OMS publica primeiras diretrizes para tratamento clínico de adultos que querem parar de fumar

A Organização Mundial da Saúde (OMS) divulgou suas primeiras diretrizes para o tratamento de adultos que querem parar de fumar. As recomendações incluem um conjunto abrangente de intervenções como suporte comportamental oferecido por profissionais de saúde, intervenções digitais e tratamentos farmacológicos.

Relatório da OPAS mostra que as DCNTs continuam sendo a principal causa de morte e incapacidade nas Américas e alerta os países para que preparem os sistemas de saúde para uma população que envelhece rapidamente

Um novo relatório da Organização Pan-Americana da Saúde (OPAS) revela que, embora a expectativa de vida tenha aumentado nas Américas, também aumentou o número de pessoas que vivem com Doenças Crônicas Não Transmissíveis (DCNT).

Cerca de 1,8 bilhão de adultos correm o risco de adoecer devido à falta de atividade física

De acordo com uma análise recente, cerca de 1,8 bilhão de adultos (31%) não praticaram os níveis recomendados de atividade física em 2022. A informação é de um estudo, fruto da colaboração entre pesquisadores da Organização Mundial da Saúde (OMS) e professores universitários, publicado recentemente na revista The Lancet Global Health.

Amoebae as training grounds for microbial pathogens.

Grazing of amoebae on microorganisms represents one of the oldest predator-prey dynamic relationships in nature. It represents a genetic "melting pot" for an ancient and continuous multi-directional inter- and intra-kingdom horizontal gene transfer between amoebae and its preys, intracellular microbial residents, endosymbionts, and giant viruses, which has shaped the evolution, selection, and adaptation of microbes that evade degradation by predatory amoeba. Unicellular phagocytic amoebae are thought to be the ancient ancestors of macrophages with highly conserved eukaryotic processes. Selection and evolution of microbes within amoeba through their evolution to target highly conserved eukaryotic processes have facilitated the expansion of their host range to mammals, causing various infectious diseases. Legionella and environmental Chlamydia harbor an immense number of eukaryotic-like proteins that are involved in ubiquitin-related processes or are tandem repeats-containing proteins involved in protein-protein and protein-chromatin interactions. Some of these eukaryotic-like proteins exhibit novel domain architecture and novel enzymatic functions absent in mammalian cells, such as ubiquitin ligases, likely acquired from amoebae. Mammalian cells and amoebae may respond similarly to microbial factors that target highly conserved eukaryotic processes, but mammalian cells may undergo an accidental response to amoeba-adapted microbial factors. We discuss specific examples of microbes that have evolved to evade amoeba predation, including the bacterial pathogens- Legionella, Chlamydia, Coxiella, Rickettssia, Francisella, Mycobacteria, Salmonella, Bartonella, Rhodococcus, Pseudomonas, Vibrio, Helicobacter, Campylobacter, and Aliarcobacter. We also discuss the fungi Cryptococcus, and Asperigillus, as well as amoebae mimiviruses/giant viruses. We propose that amoeba-microbe interactions will continue to be a major "training ground" for the evolution, selection, adaptation, and emergence of microbial pathogens equipped with unique pathogenic tools to infect mammalian hosts. However, our progress will continue to be highly dependent on additional genomic, biochemical, and cellular data of unicellular eukaryotes.

Determining the dispersion time in Staphylococcus epidermidis biofilm using physical and molecular approaches.

Despite being an innocuous commensal of human skin and mucous membranes, Staphylococcus epidermidis, infects surgical wounds and causes infections through biofilm formation. This study evaluates, in a time-dependent experiment, the self-dispersion of S. epidermidis CIP 444 biofilm when formed on borosilicate glass (hydrophilic) and polystyrene (hydrophobic) surfaces, using physical and molecular approaches. During a seven-day period of incubation, absorbance measurement revealed a drop in biofilm optical density on both studied surfaces on day 4 (0.043-0.035 nm/cm2, polystyrene), (0.06-0.053 nm/cm2, borosilicate glass). Absorbance results were correlated with crystal violet staining that showed a clear detachment from day 4. The blue color increases again on day 7, with an increase in biofilm optical density indicating the regeneration of the biofilm. Changes in gene expression in the S. epidermidis biofilm were assessed using a real-time reverse transcription-polymerase chain reaction. High expression of agr genes was detected on days 4 and 5, confirming our supposition of dispersion in this period, autolysin genes like atlE1 and aae were upregulated from day 3 until day 6 and the genes responsible for slime production and biofilm accumulation, were upregulated on days 4, 5, and 6 (ica ADBC) and on days 5, 6 and 7 (aap), indicating a dual process taking place. These findings suggest that S. epidermidis CIP 444 biofilms disperse at day 4 and reform at day 7. Over the course of the seven-day investigation, 2-ΔΔCt results showed that some genes in the biofilm were dramatically enhanced while others were significantly decreased as compared to planktonic ones.

