The social and occupational consequences of the COVID-19 pandemic among patients with multiple sclerosis in three distinct populations: A web-based cross-sectional survey.

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease COVID-19, has caused a pandemic that has rapidly affected the whole world and caused a significant threat to public health. The aim of this study was to investigate and analyze the social and occupational effects of the COVID-19 pandemic on patients with multiple sclerosis (MS) in three different countries: China, Spain, and Cuba. Methods: A cross-sectional survey was designed to assess the social and occupational effects of the COVID-19 pandemic in MS patients in these three countries, using a 25-item anonymous online questionnaire, structured into three sections. Quantitative data are expressed as mean (standard deviation), and quantitative data as absolute frequency and percentage. Results: A total of 361 participants responded to the questionnaire: 194 from China, 104 from Spain, and 63 from Cuba. We found no cases of COVID-19 among Chinese patients with MS, and few cases in Spain and Cuba. Respondents reported different levels of impact on relationships with friends, family, and colleagues, and patients in all three countries described increased use of digital or social media platforms. Spanish patients reported a significantly less negative impact than those in Cuba and China. Mental and cognitive effects were similar in all three countries, although China seemed to have a better situation. We also found that the time spent exercising decreased at specific points during the pandemic, but with few changes in dietary habits. Patients reported little or no change in their means of transport in all three countries. Most patients in all three countries reported little or no physical deterioration, especially in Chinese patients (82.47%), compared to the Spanish (70.20%) and Cuban respondents (73.02%). In general, patients from all three countries demonstrated confidence in overcoming the COVID-19 pandemic, although to a lesser extent among Spanish respondents. Conclusions: During the pandemic, family support was more effective in China than in Cuba and Spain. Neither COVID-19 infections nor the number of MS relapses increased significantly during lockdown in any of the three countries. Regarding their economic situation, Spanish MS patients reported a significantly less severe negative impact than those in Cuba and China. Patients from all three countries used digital or social media platforms more frequently, probably to maintain personal relationships. Chinese and Cuban respondents were more confident of the control of the pandemic than the Spanish, who were more pessimistic.

Introducción: El nuevo coronavirus de tipo 2, causante del síndrome respiratorio agudo severo o COVID-19, se ha expandido rápidamente a nivel mundial, convirtiéndose en una grave amenaza para la salud pública en forma de pandemia. El objetivo de este estudio es analizar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con esclerosis múltiple (EM) en 3 países diferentes (China, España y Cuba). Métodos: Diseñamos un estudio transversal para valorar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con EM procedentes de China, España y Cuba mediante un cuestionario digital de 25 preguntas divididas en 3 apartados. Los datos cuantitativos se expresan como medias y desviaciones estándar, mientras que los datos cualitativos se expresan mediante valores y porcentajes. Resultados: Un total de 361 pacientes respondieron al cuestionario (194 de China, 104 de España y 63 de Cuba). No encontramos ningún paciente chino con EM que hubiera padecido COVID-19, y los casos diagnosticados en España y Cuba fueron muy infrecuentes. A raíz de la pandemia, se observaron cambios en las relaciones con amigos, familiares y compañeros; además, los pacientes con EM usaron plataformas digitales y redes sociales con más frecuencia en los 3 países. El impacto negativo fue significativamente menor en España que en Cuba o China. Los efectos mentales y cognitivos de la pandemia fueron similares en los 3 países, aunque parece que la situación previa era mejor en China. Igualmente, observamos que el tiempo dedicado al ejercicio se redujo en momentos específicos durante la pandemia. Por el contrario, no se detectaron grandes cambios en los hábitos alimentarios. Los pacientes de los 3 países consideraron que no se produjeron cambios en su medio de transporte, o que estos fueron escasos. La mayoría de los pacientes ha experimentado poco o ningún deterioro físico, particularmente los pacientes chinos (82,47%) en comparación con los españoles (70,20%) y cubanos (73,02%). En líneas generales, todos los pacientes se mostraron esperanzados en superar la pandemia, aunque los pacientes españoles en menor grado. Conclusiones: Durante la pandemia, el apoyo familiar fue más importante en China que en Cuba o España. En ninguno de los 3 países se observó un aumento significativo en el número de casos de COVID-19 ni de brotes o recaídas durante el periodo de confinamiento. En términos económicos, los pacientes con EM españoles sufrieron un impacto negativo significativamente menor que los cubanos y chinos. Todos los pacientes usaron plataformas digitales o redes sociales con más frecuencia, probablemente con el fin de mantener relaciones personales. Los pacientes chinos y cubanos mostraron mayor confianza en el control de la pandemia que los españoles, que resultaron ser más pesimistas.

