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Introduction: After three years since the beginning of the pandemic, the new coronavirus continues to raise several questions regarding its infectious process and host response. Several mutations occurred in different regions of the SARS-CoV-2 genome, such as in the spike gene, causing the emergence of variants of concern and interest (VOCs and VOIs), of which some present higher transmissibility and virulence, especially among patients with previous comorbidities. It is essential to understand its spread dynamics to prevent and control new biological threats that may occur in the future. In this population_based retrospective observational study, we generated data and used public databases to understand SARS-CoV-2 dynamics. Methods: We sequenced 1,003 SARS-CoV-2 genomes from naso-oropharyngeal swabs and saliva samples from Pará from May 2020 to October 2022. To gather epidemiological data from Brazil and the world, we used FIOCRUZ and GISAID databases. Results: Regarding our samples, 496 (49.45%) were derived from female participants and 507 (50.55%) from male participants, and the average age was 43 years old. The Gamma variant presented the highest number of cases, with 290 (28.91%) cases, followed by delta with 53 (5.28%). Moreover, we found seven (0.69%) Omicron cases and 651 (64.9%) non-VOC cases. A significant association was observed between sex and the clinical condition (female, p = 8.65e-08; male, p = 0.008961) and age (p = 3.6e-10). Discussion: Although gamma had been officially identified only in December 2020/January 2021, we identified a gamma case from Belém (capital of Pará State) dated May 2020 and three other cases in October 2020. This indicates that this variant was circulating in the North region of Brazil several months before its formal identification and that Gamma demonstrated its actual transmission capacity only at the end of 2020. Furthermore, the public data analysis showed that SARS-CoV-2 dispersion dynamics differed in Brazil as Gamma played an important role here, while most other countries reported a new infection caused by the Delta variant. The genetic and epidemiological information of this study reinforces the relevance of having a robust genomic surveillance service that allows better management of the pandemic and that provides efficient solutions to possible new disease-causing agents.
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COVID-19 , SARS-CoV-2 , Humanos , Feminino , Masculino , Adulto , SARS-CoV-2/genética , Brasil/epidemiologia , COVID-19/epidemiologia , Análise de DadosRESUMO
Analisar o impacto do One Minute Preceptor na vivência da prática profissional de estudantes de fisioterapia de uma instituição de ensino superior que utiliza metodologia ativa de ensino no Nordeste brasileiro. Estudo de intervenção, qualiquantitativo, sequencial explanatório, realizado no centro de reabilitação, um dos cenários do hospital escola, com amostra de 20 estudantes e 10 preceptores. Ocorreu em quatro etapas, seguindo a resolução 510/16 do Conselho Nacional de Saúde, sob parecer 3.021.399. Análises quantitativas realizadas no Microsoft Office Excel 2016® e Software Rstudio®, a qualitativa conforme análise de conteúdo de Bardin. O One Minute Preceptor mostrou-se adequado a metodologia da instituição e perfil dos estudantes participantes. Estimulou, motivou e favoreceu o raciocínio crítico reflexivo, sendo percebido pelos grupos melhora na condução da preceptoria, feedback e postura ativa dos estudantes, possibilitando consolidar instrumentos facilitadores de ensino-aprendizagem em ambientes de prática clínica.
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Background: Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis and represents an important global public health issue. Single-nucleotide polymorphisms and INDELs are common genetic variations that can be located in genes associated with immune response and, therefore, they may have direct implications over the phenotype of susceptibility to infections like tuberculosis. This study aimed to investigate the association between the 17 genetic polymorphisms and susceptibility to tuberculosis in a Brazilian population. Methods: This case-control study enrolled 283 individuals with active tuberculosis and 145 health care workers. Four INDELs and 13 single nucleotide polymorphisms and were genotyped using Multiplex PCR method and TaqMan SNP Genotyping Assays. Group comparisons for categorical variables were performed using the chi-squared test, whilst the t-Student test was used to analyze the continuous variables. Multiple logistic regression analyses were performed to estimate the odds ratio (OR) with 95% confidence intervals (CI). Deviation from Hardy-Weinberg equilibrium was assessed using chi-squared tests with Bonferroni correction. The results were analyzed comparing the genotypic distributions adopting the dominant model and the estimated values ââof p corrected for multiple tests through FDR (False Discovery Rate) test. Results: The HWE test confirmed that the genotypic frequencies for polymorphisms were balanced. The frequency of Del allele was 73 and 75%, in cases and controls respectively. Frequency of Del allele was significantly higher in the control group than TB group. The homozygous Del/Del genotype was present in 51.6% of cases and 58.6% of controls. The rare Ins/Ins genotype was present in only 7.6% of controls and 6% of cases. The ACE Del/Del genotype was significantly higher in the cases than in controls revealing significant protection for TB in the domain model (OR = 0.465; p < 0.005). Conclusions: The Del/Del genotype of the rs4646994 in ACE gene was associated with susceptibility to tuberculosis. The identification of genetic variants responsible for susceptibility to tuberculosis will allow the development of new diagnostic tools for tuberculosis infection. These studies will help improve control and the future eradication of this disease.
