esclera (+76,2%), distúrbios da órbita (+20,2%), glaucoma (+66,6%) e trauma (+19,4%) apresentaram taxas aumentadas, bem como aquelas relacionadas a pálpebras (+186,9%), córnea (+33,4%), úvea (+40,2%) e herpes (+55,3%). Conclusão Observou-se drástica redução no número de atendimentos oftalmológicos durante a pandemia da Covid-19, delineando um novo perfil de atendimento, com maior frequência de quadros que levam à baixa de visão e à menor frequência de diagnósticos contagiosos e inespecíficos.

Survivin expression as a prognostic marker for breast cancer.

OBJECTIVE: Due to the speed of development observed in breast cancer, several studies aimed at discovering new biomarkers have been carried out in order to arrive at an early diagnosis. As survivin plays a fundamental role in the evasion of apoptosis in tumor cells, the aim of this study was to verify the expression profile of the survivin gene in paraffin-embedded breast tumor samples and associate it with the clinical characteristics of the patients. METHODS: This is a cross-sectional study, for which 100 tumor samples were obtained from cancer patients treated throughout the year 2019 at Instituto de Mama do Cariri (Juazeiro do Norte, in the state of Ceará). This study included women over 30 years old who had confirmed breast cancer through anatomopathological examination but excluded those with non-neoplastic breast comorbidities, other neoplasms, or chronic diseases. Survivin gene expression was assessed by quantitative polymerase chain reaction. RESULTS: The expression of survivin is associated with the lack of expression of estrogen (p=0.027) and progesterone (p>0.0005) receptors. It means that survivin expression is higher in patients in which labeling was absent for estrogen receptor and progesterone receptor. CONCLUSION: Our data reinforce that survivin expression is higher in estrogen receptor-patients, thus representing an additional prognostic tool.

Biochemical markers and anthropometric profile of children enrolled in public daycare centers

Abstract Objective: The nutritional status resultant from dietary habits along with socioeconomic conditions and the school environment are directly related to the individual's health condition not only in their childhood but also throughout adulthood. The aim of this study was to evaluate the effects of socioeconomic factors on the anthropometric profile and to analyze a probable association between this profile and biochemical markers in children attending public daycare centers. Methods: It is a transversal study developed in a probability sample of clusters of children from 6 months to 5 years old. Anthropometric and socioeconomic data were gathered at the CMEIs, questionnaires on the nutritional status were applied and blood was collected at the Family Health Units (USFs). Results: Female children are three times more likely to be underweight; in families with five members, it is 1/3 more likely that children of higher-educated parents are overweight. Among the results of the biochemical tests, hypervitaminosis A was a relevant aspect, positively correlating with copper (p=0.005) and zinc (p=0.008). Conclusion: Therefore, since the influence of the family is an important predictor of overweight and its future outcomes related to nutritional deficiencies and inadequate dietary intake, educational interventions are vital as a way to pave the path to prevention.

Lung cancer biomarkers. A literature review / Biomarcadores de câncer de pulmão. Uma revisão de literatura

ABSTRACT Lung cancer is the first in terms of incidence and mortality, being responsible worldwide for about 1.8 million deaths. In Brazil 31,270 new cases were diagnosed in 2018, 18,740 in men and 12,350 in women. One of the main challenges about lung cancer is performing an early diagnosis, in most cases the disease is detected in the late stages, which implies in poor prognoses. Tumor biomarkers are hugely relevant in early diagnosis, understanding of carcinogenesis, prognostic determination and therapeutic choice. The present paper reviews non-small cell lung cancer biomarkers described in the literature and their diagnostic, prognostic and therapeutic applications, intervention and therapeutic control for individualized therapy. Although there is still a vast universe to be explored, studies reveal a promising future for lung cancer treatment with increasingly personalized and assertive therapies that increase the chances of progression-free survival.

RESUMO O câncer de pulmão é o primeiro em incidência e mortalidade, sendo responsável mundialmente por cerca de 1,8 milhão de mortes. No Brasil, 31.270 casos novos foram diagnosticados em 2018, sendo 18.740 em homens e 12.350 em mulheres. Um dos principais desafios do câncer de pulmão é o diagnóstico precoce, na maioria das vezes a doença é detectada em fases tardias, o que implica em mau prognóstico. Os biomarcadores tumorais são extremamente relevantes no diagnóstico precoce, compreensão da carcinogênese, determinação do prognóstico e escolha terapêutica. O presente trabalho revisa biomarcadores de câncer de pulmão de células não pequenas descritos na literatura e suas aplicações diagnósticas, prognósticas e terapêuticas, intervenção e controle terapêutico para terapia individualizada. Embora ainda exista um vasto universo a ser explorado, estudos revelam um futuro promissor para o tratamento do câncer de pulmão com terapias cada vez mais personalizadas e assertivas que aumentam as chances de sobrevida livre de progressão.