Comparative transcriptomics reveal a novel tardigrade-specific DNA-binding protein induced in response to ionizing radiation.

Tardigrades are microscopic animals renowned for their ability to withstand extreme conditions, including high doses of ionizing radiation (IR). To better understand their radio-resistance, we first characterized induction and repair of DNA double- and single-strand breaks after exposure to IR in the model species Hypsibius exemplaris. Importantly, we found that the rate of single-strand breaks induced was roughly equivalent to that in human cells, suggesting that DNA repair plays a predominant role in tardigrades' radio-resistance. To identify novel tardigrade-specific genes involved, we next conducted a comparative transcriptomics analysis across three different species. In all three species, many DNA repair genes were among the most strongly overexpressed genes alongside a novel tardigrade-specific gene, which we named Tardigrade DNA damage Response 1 (TDR1). We found that TDR1 protein interacts with DNA and forms aggregates at high concentration suggesting it may condensate DNA and preserve chromosome organization until DNA repair is accomplished. Remarkably, when expressed in human cells, TDR1 improved resistance to Bleomycin, a radiomimetic drug. Based on these findings, we propose that TDR1 is a novel tardigrade-specific gene conferring resistance to IR. Our study sheds light on mechanisms of DNA repair helping cope with high levels of DNA damage inflicted by IR.

Divergent Biochemical Properties and Disparate Impact of Arrhythmogenic Calmodulin Mutations on Zebrafish Cardiac Function.

Calmodulin (CaM) is a ubiquitous, small cytosolic calcium (Ca2+)-binding sensor that plays a vital role in many cellular processes by binding and regulating the activity of over 300 protein targets. In cardiac muscle, CaM modulates directly or indirectly the activity of several proteins that play a key role in excitation-contraction coupling (ECC), such as ryanodine receptor type 2 (RyR2),  l-type Ca2+ (Cav1.2), sodium (NaV1.5) and potassium (KV7.1) channels. Many recent clinical and genetic studies have reported a series of CaM mutations in patients with life-threatening arrhythmogenic syndromes, such as long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). We recently showed that four arrhythmogenic CaM mutations (N98I, D132E, D134H, and Q136P) significantly reduce the binding of CaM to RyR2. Herein, we investigate in vivo functional effects of these CaM mutations on the normal zebrafish embryonic heart function by microinjecting complementary RNA corresponding to CaMN98I, CaMD132E, CaMD134H, and CaMQ136P mutants. Expression of CaMD132E and CaMD134H mutants results in significant reduction of the zebrafish heart rate, mimicking a severe form of human bradycardia, whereas expression of CaMQ136P results in an increased heart rate mimicking human ventricular tachycardia. Moreover, analysis of cardiac ventricular rhythm revealed that the CaMD132E and CaMN98I zebrafish groups display an irregular pattern of heart beating and increased amplitude in comparison to the control groups. Furthermore, circular dichroism spectroscopy experiments using recombinant CaM proteins reveals a decreased structural stability of the four mutants compared to the wild-type CaM protein in the presence of Ca2+. Finally, Ca2+-binding studies indicates that all CaM mutations display reduced CaM Ca2+-binding affinities, with CaMD132E exhibiting the most prominent change. Our data suggest that CaM mutations can trigger different arrhythmogenic phenotypes through multiple and complex molecular mechanisms.

Ferrocenyl-triazole complexes and their use in heavy metal cation sensing.

Complexes tris((1-ferrocenyl-1H-1,2,3-triazol-4-yl)methyl)amine (3), bis((1-ferrocenyl-1H-1,2,3-triazol-4-yl)methyl)amine (6), bis((1-ferrocenyl-1H-1,2,3-triazol-4-yl)methyl)ether (7), and 1-ferrocenyl-1H-1,2,3-triazol-4-yl)methanamine (9) were synthesized using the copper-catalyzed click reaction. Complexes 3, 6, 7, and 9 were characterized using NMR (1H and 13{1H}) and IR spectroscopy, elemental analysis, and mass spectrometry. Structures of 3, 7, and 9 in the solid state were determined using single-crystal X-ray diffraction. It was found that the triazole rings were planar and slightly twisted with respect to the cyclopentadienyl groups attached to them. Chains and 3D network structures were observed due to the presence of π⋯π and C-H⋯N interactions between the cyclopentadienyl and triazole ligands. A reversible redox behavior of the Fc groups between 239 and 257 mV with multicycle stability was characteristic for all the compounds, revealing that the electrochemically generated species Fc+ remained soluble in dichloromethane. Electrochemical sensor tests demonstrated the applicability of all the complexes to enhance the quantification sensing behavior of the screen-printed carbon electrode (SPCE) toward Cd2+, Pb2+, and Cu2+ ions.

