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1.
Immun Inflamm Dis ; 12(9): e1330, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39267468

ABSTRACT

INTRODUCTION: Chagas disease is caused by the protozoan Trypanosoma cruzi and is clinically divided into acute and chronic phases. Chronic Chagas cardiomyopathy is the most studied manifestation of the disease. Vitamin D deficiency has been suggested as a risk factor for cardiovascular disease. No studies demonstrate the action of this hormone in the cells of patients with chronic Chagas heart disease. OBJECTIVE: To evaluate the in vitro immunomodulatory effect of vitamin D on peripheral blood mononuclear cells of patients with the different chronic clinical forms of Chagas disease. Evaluating vitamin D's in vitro effect on blood cells by producing cytokines. METHODS: Thirteen patients of the undetermined form (IND), 13 of the mild cardiac form (CARD1) and 14 of the severe cardiac form (CARD2) of Chagas disease, and 12 with idiopathic heart disease (CARDid) were included. The cells obtained from peripheral blood were treated in vitro with vitamin D (1 × 10-7 M) for 24 h and cytokines were dosed in the culture supernatant. RESULTS: Although it was not possible to demonstrate statistically significant differences between the groups studied, our data showed that the cells treated with vitamin D modify (p < .05) the production of interferon-γ (IFN-γ) (decrease in IND), tumor necrosis factor-α (TNF-α) (decreased in CARD1 and CARDid), interleukin (IL)-6 (increased in all groups), and IL-10 (decreased in CARD1, CARD2, and CARDid) when compared to untreated cells. CONCLUSION: In vitro treatment with vitamin D distinctly modulated the production of cytokines by mononuclear cells of peripheral blood among patients with chronic and indeterminate cardiac clinical forms of Chagas disease.


Subject(s)
Cytokines , Leukocytes, Mononuclear , Vitamin D , Humans , Leukocytes, Mononuclear/immunology , Leukocytes, Mononuclear/metabolism , Leukocytes, Mononuclear/drug effects , Vitamin D/pharmacology , Male , Female , Middle Aged , Cytokines/metabolism , Adult , Chagas Cardiomyopathy/drug therapy , Chagas Cardiomyopathy/immunology , Chronic Disease , Trypanosoma cruzi/immunology , Trypanosoma cruzi/drug effects , Chagas Disease/drug therapy , Chagas Disease/immunology , Chagas Disease/parasitology , Aged , Cells, Cultured
2.
Commun Med (Lond) ; 4(1): 159, 2024 Aug 07.
Article in English | MEDLINE | ID: mdl-39112679

ABSTRACT

BACKGROUND: Pubertal timing is heritable, varies between individuals, and has implications for life-course health. There are many different indicators of pubertal timing, and how they relate to each other is unclear. Our aim was to quantitatively compare nine indicators of pubertal timing. METHODS: We used data from questionnaires and height, weight, and bone measurements from ages 7-17 y in a population-based cohort of 4267 females and 4251 males to compare nine growth and development-based indicators of pubertal timing. We summarise age of each indicator, their phenotypic and genetic correlations, and how they relate to established genetic risk score (GRS) for puberty timing, and phenotypic childhood body composition measures. RESULTS: We show that pubic hair in males (mean: 12.6 y) and breasts in females (11.5 y) are early indicators of puberty, and voice breaking (14.2 y) and menarche (12.7 y) are late indicators however, there is substantial variation between individuals in pubertal age. All indicators show evidence of positive phenotypic intercorrelations (e.g., r = 0.49: male genitalia and pubic hair ages), and positive genetic intercorrelations. An age at menarche GRS positively associates with all other pubertal age indicators (e.g., difference in female age at peak height velocity per SD higher GRS: 0.24 y, 95%CI: 0.21 to 0.26), as does an age at voice breaking GRS (e.g., difference in age at male axillary hair: 0.11 y, 0.07 to 0.15). Higher childhood fat mass and lean mass associated with earlier puberty timing. CONCLUSIONS: Our findings provide insights into the measurements of the timing of pubertal growth and development and illustrate value of various pubertal timing indicators in life-course research.


Age of puberty varies between individuals and can affect a person's future health. We obtained information from 8500 British children as they progressed through puberty. We compared nine measures of pubertal timing. We found that the appearance of pubic hair in boys and breasts in girls are early indicators of puberty, and that voice change and onset of menstruation are late indicators. However, there was also substantial variability between individuals in age of puberty. All puberty measures were correlated with each other and related to an individual's adult body mass index, as well as to their childhood muscle and fat mass. Our findings are useful information for health care workers and researchers who are interested in assessing and studying puberty.

