Lifestyle, meal times, and sleep patterns changes in higher education professors during COVID-19: Association with non-communicable chronic diseases.

BACKGROUND: In response to the COVID-19 pandemic, educational institutions had to swiftly adapt and transition to remote teaching in order to maintain academic activities. However, these changes presented a number of challenges for professors, which could have negative effects on their health. OBJECTIVE: To analyze the association between changes in dietary and sleep habits, physical activity level, and sedentary behavior with the development of non-communicable diseases (NCDs) among Brazilian higher education professors during the pandemic period. METHODS: This is a cross-sectional and retrospective study conducted using an online form. Generalized linear models, adjusted for age, sex, and body mass index, were used to verify the difference between pre-pandemic and pandemic periods. Logistic regression models were used to predict the odds ratio (OR) for the development of NCDs according to physical activity time, sedentary behavior time, dietary and sleep patterns. RESULTS: A total of 936 professors residing across Brazil participated in the survey. The duration of sedentary behavior increased, sleep duration slightly decreased, and meal times shifted to earlier during the pandemic. A total of 22.9%of the participants reported the diagnosis of some NCDs during this period. Physical activity practice was associated with a lower risk of diseases during the pandemic, regardless of the intensity performed. On the other hand, late eating habits and excessive food consumption during the pandemic were associated with a higher risk. CONCLUSION: The results provide data that can help in the development of public policies that promote health actions to minimize the consequences associated with the pandemic period.

Sequential therapy with topical clobetasol for 14 days followed by hydroquinone versus hydroquinone alone in facial melasma treatment: a randomized, double-blind, controlled clinical trial.

BACKGROUND: Clobetasol has demonstrated remarkable results in treating melasma within a short time frame; however, its use is limited because of the risk of local side effects. To date, there is no controlled trial on sequential clobetasol/hydroquinone for melasma. This study aimed to investigate the tolerability and efficacy of 0.05% clobetasol followed by 4% hydroquinone (CLOB-HQ) in comparison to the isolated use of 4% hydroquinone (HQ). METHODS: A double-blinded, randomized clinical trial involving 50 women with facial melasma was performed. They were directed to apply 0.05% clobetasol every night for 14 days, followed by 4% hydroquinone for 46 days (CLOB-HQ group), or the use of hydroquinone for 60 days (HQ group). Evaluations were carried out at inclusion, and after 14 and 60 days of treatment, measuring modified Melasma Area and Severity Index (mMASI), Melasma Quality of Life scale (MELASQoL), and colorimetry. The Global Aesthetic Improvement Scale (GAIS) was assessed by a blinded evaluator. RESULTS: There was no difference in the main outcomes at D14 and D60 (P > 0.1). For CLOB-HQ, the mean (CI 95%) reduction in mMASI was 13.2% (5.1-21.3%) and 43.1% (32.2-54.0%) at D14 and D60, and for HQ, they were 10.6% (5.9-27.5%) and 44.8% (33.2-52.3%). The MELASQoL, colorimetric luminosity, and GAIS showed a progressive improvement for both groups despite no difference between them. No severe side effects were identified. No cases of telangiectasias, atrophy, or perioral dermatitis were associated with the use of CLOB. CONCLUSION: The sequential CLOB-HQ regimen was safe and well tolerated, even though its efficacy was not different from HQ after 14 or 60 days of treatment. Based on these findings, the use of clobetasol 14 days before hydroquinone is not advisable for the treatment of melasma.

Dietary self-perception by women beneficiaries of the Bolsa Família Program in Fortaleza, Ceará, Brazil / Autopercepção alimentar de mulheres beneficiárias do Programa Bolsa Família em Fortaleza, Ceará, Brasil

ABSTRACT Objective To evaluate the association between dietary self-perception and socioeconomic, health, diet, and lifestyle variables of socially vulnerable women in primary health care. Methods This cross-sectional study was conducted in a Primary Health Care Unit in Fortaleza, Ceará, with 158 women beneficiaries of the Bolsa Família (Family Aid) Program. We applied a questionnaire containing socioeconomic and health variables, food knowledge, and self-perception. Pearson's chi-square test, with a 5% significance level, was adopted to investigate possible associations between women's food self-perception and other variables. Results The women had a mean age of 31.2 years. Most had a household income of less than one minimum wage (75.9%), a high school education level (53.8%), were overweight (67.7%), did not engage in physical activity (72.8%), and received dietary guidance (51.9%). Negative dietary self-perception was reported by 57.0% of the sample. Women who did not engage in physical activity had a higher frequency of negative dietary self-perception (p=0.007). Conclusion Most women showed negative dietary self-perception. The variable "physical activity" was positively associated with dietary self-perception. Knowing how women perceive their diet and which factors are associated with their food choices can help health professionals in their daily conduct in health care units.

