Immune pathway through endometriosis to ovarian cancer.

Endometriosis is an estrogen-dependent inflammatory disease, defined by the presence of functional endometrial tissue outside of the uterine cavity. This disease is one of the main gynecological diseases, affecting around 10%-15% women and girls of reproductive age, being a common gynecologic disorder. Although endometriosis is a benign disease, it shares several characteristics with invasive cancer. Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer, representing an earlier stage of neoplastic processes. This is particularly true for women with clear cell carcinoma, low-grade serous carcinoma and endometrioid. However, the carcinogenic pathways between both pathologies remain poorly understood. Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers (EAOCs) via pathways associated with oxidative stress, inflammation, and hyperestrogenism. This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis, specifically focusing on the complex relationship between the immune response to endometriosis and cancer, including the molecular mechanisms and their ramifications. Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.

Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy.

BACKGROUND: Helicobacter pylori (H. pylori) infection has been well-established as a significant risk factor for several gastrointestinal disorders. The urea breath test (UBT) has emerged as a leading non-invasive method for detecting H. pylori. Despite numerous studies confirming its substantial accuracy, the reliability of UBT results is often compromised by inherent limitations. These findings underscore the need for a rigorous statistical synthesis to clarify and reconcile the diagnostic accuracy of the UBT for the diagnosis of H. pylori infection. AIM: To determine and compare the diagnostic accuracy of 13C-UBT and 14C-UBT for H. pylori infection in adult patients with dyspepsia. METHODS: We conducted an independent search of the PubMed/MEDLINE, EMBASE, and Cochrane Central databases until April 2022. Our search included diagnostic accuracy studies that evaluated at least one of the index tests (13C-UBT or 14C-UBT) against a reference standard. We used the QUADAS-2 tool to assess the methodological quality of the studies. We utilized the bivariate random-effects model to calculate sensitivity, specificity, positive and negative test likelihood ratios (LR+ and LR-), as well as the diagnostic odds ratio (DOR), and their 95% confidence intervals. We conducted subgroup analyses based on urea dosing, time after urea administration, and assessment technique. To investigate a possible threshold effect, we conducted Spearman correlation analysis, and we generated summary receiver operating characteristic (SROC) curves to assess heterogeneity. Finally, we visually inspected a funnel plot and used Egger's test to evaluate publication bias. RESULTS: The titles and abstracts of 4621 studies were screened; 79 articles were retrieved and selected for full-text reading. Finally, 60 studies were included in the diagnostic test accuracy meta-analysis. Our analysis demonstrates superior diagnostic accuracy of 13C-UBT over 14C-UBT, indicated by higher sensitivity (96.60% vs 96.15%), specificity (96.93% vs 89.84%), likelihood ratios (LR+ 22.00 vs 10.10; LR- 0.05 vs 0.06), and area under the curve (AUC; 0.979 vs 0.968). Notably, 13C-UBT's DOR (586.47) significantly outperforms 14C-UBT (DOR 226.50), making it the preferred diagnostic tool for dyspeptic individuals with H. pylori infection. Correlation analysis revealed no threshold effect (13C-UBT: r = 0.48; 14C-UBT: r = -0.01), and SROC curves showed consistent accuracy. Both 13C-UBT and 14C-UBT showed high AUC values (13C-UBT 0.979; 14C-UBT 0.968) near 1.00, reinforcing their excellent accuracy and endorsing both as reliable diagnostic tools in clinical practice. CONCLUSION: In summary, our study has demonstrated that 13C-UBT has been found to outperform the 14C-UBT, making it the preferred diagnostic approach. Additionally, our results emphasize the significance of carefully considering urea dosage, assessment timing, and measurement techniques for both tests to enhance diagnostic precision. Nevertheless, it is crucial for researchers and clinicians to evaluate the strengths and limitations of our findings before implementing them in practice.

Exploring the Impact of the Synthesis Variables Involved in the Polyurethane Aerogels-like Materials Design.