Quick methylene blue dye elimination via SDS-Ag nanoparticles catalysts.

Methylene blue dye, being toxic, carcinogenic and non-biodegradable, poses a serious threat for human health and environmental safety. The effective and time-saving removal of such industrial dye necessitates the use of innovative technologies such as silver nanoparticle-based catalysis. Utilizing a pulsed Nd:YAG laser operating at the second harmonic generation of 532 nm with 2.6 J energy per pulse and 10 ns pulse duration, Ag nanoparticles were synthesized via an eco-friendly method with sodium dodecyl sulphate (SDS) as a capping agent. Different exposure times (15, 30, and 45 min) resulted in varying nanoparticle sizes. Characterization was achieved through UV-Vis absorption spectroscopy, scanning electron microscopy (SEM) imaging, and energy dispersive X-ray (EDX). Lorentzian fitting was used to model nanoparticle size, aligning well with SEM results. Mie's theory was applied to evaluate the absorption, scattering, and extinction cross-sectional area spectra. EDX revealed increasing Ag and carbon content with exposure time. The SDS-caped AgNPs nanoparticles were tested as catalyst for methylene blue degradation, achieving up to 92.5% removal in just 12 min with a rate constant of 0.2626 min-1, suggesting efficient and time-saving catalyst compared to previously reported Ag-based nanocatalysts.

Understanding quality of life issues in patients with advanced melanoma: Phase 1 and 2 in the development of the EORTC advanced melanoma module.

AIMS: We aimed to develop a European Organization for Research and Treatment of Cancer (EORTC) Quality of Life (QoL) module tailored for patients with advanced (resectable or unresectable stage III/IV) melanoma receiving immune checkpoint inhibitors or targeted therapy. METHODS: Following the EORTC QoL Group module development guidelines, we conducted phases 1 and 2 of the development process. In phase 1, we generated a list of health-related (HR)QoL issues through a systematic literature review and semi-structured interviews with healthcare professionals (HCPs) and patients with advanced melanoma. In phase 2, these issues were converted into questionnaire items to create the preliminary module. RESULTS: Phase 1: we retrieved 8006 articles for the literature review, of which 35 were deemed relevant, resulting in 84 HRQoL issues being extracted to create the initial issue list. Semi-structured interviews with 18 HCPs and 28 patients with advanced melanoma resulted in 28 issues being added to the initial issue list. Following EORTC module development criteria, 26 issues were removed, and two issues were added after review by patient advocates. Phase 2: To ensure uniformity and avoid duplication, 16 issues were consolidated into eight items. Additionally, an independent expert contributed one new item, resulting in a preliminary module comprising 80 HRQoL items. CONCLUSION: We identified a range of HRQoL issues (dry skin, xerostomia, and arthralgia) relevant to patients with stage III/IV melanoma. Future module development phases will refine the questionnaire. Once completed, this module will enable standardized assessment of HRQoL in patients with (locally) advanced melanoma.

Society for Endometriosis and Uterine Disorders Forum: Adenomyosis Today, Paris, France, December 12, 2023.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of Defense, or the United States Government. This symposium was supported by Sumitomo Pharma. However, the authors received no support for the creation of this manuscript, and the manuscript was created, revised and submitted solely by the authors recognized above.

Risk factors for early mortality from lung cancer: evolution over the last 20 years in the French nationwide KBP cohorts.