RESUMO Objetivo Avaliar a associação entre a autopercepção alimentar negativa e variáveis socioeconômicas, de saúde, alimentação e estilo de vida de mulheres em vulnerabilidade social, na atenção primária à saúde. Métodos Estudo do tipo transversal realizado em uma Unidade de Atenção Primária à Saúde de Fortaleza, Ceará, com 158 mulheres beneficiárias do Programa Bolsa Família. Um questionário foi aplicado contendo as variáveis investigadas. O teste Qui-quadrado de Pearson, com nível de significância 5% foi utilizado para investigar possíveis associações entre a autopercepção alimentar das mulheres e as demais variáveis. Resultados As mulheres apresentaram média de idade de 31,2 anos e a maioria tinha renda familiar inferior a um salário-mínimo (75,9%), ensino médio como o nível de escolaridade (53,8%), apresentou excesso de peso (67,7%), não praticava atividade física (72,8%) e recebeu orientações sobre alimentação (51,9%). A autopercepção alimentar negativa foi relatada por 57,0% da amostra. As mulheres que não praticavam atividade física, tiveram maior frequência de autopercepção alimentar negativa (p=0,007). Conclusão A maioria das mulheres apresentou autopercepção negativa da alimentação e a variável "atividade física" mostrou associação positiva em relação à autopercepção alimentar. Conhecer como as mulheres percebem sua alimentação e quais fatores se associam às suas escolhas pode auxiliar os profissionais de saúde em suas condutas no cotidiano dos atendimentos nas unidades de saúde.

Recessive SERPING1 Variant Leads to Kinin-Kallikrein System Control Failure in a Consanguineous Brazilian Family with Hereditary Angioedema.

Background: Hereditary angioedema (HAE) is a severe and potentially life-threatening disease. The most common forms are caused by variants in SERPING1, resulting in C1-inhibitor (C1-INH) deficiency (HAE-C1-INH). C1-INH is a serine protease inhibitor (SERPIN) that regulates multiple proteases pathways, including the kallikrein-kinin system (KKS) and its complement. In HAE-C1-INH patients, C1-INH deficiencies affect KKS control, resulting in the development of kallikrein activity in plasma and the subsequent release of bradykinin (BK). While the overwhelming majority of disease-causing SERPING1 variants are dominant, very few recessive variants have been described. We present a large Brazilian HAE-C1-INH family with a recessive form of HAE-C1-INH. Methods: Blood samples of family members were investigated for protein levels of C1-INH, C4, C1q, and C1-INH function. The SERPING1 gene was sequenced. Results: In two severely affected sisters, we identified a homozygous missense variant in SERPING1 (NM_000062.3:c.964G>A;p.Val322Met). Fourteen family members were asymptomatic heterozygous carriers of the variant. Data regarding C1-INH function in the plasma showed that homozygous p.Val322Met strongly impacts C1-INH function to inhibit C1s and kallikrein (PKa). When heterozygously expressed, it affects the C1-INH control of C1s more than that of PKa. Conclusions: These studies of the variant's effects on the structure-function relationship reinforce prior observations suggesting that C1-INH deficiency is a conformational disease.

Efficacy of dupilumab for the treatment of severe skin disease in cytotoxic T lymphocyte antigen-4 insufficiency: A role of type 2 inflammation?

We report on the successful treatment of a severe, recalcitrant dermatitis caused by CTLA-4 insufficiency with dupilumab, raising the possibility of a role of type 2 immunity in clinical conditions associated with CTLA-4 insufficiency.

3-Bromopyruvate Suppresses the Malignant Phenotype of Vemurafenib-Resistant Melanoma Cells.