3.
Cien Saude Colet ; 29(9): e14712023, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39194116

ABSTRACT

Intimate Partner Violence (IPV) among youth is a public health problem worldwide because of its high prevalence and lifelong serious consequences in health and quality of life. This cross-sectional census aimed to describe the IPV victimization among all freshman students in a Brazilian university (n=1,509), which was selected from a larger population of 2,706 freshmen. We created a 10-item questionnaire inspired by established instruments to measure the prevalence of IPV. Multivariate logistic regression assessed the association between demographic, socioeconomic, and behavioral factors with various types of IPV. We visualized co-occurrence using a Venn diagram and employed multinomial logistic regression to examine the relationship between covariates and the cooccurrence of IPV types. The chance of IPV was higher in males, those who were currently in a relationship, and those with a higher risk of alcohol abuse. These same characteristics were also associated with an increased likelihood of experiencing the co-occurrence of two or more types of IPV. Prevention strategies should consider those groups and monitoring of those who abuse alcohol, which can be a predictor behavior or a mechanism to deal with the stress arising from IPV.


Subject(s)
Crime Victims , Intimate Partner Violence , Students , Humans , Brazil/epidemiology , Male , Intimate Partner Violence/statistics & numerical data , Students/statistics & numerical data , Cross-Sectional Studies , Universities , Female , Prevalence , Young Adult , Adolescent , Surveys and Questionnaires , Crime Victims/statistics & numerical data , Risk Factors , Sex Factors , Logistic Models , Socioeconomic Factors , Adult , Quality of Life , Alcoholism/epidemiology
4.
SciELO Preprints; jul. 2024.
Preprint in English | SciELO Preprints | ID: pps-9009

ABSTRACT

Introduction: Climate change is altering individual behaviors, particularly in terms of physical activity, with significant implications for body and mental health. Objective: This review aims to provide insights for researchers, public health professionals, and policymakers to promote physical activity effectively in the face of climate change challenges. Methods: We conducted an integrative review of studies involving adults published in English, Portuguese, or Spanish, using databases such as PubMed, Scielo, Lilacs, Web of Science, and Embase. Results: Eighty-three papers were included, revealing that heat waves reduce outdoor physical activity, while indoor activities are gaining popularity due to poor air quality. Sea level rise affects coastal areas and water-based sports, limiting access to these activities. Public policies are needed to promote physical activity for various groups, considering their specific needs and limitations. Despite these challenges, physical activity can increase resilience and be a catalyst for lifestyle changes, especially in areas most affected by climate change. Conclusion: A multidisciplinary approach is crucial for developing solutions to mitigate the negative impacts of climate change on physical activity. This review highlights the urgent need for adaptation strategies in promoting physical activity in the face of a changing environment and its implications for public health.

5.
Cien Saude Colet ; 29(7): e03132024, 2024 Jul.
Article in Portuguese, English | MEDLINE | ID: mdl-38958317

ABSTRACT

Neglect is one of the most frequently reported forms of violence against children and adolescents, although it has rarely been explored in national studies. In this light, the present study aimed to analyze the personal social network of families involved in negligence against children and adolescents. This work takes a qualitative approach, anchored in the Paradigm of Complexity, conducted with twenty families involved in negligence against children and adolescents in a municipality in the countryside of the state of São Paulo, Brazil. Data collection took place through minimal maps of the personal social network and semi-structured interviews in January 2021. The networks were limited, with little to no interaction among the different services and sectors, and were predominantly homogeneous. Because they have many weakened ties, they are relatively unsupportive, pointing out difficulties in access to work, education, and health. Due to the characteristics of the network, the complexity of the phenomenon of neglect was identified, in which elements condition and perpetuate experiences of absence and fragility. Interprofessional and intersectoral views and actions are requested and recommended.


A negligência constitui uma das violências contra crianças e adolescentes mais notificadas, entretanto ainda pouco explorada em estudos nacionais. O objetivo deste estudo foi analisar a rede pessoal social de famílias envolvidas na negligência contra crianças e adolescentes. Estudo qualitativo, ancorado no paradigma da complexidade, realizado junto a 20 familiares envolvidos na negligência contra crianças e adolescentes em município do interior de São Paulo, Brasil. A coleta de dados se deu por mapas mínimos da rede pessoal social e entrevistas semiestruturadas em janeiro de 2021. As redes se apresentaram reduzidas, com pouca ou nenhuma articulação entre os diferentes serviços e setores e predominantemente homogêneas. Por terem muitos vínculos fragilizados, mostrou-se pouco sustentadora, apontando dificuldades no acesso a trabalho, educação e saúde. Pelas características da rede, identificou-se a complexidade do fenômeno da negligência, em que elementos condicionam e perpetuam vivências de ausências e fragilidades. Olhares e ações interprofissionais e intersetoriais são pleiteadas e recomendadas.


