Epidemiological Profile of Human Papillomavirus in a Healthcare Center in Portugal: Implications for Public Health Policies.

Introduction Human papillomavirus (HPV) infection, a prevalent sexually transmitted disease, affects the majority of sexually active individuals at least once in their lifetime. Cervical cancer stands as a significant contributor to mortality among women. Cervical cancer screening (CCS) and HPV vaccination are recent, with few studies about their impact on the prevalence of HPV types. The emergence of novel predominant pathogen strains can be driven by vaccine-induced pathogen strain replacement, thereby enhancing and altering selection. Objective The aim of the study was to characterize the high-risk (HR) HPV infection in two Portuguese primary care units (PCUs). Materials and methods In this observational, cross-sectional, and descriptive study, we included women aged 25-64 years and registered in two PCUs, who were screened by SiiMA Rastreios (population-based screening management application), and were HR-HPV positive, between August 2015 and May 2018. The results of cervical cancer screening (CCS) can be accessed through the SiiMA Rastreios information system. For data treatment, we used MS Excel (Microsoft Corporation, Redmond, Washington, USA), IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, USA), and non-parametric tests. Results In our study, we included 4,614 women aged between 25 and 64 years old. CCS was performed on 24.47%, of whom 39.95% were tested for HR-HPV. The infection rate was 18.85%, and all 14 types of infection were identified. The most common HPV type was 31, followed by 16 and 68. We found HPV other than 16/18 in 84.43%. We found coinfections in 34.1%, with no statistically significant difference by age group. In the 25-34 age group, the incidence of infection was 33.7% vs. 17.54% in the 35-54 age group and 4.55% in the 55-64 age group. HPV16 was the most common infection in the 25-34 age group. In nulliparous women, the most common was HPV31. The relationship between smoking habits and HR-HPV infection was statistically significant, but economic insufficiency was not. Conclusion The infection incidence in this study was slightly higher than in the 2011 national study. Statistically, the infection rate was significantly higher in the younger age groups. The most frequent type varied from the national and international study results. This may be due to regional differences in HPV infection, changes in the pattern of incidence, or the effect of vaccination. The HPV pattern may be changing, so the scientific community must keep updated to develop increasingly efficient screening and vaccination programs.

A polyvalent RNA vaccine reduces the immune imprinting phenotype in mice and induces neutralizing antibodies against omicron SARS-CoV-2.

Immune imprinting is now evident in COVID-19 vaccinated people. This phenomenon may impair the development of effective neutralizing antibodies against variants of concern (VoCs), mainly Omicron and its subvariants. Consequently, the boost doses with bivalent vaccines have not shown a significant gain of function regarding the neutralization of Omicron. The approach to design COVID-19 vaccines must be revised to improve the effectiveness against VoCs. Here, we took advantage of the self-amplifying characteristic of RepRNA and developed a polyvalent formulation composed of mRNA from five VoCs. LION/RepRNA Polyvalent induced neutralizing antibodies in mice previously immunized with LION/RepRNA D614G and reduced the imprinted phenotype associated with low neutralization capacity of Omicron B.1.1.529 pseudoviruses. The polyvalent vaccine can be a strategy to handle the low neutralization of Omicron VoC, despite booster doses with either monovalent or bivalent vaccines.

RNA Combined with Nanoformulation to Advance Therapeutic Technologies.

Nucleic acid-based therapies have the potential to address numerous diseases that pose significant challenges to more traditional methods. RNA-based therapies have emerged as a promising avenue, utilizing nanoformulation treatments to target a range of pathologies. Nanoformulation offers several advantages compared to other treatment modalities, including targeted delivery, low toxicity, and bioactivity suitable for drug loading. At present, various types of nanoformulations are available, such as liposomes, polymeric nanoparticles (NPs), magnetic NPs, nanoshells, and solid lipid nanoparticles (SLNs). RNA-based therapy utilizes intracellular gene nanoparticles with messenger RNA (mRNA) emerging prominently in cancer therapy and immunotechnology against infectious diseases. The approval of mRNA-based technology opens doors for future technological advancements, particularly self-amplifying replicon RNA (repRNA). RepRNA is a novel platform in gene therapy, comprising viral RNA with a unique molecular property that enables the amplification of all encoded genetic information countless times. As a result, repRNA-based therapies have achieved significant levels of gene expression. In this context, the primary objective of this study is to furnish a comprehensive review of repRNA and its applications in nanoformulation treatments, with a specific focus on encapsulated nanoparticles. The overarching goal is to provide an extensive overview of the use of repRNA in conjunction with nanoformulations across a range of treatments and therapies.

Incidence and Predictive Factors for Amputations Derived From Charcot's Neuroarthropathy in Persons With Diabetes.