(1) BRAF mutations are associated with high mortality and are a substantial factor in therapeutic decisions. Therapies targeting BRAF-mutated tumors, such as vemurafenib (PLX), have significantly improved the overall survival of melanoma patients. However, patient relapse and low response rates remain challenging, even with contemporary therapeutic alternatives. Highly proliferative tumors often rely on glycolysis to sustain their aggressive phenotype. 3-bromopyruvate (3BP) is a promising glycolysis inhibitor reported to mitigate resistance in tumors. This study aimed to evaluate the potential of 3BP as an antineoplastic agent for PLX-resistant melanoma treatment. (2) The effect of 3BP alone or in combination with PLX on viability, proliferation, colony formation, cell death, migration, invasion, epithelial-mesenchymal marker and metabolic protein expression, extracellular glucose and lactate, and reactive species were evaluated in two PLX-resistant melanoma cell lines. (3) 3BP treatment, which was more effective as monotherapy than combined with PLX, disturbed the metabolic and epithelial-mesenchymal profile of PLX-resistant cells, impairing their proliferation, migration, and invasion and triggering cell death. (4) 3BP monotherapy is a potent metabolic-disrupting agent against PLX-resistant melanomas, supporting the suppression of the malignant phenotype in this type of neoplasia.

Bioprospecting antibiotic properties in photodynamic therapy of lipids from Codium tomemtosum and Chlorella vulgaris.

The growing resistance from pathogens against antibiotics has increased the research for new compounds and strategies with antibacterial potential. Lipids from algae are emerging as natural and potent bioactive molecules with interesting results regarding the inactivation of bacteria, viruses, and fungi. The combination of algae lipids with innovative strategies, such as antibacterial photodynamic therapy (aPDT) can enhance their antimicrobial potential. In this work, we aimed to evaluate the antibacterial potential in aPDT of total lipid extracts and polar lipid fractions from the green macroalga, Codium tomentosum, and the green microalga, Chlorella vulgaris on a Gram-positive bacteria Staphylococcus aureus. Total lipid extracts and polar lipid fractions were characterized by LC-MS. The results revealed that the total extracts of algae promote S. aureus inhibition after light irradiation, with a decrease of ca. 6 log10 (CFU/mL) after 15 min of treatment with both extracts of algae. The polar lipid fractions, composed by phospholipids, glycolipids and betaine lipids, from C. tomentosum and C. vulgaris also revealed antibacterial potential in combination with aPDT, but a decrease of ca. 6 log10 (CFU/mL) was reached at 60 min of treatment, later than with the total extracts. These results unveil algae lipids as antibacterial compounds in combination with aPDT displaying an alternative from natural origin to tackle pathogen resistance.

From Health Literacy to Self-Care: Contributions of the Specialist Nurse in Rehabilitation Nursing.

(1) Background: Initiatives aimed at assessing and intervening in health literacy have the potential to promote adherence to self-care behaviours, which is the main focus of intervention by rehabilitation nurses. Thus, the objectives were to analyse the level of health literacy of working-age citizens and identify priority areas for intervention by rehabilitation nurses. (2) Methods: Quantitative, correlational and cross-sectional study, conducted in a multinational company, with the participation of 161 workers. The data were collected between 14 April and 7 May 2021, using a self-completion questionnaire composed of sociodemographic and clinical characterization and the European Health Literacy Survey, following a favourable opinion from the Ethics Committee and the company's management. (3) Results: Overall, low to moderate literacy scores were predominant. Age and education were significantly associated with literacy scores. Workers with higher levels of health literacy had no diagnosed illnesses, took less medication, reported less sadness, fewer memory changes and less muscle and joint pain. (4) Conclusions: The fact that higher levels of health literacy trigger self-care behaviours and, consequently, fewer health problems reinforces the need for rehabilitation nurses to invest in this area.

Da literacia em saúde aos estilos de vida: Contributos do enfermeiro especialista em enfermagem de reabilitação / From health literacy to lifestyles: Contributions of nurse specialist in rehabilitation nursing