This research presents a novel approach to synthesising polyurethane (PUR)-based aerogels at the pilot scale, optimizing synthesis variables such as the gelation solvent, solids content, chain extender/isocyanate ratio, and dispersion mode. The solids content (2-11 wt.%) is the parameter with the most influence on the density of the aerogels, with a clear decrease in this property as the solids content decreases. On the other hand, it was demonstrated that minimizing the excess of ethylenediamine (used as chain extender) in relation to the isocyanate is a valuable consideration to improve the thermal conductivity of the aerogel. Related to the chain extender/isocyanate ratio, a compromise situation where the initial isocyanate reacts almost completely is crucial. Fourier-transform infrared spectroscopy was used to conduct such monitoring during the reaction. Once the conditions were optimised, the aerogel showing improved properties was synthesised using ethyl acetate as the gelling solvent, a 3.7 wt.% solids content, an ethylenediamine/isocyanate ratio of 0.20, and sonication as the dispersion mode, attaining a thermal conductivity of 0.030 W m-1 K-1 and a density of 0.046 g cm-3. Therefore, the synthesized aerogel emerges as a promising candidate for use in the construction and automotive industries.

Membraneless, self-powered immunosensing of a cardiac biomarker by exploiting a PEC platform based on CaBi2Ta2O9 combined with bismuth oxyiodides.

This work describes the development of a membraneless, self-powered immunosensor exploiting a photoelectrochemical system based on two photoelectrodes for cardiac troponin I (cTn). An electrode based on CaBi2Ta2O9 combined with bismuth oxyiodides (BiOI/Bi4O5I2/Bi5O7I) was modified with the cTnI antibody (anti-cTnI) and applied in a photoelectrochemical cell as a photoanode. To perform the cTnI detection exploiting a self-powered photoelectrochemical setup, the immunosensor (anti-cTnI/BiOI/Bi4O5I2/Bi5O7I/CaBi2Ta2O9/FTO) was coupled to a photoelectrochemical cell containing a photocathode based on CuBi2O4 (CBO/FTO) for zero-biased photoelectrochemical immunosensing of cardiac troponin I (cTnI) biomarker. For comparison purposes, the photoanode was applied for cTnI detection in a three-electrode electrochemical cell. The spectroscopic, structural, and morphological characteristics of the photoelectrochemical (PEC) materials were evaluated using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). Electrochemical impedance spectroscopy (EIS) measurements were performed in the presence and absence of light to investigate the effects of photons on the charge transfer resistance of the photoanode. The influence of the cTnI biomarker on the photoelectrochemical response of the anti-cTnI antibody-modified photoelectrochemical platform (anti-cTnI/BiOI/Bi4O5I2/Bi5O7I/CaBi2Ta2O9/FTO) was evaluated by measuring the photocurrent of the system. The immunosensor presented a linear response ranging from 1 pg mL-1 to 200 ng mL-1 as well as a mean recovery percentage between 95.7% and 108.0% in real human serum samples for the cTnI biomarker.

Benefits of using polymeric nanoparticles in breast cancer treatment: a systematic review.

Breast cancer comprises approximately 20% of all malignant neoplasm cases globally. Due to the limitations associated with conventional therapeutic approaches, extensive investigations have been undertaken to develop novel treatments that exhibit enhanced specificity and minimized adverse effects. Consequently, the application of polymeric nanoformulations for targeted drug delivery has gained significant attention within the biomedical field. Therefore, the primary objective of this study was to explore the inherent advantages and efficacy of employing polymeric nanoformulations for drug delivery in breast cancer treatment, as compared to traditional therapies. A comprehensive literature search was conducted across prominent databases including PubMed/MEDLINE, Embase, and Scopus, utilizing specific search strings. This meticulous approach yielded a total of 12 relevant articles for in-depth analysis and discussion. The findings from the selected studies underscore the effectiveness of employing polymeric nanoparticles as a drug delivery strategy, showcasing noteworthy improvements in cellular uptake and sustained intracellular retention of encapsulated therapeutic agents. Additionally, these nanoformulations exhibited superior efficacy, safety, and drug delivery capabilities. The utilization of polymeric nanoparticles in drug delivery has demonstrated a substantial enhancement in treatment efficacy, with the ability to achieve higher concentrations of active ingredients within tumor tissues, augment cellular uptake and drug concentrations, and sustain intracellular retention. Consequently, this innovative approach prolongs drug release in lower quantities, ultimately contributing to improved treatment outcomes.