The influence of social isolation on the incidence of positivity in COVID-19 tests in a metropolitan region of São Paulo, Brazil / A influência do isolamento social na incidência de positividade nos testes de COVID-19 em região metropolitana de São Paulo, Brasil

INTRODUCTION: With the arrival of the SARS-CoV-2 (Coronavirus 2 of severe acute respiratory syndrome) pandemic in Brazil, especially in the city of São Paulo, there was a need to apply social isolation policies associated with testing, covering all municipalities. The Clinical Analysis Laboratory of Centro Universitário FMABC was one of the first laboratories to receive certification and qualification to perform RT-PCR (reverse transcriptase reaction followed by polymerase chain reaction) tests in the metropolitan region of São Paulo OBJECTIVE: Aim to analyze the influence of adopting social isolation on the incidence of positivity in COVID-19 tests in the metropolitan region of São Paulo, Brazil METHODS: a descriptive study carried out from March to May 2020, epidemiological data were collected from each unit served and organized by the data controllership team of the Clinical Analysis Laboratory of FMABC. Epidemiological, demographic, and laboratory data were extracted from the Matrix® outpatient data management system. Clinically suspected cases and confirmed by laboratory tests (RT-PCR and serological tests) were entered. The tests were divided into serological tests using the RT-PCR molecular test, on samples of nasopharyngeal mucosal scrapings collected with sterile Swab RESULTS: It were evaluated PCR test and antibody presence (IgA, IgM and IgG) in blood samples of 16.297 patients. 22.718 tests were performed for the diagnosis of COVID-19, both RT-PCR (10.410 tests) and serological tests to detect anti-SARS-CoV-2 antibodies, IgA, IgM and IgG, a total of 16.297 patients were assessed, 63% women and 37% men. It was observed that the social isolation policies adopted during this period contained the massive expansion of contamination, at least while the social isolation rates were above 55% CONCLUSION: The data of this study demonstrated the effectiveness of social isolation in containing the positive contamination of SARS-CoV-2 in the metropolitan region of São Paulo, at least for the first three months

INTRODUÇÃO: com a chegada da pandemia de SARS-CoV-2 (Coronavirus 2 da síndrome respiratória aguda grave) ao Brasil, especialmente na cidade de São Paulo, houve a necessidade de aplicar medidas de distanciamento social associado a testagem, que abrangesse todos os municípios. A região metropolitana de São Paulo compreende 39 municípios e possui uma rede de laboratórios habilitados a realizar a testagem para a detecção do coronavírus, tanto testes sorológicos quanto moleculares. O Laboratório de Análises Clínicas do Centro Universitário ABC/FMABC foi um dos primeiros laboratórios a receber a certificação e habilitação para realizar os testes RT-PCR (reação da transcriptase reversa seguida pela reação em cadeia da polimerase) na região metropolitana de São Paulo OBJETIVO: analisar a influência da adoção do isolamento social na incidência de positividade nos testes de COVID-19 em região metropolitana de São Paulo, Brasil MÉTODO: estudo descritivo realizado no período de março a maio de 2020, os dados epidemiológicos foram coletados de cada unidade atendida e organizada pela equipe de controladoria de dados do Laboratório de Análises Clínicas da FMABC. Os dados epidemiológicos, demográficos e laboratoriais foram extraídos do sistema Matrix® de gerenciamento de dados ambulatoriais. Foram inseridos os casos clinicamente suspeitos e confirmados por testes de laboratório (RT-PCR e testes sorológicos). Os testes foram divididos em testes sorológicos no teste molecular RT-PCR, em amostras de raspado de mucosa nasofaríngea coletada com Swab estéril RESULTADOS: foram avaliados o teste de RT-PCR e a presença de anticorpos (IgA, IgM e IgG) em amostras de sangue de 16.297 pacientes. Foram realizados 22.718 testes para o diagnóstico de COVID-19, tanto RT-PCR (10.410 testes), quanto testes sorológicos para detecção de anticorpos anti-SARS-CoV-2, IgA, IgM e IgG, um total de 16.297 pacientes foram avaliados, 63% mulheres e 37% homens. Observou-se que as políticas de isolamento social adotadas nesse período continham a expansão massiva da contaminação, pelo menos enquanto as taxas de isolamento social eram superiores a 55% CONCLUSÃO: nossos dados demonstraram a efetividade do isolamento social na retenção da positividade da contaminação do SARS-CoV-2 nas cidades contempladas pelo serviço de testagem do Centro Universitário Saúde ABC, pelo menos nos três primeiros meses