Em Portugal, o Exercício Profissional dos Enfermeiros Especialistas em Enfermagem de Reabilitação (EEER) sustenta-se nas competências específicas, bem como nos enunciados descritivos dos Padrões de Qualidade dos Cuidados Especializados em Enfermagem de Reabilitação, que se encontram agrupados em oitos categorias, nas quais se engloba a Promoção da Saúde e a Prevenção de Complicações. Particularizando o referido para alguns contextos, embora na saúde ocupacional, seja tenue o investimento do EEER no enunciado descritivo Promoção da Saúde, atualmente emergem discussões sobre a relevância de uma intervenção sistematizada e intencional nesta área. E a verdade é que constitui uma oportunidade de fazer a diferença na vida de um elevado número de pessoas em idade ativa, em que a mudança de comportamentos pode vir a refletir-se na diminuição do número de co-morbilidades futuras. Para a promoção da referida mudança de comportamento é essencial a existência de um adequado nível de literacia em saúde. Face ao referido, emerge a possibilidade do aumento da literacia em saúde determinar a aquisição de estilos de vida mais saudáveis, o que consequentemente, justifica a necessidade dos EEER colmatarem a lacuna da sua intervenção nesta área. Assim, este estudo tem como finalidade contribuir para clarificar a relevância da intervenção dos EEER para o nível de literacia em saúde e, consequentemente, para adoção de estilos de vida mais saudáveis na população em idade ativa. Neste sentido, foi realizado o presente estudo de natureza quantitativa, correlacional e transversal, em que a colheita de dados foi efetuada aos trabalhadores de uma empresa multinacional da região Norte do país. A técnica de amostragem usada foi não probabilistica por conveniência e como instrumento de colheita de dados foi utilizado um questionário de auto-preenchimento. Na seleção da amostra foram excluídos os trabalhadores que se encontravam de licença, independentemente do motivo, bem como os que trabalham fora da empresa sede, sendo que desta forma a nossa amostra ficou constituída por 161 trabalhadores, maioritariamente do género masculino (93,2%), com idades compreendidas entre os 30 ­ 60 anos, casados ou a viver em união de facto (58,4%) e com um nível de escolaridade de ensino secundário (41,6%). Em relação à condição de saúde, verificamos que apesar dos participantes se encontrarem num estado considerado de pré-obesidade, maioritariamente não existem doenças diagnosticadas (70,2%), sendo que quando existem, realçam-se a hipertensão arterial (31,3%) e a dislipidemia (14,5%). Decorrente destas doenças, os fármacos que predominaram foram os anti-hipertensores (25,7%) e os antidislipidémicos (15,6%). Verificamos ainda que os sintomas mais frequentes são a dimunição da visão (36,6%) e as manifestações do foro músculo-esquelético, nas quais se destacam dores articulares (31,7%) e musculares (29,8%). Em relação à literacia em saúde e aos estilos de vida promotores de saúde predominaram índices baixos a moderados. No que se refere aos estilos de vida o score médio foi inferior na subescala Atividade Física e mais elevado na subescalas Crescimento Espiritual e Relações Interpessoais. Constatou-se que maior literacia em saúde é geralmente acompanhada de menos problemas de saúde. Além disso, a ausência de problemas de saúde é acompanhada por scores mais elevados nos estilos de vida promotores de saúde. Decorrendo dos resultados obtidos, no âmbito das competências do EEER são sugeridas orientações para desenvolvimento de programas de ginástica laboral, alongamentos, atividade física, exercício físico e educação postural personalizados, tendo em conta o posto de trabalho e as queixas dos trabalhadores. Foram ainda propostas sessões de formação no âmbito da alimentação, hábitos de saúde saudáveis, gestão da doença e gestão de stress, bem como, a disponibilização de material didático aos trabalhadores sobre as diversas temáticas.