Role of non-Helicobacter pylori gastric Helicobacters in helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma.

Marginal zone lymphomas rank as the third most prevalent form of non-Hodgkin B-cell lymphoma, trailing behind diffuse large B-cell lymphoma and follicular lymphoma. Gastric mucosa-associated lymphoid tissue lymphoma (GML) is a low-grade B-cell neoplasia frequently correlated with Helicobacter pylori (H. pylori)-induced chronic gastritis. On the other hand, a specific subset of individuals diagnosed with GML does not exhibit H. pylori infection. In contrast to its H. pylori-positive counterpart, it was previously believed that H. pylori-negative GML was less likely to respond to antimicrobial therapy. Despite this, surprisingly, in-creasing evidence supports that a considerable proportion of patients with H. pylori-negative GML show complete histopathological remission after bacterial eradication therapy. Nonetheless, the precise mechanisms underlying this treatment responsiveness are not yet fully comprehended. In recent years, there has been growing interest in investigating the role of non-H. pylori gastric helicobacters (NHPHs) in the pathogenesis of H. pylori-negative GML. However, additional research is required to establish the causal relationship between NHPHs and GML. In this minireview, we examined the current understanding and proposed prospects on the involvement of NHPHs in H. pylori-negative GML, as well as their potential response to bacterial eradication therapy.

Pediatric multisystem inflammatory syndrome associated with COVID-19: Insights in pathogenesis and clinical management.

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a major challenge to be faced in recent years. While adults suffered the highest morbidity and mortality rates of coronavirus disease 2019, children were thought to be exclusively asymptomatic or to present with mild conditions. However, around April 2020, there was an outbreak of a new clinical syndrome related to SARS-CoV-2 in children - multisystemic inflammatory syndrome in children (MIS-C) - which comprises a severe and uncon-trolled hyperinflammatory response with multiorgan involvement. The Centers for Disease Control and Prevention considers a suspected case of MIS-C an individual aged < 21 years presenting with fever, high inflammatory markers levels, and evidence of clinically severe illness, with multisystem (> 2) organ involvement, no alternative plausible diagnoses, and positive for recent SARS-CoV-2 infection. Despite its severity, there are no definitive disease management guidelines for this condition. Conversely, the complex pathogenesis of MIS-C is still not completely understood, although it seems to rely upon immune dysregulation. Hence, in this study, we aim to bring together current evidence regarding the pathogenic mechanisms of MIS-C, clinical picture and management, in order to provide insights for clinical practice and implications for future research directions.

Correction to "Performance of a serological IgM and IgG qualitative test for COVID-19 diagnosis: An experimental study in Brazil".

[This corrects the article on p. 100 in vol. 12, PMID: 36196438.].

Trajectories of Parental Daily Stress: An Ecological Momentary Assessment Study during the COVID-19 Lockdown.

The COVID-19 pandemic was a source of significant stress due to health and safety concerns and measures to control the virus' spread, such as mobility restrictions. This measure was especially demanding for parents with school aged children, who had to find new work-family balance as their children participate in online education while attempting to work remotely. To evaluate parents' stress trajectories during the pandemic, we conducted Ecological Momentary Assessments (EMAs) during lockdown for 29 days in 68 families in Santiago, Chile. In addition, we evaluated the role of educational level and income, co-parenting, and number of children in parents' stress trajectories. Our results showed that during the first weeks of lockdown expected protective factors (i.e., income and co-parental support) were not able to influence parents' daily stress management. Moreover, parents with higher educational levels reported worse stress adaptation than less educated parents. On the other hand, co-parental conflict was significantly associated with parent's stress. Our study captured an acute response to COVID-19 related challenges. This study contributes to understanding how parents adjust to stress during adverse circumstances such as the COVID-19 pandemic.