Subject(s)
Child Abuse , Interviews as Topic , Humans , Brazil , Child , Adolescent , Female , Male , Family/psychology , Adult , Social Support , Social Networking
6.
Acta Biomater ; 185: 98-110, 2024 Sep 01.
Article in English | MEDLINE | ID: mdl-39002920

ABSTRACT

Magnesium as a biodegradable material offers promising results in recent studies of different maxillo-facial fracture models. To overcome adverse effects caused by the fast corrosion of pure magnesium in fluid surroundings, various alloys, and surface modifications are tested in animal models. In specified cases, magnesium screws already appeared for clinical use in maxillofacial surgery. The present study aims to compare the bone healing outcome in a non-load-bearing fracture scenario of the forehead in sheep when fixed with standard-sized WE43 magnesium fixation plates and screws with plasma electrolytic oxidation (PEO) surface modification in contrast to titanium osteosynthesis. Surgery was performed on 24 merino mix sheep. The plates and screws were explanted en-bloc with the surrounding tissue after four and twelve weeks. The outcome of bone healing was investigated with micro-computed tomography, histological, immunohistological, and fluorescence analysis. There was no significant difference between groups concerning the bone volume, bone volume/ total volume, and newly formed bone in volumetric and histological analysis at both times of investigation. The fluorescence analysis revealed a significantly lower signal in the magnesium group after one week, although there was no difference in the number of osteoclasts per mm2. The magnesium group had significantly fewer vessels per mm2 in the healing tissue. In conclusion, the non-inferiority of WE43-based magnesium implants with PEO surface modification was verified concerning fracture healing under non-load-bearing conditions in a defect model. STATEMENT OF SIGNIFICANCE: Titanium implants, the current gold standard of fracture fixation, can lead to adverse effects linked to the implant material and often require surgical removal. Therefore, degradable metals like the magnesium alloy WE43 with plasma electrolytic oxidation (PEO) surface modification gained interest. Yet, miniplates of this alloy with PEO surface modification have not been examined in a fracture defect model of the facial skeleton in a large animal model. This study shows, for the first time, the non-inferiority of magnesium miniplates compared to titanium miniplates. In radiological and histological analysis, bone healing was undisturbed. Magnesium miniplates can reduce the number of interventions for implant removal, thus reducing the risk for the patient and minimizing the costs.


Subject(s)
Bone Plates , Fracture Healing , Magnesium , Titanium , Animals , Magnesium/pharmacology , Magnesium/chemistry , Titanium/chemistry , Titanium/pharmacology , Sheep , Oxidation-Reduction , Surface Properties , Bone Screws , Plasma Gases/pharmacology , Plasma Gases/chemistry , Disease Models, Animal , Female , Electrolysis
7.
ACS Biomater Sci Eng ; 10(8): 4901-4915, 2024 Aug 12.
Article in English | MEDLINE | ID: mdl-39072479

ABSTRACT

Titanium plates are the current gold standard for fracture fixation of the mandible. Magnesium alloys such as WE43 are suitable biodegradable alternatives due to their high biocompatibility and elasticity modulus close to those of cortical bone. By surface modification, the reagibility of magnesium and thus hydrogen gas accumulation per time are further reduced, bringing plate fixation with magnesium closer to clinical application. This study aimed to compare bone healing in a monocortical mandibular fracture model in sheep with a human-standard size, magnesium-based, plasma electrolytic-oxidation (PEO) surface modified miniplate fixation system following 4 and 12 weeks. Bone healing was analyzed using micro-computed tomography and histological analysis with Movat's pentachrome and Giemsa staining. For evaluation of the tissue's osteogenic activity, polychrome fluorescent labeling was performed, and vascularization was analyzed using immunohistochemical staining for alpha-smooth muscle actin. Bone density and bone mineralization did not differ significantly between titanium and magnesium (BV/TV: T1: 8.74 ± 2.30%, M1: 6.83 ± 2.89%, p = 0.589 and T2: 71.99 ± 3.13%, M2: 68.58 ± 3.74%, p = 0.394; MinB: T1: 26.16 ± 9.21%, M1: 22.15 ± 7.99%, p = 0.818 and T2: 77.56 ± 3.61%, M2: 79.06 ± 4.46%, p = 0.699). After 12 weeks, minor differences were observed regarding bone microstructure, osteogenic activity, and vascularization. There was significance with regard to bone microstructure (TrTh: T2: 0.08 ± 0.01 mm, M2: 0.06 ± 0.01 mm; p = 0.041). Nevertheless, these differences did not interfere with bone healing. In this study, adequate bone healing was observed in both groups. Only after 12 weeks were some differences detected with larger trabecular spacing and more vessel density in magnesium vs titanium plates. However, a longer observational time with full resorption of the implants should be targeted in future investigations.


Subject(s)
Bone Plates , Magnesium , Mandible , Titanium , Animals , Magnesium/pharmacology , Titanium/chemistry , Titanium/pharmacology , Sheep , Mandible/surgery , Mandible/diagnostic imaging , Fracture Healing/drug effects , Surface Properties , Osteogenesis/drug effects , Mandibular Fractures/surgery , Mandibular Fractures/diagnostic imaging , X-Ray Microtomography , Alloys/chemistry
8.
JACC Adv ; 3(2): 100808, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38939392