BACKGROUND: The impact of the most recent advances, including targeted therapies and immune checkpoint inhibitors, on early (3-month) mortality in lung cancer is unknown. The aims of this study were to evaluate the real-world rate of and risk factors for early mortality, as well as trends in early mortality over the last 20 years. MATERIALS AND METHODS: The KBP prospective observational multicenter studies have been conducted every 10 years since 2000. These studies collect data on all newly diagnosed patients with lung cancer (all stages and histologies) over 1 year in non-academic public hospital pulmonology or oncology units in France. In this study, we analyzed data on patient and tumor characteristics from participants in the KBP-2020 cohort and compared the characteristics of patients who died within 3 months of diagnosis with those of all other patients within the cohort. We also carried out a comparative analysis with the KBP-2000 and KBP-2010 cohorts. RESULTS: Overall, 8999 patients from 82 centers were included in the KBP-2020 cohort. Three-month survival data were available for 8827 patients, of whom 1792 (20.3%) had died. Risk factors for early mortality were: male sex, age >70 years, symptomatic disease at diagnosis, ever smoker, weight loss >10 kg, poor Eastern Cooperative Oncology Group performance status (≥1), large-cell carcinoma or not otherwise specified, and stage ≥IIIC disease. The overall 3-month mortality rate was found to have decreased significantly over the last 20 years, from 24.7% in KBP-2000 to 23.4% in KBP-2010 and 20.3% in KBP-2020 (P < 0.0001). CONCLUSION: Early mortality among patients with lung cancer has significantly decreased over the last 20 years which may reflect recent improvements in treatments. However, early mortality remained extremely high in 2020, particularly when viewed in light of improvements in longer-term survival. Delays in lung cancer diagnosis and management could contribute to this finding.

Impact of Relugolix Combination Therapy on Functioning and Quality of Life in Women with Endometriosis-Associated Pain.

OBJECTIVE: To evaluate the effect of relugolix combination therapy (relugolix CT; 40 mg relugolix, 1 mg estradiol, and 0.5 mg norethisterone acetate) for up to 2 years in the SPIRIT long-term extension (LTE) study on functioning and health-related quality of life (QoL), using the Endometriosis Health Profile (EHP)-30 questionnaire, and assess how changes in QoL domains correlated with improvements in dysmenorrhea and non-menstrual pelvic pain (NMPP). DESIGN: Long-term extension (LTE) study of the SPIRIT phase 3 trials. SUBJECTS: Premenopausal women with moderate-to-severe endometriosis pain who previously completed the randomized SPIRIT trials were eligible to enroll in an 80-week LTE where all women received relugolix CT. INTERVENTIONS: Relugolix combination therapy (relugolix CT: relugolix 40 mg, estradiol 1 mg, norethindrone acetate 0.5 mg) MAIN OUTCOME MEASURE(S): Least square (LS) mean changes in the EHP-30 domain and total scores from baseline (pivotal) were analyzed using a mixed-effects model. Results up to104 weeks are reported by pivotal trial treatment group with a focus on the relugolix CT group (ie, relugolix CT or placebo for 24 weeks, or delayed relugolix CT [relugolix 40 mg monotherapy for 12 weeks, followed by relugolix CT for 12 weeks]). In addition, the relationships between changes in dysmenorrhea and NMPP and changes in EHP-30 scores were assessed. RESULTS: In the 277 women treated with relugolix CT, LS mean EHP-30 pain domain scores improved by 57.8% (LS mean change:-32.8; 95% CI:-35.5, -30.1), 66.4% (LS mean change:-37.7; 95% CI:-40.3,-35.0); and 72.2% (LS mean change:-41.3; 95% CI:-43.9,-38.7) at Weeks 24, 52, and 104, respectively. The proportions of women with clinically meaningful improvement on the EHP-30 pain domain were 75.9%, 83.6% and 88.6% at weeks 24, 52, and 104, respectively. Non-pain EHP-30 domain and total scores likewise improved. A positive correlation between changes in dysmenorrhea/NMPP and all EHP -30 domain scores was observed. Results were similar for the delayed relugolix CT and placebo→relugolix CT groups. CONCLUSIONS: Sustained reduction of endometriosis-associated pain with relugolix CT observed up to 104 weeks was accompanied by improvements in functioning and health-related QoL. These findings complement the results of the pivotal SPIRIT trials, which showed relugolix combination therapy significantly reduced dysmenorrhea, non-menstrual pelvic pain (NMPP) and dyspareunia vs placebo in premenopausal women with endometriosis-associated pain.

Optimizing nutrient utilization, hydraulic loading rate, and feed conversion ratios through freshwater IMTA-aquaponic and hydroponic systems as an environmentally sustainable aquaculture concept.