Incidence of clinical and subclinical macular edema in patients submitted to phacoemulsification in a university health service

INTRODUCTION: The incidence of cystoid macular edema (CME) after cataract surgery varies substantially and depending on the diagnostic method used. In addition, other factors that influence the incidence of CME are the technique of surgery and the associated comorbidities. OBJECTIVE: The aim of the present study was to evaluate the incidence of EMC after uncomplicated phacoemulsification surgery, using the spectral domain optical coherence tomography (OCT). METHODS: The incidence of subclinical and clinical CME was evaluated in 14 patients who underwent uncomplicated phacoemulsification surgery, using OCT before the surgical procedure and after seven and 28 days after it. The volunteers could not use a prostaglandin analogue or present any retinopathy that compromised visual acuity. RESULTS: The incidence of clinically significant CME was 6.4%, however retinal thickening by OCT was observed in all patients in the fourth postoperative week. Regarding gender and laterality, the percentages were similar. CONCLUSION: In this study, we obtained a low incidence of EMC in patients assisted at this center, corroborating multicenter studies.

Dexamethasone intravitreal implant for macular edema: a pilot study in a public health center

INTRODUCTION: Macula edema consists in one of the most common causes of visual impairment. OBJECTIVE: To evaluate the safety and efficacy of continuous release of 0.7 mg dexamethasone (using implantable device) for treatment of macular edema. METHODS: Cross-sectional observational study of 16 patients treated with 0.7 mg dexamethasone intraocular implant. Visual acuity, intraocular pressure and central macular thickness were recorded at baseline, 1-month and 3-month follow-up. RESULTS: 15 eyes of 13 patients were included. Most eyes (n=9) improve visual acuity from baseline at 1-month follow-up; this improvement persisted through 3-monyh follow-up in six eyes. The central macular thickness decreased in the majority of the subjects at 1-month (n=12) and at 3-month (n=10) follow-up. Three eyes presented with elevated intraocular pressure. CONCLUSION: Dexamethasone implant can both reduce the risk of vision loss and improve anatomical features of macular edema due to several pathologies studied. This implant may be used safely and should be considered a therapeutic option to Brazilian Public Health System.

Post-operative complications of penetrating corneal keratoplasty in patients with anterior segment toxic syndrome secondary to cataract surgery

INTRODUCTION: Toxic Anterior Segment Syndrome (TASS) after cataract surgery may cause severe corneal decompensation that compromises corneal transparency and may require penetrating corneal keratoplasty to improve visual acuity. OBJECTIVE: We evaluated the postoperative complications of patients who underwent penetrating corneal transplantation for severe corneal decompensation secondary to TASS after cataract surgery, such as persistent epithelial defect, glaucoma, and primary and secondary transplant button failure. We will also evaluate pre- and postoperative visual acuity, graft survival time, and the presence of anterior chamber disorganization. METHODS: Retrospective observational study in which a review of medical records of 9 patients diagnosed with TASS after cataract surgery who underwent penetrating corneal keratoplasty will occur. RESULTS: In the present study all operated patients had glaucoma after penetrating corneal transplantation, and this presence of glaucoma was not correlated with graft survival time and with any other parameter evaluated. The presence of persistent epithelial defect correlated negatively with visual acuity. CONCLUSION: Postoperative complications of penetrating corneal transplantation in patients with TASS were frequent, such as glaucoma, primary and secondary button failure and persistent epithelial defect. The only complication that compromised visual acuity was the persistent epithelial defect. All patients evolved with glaucoma.