Distribution, composition and seasonality of aquatic birds in the Nhecolândia sub-region of South Pantanal, Brazil.

Despite remarkable significance of Pantanal for the conservation of aquatic birds, the status of their populations, the spatiotemporal patterns of distribution and habitat use and structure of communities are little known. Thus, we studied three aquatic environments (Negro river, bays and salines) from 2007 to 2009 in the Nhecolândia Pantanal to verify the distribution and composition of aquatic birds and also if there is significant seasonal influence on these aspects. We adopted the transect method (288 hours of sampling) and recorded 135 species (7.834 individuals). The Negro river showed the highest diversity, while the salines the lowest. The similarity of aquatic bird communities was higher between bays and salines, followed by Negro river and bays and lower between salines and Negro river. The equidistribution is more variable in the salines and more stable in the Negro river. The environments strongly differ from each other in aquatic bird composition in space (habitat use and distribution) and time (seasonal water fluctuations). The diversity of bird community in the dry season varies significantly in the salines, followed by the bays and more stable in the Negro river. The Negro river, regardless of large annual amplitude of flow, is more seasonally stable since its riparian vegetation is continuous (not isolated) and constant. These aspects provide better conditions to stay all year, contributing to decrease the seasonal nomadic tendencies of aquatic birds. Finally, all these data provide strong arguments to the preservation of all phytophysiognomies in the Nhecolândia sub- region of Pantanal, but with special attention to the salines widely used by many flocks of aquatic birds (mainly in the dry season) and migrant and/or rare species restricted to this habitat.

Occurrence of furan in commercial processed foods in Brazil.

Selected commercial processed foods available in the Brazilian market (306 samples) were analysed for furan content using a validated gas chromatography-mass spectrometry method preceded by headspace solid phase micro-extraction (HS-SPME-GC/MS). Canned and jarred foods, including vegetable, meat, fruit and sweet products, showed levels up to 32.8 µg kg⁻¹, with the highest concentrations observed in vegetables and meats. For coffee, furan content ranged from 253.0 to 5021.4 µg kg⁻¹ in the roasted ground coffee and from not detected to 156.6 µg kg⁻¹ in the beverage. For sauces, levels up to 138.1 µg kg⁻¹ were found. In cereal-based products, the highest concentrations (up to 191.3 µg kg⁻¹) were observed in breakfast cereal (corn flakes), cracker (cream crackers) and biscuit (wafer). In general, these results are comparable with those reported in other countries and will be useful for a preliminary estimate of the furan dietary intake in Brazil.

Ultrasound criteria and CA 125 as predictive variables of ovarian cancer in women with adnexal tumors.

OBJECTIVES: To evaluate the capacity to predict malignancy in women with adnexal tumors using CA 125 measurement and ultrasound criteria. METHODS: This was a cross-sectional study including 103 women with a total of 110 adnexal tumors. CA 125 level was measured in a sample of peripheral blood. Lesions were classified by ultrasound, using standardized predetermined criteria, as benign (B) or malignant (M). Those that could not be classified by these criteria were assessed subjectively. Histopathologic examination of surgical specimens was used as the gold standard. RESULTS: Of 110 tumors, 79 (71.8%) were benign and 31 (28.2%) were malignant on histopathology. Ultrasound criteria could be applied to 91 (82.7%) tumors, resulting in a sensitivity of 90%, specificity of 87%, positive predictive value (PPV) of 69% and negative predictive value (NPV) of 97%. In tumors not classifiable according to ultrasound criteria, subjective sonographic assessment gave a sensitivity of 67%, specificity of 80%, PPV of 75% and NPV of 73%. At a cut-off point of 37.4 U/mL, CA 125 had a sensitivity of 69%, a specificity of 87.8%, a PPV of 69% and a NPV of 88% for detection of malignancy. When CA 125 was associated with age and ultrasound criteria in a logistic regression model, the sensitivity and specificity increased in the subset of sonographically malignant tumors. CONCLUSION: The majority of tumors were correctly classified using ultrasound criteria. CA 125 alone performed worse than did ultrasound in discriminating malignant from benign adnexal tumors. CA 125 measurement contributed to the diagnosis of malignancy, improving overall specificity, only in sonographically malignant tumors.

Spectral analysis of flowers used by nectar-feeding birds in an urban area in Southeastern Brazil.