Effectiveness of Helicobacter pylori eradication in the treatment of early-stage gastric mucosa-associated lymphoid tissue lymphoma: An up-to-date meta-analysis.

BACKGROUND: Gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) is usually a low-grade B-cell neoplasia strongly associated with Helicobacter pylori (H. pylori)-induced chronic gastritis. Clinical practice guidelines currently recommend H. pylori eradication as the preferred initial treatment for early-stage GML. To determine the practical effect of bacterial eradication as the sole initial therapy for early-stage GML, an updated analysis and review of available evidence is imperative. AIM: To perform a meta-analysis to assess the rate of complete remission (CR) of H. pylori-positive early-stage GML following bacterial eradication. METHODS: We performed independent, computer-assisted literature searches using the PubMed/MEDLINE, Embase, and Cochrane Central databases through September 2022. Prospective and retrospective observational studies evaluating the CR of early-stage GML following bacterial eradication in H. pylori-positive patients. The risk of bias was assessed using Joanna Briggs Institute (JBI) Critical Appraisal Tools. The pooled estimate of the complete histopathological remission rate and respective confidence intervals (95%CI) were calculated following the random-effects model. Heterogeneity and inconsistency were assessed using Cochran's Q test and I2 statistic, and heterogeneity was defined as P < 0.01 and I² > 50%, respectively. Subgroup and meta-regression analyses were conducted to explore potential sources of heterogeneity. RESULTS: The titles and abstracts of 1576 studies were screened; 96 articles were retrieved and selected for full-text reading. Finally, 61 studies were included in the proportional meta-analysis (P-MA). Forty-six were prospective and fifteen were retrospective uncontrolled, single-arm, observational studies. The overall risk of bias was low to moderate in all but a single report, with an average critical appraisal score across all studies of 79.02%. A total of 2936 H. pylori-positive early-stage GML patients, in whom H. pylori was successfully eradicated, were included in the analysis. The pooled CR of H. pylori-positive early-stage GML after bacterial eradication was 75.18% (95%CI: 70.45%-79.91%). P-MA indicated the substantial heterogeneity in CR reported across studies (I 2 = 92%; P < 0.01). Meta-regression analysis identified statistically significant effect modifiers, including the proportion of patients with t(11;18)(q21;q21)-positive GML and the risk of bias in each study. CONCLUSION: Comprehensive synthesis of available evidence suggests that H. pylori eradication is effective as the sole initial therapy for early-stage GML. Although the substantial heterogeneity observed across studies limits the interpretation of the pooled overall CR, the present study is a relevant to informing clinical practice.

Immunotherapy in glioblastoma treatment: Current state and future prospects.

Glioblastoma remains as the most common and aggressive malignant brain tumor, standing with a poor prognosis and treatment prospective. Despite the aggressive standard care, such as surgical resection and chemoradiation, median survival rates are low. In this regard, immunotherapeutic strategies aim to become more attractive for glioblastoma, considering its recent advances and approaches. In this review, we provide an overview of the current status and progress in immunotherapy for glioblastoma, going through the fundamental knowledge on immune targeting to promising strategies, such as Chimeric antigen receptor T-Cell therapy, immune checkpoint inhibitors, cytokine-based treatment, oncolytic virus and vaccine-based techniques. At last, it is discussed innovative methods to overcome diverse challenges, and future perspectives in this area.

Trend in hospitalizations due to ambulatory care-sensitive conditions in the Federal District.