Em Portugal, o Exercício Profissional dos Enfermeiros Especialistas em Enfermagem de Reabilitação (EEER) sustenta-se nas competências específicas, bem como nos enunciados descritivos dos Padrões de Qualidade dos Cuidados Especializados em Enfermagem de Reabilitação, que se encontram agrupados em oitos categorias, nas quais se engloba a Promoção da Saúde e a Prevenção de Complicações. Particularizando o referido para alguns contextos, embora na saúde ocupacional, seja tenue o investimento do EEER no enunciado descritivo Promoção da Saúde, atualmente emergem discussões sobre a relevância de uma intervenção sistematizada e intencional nesta área. E a verdade é que constitui uma oportunidade de fazer a diferença na vida de um elevado número de pessoas em idade ativa, em que a mudança de comportamentos pode vir a refletir-se na diminuição do número de co-morbilidades futuras. Para a promoção da referida mudança de comportamento é essencial a existência de um adequado nível de literacia em saúde. Face ao referido, emerge a possibilidade do aumento da literacia em saúde determinar a aquisição de estilos de vida mais saudáveis, o que consequentemente, justifica a necessidade dos EEER colmatarem a lacuna da sua intervenção nesta área. Assim, este estudo tem como finalidade contribuir para clarificar a relevância da intervenção dos EEER para o nível de literacia em saúde e, consequentemente, para adoção de estilos de vida mais saudáveis na população em idade ativa. Neste sentido, foi realizado o presente estudo de natureza quantitativa, correlacional e transversal, em que a colheita de dados foi efetuada aos trabalhadores de uma empresa multinacional da região Norte do país. A técnica de amostragem usada foi não probabilistica por conveniência e como instrumento de colheita de dados foi utilizado um questionário de auto-preenchimento. Na seleção da amostra foram excluídos os trabalhadores que se encontravam de licença, independentemente do motivo, bem como os que trabalham fora da empresa sede, sendo que desta forma a nossa amostra ficou constituída por 161 trabalhadores, maioritariamente do género masculino (93,2%), com idades compreendidas entre os 30 ­ 60 anos, casados ou a viver em união de facto (58,4%) e com um nível de escolaridade de ensino secundário (41,6%). Em relação à condição de saúde, verificamos que apesar dos participantes se encontrarem num estado considerado de pré-obesidade, maioritariamente não existem doenças diagnosticadas (70,2%), sendo que quando existem, realçam-se a hipertensão arterial (31,3%) e a dislipidemia (14,5%). Decorrente destas doenças, os fármacos que predominaram foram os anti-hipertensores (25,7%) e os antidislipidémicos (15,6%). Verificamos ainda que os sintomas mais frequentes são a dimunição da visão (36,6%) e as manifestações do foro músculo-esquelético, nas quais se destacam dores articulares (31,7%) e musculares (29,8%). Em relação à literacia em saúde e aos estilos de vida promotores de saúde predominaram índices baixos a moderados. No que se refere aos estilos de vida o score médio foi inferior na subescala Atividade Física e mais elevado na subescalas Crescimento Espiritual e Relações Interpessoais. Constatou-se que maior literacia em saúde é geralmente acompanhada de menos problemas de saúde. Além disso, a ausência de problemas de saúde é acompanhada por scores mais elevados nos estilos de vida promotores de saúde. Decorrendo dos resultados obtidos, no âmbito das competências do EEER são sugeridas orientações para desenvolvimento de programas de ginástica laboral, alongamentos, atividade física, exercício físico e educação postural personalizados, tendo em conta o posto de trabalho e as queixas dos trabalhadores. Foram ainda propostas sessões de formação no âmbito da alimentação, hábitos de saúde saudáveis, gestão da doença e gestão de stress, bem como, a disponibilização de material didático aos trabalhadores sobre as diversas temáticas. In Portugal, the Professional Practice of Specialist Nurses in Rehabilitation Nursing is based on specific competences, as well as on the descriptive statements of the Quality Standards of Specialized Care in Rehabilitation Nursing, which are grouped into eight categories, in which it encompasses Health Promotion and Complication Prevention. Particularizing the above for some contexts, although in occupational health, the investment of the Professional Practice of Specialist Nurses in Rehabilitation Nursing in the descriptive statement Health Promotion is tenuous, discussions are currently emerging about the relevance of a systematic and intentional intervention in this area. And the truth is that it constitutes an opportunity to make a difference in the lives of a large number of people of working age, in which the change in behavior may be reflected in a reduction in the number of future co-morbidities. The existence of an adequate level of Health Literacy is essential to promote this change in behavior. In view of the above, the possibility of increasing Health Literacy to determine the acquisition of healthier Lifestyles emerges, which consequently justifies the need for the Professional Practice of Specialist Nurses in Rehabilitation Nursing to fill the gap in their intervention in this area. Thus, this study aims to contribute to clarifying the relevance of the Professional Practice of Specialist Nurses in Rehabilitation Nursing intervention for the level of Health Literacy and, consequently, for the adoption of healthier lifestyles in the working age population. In this sense, this study was carried out of a quantitative, correlational and cross-sectional nature, in which the data collection was carried out on the workers of a multinational company in the North region of the country. The sampling technique used was non-probabilistic for convenience and a self-administered questionnaire was used as a data collection instrument. In the selection of the sample, workers who were on leave, regardless of the reason, as well as those who work outside the head office were excluded, and thus our sample consisted of 161 workers, mostly male (93,2%), aged between 30 ­ 60 years, married or living in a de facto union (58,4%) and with a level of secondary education (41,6%). Regarding the health condition, we found that although the participants are in a state considered to be pre-obesity, mostly there are no diagnosed diseases (70,2%), and when they do exist, Hypertension stands out (31,3%) and Dyslipidemia (14,5%). As a result of these diseases, the drugs that predominated were anti-hypertensive (25.7%) and anti-dyslipidemic (15,6%). We also found that the most frequent symptoms are reduced vision (36,6%) and manifestations of the musculoskeletal area, in which joint (31,7%) and muscle (29,8%) pains stand out. In relation to Health Literacy and Health-promoting Lifestyles, low to moderate rates predominated. About Lifestyles, the average score was lower on the Physical Activity subscale and higher on the Spiritual Growth and Interpersonal Relations subscales. It has been found that greater Health Literacy is generally accompanied by fewer health problems. In addition, the absence of health problems is accompanied by higher scores in Health-Promoting Lifestyles. As a result of the results obtained, within the scope of the competences of the EEER, guidelines are suggested for the development of occupational gymnastics programs, stretching, physical activity, physical exercise and personalized postural education, taking into account the work position and the complaints of workers. Training sessions were also proposed in the field of nutrition, healthy health habits, disease management and stress management, as well as the provision of educational material to workers on the various topics