Charcot's neuroarthropathy (CN) is the progressive destruction of the bones and joints of the feet, as a consequence of severe peripheral neuropathy, which predisposes patients to amputations. The purpose of this study was to measure the cumulative incidence of amputations resulting from CN and risk factors among amputated people with diabetes mellitus (DM). This was an epidemiological, observational, and retrospective study of 114 patients with DM who had an amputation involving the lower limbs. Data were collected from 2 specialized outpatient clinics between 2015 and 2019, including socio-demographic and clinical variables (cause of amputation: CN, peripheral arterial disease [PAD], infected ulcers, fracture, osteomyelitis, and others; body mass index [BMI]; 1 or 2 DM, time since DM diagnosis, insulin treatment, glycated hemoglobin; creatinine; smoking and drinking; systemic arterial hypertension, diabetic retinopathy, diabetic kidney disease, diabetic peripheral neuropathy, acute myocardial infarction, PAD, and stroke; characteristics of amputation [level and laterality], in addition to the specific variables related to CN [time of amputation in relation to the diagnosis of CN, diagnosis of CN in the acute phase, and treatment implemented in the acute phase]). We compared socio-demographic and clinical characteristics, including types of amputation, between patients with and without CN. Statistical analyses were performed using the 2 sample t-test or Wilcoxon-Mann-Whitney test, for quantitative variables, and the Pearson's χ2 test or Fisher's exact test for categorical variables. The investigation of the possible association of predictive factors for a CN amputation was carried out through logistic regression. The amputation caused by CN was present in 27 patients with a cumulative incidence of 23.7% in 5 years. There was a statistically significant association between BMI and the occurrence of CN (odds ratio: 1.083; 95% confidence interval: 1.001-1.173; P = .048); higher values of BMI were associated with a higher occurrence of amputations secondary from CN.

The prevalence of skin tears and associated factors in hospitalised patients with cancer.

OBJECTIVE: Oncology patients are vulnerable to skin breakdown. The primary purpose of this study was to estimate the prevalence of skin tears (STs) in hospitalised patients with cancer and to explore related sociodemographic and clinical factors. METHOD: This was an observational, epidemiological, cross-sectional study conducted in an oncology hospital in the city of São Paulo. All STs were classified using the STAR Classification adapted and validated for Brazil. RESULTS: Of the 341 patients evaluated, 22 had STs, equating to a prevalence of 6.5%. A higher number of STs were noted on the lower limbs (26.9%) than on other body areas. The main factors associated with STs were the use of anticoagulants, the presence of ecchymosis and the use of incontinence briefs. CONCLUSION: This study contributed to a better understanding of the epidemiology of STs in hospitalised patients with cancer, as well as its associated factors. Results may inform nursing professionals with regard to the need to develop prevention strategies and early interventions.

Webinar - Melhores práticas clínicas para o manejo da dor isquêmica na Doença Arterial Periférica

A Doença Arterial Periférica afeta perto de 4% de todos os canadenses com mais de 40 anos e até 20% dos indivíduos com mais de 75 anos, pondo as doenças arteriais de membros inferiores com o sem úlcera, no meio de uma preocupação crescente. Esta preocupação também se extende à dor de difícil manejo, que é um dos principais sintomas desta doença que impacta grandemente a Qualidade de Vida Relacionada à Saúde destes indivíduos e aumenta o custo de tratamento para a sociedade e o sistema de saúde. Neste webinar, o Dr. Kevin Woo da Queen’s University em Kingston (ON, Canadá) apresenta algumas das melhores prácticas clínicas para o manejo da dor isquêmica na Doença Arterial Periférica. O webinar é promovido pelo Programa de Pós-Graduação em Enfermagem na Saúde do Adulto (PROESA) da Escola de Enfermagem da Universidade de São Paulo, e apoiado pelo programa Líderes Emergentes nas Américas (ELAP) do Governo Canadiense e pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) do Governo Brasileiro.

Prevalence of diabetic foot ulcers and their associated factors in patients from public hospitals in manaus-am.

AIM: The purpose of this study was to identify and analyze the prevalence of diabetic foot ulcers (DFU) as well as associating factors in the city of Manaus, Amazonas State, Brazil. METHODS: This was an observational, epidemiological, cross-sectional study, point prevalence, with 229 adults' diabetic inpatients from seven hospitals. Written signed consent was obtained from all participants or their legal representative if they had a cognitive impairment. Sociodemographic and clinical data were collected through interviews and medical records. Each participant was examined by the research team to evaluate for foot deformity. RESULTS: Of the 229 patients diagnosed with DM, 60 presented DFU, resulting in a prevalence of 26.2 %. The logistic regression model that included all variables with a significance level of 5 % (p ≤ 0.05) shows: Patients with PAD were more likely to have DFU (OR = 2956; p = 0,01). The use of emollients (OR = 0.097; p < 0.001) and anticoagulants (OR = 0.149; p = 0.002) were related to reduced likelihood for developing DFU. CONCLUSION: This study contributes to a better understanding of DFU epidemiology in hospitalized patients, as well as the factors associated with them. The results are important for nursing in order to develop early prevention and intervention strategies.