The objective of this study was to determine the spectral characteristic of nectar-producing flowers visited by nectarivorous birds in urban areas. This study was carried out in the central area of the city of Taubaté, in the northeast of the State of São Paulo. The sample areas included green areas, such as squares and parks, and the vegetation of streets and avenues. Twelve plant species were recorded with flowers visited by five nectar-feeding birds. The most visited flower species were those that reflected in long wavelengths (>600 nm). The study discussed the birds' detection capability due to the tetrachromatic vision of nectar-feeding birds and the conspicuity of flowers in urban environments. Finally, the study assessed the scarcity of plants attractive to nectar-feeding birds and the need for a management strategy to favour these species and biodiversity in urban areas.

Determination of furan levels in commercial samples of baby food from Brazil and preliminary risk assessment.

Commercial baby food samples available on the Brazilian market (n = 31) were analysed for furan content using a gas chromatography-mass spectrometry method preceded by solid-phase microextraction. A limit of detection of 0.7 microg kg(-1), a limit of quantitation of 2.4 microg kg(-1), mean recoveries varying from 80% to 107%, and coefficients of variation ranging from 5.6% to 9.4% for repeatability and from 7.4% to 12.4% for within-laboratory reproducibility were obtained during an in-house validation. The levels of furan found in the samples were from not detected to 95.5 microg kg(-1). Samples containing vegetables and meat showed higher furan levels as compared with those containing only fruits. An exposure assessment showed furan intakes up to 2.4 microg kg(-1) body weight day(-1) (99th percentile) for babies fed exclusively with commercial baby foods. Margins of exposure obtained from intakes estimated in this work indicated a potential public health concern.

Analysis of the feeding habits of the swallow-tailed hummingbird, Eupetomena macroura (Gmelin, 1788), in an urban park in southeastern Brazil.

The aim of this work was to observe and describe the feeding habits and available food resources of the swallow-tailed hummingbird, Eupetomena macroura. The study was carried out in a municipal park located in the city of Taubaté, in the state of São Paulo. The observations took place between December 2003 and October 2004, recording the following variables: 1) the plant species visited for feeding and territorial defense; 2) the kinds of food resources; and 3) the kinds of flight to procure and obtain food. E. macroura visited 12 plant species. For territorial defense, Mangifera indica was the most visited, whereas Malvaviscus arboreus was most visited for feeding. The foliage was the plant part that received the most frequent visits. In order to obtain nectar, the only species visited was M. arboreus; to obtain arthropods, the species most visited were Mangifera indica and Hymenaea stilbocarpa. In the dry season, the hummingbirds visited flowers, whereas in the rainy season they visited leaves to acquire food. The arthropod groups most frequently found on leafy branches were Homoptera and Psocoptera. Finally, the results of the type of flight analysis showed that flight used to capture food was more often observed than were flights to search for food. In conclusion, these observations suggest that E. macroura shows plasticity in feeding behavior, which can help it to persist in urban areas.

Analysis of the feeding habits of the swallow-tailed hummingbird, Eupetomena macroura (Gmelin, 1788), in an urban park in southeastern Brazil / Análise do comportamento alimentar do beija-flor tesourão, Eupetomena macroura (Gmelin, 1788), em um parque urbano localizado na região sudeste do Brasil

The aim of this work was to observe and describe the feeding habits and available food resources of the swallow-tailed hummingbird, Eupetomena macroura. The study was carried out in a municipal park located in the city of Taubaté, in the state of São Paulo. The observations took place between December 2003 and October 2004, recording the following variables: 1) the plant species visited for feeding and territorial defense; 2) the kinds of food resources; and 3) the kinds of flight to procure and obtain food. E. macroura visited 12 plant species. For territorial defense, Mangifera indica was the most visited, whereas Malvaviscus arboreus was most visited for feeding. The foliage was the plant part that received the most frequent visits. In order to obtain nectar, the only species visited was M. arboreus; to obtain arthropods, the species most visited were Mangifera indica and Hymenaea stilbocarpa. In the dry season, the hummingbirds visited flowers, whereas in the rainy season they visited leaves to acquire food. The arthropod groups most frequently found on leafy branches were Homoptera and Psocoptera. Finally, the results of the type of flight analysis showed that flight used to capture food was more often observed than were flights to search for food. In conclusion, these observations suggest that E. macroura shows plasticity in feeding behavior, which can help it to persist in urban areas.