Efficacy of House Dust Mite Sublingual Immunotherapy in Patients with Atopic Dermatitis: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Sensitization to house dust mites (HDMs) is frequent in patients with atopic dermatitis. OBJECTIVE: To investigate the efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides pteronyssinus extract in patients with atopic dermatitis sensitized to HDM. METHODS: In this randomized, double-blind, placebo-controlled trial, we enrolled 91 patients 3 years or older, with SCORing Atopic Dermatitis (SCORAD) score greater than or equal to 15 and positive skin test result and/or IgE to D pteronyssinus. Patients were stratified according to age (<12 and ≥12 years) to receive HDM SLIT or placebo for 18 months. Primary outcome was a greater than or equal to 15-point decrease in SCORAD score. Secondary outcomes were decreases in SCORAD and objective SCORAD, Eczema Area and Severity Index, visual analog scale for symptoms, and pruritus scale scores; Investigator's Global Assessment 0/1; and decrease greater than or equal to 4 points in Dermatology Life Quality Index. Background therapy was maintained. RESULTS: A total of 66 patients completed the study (35 HDM SLIT, 31 placebo). After 18 months, 74.2% and 58% of patients in the HDM SLIT group and the placebo group, respectively, showed greater than or equal to 15-point decrease in SCORAD score (relative risk, 1.28; 95% CI, 0.89-1.83). Significant SCORAD score decreases from baseline of 55.6% and 34.5% in HDM SLIT and placebo groups (mean difference, 20.4; 95% CI, 3.89-37.3), significant objective SCORAD score decreases of 56.8% and 34.9% in HDM SLIT and placebo groups (mean difference, 21.3; 95% CI, 0.66-41.81), and more patients with Investigator's Global Assessment 0/1 in the HDM SLIT group as compared with the placebo group (14 of 35 vs 5 of 31; relative risk, 2.63; 95% CI, 1.09-6.39) were observed at 18 months. CONCLUSIONS: Our results suggest that HDM SLIT may be effective in HDM-sensitized patients as an add-on treatment for atopic dermatitis.

Prognóstico da COVID-19 em pacientes com coinfecção viral: revisão de literatura / COVID-19 prognosis in patients with viral coinfection: literature review

Casos de infecção pelo coronavírus surgiram em 2019 e fatores de risco podem conduzir complicações, entre elas, a coinfecção viral podendo comprometer a resposta imunológica e interferir no prognóstico. Objetivos: Analisar estudos sobre coinfecção viral na COVID-19, avaliando prevalência e correlação com seu prognóstico. Métodos: Foram realizadas buscas em bases de dados utilizando os descritores: SARS-COV 2, coinfecção, vírus, coronavírus, e COVID-19. Resultados: Foram selecionados 12 artigos com os seguintes vírus: influenza, HIV e herpes. Apesar da coinfecção com influenza ser pouco prevalente, seu reconhecimento permitiu compreender diferentes manifestações clínicas e tratamento adequado. Já a coinfecção com HIV revelou que pacientes com AIDS não tratada tiveram pior prognóstico. Por fim, a coinfecção com herpes resultou em reativação, com os seguintes tipos associados: HSV-1, HSV-3, EBV, CMV e HHV-6. Conclusão: Não há evidências científicas suficientes para afirmar que a coinfecção com SARS-COV 2 com outros vírus traz pior prognóstico para COVID-19, sendo necessários mais estudos sobre tais interações