OBJECTIVES: to analyze the trend, according to sex, of Ambulatory Care-Sensitive Conditions in the Primary Health Care of the Federal District, from 2009 to 2019. METHODS: ecological trend study using ACSC hospitalization data available in the Hospitalization System of the Single Health System. The Prais-Winsten method was used to calculate the annual rate variation, expressed in percentages. The dependent variable was the logarithm of the rates, and the independent one, the years in the time series. RESULTS: the Federal District registered 2,103,951 general hospitalizations, 16.4% of which were due to Ambulatory Care-Sensitive Conditions. Males had a higher rate of hospitalization in the period, and both sexes showed a stationary trend. CONCLUSIONS: the time trend of Ambulatory Care- Sensitive Conditions was stationary, but further studies are necessary regarding primary health care coverage.

Trend in hospitalizations due to ambulatory care-sensitive conditions in the Federal District / Tendencia de las internaciones por condiciones sensibles a la atención primaria de salud en Distrito Federal / Tendência das internações por condições sensíveis à atenção primária à saúde no Distrito Federal

ABSTRACT Objectives: to analyze the trend, according to sex, of Ambulatory Care-Sensitive Conditions in the Primary Health Care of the Federal District, from 2009 to 2019. Methods: ecological trend study using ACSC hospitalization data available in the Hospitalization System of the Single Health System. The Prais-Winsten method was used to calculate the annual rate variation, expressed in percentages. The dependent variable was the logarithm of the rates, and the independent one, the years in the time series. Results: the Federal District registered 2,103,951 general hospitalizations, 16.4% of which were due to Ambulatory Care-Sensitive Conditions. Males had a higher rate of hospitalization in the period, and both sexes showed a stationary trend. Conclusions: the time trend of Ambulatory Care- Sensitive Conditions was stationary, but further studies are necessary regarding primary health care coverage.

RESUMEN Objetivos: analizar tendencia de Internaciones por Condiciones Sensibles a la Atención Primaria por sexo en Distrito Federal desde 2009 a 2019. Métodos: estudio ecológico de tendencia con datos de ICSAP disponibles en el Sistema de Internaciones Hospitalarias del Sistema Único de Salud. Utilizado método de Prais-Winsten para el cálculo de la variación porcentual anual de las tasas. La variable dependiente fue el logaritmo de las tasas, y la independiente, los años de la serie temporal. Resultados: Distrito Federal registró 2.103.951 internaciones generales, siendo 16,4% Internaciones por Condiciones Sensibles a la Atención Primaria. El sexo masculino obtuvo la mayor tasa de internación en todo el periodo y hubo tendencia estacionaria tanto para el sexo masculino mientras el femenino. Conclusiones: las tendencias temporales de las Internaciones por Condiciones Sensibles a la Atención Ambulatoria mostradas estacionarias, pero resaltada la necesidad de estudios de correlación con la cobertura de la atención primaria de salud.

RESUMO Objetivos: analisar a tendência das Internações por Condições Sensíveis à Atenção Primária por sexo no Distrito Federal, no período de 2009 a 2019. Métodos: estudo ecológico de tendência com dados de ICSAP disponíveis no Sistema de Internações Hospitalares do Sistema Único de Saúde. Utilizou-se o método de Prais-Winsten para o cálculo da variação percentual anual das taxas. A variável dependente foi o logaritmo das taxas; e a variável independente, os anos da série temporal. Resultados: o Distrito Federal registrou 2.103.951 internações gerais, sendo 16,4% Internações por Condições Sensíveis à Atenção Primária. O sexo masculino obteve a maior taxa de internação em todo o período, e houve tendência estacionária tanto para o sexo masculino quanto para o sexo feminino. Conclusões: as tendências temporais das Internações por Condições Sensíveis à Atenção Primária mostraram-se estacionárias, porém ressalta-se a necessidade de estudos de correlação com a cobertura da Atenção Primária à Saúde.