O objetivo deste trabalho foi observar e descrever o hábito alimentar do Beija-flor Tesourão, Eupetomena macroura. O estudo foi realizado em um parque municipal, situado na cidade de Taubaté, Estado de São Paulo. As observações ocorreram entre dezembro de 2003 e outubro de 2004, período em que foram observadas as seguintes variáveis: 1) as espécies de plantas visitadas para alimentação e defesa territorial; 2) o tipo de recurso alimentar; e 3) a freqüência de vôo para busca e obtenção de alimento. Foram registradas 12 espécies de plantas visitadas pelo E. macroura, visto que Mangifera indica e Malvaviscus arboreus foram as mais utilizadas para defesa territorial e para alimentação, respectivamente. O maior índice de flores visitadas foi observada para Malvaviscus arboreus. Mangifera indica e Hymenaea stilbocarpa foram as espécies que apresentaram maior freqüência de visita em folhas e ramos. Na estação seca, o beija-flor tesourão visitou flores para obtenção de alimento, já na estação úmida a maior parte do alimento foi adquirida entre folhas e ramos. Quando analisados as folhas e ramos visitados pelos indivíduos quanto à presença de artrópodes, os resultados obtidos indicaram que os grupos mais abundantes foram Homoptera e Psocoptera. Finalmente, pela análise do tipo de vôo, observou-se que o vôo que representa captura de alimento foi mais vezes observado do que aquele que é utilizado para procura de alimento. Os resultados sugerem uma flexibilidade trófica do E. macroura, fato que pode auxiliar na permanência da espécie em áreas urbanas.

Acute myocardial infarction with cardiogenic shock: treatment with mechanical circulatory assistance and heart transplantation.

UNLABELLED: The mortality of cardiogenic shock (CS) after an acute myocardial infarction (AMI) still remains high. Thrombolysis, PTCA or CABG, when possible, can improve the results, but when all the treatments fail death is almost certain. OBJECTIVE: We investigate the use of the mechanical circulatory assistance (MCA) and heart transplantation (HT) to improve the adverse results in this irreversible situation. METHODS: Among 11 patients with irreversible CS after an AMI we used a MCA (Abiomed BVS-5000). After improvement and hemodynamic stabilization, we performed heart transplantation in 7 patients of mean age 52 years (35-60) including two women. The MCA was univentricular in 7 patients and biventricular in 4. Mean duration of the MCA was 5 days (1-12). RESULTS: Three patients died during the MCA: two due to cerebrovascular accidents and one multiorgan failure. Weaning was possible in one patient. Among Seven transplanted patients one died due to sepsis. Seven (64%) patients are long-term survivors. CONCLUSION: When all the treatments have failed for CS after an AMI, MCA may be used as a bridge to heart transplantation in a select group of patients where the procedure is not contraindicated. The long-term results of 64% survivors in our experience is satisfactory.

Estimates of the mean per capita daily intake of benzoic and sorbic acids in Brazil.

The daily intakes of benzoates and sorbates from selected food categories were estimated in Brazil in 1999. The Budget method was used as a first screening procedure for the estimation of the safety aspects of the maximum permitted levels of benzoates and sorbates established by the Brazilian food legislation. This screening indicated that benzoates should be further investigated. In a second step, the daily intakes of these preservatives were assessed by combining measured levels of these additives with national food consumption data derived from a household economic survey and a packaged good market survey. Benzoate and sorbate levels in soft drinks, fruit juices, margarine, yoghurt and cheese were determined by HPLC with a photodiode array detector (detection at 228 nm for benzoic acid, 260 nm for sorbic acid). The estimated intakes of benzoates and sorbates for the average consumer were below the ADIs, ranging from 0.3 to 0.9 and 0.2 to 0.3 mg kg(-1) body weight, respectively. Soft drinks were identified as the main source of benzoates representing >80% of the estimated intake.

Estimates of the theoretical maximum daily intake of phenolic antioxidants BHA, BHT and TBHQ in Brazil.

The theoretical maximum daily intakes (TMDI) of the phenolic antioxidants butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT) and tertbutyl hydroquinone (TBHQ) in Brazil were estimated using food consumption data derived from a household economic survey and a packaged goods market survey. The estimates were based on maximum levels of use of the food additives specified in national food standards. The calculated intakes of the three additives for the mean consumer were below the ADIs. Estimates of TMDI for BHA, BHT and TBHQ ranged from 0.09 to 0.15, 0.05 to 0.10 and 0.07 to 0.12 mg/kg of body weight, respectively. To check if the additives are actually used at their maximum authorized levels, analytical determinations of these compounds in selected food categories were carried out using HPLC with UV detection. BHT and TBHQ concentrations in foodstuffs considered to be representive sources of these antioxidants in the diet were below the respective maximum permitted levels. BHA was not detected in any of the analysed samples. Based on the maximal approach and on the analytical data, it is unlikely that the current ADI of BHA (0.5 mg/kg body weight), BHT (0.3 mg/kg body weight) and TBHQ (0.7 mg/kg body weight) will be exceeded in practice by the average Brazilian consumer.