Cases of coronavirus infection emerged in 2019 and risk factors can lead to complications, including viral coinfection, which can compromise the immune response and interfere with prognosis. Objectives: To analyze studies on viral coinfection in COVID-19, evaluating prevalence and correlation with its prognosis. Methods: Database searches were performed using the descriptors: SARS-COV 2, coinfection, virus, coronavirus, and COVID-19. Results: Twelve articles with the following viruses were selected: influenza, HIV and herpes. Although coinfection with influenza is not very prevalent, its recognition made it possible to understand different clinical manifestations and appropriate treatment. Coinfection with HIV revealed that patients with untreated AIDS had a worse prognosis. Finally, coinfection with herpes resulted in reactivation, with the following types associated: HSV-1, HSV-3, EBV, CMV, and HHV-6. Conclusion: There is not enough scientific evidence to state that co-infection with SARS-COV 2 with other viruses brings a worse prognosis for COVID-19, and further studies on such interactions are needed

High-solid enzymatic hydrolysis of sugarcane bagasse and ethanol production in repeated batch process using column reactors.

Alkaline sulfite pretreated sugarcane bagasse was enzymatically hydrolyzed in a packed-bed column reactor and a bubble column reactor was evaluated to produce ethanol from the hydrolysate. Initial solid loadings of 9-16% were used in column reactor in the hydrolysis step, and the use of lower value (9%) resulted in 41 g L-1 of glucose in the hydrolysate, corresponding to 87% of cellulose hydrolysis yield. This yield was reduced to 65% for a solid loading of 16%, corresponding to a glucose concentration of 54 g L-1. Subsequently, Saccharomyces cerevisiae and Scheffersomyces stipitis were used for ethanol production in medium based on hydrolysate previously obtained, using different aeration flowrates (0.3, 0.5 and 0.7 vvm). In simple batch fermentation using S. cerevisiae, higher ethanol yield (0.40 g.g-1) and productivity (1.58 g.L-1.h-1) were achieved using 0.5 vvm. When S. stipitis was used in simple batch co-fermentations, the maximum ethanol productivities were obtained using 0.5 and 0.7 vvm (0.64 and 0.63 g.L-1.h-1, respectively). Successive repeated batches resulted in average ethanol concentration of 38 g.L-1 and fermentation efficiency of 82%, when using S. cerevisiae. For S. stipitis, those values were, respectively, 36 g.L-1 and 50%, with volumetric productivity increased along the cycles. Thus, the potential of the bioreactors as simple systems for use in the biological steps of biorefineries was demonstrated. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-021-02932-3.

Systematic review of ratios between disease /health periodontitis modulators and meta-analysis of their levels in gingival tissue and biological fluids.

OBJECTIVE: The ratio between molecules which acts towards the diseased or healthy phenotype determine whether the periodontitis lesions will progress or stabilize. Considering gingival tissue and biofluids, we aimed to present a systematic review (qualitative analysis) on the ratios between disease/health periodontitis modulators, and a meta-analysis (quantitative analysis) of their levels in individuals with periodontitis compared to controls. DESIGN: Electronic searches of the PubMed, Scopus, EMBASE and Web of Science databases were conducted for publications up to May 2020. RESULTS: A total of 53 publications were included in the systematic review, being 22 of them focusing on the ratios between Interleukin [IL]-1/IL-10, IL-6/IL-10, IL-1/IL-1RA and RANKL/OPG. Twenty-one publications were eligible for meta-analyses. The ratios of IL-1, IL-6 and RANKL mRNA levels were significantly higher in diseased gingival tissue, as well as their protein levels in gingival crevicular fluid (GCF) of periodontitis individuals. Considering the saliva levels, the RANKL/OPG ratio was higher in periodontitis subjects in comparison to controls. Meta-analyses showed higher IL-1ß, IL-1α, IL-6 and IL-10 gene expressions in gingival tissue and protein levels in GCF, while RANKL was higher in GCF of periodontitis individuals in comparison to controls. CONCLUSIONS: Both the ratios and meta-analyses showed higher levels of modulators in gingival tissue and GCF of diseased individuals.

Decreasing Attacks and Improving Quality of Life through a Systematic Management Program for Patients with Hereditary Angioedema.