Side effects of 1% cyclopentolate hydrochloride in children and adolescents attended at Centro Universitário FMABC

INTRODUCTION: It is known that vision disorders are within the context of public health problems. In childhood, during the neuropsychomotor development phase, visual changes are crucial, since there is a strong correlation between poor school performance and changes in acuity. For these reasons, ophthalmological examination in children, including refraction, is extremely important, aiming at the early diagnosis of diseases and possible refractive errors that may compromise the child's life and development. 1% cyclopentolate hydrochloride eye drops are the most used during ophthalmic clinical evaluation as a cycloplegic and mydriatic agent to assist in refractive examination. OBJECTIVE: The ocular and systemic side effects of 1% cyclopentolate hydrochloride eye drops were studied in patients who underwent static refractive examination in the strabismus sector of the Ophthalmology Discipline of the Centro Universitário FMABC. METHODS: A drop of 1% cyclopentolate is instilled in both eyes of each patient and the possible ocular and systemic signs and symptoms presented were observed after 40 minutes and 24 hours after instillation. RESULTS: We expect to find ocular side effects more evident than systemic symptoms in the two evaluation times (40 minutes and 24 hours after instillation). All symptoms (ocular and systemic) are reversed spontaneously. CONCLUSION: The present study aims to show that the side effects observed by the topical (ocular) use of cyclopentolate eye drops 1% are few and present spontaneous reversal both from an eye point of view, as well as from a systemic point of view.

Diabetic macular edema: a literature review

Diabetic Macular Edema is a major cause of visual impairment in economically active population, being responsible for a significant impact in quality of life in the affected population, as well as high costs to the health care system. Over decades, some studies have compared treatments using Laser, Anti-VEGF and intravitreous corticosteroids, establishing protocols to reach effectives therapies. Thus, it is essential an entire understanding of available therapies to reach the goal of disease control, in an individual basis and in a collective health care system, as efficient as possible.

Retinal findings in hospitalised patients with severe COVID-19.

AIM: To identify retinal findings using dilated eye examination, which are possibly related to SARS-CoV-2 infection in hospitalised patients with confirmed severe COVID-19. METHODS: In this cross-sectional study, hospitalised patients with confirmed severe COVID-19 in a single referral centre for the treatment of COVID-19, in Santo André, São Paulo Metropolitan Area, Brazil, underwent dilated eye examination of both eyes performed by a retina specialist. Findings were recorded using a portable digital fundus camera. Retinographies were analysed by two retina specialists. Medical records were reviewed for assessment of patient demographics, baseline comorbidities and clinical data. RESULTS: There were a total of 18 patients, nine (50%) male, median IQR age of 62.5 (12) years. Ten of the 18 patients (55.6%; 95% CI 33.7 to 75.4) had abnormalities on dilated eye examination. The main findings were flame-shaped haemorrhages (N=4; 22.2%; 95% CI 9.0 to 45.2) and ischaemic pattern lesions (cotton wool spots and retinal sectorial pallor) (N=4; 22.2%; 95% CI 9.0 to 45.2), with one patient having both cotton wool spots and flame-shaped haemorrhages. CONCLUSION: These findings suggest that patients with severe COVID-19 have acute vascular lesions of the inner retina including flame-shaped haemorrhages and cotton wool spots. Further studies controlling for confounding factors are necessary to properly assess these findings so as to increase the understanding of COVID-19 pathophysiology and to identify new therapies.

Neonatal mortality in Luanda, Angola: what can be done to reduce it? / Mortalidade neonatal em Luanda, Angola: o que pode ser feito para sua redução?

INTRODUCTION: One of the main health indicators is infant mortality rate, which is a metric of living conditions and population development. The goal of reducing neonatal mortality requires an adequate knowledge of the real factors at each level of health care so that maternal and human resources are efficiently channeled to the constraint. Countries that have paid special attention to improving health services for the entire pregnancy-puerperal cycle have attained the reduction of infant mortality, especially early neonatal mortality. OBJECTIVE: The present study aims to describe the profile and analyze the risk factors associated with neonatal mortality in the Angolan context at a tertiary level public maternity hospital, located in Luanda. METHODS: This is a retrospective cross-sectional study with a quantitative approach, using secondary data, of provincial base in hospital and ministerial registry instruments from January to December 2012. RESULTS: The results show that the neonatal deaths are not mere occurrences, since they indicate failures of the political powers, professionals of the health system and of the families. CONCLUSIONS: This study suggests that the major risk factor for birth mortality in Luanda is the type of delivery (c-section) and that this data is not related to the age of the mother or to premature birth. We also found that there was higher mortality between May and July, during the period of lower rainfall index in the region. However, further studies are needed that may provide a logical framework and arguments for realistic policies to mitigate neonatal mortality.