Caffeine daily intake from dietary sources in Brazil.

A survey on the potential intake of caffeine was carried out in Campinas, SP, Brazil, in the summer of 1993. The survey was based on a representative sample of 600 individuals, 9-80 years old, who were asked about their habitual usage of coffee, tea, chocolate products and carbonated beverages. Caffeine levels in the products were determined by high performance liquid chromatography with a UV-visible detector at 254 nm. Individual daily intakes (mg/kg b.w.) of caffeine were calculated from the consumption data generated by the survey and the caffeine content of the analysed products. Of all those interviewed, 81% consumed soft drinks regularly, 75% coffee, 65% chocolate products and 37% tea. Of the analysed products, coffee showed the highest amount of caffeine. The average and median potential daily intake of caffeine by the studied population were, respectively, 2.74 and 1.85 mg/kg b.w. Coffee, tea, chocolate products and carbonated beverages accounted for median individual daily intakes of 1.90, 0.32, 0.19, and 0.19 mg/kg b.w., respectively. These data show that coffee is the most important vehicle for caffeine intake within the studied population.

[Regulatory aspects in the use of natural colorants]. / Regulamentação de uso de corantes naturais.

A number of preparations of natural colours from vegetable, insect and algae sources are presently used in various foods, although many of them have not been evaluated in relation to their safety of use. In evaluating the toxicity of food additives the concept of the Acceptable Daily Intake (ADI) has been used to provide an indication of safety for use and to enable regulatory authorities to take adequate legislative measures for their control. This paper will focus on the principles for the safety assessment of food additives, with emphasis on the guidelines that have been established by the Joint Expert Committee on Food Additives and Contaminants (JECFA) for evaluating natural food colours. Recent data on the potential intake of annato extracts in Brazil and current aspects of regulation of food colours at the level of MERCOSUR will also be presented.

Familial hairy cell leukemia: a HLA-linked disease or farmers-linked disease?

In the 16 cases of familial HCL published, different HLA have been found. Although specific HLA antigens were found to have the same structure in some cases that suggests a genetic predisposition to HCL. Environmental factors, specifically farming labours, were implicated in too. We add two cases (father and son, both farmers), Their HLA haplotype has not been described, but the type A2Bw4Bw6 and Bw6, presented in father and/or son, have been.

Benzo(a)pyrene in Brazilian vegetable oils.

Samples of vegetable oils on the Brazilian market including rape seed, corn, soybean, sunflower, rice, palm and garlic were analysed for benzo(a)pyrene (B(a)P). The analytical method involved liquid-liquid extraction, clean-up on silica gel column and determination by high performance liquid chromatography using fluorescence detection. The limit of detection was 0.5 microgram/kg. Benzo(a)pyrene was detected in almost all samples, at levels up to 58.9 micrograms/kg. The mean levels of B(a)P in rice, sunflower, soybean, corn and palm oils were 1.8, 0.2, 2.2, 10.8 and 2.1 micrograms/kg respectively. No B(a)P was detected in garlic and rape seed oils. The data indicate that the levels of B(a)P found in Brazilian corn oils are relatively higher than those published in the literature for European corn oils.

Potential intake of intense sweeteners in Brazil.

A survey of intense sweetener intakes was carried out in the winter of 1990 and summer of 1991 in Brazil. Data on the potential intake of the intense sweeteners aspartame, cyclamate and saccharin were generated, based on a representative sample of 673 individuals who completed a questionnaire designed to collect information on demographic details and habitual usage of sweetener-containing food and drinks. The respondents were randomly chosen among intense sweetener consumers living the cities of Campinas, São Paulo and Curitiba, Paraná. Potential daily intakes by individuals were calculated for each sweetener by combining each person's consumption of sweetener-containing food and beverages with information generated by the determination of the concentrations of the sweeteners used in these products. The data showed that 72% of the studied population consumed saccharin, 67% cyclamate and 40% aspartame. The main reasons alleged for the use of intense sweeteners were weight-control diet (36%), diabetes (35%) and weight loss (23%). Table-top sweeteners were the major source of sweeteners, followed by soft drinks. The median daily intake of aspartame, cyclamate and saccharin represented approximately 2.9, 15.5, and 16-4% of the corresponding ADI, respectively. Diabetics in general had a much higher intake within the studied population.

Constrictive pericarditis after heart transplantation: report of two cases.

We report two cases of constrictive pericarditis after heart transplantation. It is noteworthy that constriction developed after a healed intrathoracic infection in the two patients. Unlike previous reported experiences, pericardiectomy was uneventful and successfully performed, although incomplete improvement was achieved in one case.