ABSTRACT

Background: Prenatal urban environmental exposures have been associated with blood pressure in children. The dynamic of these associations across childhood and later ages is unknown. Objectives: The purpose of this study was to assess associations of prenatal urban environmental exposures with blood pressure trajectories from childhood to early adulthood. Methods: Repeated measures of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were collected in up to 7,454 participants from a UK birth cohort. Prenatal urban exposures (n = 43) covered measures of noise, air pollution, built environment, natural spaces, traffic, meteorology, and food environment. An exposome-wide association study approach was used. Linear spline mixed-effects models were used to model associations of each exposure with trajectories of blood pressure. Replication was sought in 4 independent European cohorts (up to 9,261). Results: In discovery analyses, higher humidity was associated with a faster increase (mean yearly change in SBP for an interquartile range increase in humidity: 0.29 mm Hg/y, 95% CI: 0.20-0.39) and higher temperature with a slower increase (mean yearly change in SBP per interquartile range increase in temperature: -0.17 mm Hg/y, 95% CI: -0.28 to -0.07) in SBP in childhood. Higher levels of humidity and air pollution were associated with faster increase in DBP in childhood and slower increase in adolescence. There was little evidence of an association of other exposures with change in SBP or DBP. Results for humidity and temperature, but not for air pollution, were replicated in other cohorts. Conclusions: Replicated findings suggest that higher prenatal humidity and temperature could modulate blood pressure changes across childhood.

9.
Bioresour Technol ; 406: 130975, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38879058

ABSTRACT

Particulate matter hydrolysis is the bottleneck in anaerobic treatment of municipal wastewater in temperate climates. Low temperatures theoretically slow enzyme-substrate interactions, hindering utilization kinetics, but this remains poorly understood. ß-glucosidase, protease, and lipase activities were evaluated in two pilot-scale upflow anaerobic sludge blanket (UASB) reactors, inoculated with different sludges and later converted to anaerobic membrane bioreactors (AnMBRs). Despite similar methane production and solids hydrolysis rates, significant differences emerged. Specific activity peaked at 37 °C, excluding the predominance of psychrophilic enzymes. Nevertheless, the Michaelis-Menten constant (Km) indicated high enzyme-substrate affinity at the operational temperature of 15-20 °C, notably greater in AnMBRs. It is shown, for the first time, that different seed sludges can equally adapt, as hydrolytic enzymatic affinity to the substrate reached similar values in the two reactors at the operational temperature and identified that membrane ultrafiltration impacted hydrolysis by a favourable enzyme Michaelis-Menten constant.


Subject(s)
Bioreactors , Wastewater , Water Purification , Hydrolysis , Wastewater/chemistry , Anaerobiosis , Water Purification/methods , Climate , Lipase/metabolism , Sewage , Temperature , Kinetics , Peptide Hydrolases/metabolism , Methane/metabolism , beta-Glucosidase/metabolism , Waste Disposal, Fluid/methods
10.
Article in English | MEDLINE | ID: mdl-38791754

ABSTRACT

Although golf is a low-impact sport without physical contact, its movements are carried out over a large range of motion, and their repetition can predispose athletes to the development of injuries. This study aimed to investigate the epidemiology of musculoskeletal injuries in golf athletes who participated in championships in southern Portugal, determining the types, locations and mechanisms of injury and their associated risk factors. The sample consisted of 140 athletes aged between 18 and 72 years, 133 (95%) being male. The measuring instrument was a questionnaire about sociodemographics, modality and injuries' characteristics. Throughout golf practice, 70 (50%) athletes reported injuries, totaling 133 injuries. In the 12-month period, 43 (30.7%) athletes suffered injuries, totaling 65 injuries. The injury proportion was of 0.31, and the injury rate was of 0.33 injuries per 1000 h of golf training. The most common injury type was muscle sprain or rupture (19; 30.9%), located in the lumbar spine (17; 27%), in which the repetitive movements were the main injury mechanism (42; 66.7%). The athletes who trained 4 times or more per week were 3.5 more likely (CI: 0.97-12.36; p = 0.056) to develop an injury while playing golf. Moderate injury presence was observed, with the high training frequency being an associated risk factor.


Subject(s)
Athletic Injuries , Golf , Humans , Portugal/epidemiology , Golf/injuries , Male , Adult , Young Adult , Adolescent , Female , Middle Aged , Athletic Injuries/epidemiology , Aged , Risk Factors , Athletes/statistics & numerical data , Surveys and Questionnaires , Musculoskeletal System/injuries
11.
Adv Ther ; 41(7): 2826-2844, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38771475

ABSTRACT

INTRODUCTION: Empagliflozin is a sodium-glucose co-transporter-2 inhibitor used to treat type 2 diabetes (T2D) to improve glycemic control, reduce risk of cardiovascular death in patients with T2D, and treat patients with symptomatic chronic heart failure (HF) and chronic kidney disease (CKD). The safety profile of empagliflozin is well documented, although adverse events (AEs) remain of interest to clinicians. This study provides an up-to-date safety evaluation of empagliflozin. METHODS: Data were pooled from four long-term trials which included: patients with T2D and established cardiovascular disease (EMPA-REG OUTCOME), patients with HF, with/without diabetes (EMPEROR-Reduced and EMPEROR-Preserved), and patients with CKD, with/without diabetes (EMPA-KIDNEY). Since three of the four trials evaluated empagliflozin 10 mg, the meta-analysis was restricted to this dose. RESULTS: Total trial medication exposure was 19,727 patient-years for patients who received empagliflozin (n = 10,472) and 19,447 patient-years for placebo (n = 10,461). The percentages of patients with serious AEs, fatal AEs, and AEs leading to discontinuation were similar for both groups. The incidences of serious urinary tract infection and serious pyelonephritis or urosepsis were similar for both groups but higher for women taking empagliflozin versus placebo. Serious genital infections were not increased with empagliflozin versus placebo. There was a slight increase in ketoacidosis and serious volume depletion in patients who received empagliflozin versus placebo. The occurrence of serious acute kidney injury was lower with empagliflozin versus placebo. Empagliflozin was not associated with an increased incidence of severe hypoglycemia, bone fractures, or lower limb amputations. Empagliflozin is therefore considered safe in people without diabetes, the elderly, patients with very low estimated glomerular filtration rate, low body mass index, and HF. Safety is unaltered by blood pressure, concomitant medication for hypertension, HF, and immunosuppression. CONCLUSION: This meta-analysis of long-term safety data extends current knowledge and confirms the safety and tolerability of empagliflozin.