Floristic data to support conservation in the Amazonian canga / Dados florísticos para apoiar a conservação nas cangas amazônicas

Abstract Canga is an environment of great natural and economic value because it harbours a considerable number of endemic species on a substrate that is rich in iron ore. In the Amazon, this open vegetation type grows on top of isolated outcrops in a dense forest matrix found in the Carajás region, in southeastern Pará. Of these outcrops, the Parque Nacional dos Campos Ferruginosos (PNCF) is the only area of Amazonian canga with a strict protection status. Therefore, industrial activity in the region needs to implement mitigation actions to ensure species and habitat conservation. The objective of this study is to complement and review the floristic list of this recently created protected area, enabling us to compare the floristic similarity between it and other 14 Amazonian canga outcrops found outside the conservation units of full protection in the region. This data provides a basis to understand the floristic and phylogenetic complementarity of those patches to support conservation action. For this, six field trips were carried out in the Serra da Bocaina and two in the Serra do Tarzan, respectively, in order to increase the sampling efforts in PNCF and to obtain a more comprehensive plant list. Floristic composition was investigated using multivariate analyses (non-metric multidimensional scaling and unweighted pair group method with arithmetic mean) and phylogenetic structure across studied areas. We added 159 species to the floristic list of the PNCF and the results of the analyses showed that all 16 areas (n.b. PNCF comprises two of these sites) have an overall floristic similarity of 42%, with the least similar areas at 35% and the most similar at 50%. The different micro-habitats found in each study site highlight the high beta diversity of the Amazonian canga sites, making each area unique. Therefore, even if the Parque Nacional dos Campos Ferruginosos does not harbour all the species found in the other Amazonian canga sites, it is strategic for the conservation of the vegetation on ferruginous outcrops in the Amazon, protecting its biodiversity, different habitats, and associated ecosystem services.

Resumo Canga é um ambiente de grande valor natural e econômico por abrigar um número considerável de espécies endêmicas sobre substrato rico em minério de ferro. Na Amazônia, esse tipo de vegetação aberta cresce sobre afloramentos isolados em uma matriz de floresta densa encontrada na região de Carajás, no sudeste do Pará. Dentre esses afloramentos, o Parque Nacional dos Campos Ferruginosos (PNCF) é a única área de canga Amazônica que apresenta o status de proteção integral permanente. Dessa forma, a atividade industrial presente na região necessita implementar ações de mitigação para assegurar a conservação de espécies e habitats relacionados às cangas. O objetivo deste estudo é complementar e revisar a lista florística dessa área protegida, recentemente criada, permitindo comparar a sua similaridade florística com outros 14 afloramentos de cangas Amazônicas localizados fora de unidades de conservação de proteção integral encontradas na região. Tais dados fornecem subsídio para entender a complementaridade florística e filogenética desses fragmentos para apoiar ações de conservação. Para isso, foram realizadas seis viagens de coleta à Serra da Bocaina e à Serra do Tarzan, respectivamente, para aumentar o esforço amostral no PNCF e obter uma lista de plantas mais abrangente. A composição florística foi investigada por meio de análises multivariadas (non-metric multidimensional scaling and unweighted pair group method with arithmetic mean) e estrutura filogenética nas áreas estudadas. Nós adicionamos 159 espécies na lista florística do PNCF e os resultados das análises demonstraram que todas as 16 áreas (n.b. o PNCF compreende duas dessas áreas) têm uma similaridade florística total de 42%, com áreas menos similares de 35% e as mais similares de 50%. Os micro-habitats encontrados em cada área de estudo evidenciam a alta diversidade beta das áreas de cangas Amazônicas, o que as tornam únicas. Portanto, ainda que o Parque Nacional dos Campos Ferruginosos não abrigue todas as espécies encontradas em outras áreas de cangas Amazônicas, ele é estratégico para a conservação dos afloramentos ferruginosos na Amazônia, protegendo a sua biodiversidade, os diferentes habitats e os serviços ecossistêmicos associados.

Crohn's disease and clinical management today: How it does?