Impact of Microphone Configuration on Speech Perception of Cochlear Implant Users in Traffic Noise.

OBJECTIVE: The aim of this study was to investigate the impact of microphone configuration and noise reduction algorithm on speech perception of cochlear implant (CI) users in a moving noise setup. METHOD: Eleven CI users provided with Advanced Bionics implant systems participated in this study. All tests were conducted with three different microphone settings: (a) omnidirectional behind the ear (BTE), (b) inside the pinna (ITP), and (c) adaptive directional microphone (adaptive beamformer, ABF). Speech reception thresholds (SRTs) were measured using the Oldenburg sentence test in a moving noise source condition. Furthermore, the effect of a noise reduction algorithm on speech perception was measured in a condition with an additional static noise source. RESULTS: The ABF setting significantly improved SRT by 5.7 dB compared with the BTE microphone, and by 4.7 dB compared with the ITP microphone in the moving noise condition. In the presence of an additional static noise source, there was a significant improvement in SRT of 0.9 dB with the use of NR in addition to ABF. CONCLUSION: Adaptive beamforming can significantly improve speech perception in moving noise. Depending on the noise condition, the combination of ABF with NR can provide additional benefit.

[Impact of microphone position on sound localization in cochlear implant users]. / Einfluss der Mikrofonposition auf die akustische Lokalisation bei Cochlea-Implantat-Nutzern.

OBJECTIVE: The delivery of directional cues of a hearing device microphone are highly dependent on the position of the microphones. The aim of this work was the evaluation of different microphone positions with regard to the transmission of interaural time and level differences as well as the spectral characteristics and its impact on the localization abilities. METHODS: Head-related transfer functions of 30 subjects were measured with three different omnidirectional microphones at different positions: in the pinna (ITP), behind the ear (BTE), at the entrance of the ear canal (EEC). Sound localization abilities of 12 bilateral CI users was assessed for the microphone positions ITP and BTE. RESULTS: Only the microphone positions in the ear (ITP, EEC) could sample the spectral cues of the pinna. However, the positioning of the microphone inside of the pinna did not significantly improve sound localization abilities compared to BTE microphones. For sound incidence from rear significantly less front-back confusions were achieved with the microphone inside of the pinna. CONCLUSION: The microphone position in the pinna showed only a slight improvement in sound localization compared with BTE microphones in CI users. A precondition for better sound localization abilities is the improvement of the delivery of temporal and spectral fine structure cues in CI systems.

[Prevalence of self-reported constipation in adults from the general population]. / Prevalência de constipação intestinal autorreferida em adultos da população geral.

OBJECTIVE: To estimate the prevalence of self-reported constipation and associated factors in the general population of a Brazilian city. METHOD: Secondary analysis of an epidemiological study, population-based, cross-sectional study, about bowel habits of Brazilian population. A total of 2,162 individuals were interviewed using two instruments: sociodemographic data and the adapted and validated Brazilian version of the "Bowel Function in the Community" tool. RESULTS: There was a prevalence of 25.2% for the self-reported constipation, 37.2% among women and 10.2% among men. Stroke and old age were associated with constipation in the three statistical models used. CONCLUSION: The prevalence found showed to be similar to the findings in the literature, although some associated factors obtained here have never been investigated.

Prevalence of self-reported constipation in adults from the general population / Prevalencia de constipación autorreferido en adultos de la población general / Prevalência de constipação intestinal autorreferida em adultos da população geral

OBJECTIVE To estimate the prevalence of self-reported constipation and associated factors in the general population of a Brazilian city. METHOD Secondary analysis of an epidemiological study, population-based, cross-sectional study, about bowel habits of Brazilian population. A total of 2,162 individuals were interviewed using two instruments: sociodemographic data and the adapted and validated Brazilian version of the "Bowel Function in the Community" tool. RESULTS There was a prevalence of 25.2% for the self-reported constipation, 37.2% among women and 10.2% among men. Stroke and old age were associated with constipation in the three statistical models used. CONCLUSION The prevalence found showed to be similar to the findings in the literature, although some associated factors obtained here have never been investigated. .