Water quality in land-based fish production can be controlled through either instantaneous water exchange or costly wastewater treatment followed by recirculation. Agricultural-aquaculture integration is an excellent alternative technique for reducing nutrient discharge levels, boosting profitability, and converting fish culture wastewater into valuable products. The current study employed a solar energy system to power two separate IMTA-aquaponics systems (Nutrient Film Technique, NFT, and Floating Raft Systems, FRS) for the cultivation of Nile tilapia, African catfish, thin-lipped grey mullet, freshwater crayfish, freshwater mussels, and a variety of vegetables. Tilapia and catfish were fed exclusively on diets under the IMTA system. All wastewater from tilapia and catfish ponds, both dissolved and solid, flows sequentially to ponds containing other cultivated species. The water then flows through the IMTA system's terminal point to the NFT and FRS systems before returning to the tilapia and catfish ponds, allowing complete control of the nutrient flow throughout this entire circular system. Two 147-day production cycles were concluded. The results from the second production cycle are reported. Total biomass gain for aquatic species in the IMTA system was 736.46 kg, compared to 145.49 kg in the tilapia and 271.01 kg in the catfish monoculture systems. The current IMTA system had a cumulative feed conversion ratio (FCR) of 0.90, while the FCRs for tilapia and catfish were 1.28 and 1.42, respectively. Nile tilapia and catfish consumed 571.90 kg of feed containing 25.70 kg of nitrogen (N) and 9.70 kg of phosphorus (P), reflecting, and gaining 11.41 and 3.93 kg of dietary N and P, representing 44.40 and 40.46% dietary N and P retention, respectively. In the IMTA system, the addition of mullet and prawn as detrivores aquatic animals improves dietary N and P utilization efficiency to 59.06 and 51.19%, respectively, while the addition of mussels as herbivore animals improves dietary N and P utilization efficiency to 65.61 and 54.67%, respectively. Finally, using FRS and NFT as hydroponic systems increased dietary N and P efficiency to 83.51% N and 96.82% P, respectively. This study shows that the IMTA-Aquaponic system, as a bio-integrated food production system, can convert the majority of fish-fed residues into valuable products suitable for desert, rural, and urban areas in impoverished and developing countries.

Triglyceride glucose index as a marker of primary patency rate of arteriovenous fistula in diabetic hemodialysis patients.

OBJECTIVE: Arteriovenous fistula (AVF) structures are vital formations used for hemodialysis. Diabetes mellitus (DM) is a critical disease affecting the vascular system. The triglyceride glucose (TyG) index has been shown to be associated with major adverse cardiovascular events in patients with Type 2 DM. In this study, we aimed to investigate the effect of the TyG index on the primary AVF patency of diabetic patients. PATIENTS AND METHODS: Between March 2018 and March 2023, patients with DM who underwent AVF surgery in our clinic due to end-stage renal disease were retrospectively included in this study. The patients who could receive hemodialysis were determined as Group 1, and those who could not were determined as Group 2. RESULTS: A total of 189 patients were included in the study. Those who did not develop AVF primary failure were included in Group 1 [n=138, median age = 59 (22-77) years], and those who did were included in Group 2 [n=51, median age = 63 (20-81) years]. In the multivariate analysis, age >70 years (OR: 0.871, 95% CI: 0.594-0.983, p=0.039), the presence of PAD (OR: 0.582, 95% CI: 0.0.458-0.896, p=0.046), and TyG index (OR: 0.879, 95% CI: 0.591-0.916, p<0.001) were determined as independent predictors for primary AVF failure. CONCLUSIONS: This study demonstrated that the TyG index value, calculated from blood samples taken at the time of hospital admission in hemodialysis patients with diabetes mellitus (DM), is an independent predictor of primary AVF failure following AVF surgery.

Anterior segment optical coherence tomography (AS-OCT) in strabismus following trauma.

We describe 3 cases of ocular trauma that presented with strabismus. Anterior segment optical coherence tomography was used to delineate the morphology of extraocular muscle insertions and proved helpful in diagnosis and management.

Oral health status, behavior, and practices among hearing impaired children attending a specialized school in Jordan.

AIMS: To assess the oral health status and related factors among hearing impaired schoolchildren. METHODS: A cross-sectional study among 115 hearing impaired schoolchildren enrolled at the School of the Deaf in Jordan. The World Health Organization (WHO) methodology and criteria were applied to collect data on caries, gingival bleeding. The WHO classification modified by Andreasen et al. was used to record traumatic dental injuries (TDIs). Sociodemographic data, oral health practices, and oral health related quality of life information were collected using a structured questionnaire. RESULTS: The prevalence of caries among the study sample was 84.3%, the dominating component was untreated dental caries. Mean decayed, missing, filled primary teeth (dmft) was 8 in the primary dentition and 3.62 in the mixed dentition, mean Decayed, Missing, Filled permanent Teeth (DMFT) was 1.38 in the mixed dentition and 2.87 in the permanent. The overall mean of gingival bleeding percentage among the whole study sample was 70.38%. the prevalence of TDIs was of 11.3% and mostly caused by falls. CONCLUSIONS: The prevalence of dental caries and caries experience, rate of gingival bleeding and dental trauma in children with hearing impaired individuals are high compared to figures observed in studies conducted among Jordanian schoolchildren with normal hearing. Dental diseases impact the quality of life of these individuals.