INTRODUCTION: Prevention of attacks is a major goal in management of patients with hereditary angioedema (HAE). We aimed to investigate the effects of a systematic intervention for HAE patients. METHODS: Thirty-three patients with HAE with C1-inhibitor deficiency, belonging to a single family, participated in a management program coordinated by an allergist/immunologist. Angioedema attacks before intervention were ascertained by interviews and emergency room charts and recorded prospectively by patients or caregivers after enrollment. Mean number of attacks/month was compared at 12 months preintervention and 8 and 14 months within intervention. Patient-reported outcome instruments were used to assess quality of life, including HAE Quality of Life (HAE-QoL) questionnaire, psychological conditions, and work impairment, at baseline and 8 and 14 months within intervention. Data were stored in REDCap platform and analyzed by adjusted Bayesian models of double Poisson regression. RESULTS: Mean number of attacks/month significantly decreased (95% credible interval [CrI] excluding 0) from 1.15 preintervention to 0.25 and 0.23, 8 and 14 months within intervention, with mean decreases of -0.89 (95% CrI: -1.21 to -0.58) and -0.92 (95% CrI: -1.22 to -0.60), respectively. HAE-QoL scores showed mean total increases of 15.2 (95% CrI: 1.23-29.77) and 26 (95% CrI: 14.56-39.02) at 8 and 14 months within the study, as compared to baseline, revealing marked improvement in quality of life. Significant increase in role-emotional and reduction of depression, stress, and anxiety were observed at 14 months. CONCLUSION: A systematic approach integrating HAE-specific care with effective handling of psychological issues decreased the number of attacks and improved quality of life, targets for best practice in HAE.

Desenvolvimento de grupo educativo de nutrição para mulheres na atenção primária à saúde / Development of nutrition educational group for women in primary health care

O objetivo deste estudo foi desenvolver grupo educativo de nutrição com mulheres na atenção primária à saúde. O método utilizado foi a intervenção comunitária realizada em Unidade de Atenção Primária à Saúde (UAPS) em Fortaleza (CE), em que buscou-se auxiliar as participantes para escolhas alimentares e estilos de vida saudáveis. Doze atividades com temas propostos pelo grupo foram trabalhados de maneira participativa. Para avaliação da experiência, houve análise das falas gravadas e do conteúdo do diário de campo. Quinze mulheres tomaram parte da experiência cujo resultado mostrou que elas se envolveram intensamente nas atividades e avaliaram a iniciativa de maneira positiva. A baixa adesão foi o principal desafio. Concluiu-se que o desenvolvimento do grupo educativo de nutrição aponta ser uma experiência viável desde que pensada e desenvolvida coletivamente e envolva a equipe de execução, profissionais da unidade de saúde e os participantes.

This study aimed to develop an educational group in nutrition for women who in primary health care. The method was the community intervention, carried out in a Primary Health Care Unit (UAPS) in Fortaleza (CE), where sought to empower participants for healthy food choices and lifestyles. Twelve activities proposed by the participants and worked in a participative and playful way. For evaluation of the experience, there was an analysis of the recorded statements and the contents of the field diary. There was participation 15 women and the experience showed that they were intensely involved in the activities and evaluated the experience positive. Low adherence was the main challenge. The study concluded that the development of the nutritional education group points to be a viable experience provided that it is thought and developed collectively and involves the execution team, health unit professionals and participants.

Acquired Angioedema due to C1 Inhibitor Deficiency Preceding Splenic Marginal Zone Lymphoma: Further Insights from Clinical Practice.

BACKGROUND: Acquired angioedema due to C1 inhibitor deficiency (AAE-C1-INH) is a very rare disease. In clinical practice, it may be difficult to differentiate AAE-C1-INH from hereditary angioedema due to C1-INH deficiency (HAE-C1-INH). In both conditions, patients are at an increased risk of death from asphyxiation due to upper airway obstruction. The association of AAE-C1-INH with lymphoproliferative and autoimmune diseases, and with presence of anti-C1-INH antibodies has been well documented, and treatment of the underlying condition may result in complete remission of angioedema. OBJECTIVES: To discuss the clinical evaluation, diagnosis, and treatment outcomes of AAE-C1-INH in the context of the care of 2 patients with recurrent isolated angioedema. METHODS: Two patients were followed up prospectively at our clinic. Measurements of C3, C4, C1-INH, and C1q levels were carried out by nephelometry, and the functional activity of C1-INH was determined by a chromogenic assay. Hematological investigation included morphological and immunophenotyping analysis of peripheral blood, bone marrow, and spleen histopathology. Sequencing of the 8 exons and adjacent intronic regions of the SERPING1 gene was performed using the Sanger method. RESULTS: Two patients were diagnosed with AAE-C1-INH associated with splenic marginal zone lymphoma during follow-up. CONCLUSIONS: Close follow-up, including detailed clinical history, physical examination, and laboratory tests, of our patients with AAE-C1-INH was essential for the early diagnosis and successful treatment of the lymphoproliferative disease, leading to the resolution of the angioedema attacks.