OBJETIVO Estimar la prevalencia de estreñimiento autorreferido y los factores asociados en la población general de una ciudad brasileña. MÉTODO Análisis secundario de un estudio epidemiológico, de base poblacional y transversal, acerca del hábito intestinal en la población brasileña. Fueron entrevistados 2.162 individuos utilizándose dos instrumentos: datos sociodemográficos y hábito intestinal en la población. RESULTADOS Se logró prevalencia del 25,2% para el estreñimiento autorreferido, siendo el 37,2% para mujeres y el 10,2% entre los hombres. Accidente Vascular Encefálico y edad avanzada presentaron asociación con constipación en los tres modelos estadísticos utilizados. CONCLUSIÓN La prevalencia encontrada se mostró similar a los hallazgos de la literatura internacional, aunque algunos factores asociados aquí obtenidos nunca se hayan investigado. .

OBJETIVO Estimar a prevalência de constipação intestinal autorreferida e os fatores associados na população geral de uma cidade brasileira. MÉTODO Análise secundária de um estudo epidemiológico, de base populacional e transversal, sobre o hábito intestinal na população brasileira. Foram entrevistados 2.162 indivíduos utilizando-se dois instrumentos: dados sociodemográficos e hábito intestinal na população. RESULTADOS Obteve-se prevalência de 25,2% para a constipação autorreferida, sendo 37,2% para mulheres e 10,2% entre homens. Acidente Vascular Encefálico e idade avançada apresentaram associação com constipação nos três modelos estatísticos utilizados. CONCLUSÃO A prevalência encontrada mostrou-se similar aos achados na literatura internacional, embora alguns fatores associados aqui obtidos nunca tenham sido investigados. .

Avaliação do grau de depressão em pacientes com insuficiência renal crônica submetidos à hemodiálise / Evaluation of depression level in patients submitted to hemodialysis presenting chronic renal insufficiency

A insuficiência renal crônica é uma doença que resulta em inúmeros processos adaptativos que em sua maioria afeta diretamente a qualidade de vida do paciente, sendo que este sofre várias restrições decorrentes da doença e do tratamento, assim este indivíduo submetido à hemodiálisepode manifestar sintomas depressivos, portanto o presente estudo teve a finalidade de quantificar o grau de depressão para que este aspecto seja melhor abordado neste paciente, investindo em programas que diminuam o impacto que o tratamento provoca neste indivíduo atendendo assim, suas necessidades, resultando na maior aderência ao tratamento e melhora na qualidade de vida. Portanto, esse trabalho teve por objetivo avaliar o perfil dos pacientes com IRC submetidos a hemodiálise, caracterizando a população estudada segundo dados epidemiológicos e mensurando o grau de depressão segundo o questionário de Beck. Trata-se de um estudo descritivo, de campo, prospectivo, com abordagem quantitativa, que foi realizado em uma clínica pública de atendimento a pacientes em tratamento dialítico de ambos os sexos, com idade entre 18 e 85 anos no período de julho e agosto de 2006. Após análise dos dados, observamos que dos 30 pacientes estudados, 12 (40 por cento) manifestam algum tipo de depressão, sendo que dois (7 por cento) apresentam depressão do tipo grave. Os resultados apontam para uma incidência de depressão relevante, fazendo-se necessário o trabalho do enfermeiro indispensável para o diagnóstico precoce, orientação e educação para o tratamento mais efetivo da depressão, investindo em programas e apoio para melhoria na qualidade de vida destes pacientes.

Desinstitucionalizacao: estao os profissionais de saude mental bem informados?

Foi feito um levantamento sobre a familiaridade dos psiquiatras a respeito da literatura referente a desinstitucionalizacao dos doentes mentais. Um questionario contendo 16 itens de conhecimento sobre o assunto foi enviado a 76 Departamentos de Psiquiatria das Universidades brasileiras. Apenas 48 por cento responderam os questionarios. Os resultados indicam um nivel moderado de familiaridade dos sujeitos com o assunto, pois a porcentagem de respostas corretas foi de 70 por cento, um pouco acima do nivel do acaso (50 por cento). Os dados sugerem ainda um vies em favor da desinstitucionalizacao, pois os erros observados indicam uma tendencia para subestimar os efeitos da medicacao e superestimar os efeitos da intervencao comunitaria. Alem disso, a maioria acredita erroneamente que o processo de desinstitucionalizacao nasceu a partir de pesquisas avaliadas comprovando sua eficacia. O peso para a familia dos pacientes foi superestimado por uma parte da amostra. Os resultados foram comparados com uma amostra canadense de profissionais de saude mental e uma amostra brasileira de psicologos. Os erros citados acima sao semelhantes nas tres amostras, apesar das diferencas de contexto.