Empagliflozin is used in adults with type 2 diabetes mellitus (T2D) to improve blood glucose control and in people with T2D and established cardiovascular disease to reduce the risk of death from cardiovascular disease. Also, it is used to treat people with chronic heart failure or chronic kidney disease. Although many clinical trials have shown the effectiveness and safety of empagliflozin, the evaluation of adverse events (AEs) remains of interest. This study further examined the safety of empagliflozin by analyzing four large, long-term clinical trials. These trials included over 20,900 patients with T2D and established cardiovascular disease, patients with heart failure, and patients with chronic kidney disease. Adverse events of interest were pooled and analyzed. Results show the risk of the investigated AEs was similar whether patients had received empagliflozin or placebo. The risk of urinary tract infections, including those that spread to the kidneys, was higher for women taking empagliflozin versus placebo. Ketoacidosis was rare but more frequent in patients taking empagliflozin. A reduction in blood volume was slightly more frequent in people taking empagliflozin versus placebo. The risk of kidney injury was reduced in patients taking empagliflozin versus placebo. The risk of genital infections, hypoglycemia, bone fractures, or lower limb amputations was not increased with empagliflozin. No new safety concerns were raised, including in people who were elderly, had kidney disease, low body weight, T2D, or heart failure. This analysis is consistent with current knowledge of empagliflozin safety in a broad range of patients.


Subject(s)
Benzhydryl Compounds , Cardiovascular Diseases , Diabetes Mellitus, Type 2 , Glucosides , Sodium-Glucose Transporter 2 Inhibitors , Humans , Glucosides/therapeutic use , Glucosides/adverse effects , Benzhydryl Compounds/therapeutic use , Benzhydryl Compounds/adverse effects , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/complications , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Female , Male , Renal Insufficiency, Chronic , Heart Failure , Middle Aged , Aged , Hypoglycemic Agents/therapeutic use , Hypoglycemic Agents/adverse effects , Randomized Controlled Trials as Topic
12.
PLoS One ; 19(5): e0303068, 2024.
Article in English | MEDLINE | ID: mdl-38753673

ABSTRACT

The objective of this article was to analyze the factors associated with complex multimorbidity (CMM) among hemodialysis patients in a metropolitan region in southeastern Brazil. To this end, a cross-sectional epidemiological survey was carried out with 1,024 individuals in the year 2019. CMM data were collected through the application of a questionnaire to hemodialysis patients. The binary logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) between independent variables and CMM. The prevalence of CMM was 81% and the results indicated that: living in cities with a low rate of general mortality (OR = 0.395, 95%CI = 0.179-0.870), being aged between 18 and 29 (OR = 0.402, 95%CI = 0.196-0.825), having an elementary education (OR = 0.536, 95%CI = 0.290-0.966) and assessing health as good/very good (OR = 0.446, 95%CI = 0.301-0.661) are factors that reduced the chances of having CMM, whereas a longer period of hemodialysis (OR = 1.779 and 95%CI = 1.057-2.997) increased the chances of CMM. The findings show that characteristics of the social and individual context are associated with CMM in hemodialysis patients, signaling the need for public health policies that include monitoring the complex multimorbidity condition among individuals undergoing hemodialysis treatment.


Subject(s)
Multimorbidity , Renal Dialysis , Humans , Brazil/epidemiology , Renal Dialysis/statistics & numerical data , Female , Male , Adult , Middle Aged , Cross-Sectional Studies , Adolescent , Young Adult , Aged , Prevalence , Surveys and Questionnaires , Risk Factors
13.
Article in English | MEDLINE | ID: mdl-38594794

ABSTRACT

Abstract: Dengue virus (DENV) infection causes 390 million infections per year and 40,000 deaths globally. It is endemic in many countries in Asia, Africa, the Americas, the Caribbean, and Oceania. Dengue is endemic in Timor-Leste year-round, but peak transmission occurs during the rainy season. We briefly describe the epidemiology of DENV in the Municipality of Dili between 2018 and 2022. There were 6,234 cases notified, with a mean annual incidence rate of 330 cases per 100,000 population. There were 55 deaths (case fatality rate 0.9%). The peak annual incidence (3,904 cases) occurred in 2022 after an outbreak was declared in January of that year; this outbreak included 760 cases of dengue haemorrhagic fever and 35 deaths. The number of outbreak cases requiring hospital treatment exceeded the usual capacity, but facilities established for coronavirus disease 2019 (COVID-19) isolation and treatment were repurposed to meet this demand. Existing strategies of vector control, minimising breeding sites and promoting early presentation for treatment should continue, as should the utilisation of surveillance systems and treatment facilities established during the COVID-19 pandemic. However, dengue incidence remains high, and other dengue control strategies-including the deployment of Wolbachia-infected mosquitoes-should be considered in Timor-Leste.