INTRODUÇÃO: Um dos principais indicadores de saúde é a taxa de mortalidade infantil, que é uma métrica de condições de vida e desenvolvimento populacional. A redução da mortalidade neonatal requer um conhecimento adequado dos fatores reais em cada nível de atenção à saúde, de modo que os recursos maternos e humanos sejam eficientemente avaliados. Os países que deram atenção especial à melhoria dos serviços de saúde para todo o ciclo gravídico-puerperal atingiram a redução da mortalidade infantil, especialmente a mortalidade neonatal precoce. OBJETIVO: O presente estudo tem como objetivo descrever o perfil e analisar os fatores de risco associados à mortalidade neonatal em uma maternidade pública de nível terciário localizada em Luanda, Angola. MÉTODO: Trata-se de um estudo retrospectivo de corte transversal com abordagem quantitativa, utilizando dados secundários de base provincial em instrumentos de registro hospitalar e ministerial de janeiro a dezembro de 2012. RESULTADOS: Os resultados mostram que os óbitos neonatais não são meras ocorrências, pois indicam falhas dos poderes políticos, de profissionais do sistema de saúde e das famílias. CONSLUSÃO: Este estudo sugere que o maior fator de risco para mortalidade ao nascimento em Luanda é o tipo de parto (c-section) e que este dado não está relacionado com a idade da mãe ou com o nascimento prematuro. Identificamos também que houve maior mortalidade entre os meses de maio a julho, durante o período de menor índice de chuvas na região. No entanto, são necessários mais estudos que possam fornecer um quadro lógico e argumentos para políticas realistas para mitigar a mortalidade neonatal.

The role of Survivin as a biomarker and potential prognostic factor for breast cancer.

Breast cancer (BC) is one of the primary health problems worldwide. As the most common cancer in women in the world and in Brasil, behind only non-melanoma skin cancer, this neoplasm corresponds to approximately 28% of new cases per year in the country. BC also affects men, although the incidence corresponds to only 1% of total cases. Currently, most of the chemotherapeutic agents used in BC treatment are extremely toxic and cause long-term side effects. There is also a need to obtain earlier diagnoses, more accurate prognoses and make new therapies available that are more selective and effective in order to improve the current scenario. Therefore, this work sought to evaluate the importance of the biomarker survivin (Sur) in relation to BC, through the detailing of the role of Sur as a biomarker, the correlation between this protein and the prognosis of BC patients, and a summary of therapeutic strategies that target Sur for the development of new anticancer therapies.

The role of Survivin as a biomarker and potential prognostic factor for breast cancer

SUMMARY Breast cancer (BC) is one of the primary health problems worldwide. As the most common cancer in women in the world and in Brasil, behind only non-melanoma skin cancer, this neoplasm corresponds to approximately 28% of new cases per year in the country. BC also affects men, although the incidence corresponds to only 1% of total cases. Currently, most of the chemotherapeutic agents used in BC treatment are extremely toxic and cause long-term side effects. There is also a need to obtain earlier diagnoses, more accurate prognoses and make new therapies available that are more selective and effective in order to improve the current scenario. Therefore, this work sought to evaluate the importance of the biomarker survivin (Sur) in relation to BC, through the detailing of the role of Sur as a biomarker, the correlation between this protein and the prognosis of BC patients, and a summary of therapeutic strategies that target Sur for the development of new anticancer therapies.

RESUMO O câncer de mama (CM) é um dos principais problemas de saúde em todo o mundo. Como o câncer mais comum em mulheres no mundo e no Brasil, precedido apenas pelo câncer de pele não melanoma, essa neoplasia corresponde a aproximadamente 28% dos novos casos por ano no país. O CM também afeta homens, embora a incidência corresponda a apenas 1% do total de casos. Atualmente, a maioria dos agentes quimioterápicos utilizados no tratamento do CM são extremamente tóxicos e causam efeitos colaterais a longo prazo. Há também a necessidade de se obterem diagnósticos mais precoces, prognósticos mais precisos e disponibilizar novas terapias seletivas e efetivas, a fim de melhorar o cenário atual. Portanto, este trabalho buscou avaliar a importância do biomarcador Survivina (Sur) em relação ao CM, por meio do detalhamento do papel do Sur como biomarcador, da correlação entre essa proteína com o prognóstico de pacientes com CM e de um resumo do tratamento terapêutico e das estratégias que visam utilizar a Sur para o desenvolvimento de novas terapias anticâncer.