Crohn's Disease (CD) is an Inflammatory Bowel Disease and is characterized by an immune-mediated nature. Its etiology results from the interaction between genetic, enviromental and microbial factors. Regarding pathophysiology, it involves high levels of interleukin (IL)-12, IL-17, and Th1 profile, along with loss of tolerance mechanisms, an increase in pro-inflammatory interleukins, beyond the possibility to affect any part of the gastrointestinal tract. Its symptoms include abdominal pain, chronic diarrhea, weight loss, anorexia, and fatigue, as well as blood in the stool or rectum. Additionally, conditions comprising musculoskeletal, cutaneous, ocular, hepatic, and hematological alterations may be associated with this scenario and extra-intestinal presentation, such as erythema nodosum, anterior uveitis, osteoporosis, and arthritis can also occur. Today, clinical history, exams as fecal calprotectin, ileocolonocopy, and capsule endoscopy can be performed in the diagnosis investigation, along with treatments to induce and maintain remission. In this sense, anti-inflammatory drugs, such as corticosteroids, immunomodulators, and biological agents, as well as surgery and non-pharmacological interventions plays a role in its therapy. The aim of this review is to bring more current evidence to clinical management of CD, as well as to briefly discuss aspects of its pathophysiology, surveillance, and associated disorders.

Influence of Helicobacter pylori oncoprotein CagA in gastric cancer: A critical-reflective analysis.

Gastric cancer is the fifth most common malignancy and third leading cancer-related cause of death worldwide. Helicobacter pylori is a Gram-negative bacterium that inhabits the gastric environment of 60.3% of the world's population and represents the main risk factor for the onset of gastric neoplasms. CagA is the most important virulence factor in H. pylori, and is a translocated oncoprotein that induces morphofunctional modifications in gastric epithelial cells and a chronic inflammatory response that increases the risk of developing precancerous lesions. Upon translocation and tyrosine phosphorylation, CagA moves to the cell membrane and acts as a pathological scaffold protein that simultaneously interacts with multiple intracellular signaling pathways, thereby disrupting cell proliferation, differentiation and apoptosis. All these alterations in cell biology increase the risk of damaged cells acquiring pro-oncogenic genetic changes. In this sense, once gastric cancer sets in, its perpetuation is independent of the presence of the oncoprotein, characterizing a "hit-and-run" carcinogenic mechanism. Therefore, this review aims to describe H. pylori- and CagA-related oncogenic mechanisms, to update readers and discuss the novelties and perspectives in this field.

Role of nickel-regulated small RNA in modulation of Helicobacter pylori virulence factors.

Helicobacter pylori (H. pylori) is a Gram-negative bacterium that infects about half of the world's population. H. pylori infection prevails by several mechanisms of adaptation of the bacteria and by its virulence factors including the cytotoxin associated antigen A (CagA). CagA is an oncoprotein that is the protagonist of gastric carcinogenesis associated with prolonged H. pylori infection. In this sense, small regulatory RNAs (sRNAs) are important macromolecules capable of inhibiting and activating gene expression. This function allows sRNAs to act in adjusting to unstable environmental conditions and in responding to cellular stresses in bacterial infections. Recent discoveries have shown that nickel-regulated small RNA (NikS) is a post-transcriptional regulator of virulence properties of H. pylori, including the oncoprotein CagA. Notably, high concentrations of nickel cause the reduction of NikS expression and consequently this increases the levels of CagA. In addition, NikS expression appears to be lower in clinical isolates from patients with gastric cancer when compared to patients without. With that in mind, this minireview approaches, in an accessible way, the most important and current aspects about the role of NikS in the control of virulence factors of H. pylori and the potential clinical repercussions of this modulation.

Performance of a serological IgM and IgG qualitative test for COVID-19 diagnosis: An experimental study in Brazil.

Qualitative antibody tests are an easy, point-of-care diagnostic method that is useful in diagnosing coronavirus disease 2019, especially in situations where reverse transcription-polymerase chain reaction is negative. However, some factors are able to affect its sensitivity and accuracy, which may contribute to these tests not being used as a first-line diagnostic tool.