Subject(s)
Dengue Virus , Dengue , Animals , Humans , Timor-Leste/epidemiology , Pandemics , Australia/epidemiology , Dengue/epidemiology
14.
Article in English | MEDLINE | ID: mdl-38594795

ABSTRACT

Abstract: Timor-Leste is a mountainous, half-island nation with a population of 1.3 million, which shares a land border with Indonesia and is 550 km from Darwin, Australia. Since independence in 2002, Timor-Leste has achieved significant development; however, high levels of poverty remain. Chikungunya virus (CHIKV) is endemic in over 100 countries in Africa, Asia, Europe and in the Americas. It is transmitted by the bite of infected Aedes aegypti or Ae. albopictus mosquitoes, which are present in Timor-Leste and which contribute to annual rainy-season dengue virus (DENV) outbreaks. Symptomatic people typically suffer from acute onset of fever, usually accompanied by severe arthritis or arthralgia. Joint pain can be debilitating for several days, and may sometimes last for weeks, months or years. Unlike DENV infection which has significant mortality, most people recover completely. Between 2002 and 2023, there were 26 cases of CHIKV notified in Australia who acquired their infection in Timor-Leste; however, laboratory testing capability for CHIKV in Timor-Leste only became available in 2021 using polymerase chain reaction (PCR). The first locally diagnosed case was notified in November 2023. In January 2024, an outbreak of CHIKV was recognised in Timor-Leste for the first time, with 195 outbreak cases reported during 1-31 January 2024; all were PCR positive. There were no cases hospitalised, and no deaths. The median age of cases was 17 years (range 1-76 years); 51% were males. Cases were reported across the country; most (88/195) were from Dili, although the highest incidence was seen in the neighbouring municipality of Ermera (monthly incidence rate of 58.8 cases per 100,000 population). This first reported outbreak of CHIKV in Timor-Leste highlights the need for improved mosquito-borne illness control and response strategies, including minimising breeding sites and promoting early presentation for treatment and differential diagnosis from DENV, and consideration of the deployment of Wolbachia-infected mosquitoes, particularly as they have shown to reduce the transmission of CHIKV, DENV and Zika virus, all of which pose threats in Timor-Leste.


Subject(s)
Chikungunya Fever , Chikungunya virus , Zika Virus Infection , Zika Virus , Male , Animals , Humans , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Female , Chikungunya Fever/epidemiology , Timor-Leste/epidemiology , Australia/epidemiology , Chikungunya virus/genetics , Disease Outbreaks , Zika Virus Infection/epidemiology , Zika Virus Infection/prevention & control
15.
Mol Biochem Parasitol ; 258: 111618, 2024 06.
Article in English | MEDLINE | ID: mdl-38588892

ABSTRACT

Trypanosoma cruzi is a parasite with a high capacity to adapt to the host. Animal models have already demonstrated that the tropism of this parasite occurs not only in cardiac/digestive tissues but also in adipose tissue (AT). That said, the consequences ofT. cruziinfection for AT and the implications of treatment with Benzonidazole in this tissue are under discussion. Here, we tested the hypothesis that T. cruzi infection in adipose tissue upon treatment with Benzonidazole (Bz) and the interaction of mononuclear immune cells (PBMC) influences the relative expression of ACAT1, FASN, and PNPLA2 genes. Thus, stem cells derived from adipose tissue (ADSC) after adipogenic differentiation were indirectly cultivated with PBMC after infection with the T. cruzi Y strain and treatment with Bz. We use the TcSAT-IAM system and RT-qPCR to evaluate the parasite load and the relative quantification (ΔCt) of the ACAT1, FASN, and PNPLA2 genes. Our results demonstrate that treatment with Bz did not reduce adipocyte infection in the presence (p-value: 0.5796) or absence (p-value: 0.1854) of cultivation with PBMC. In addition, even though there is no statistical difference when compared to the control group (AT), T. cruzi induces the FASN expression (Rq: 14.00). However, treatment with Bz in AT suggests the increases of PNPLA2 expression levels (Rq: 12.58), even in the absence of T. cruzi infection. During indirect cultivation with PBMC, T. cruzi smooths the expression of PNPLA2 (Rq: 0.824) and instigates the expression of ACAT1 (Rq: 1.632) and FASN (Rq: 1.394). Furthermore, the treatment with Bz during infection induces PNPLA2 expression (Rq: 1.871), maintaining FASN expression levels (Rq: 1.334). Given this, our results indicate that treatment with Benzonidazole did not decrease T. cruzi infection in adipose tissue. However, treating the adipocyte cells with Bz during the interaction with PBMC cells influences the lipid pathways scenario, inducing lipolytic metabolism through the expression of PNPLA2.