Effect of mild aerobic exercise in atrial granules of mice with chronic Chagas Disease / Efeito do exercício aeróbico leve em grânulos atriais de camundongos com doença de Chagas crônica

Background: Chagas disease presents in different clinical forms, ranging from asymptomatic to acute, with destruction of heart cells and a possibility of death. In the chronic phase, the parasites can cause serious injuries to different tissues.Objectives: Our objective was to study the effects of physical exercise (swimming) in atrial granules and components of cardiomyocytes in mice with chronic Chagas disease. Methods: In total, 20 male mice were divided into four different groups: untrained control (UC), trained control (TC), untrained infected (UI), and trained infected (TI). In the UI and TI groups, 1,000 forms of Trypanosoma cruzi (Y strain) were inoculated intraperitoneally. After 40 days of infection and proof of chronic phase, the exercise protocol began. The UC and UI groups performed exercise for 10 min/day, and the TC and TI groups followed a training protocol five times a week for 30 minutes during 8 weeks. Ultrathin sections were subjected to morphometric and stereological analyses using electron photomicrographs (x15000) obtained by transmission electron microscopy.Results: The TI group showed the lowest percentage of small granules (58%), while the UI group presented 80% of these granules. The volume density of the Golgi complex and myofibrils in the TI group were reduced compared with those in the UI group, while the parameters of atrial granules and mitochondria increased. Conclusion: Our results suggest that mild physical exercise changes the morphological and morphometric parameters of granules and organelles in the cardiac atrium of mice infected with T. cruzi, and produces moderate beneficial effects on the cardiovascular system

Effect of physical exercise on the renal structures of ovariectomized female LDL knockout mice / Efecto del ejercicio físico sobre las estructuras renales de ratones hembras con LDL ovariectomizadas

SUMMARY: The reduction of ovarian function and a decrease in estrogen levels marked by menopause are related to increased susceptibility to develop dyslipidemia. These alterations in the lipid profile can have consequences in renal tissue and generate injuries that may progress to renal failure. The practice of physical activity is an important factor for the treatment and prevention of dyslipidemia and its consequences. The objective of this study is to observe the effects of physical exercise on the right kidney of ovariectomized female LDL knockout mice. Animals were submitted to moderate physical exercise, sacrificed, and the right kidney was removed for morphometric and stereological analysis. The results showed that dyslipidemia promoted a decrease in the areas of the corpuscle and renal glomerulus, in the volume density of light in both the proximal and distal convoluted tubules, and an increase in capsular space, particularly more marked in the proximal tubules. We also observed that physical exercise decreased the analyzed parameters. Our results suggest the association of physical training and dyslipidemia presents a tendency to reduce the dimensions of morphometric and stereological parameters of the kidney. These changes may be related to metabolic and physiological adaptation of renal tissue during physical exercise.

RESUMEN: La reducción de la función ovárica y una disminución en los niveles de estrógeno, marcados por la menopausia, se relacionan con una mayor susceptibilidad a desarrollar dislipidemia. Estas alteraciones en el perfil lipídico pueden tener consecuencias en el tejido renal y generar lesiones que pueden progresar a insuficiencia renal. La práctica de la actividad física es un factor importante para el tratamiento y la prevención de la dislipidemia y sus consecuencias. El objetivo de este estudio fue observar los efectos del ejercicio físico en el riñón derecho de ratones hembras con LDL ovariectomizados. Los animales fueron sometidos a ejercicio físico moderado, se sacrificaron y se extrajo el riñón derecho para el análisis morfométrico y estereológico. Los resultados mostraron que la dislipidemia promovió una disminución en las áreas del corpúsculo y el glomérulo renal, en la densidad volumétrica de la luz en los túbulos contorneados proximales y distales, y un aumento en el espacio capsular, particularmente más marcado en los túbulos proximales. También observamos que el ejercicio físico disminuyó los parámetros analizados. Nuestros resultados sugieren que la asociación del entrenamiento físico y la dislipidemia presentan una tendencia a reducir las dimensiones de los parámetros morfométricos y estereológicos del riñón. Estos cambios pueden estar relacionados con la adaptación metabólica y fisiológica del tejido renal durante el ejercicio físico.

Obstructive sleep apnea syndrome and sleep quality in hypertensive patients.

INTRODUCTION: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. OBJECTIVE: To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. METHOD: A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. RESULTS: Group I (using up to two antihypertensive agents - 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs - 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. CONCLUSION: Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).