COVID-19 neuropsychiatric repercussions: Current evidence on the subject.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the entire world, causing the coronavirus disease 2019 (COVID-19) pandemic since it was first discovered in Wuhan, China in December 2019. Among the clinical presentation of the disease, in addition to fever, fatigue, cough, dyspnea, diarrhea, nausea, vomiting, and abdominal pain, infected patients may also experience neurological and psychiatric repercussions during the course of the disease and as a post-COVID-19 sequelae. Thus, headache, dizziness, olfactory and gustatory dysfunction, cerebrovascular disorders, neuromuscular abnormalities, anxiety, depression, and post-traumatic stress disorder can occur both from the infection itself and from social distancing and quarantine. According to current evidence about this infection, the virus has the ability to infect the central nervous system (CNS) via angiotensin-converting enzyme 2 (ACE2) receptors on host cells. Several studies have shown the presence of ACE2 in nerve cells and nasal mucosa, as well as transmembrane serine protease 2, key points for interaction with the viral Spike glycoprotein and entry into the CNS, being olfactory tract and blood-brain barrier, through hematogenous dissemination, potential pathways. Thus, the presence of SARS-CoV-2 in the CNS supports the development of neuropsychiatric symptoms. The management of these manifestations seems more complex, given that the dense parenchyma and impermeability of brain tissue, despite protecting the brain from the infectious process, may hinder virus elimination. Still, some alternatives used in non-COVID-19 situations may lead to worse prognosis of acute respiratory syndrome, requiring caution. Therefore, the aim of this review is to bring more current points related to this infection in the CNS, as well as the repercussions of the isolation involved by the pandemic and to present perspectives on interventions in this scenario.

Epidemiological pattern of births from the largest surveillance database of live births in Brazil "SINASC" before and during the COVID-19 pandemic in the Brazilian Amazon

The surveillance of live births in Brazil has been carried out since 1990 by the Information System on Live Births (SINASC), which was implemented by the Ministry of Health aiming at standardized registration on a national level. The state of Para is part of the Brazilian Amazon, northern Brazil, which has several unique characteristics. Thus, the purpose of this study was to identify the epidemiological pattern of live births before and during the pandemic of COVID-19 in the state of Para, 2016 to 2020. This is an ecological epidemiological time-series study, using epidemiological surveillance data from DATASUS, referring to the Live Births Information System (SINASC). These are data that have been treated by surveillance and are in aggregate format. The study population is the live births residing in the state of Para, in the period from 2016 to 2020. The data collection instrument was the Declaration of Live Births (DLB). There were 689,454 live births, and the highest rates of births were and continued to remain in the Marajo II, Baixo Amazonas, Xingu, and Tapajos regions. The Metropolitan I and Araguaia regions were and continue to be the lowest rates in the state. Age of the mother 15 to 19 years old 22.29%, 20 to 24 years old 30.05% and 25 to 29 years old 22.58%, most of the single pregnancy type 98.32%, prenatal consultations, performed 7 or more 48.10%, followed by 4 to 6 consultations 33.98%, most presented 7 or more years of the study 48.10%, followed by 3 to 6 years 33.98%. Represented 51.21% male and 48.77% female. The occurrence of congenital anomalies represented 0.52% of live births. Another congenital malformation and deformity were the most prevalent at 25.53%, followed by Congenital deformities of the feet 14.90%, Other congenital malformations of the nervous system 14.84%, and Other congenital malformations 10.77%, Cleft lip, and cleft palate 8.88%, Other congenital malformations digestive tract 8.10%. The demographic transition has already occurred for several decades, including the reduction of fertility and birth rate, so our study showed that the reduction in the number of live births was already a reality in the country, but we emphasize that this reduction was enhanced by the pandemic. We observed greater adherence to prenatal care and a lower prevalence of low birth weight compared to other studies, but the limitation was the absence of studies in the same place of the research. Regarding data incompleteness, we emphasize the ignored fields that reflect the fragility in the surveillance of live births, which was reinforced by the literature.