Subject(s)
Acyltransferases , Adipose Tissue , Fatty Acid Synthase, Type I , Leukocytes, Mononuclear , Lipase , Trypanosoma cruzi , Humans , Leukocytes, Mononuclear/immunology , Leukocytes, Mononuclear/parasitology , Adipose Tissue/parasitology , Adipose Tissue/metabolism , Trypanosoma cruzi/drug effects , Trypanosoma cruzi/genetics , Lipase/genetics , Lipase/metabolism , Fatty Acid Synthase, Type I/genetics , Fatty Acid Synthase, Type I/metabolism , Acetyl-CoA C-Acetyltransferase/genetics , Acetyl-CoA C-Acetyltransferase/metabolism , Chagas Disease/drug therapy , Chagas Disease/parasitology , Chagas Disease/genetics , Membrane Proteins/genetics , Membrane Proteins/metabolism , Parasite Load , Gene Expression , Cells, Cultured
16.
BMC Pregnancy Childbirth ; 24(1): 333, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38689215

ABSTRACT

BACKGROUND: Lower socioeconomic position (SEP) associates with adverse pregnancy and perinatal outcomes and with less favourable metabolic profile in nonpregnant adults. Socioeconomic differences in pregnancy metabolic profile are unknown. We investigated association between a composite measure of SEP and pregnancy metabolic profile in White European (WE) and South Asian (SA) women. METHODS: We included 3,905 WE and 4,404 SA pregnant women from a population-based UK cohort. Latent class analysis was applied to nineteen individual, household, and area-based SEP indicators (collected by questionnaires or linkage to residential address) to derive a composite SEP latent variable. Targeted nuclear magnetic resonance spectroscopy was used to determine 148 metabolic traits from mid-pregnancy serum samples. Associations between SEP and metabolic traits were examined using linear regressions adjusted for gestational age and weighted by latent class probabilities. RESULTS: Five SEP sub-groups were identified and labelled 'Highest SEP' (48% WE and 52% SA), 'High-Medium SEP' (77% and 23%), 'Medium SEP' (56% and 44%) 'Low-Medium SEP' (21% and 79%), and 'Lowest SEP' (52% and 48%). Lower SEP was associated with more adverse levels of 113 metabolic traits, including lower high-density lipoprotein (HDL) and higher triglycerides and very low-density lipoprotein (VLDL) traits. For example, mean standardized difference (95%CI) in concentration of small VLDL particles (vs. Highest SEP) was 0.12 standard deviation (SD) units (0.05 to 0.20) for 'Medium SEP' and 0.25SD (0.18 to 0.32) for 'Lowest SEP'. There was statistical evidence of ethnic differences in associations of SEP with 31 traits, primarily characterised by stronger associations in WE women e.g., mean difference in HDL cholesterol in WE and SA women respectively (vs. Highest-SEP) was -0.30SD (-0.41 to -0.20) and -0.16SD (-0.27 to -0.05) for 'Medium SEP', and -0.62SD (-0.72 to -0.52) and -0.29SD (-0.40 to -0.20) for 'Lowest SEP'. CONCLUSIONS: We found widespread socioeconomic differences in metabolic traits in pregnant WE and SA women residing in the UK. Further research is needed to understand whether the socioeconomic differences we observe here reflect pre-conception differences or differences in the metabolic pregnancy response. If replicated, it would be important to explore if these differences contribute to socioeconomic differences in pregnancy outcomes.


Subject(s)
Triglycerides , White People , Adult , Female , Humans , Pregnancy , Young Adult , Asian People/statistics & numerical data , Cohort Studies , Latent Class Analysis , Lipoproteins, HDL/blood , Lipoproteins, VLDL/blood , Metabolome , Social Class , Socioeconomic Factors , Triglycerides/blood , United Kingdom , White People/statistics & numerical data , South Asian People
17.
Curr Med Chem ; 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38676530

ABSTRACT

The pursuit of novel treatment alternatives to address the accumulated resistance to antimicrobials over the years has prompted the scientific community to explore biodiversity, particularly animal venom, as a potential source of new antimicrobial drugs. Snake venoms, with their complex mixtures of components, are particularly promising targets for investigation in this regard. The search for novel molecules exhibiting antimicrobial activity against multidrug-resistant strains is of paramount importance for public health and numerous research groups worldwide. High expectations within the healthcare field are supported by the scientific literature, which highlights the potential development of innovative drugs through in vivo and in vitro application, depending on dose titration. Snake venoms and their molecules and peptides offer exponential possibilities for biotechnological applications as antimicrobial agents. However, many uncertainties and unexplored avenues remain, presenting opportunities for discoveries and research.

18.
Nutrients ; 16(8)2024 Apr 17.
Article in English | MEDLINE | ID: mdl-38674887

ABSTRACT

Childhood obesity has been associated with increased sodium intake. Nonetheless, evidence linking sodium intake to Body Mass Index (BMI) and Body Fat Mass Percentage (%BF) remains limited, especially in the pediatric age group. Therefore, this study aims to investigate whether there is an association between 24 h urinary sodium excretion with BMI and %BF in a sample group of children from the ARIA study. This cross-sectional analysis included 303 children aged 7 to 12 from across 20 public schools in Porto, Portugal. Weight and %BF were assessed using the Tanita™ BC-418 Segmental Body Analyzer. Children's Total Energy Intake (TEI) was estimated through a single 24 h Recall Questionnaire, and urinary sodium and potassium excretion was estimated by a 24 h urine collection. The association of %BF and BMI with 24 h sodium excretion was estimated by a binary logistic regression adjusted for sex, age, physical activity, total energy intake, parental education, and 24 h urinary excreted potassium. There was a significant positive association between higher levels of urinary sodium excretion and higher %BF values, even after adjusting for confounders. However, the same was not observed for BMI. Our findings suggest that higher sodium intake is associated with higher values of %BF among children, regardless of TEI and potassium intake.


Subject(s)
Body Mass Index , Sodium, Dietary , Sodium , Humans , Female , Male , Child , Cross-Sectional Studies , Sodium/urine , Portugal , Sodium, Dietary/urine , Energy Intake , Pediatric Obesity/urine , Pediatric Obesity/epidemiology , Adipose Tissue/metabolism , Adiposity
19.
Arq Bras Oftalmol ; 87(3): e20230038, 2024.
Article in English | MEDLINE | ID: mdl-38537047

ABSTRACT

PURPOSE: To assess the effect of the Coronavirus disease 2019 (COVID-19) pandemic on cataract surgery by residents who had mandatory surgical simulator training during residency. METHODS: In this retrospective, observational analytical study, the total number of cataract surgeries and surgical complications by all senior residents of 2019 (2019 class; prepandemic) and 2020 (2020 class; affected by the reduced number of elective surgeries due to the COVID-19 pandemic) were collected and compared. All residents had routine mandatory cataract surgery training on a virtual surgical simulator during residency. The total score obtained by these residents on cataract challenges of the surgical simulator was also evaluated. RESULTS: The 2020 and 2019 classes performed 1275 and 2561 cataract surgeries, respectively. This revealed a reduction of 50.2% in the total number of procedures performed by the 2020 class because of the pandemic. The incidence of surgical complications was not statistically different between the two groups (4.2% in the 2019 class and 4.9% in the 2020 class; p=0.314). Both groups also did not differ in their mean scores on the simulator's cataract challenges (p<0.696). CONCLUSION: Despite the reduction of 50.2% in the total number of cataract surgeries performed by senior residents of 2020 during the COVID-19 pandemic, the incidence of surgical complications did not increase. This suggests that surgical simulator training during residency mitigated the negative effects of the reduced surgical volume during the pandemic.


Subject(s)
COVID-19 , Cataract , Internship and Residency , Humans , Pandemics/prevention & control , Retrospective Studies , COVID-19/epidemiology , COVID-19/prevention & control , Clinical Competence
20.
J Interferon Cytokine Res ; 44(5): 198-207, 2024 May.
Article in English | MEDLINE | ID: mdl-38512222

ABSTRACT

Melanoma, an infrequent yet significant variant of skin cancer, emerges as a primary cause of brain metastasis among various malignancies. Despite recognizing the involvement of inflammatory molecules, particularly chemokines, in shaping the metastatic microenvironment, the intricate cellular signaling mechanisms underlying cerebral metastasis remain elusive. In our pursuit to unravel the role of cytokines in melanoma metastasis, we devised a protocol utilizing mixed cerebral cortical cells and SK-MEL-28 melanoma cell lines. Contrary to expectations, we observed no discernible morphological change in melanoma cells exposed to a cerebral conditioned medium (CM). However, a substantial increase in both migration and proliferation was quantitatively noted. Profiling the chemokine secretion by melanoma in response to the cerebral CM unveiled the pivotal role of interferon gamma-induced protein 10 (CXCL10), inhibiting the secretion of interleukin 8 (CXCL8). Furthermore, through a transwell assay, we demonstrated that knockdown CXCL10 led to a significant decrease in the migration of the SK-MEL-28 cell line. In conclusion, our findings suggest that a cerebral CM induces melanoma cell migration, while modulating the secretion of CXCL10 and CXCL8 in the context of brain metastases. These insights advance our understanding of the underlying mechanisms in melanoma cerebral metastasis, paving the way for further exploration and targeted therapeutic interventions.


Subject(s)
Cell Movement , Chemokine CXCL10 , Melanoma , Signal Transduction , Chemokine CXCL10/metabolism , Chemokine CXCL10/genetics , Humans , Culture Media, Conditioned/pharmacology , Melanoma/pathology , Melanoma/metabolism , Cell Line, Tumor , Interleukin-8/metabolism , Brain Neoplasms/metabolism , Brain Neoplasms/pathology , Brain Neoplasms/secondary , Neoplasm Invasiveness , Cell Proliferation , Cerebral Cortex/metabolism , Cerebral Cortex/pathology
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