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Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm derived from the balanced reciprocal translocation of chromosomes 9 and 22 t (9q34 and 22q11), which leads to the formation of the Philadelphia chromosome and fusion of the BCR-ABL genes. The first-line treatment for CML is imatinib, a tyrosine kinase inhibitor that acts on the BCR-ABL protein. However, even though it is a target-specific drug, about 25% of patients do not respond to this treatment. The resistance mechanisms involved in this process have been investigated and studies have shown that germinal alterations can influence this mechanism. The aim of this work was to investigate 32 polymorphisms in 24 genes of carcinogenic pathway to verify the influence of these genetic variants on the response to treatment with imatinib. Our results demonstrated that individuals with the recessive GG genotype for the rs2372536 variant in the ATIC gene are approximately three times more likely to experience treatment failure with imatinib (p = 0.045, HR = 2.726, 95% CI = 0.9986-7.441), as well as individuals with the TT genotype for the rs10821936 variant in the ARID5B gene, who also have a higher risk for treatment failure with imatinib over time (p = 0.02, HR = 0.4053, IC 95% = 0.1802-0.911). In conclusion, we show that variants in the ATIC and ARIDB5 gene, never screened in previous studies, could potentially influence the therapeutic response to imatinib in patients treated for CML.
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Benzamidas , Leucemia Mielogênica Crônica BCR-ABL Positiva , Proteínas de Ligação a DNA/genética , Resistencia a Medicamentos Antineoplásicos/genética , Humanos , Hidroximetil e Formil Transferases , Mesilato de Imatinib/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Complexos Multienzimáticos , Nucleotídeo Desaminases , Piperazinas , Pirimidinas/uso terapêutico , Fatores de Transcrição/genética , Translocação GenéticaRESUMO
BACKGROUND: Target treatment using site-specific nanosystems is a hot topic for treating several diseases, especially cancer. OBJECTIVE: The study was set out to develop site-specific liposomes using ConcanavalinA (ConA) to target ß- lapachone(ß-lap) to human breast cancer cells. METHODS: Liposomes were prepared and characterized according to diameter size, zeta potential, ConA conjugation(%) and ß-lap encapsulation efficiency (%). Isothermal Titration Calorimetry evaluated the binding energy between the biomolecules, which compose of the liposomes. ConA avidity was assessed before and after conjugation. Cytotoxicity was evaluated, and fluorescence microscopy was performed to investigate the influence of ConA influenced on MCF-7 uptake. RESULTS: Uncoated and ConA-coated liposomes presented size, and zeta potential values from 97.46 ± 2.01 to 152.23 ± 2.73 nm, and -6.83 ± 0.28 to -17.23 ±0.64 mV, respectively. Both ConA conjugation and ß-lap encapsulation efficiency were approximately 100%. The favorable and spontaneous process confirmed the binding between ConA and the lipid. Hemagglutination assay confirmed ConA avidity once Lipo-ConA and Lipo-PEG-ConA were able to hemagglutinate the red blood cells at 128-1 and 256-1, respectively. Lipo-ConA was not cytotoxic, and the site-specific liposomes presented the highest toxicity. ConA-coated liposomes were more internalized by MCF7 than uncoated-liposomes. CONCLUSION: Therefore, the presence of ConA on the surface of liposomes influenced MCF7 uptake, in that way could be used as a promising site-specific system to target ß-lap to cancer cells.
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Neoplasias da Mama , Naftoquinonas , Neoplasias da Mama/tratamento farmacológico , Concanavalina A , Feminino , Humanos , Lipossomos/química , Naftoquinonas/químicaRESUMO
Abstract Introduction Since the new coronavirus (SARS-CoV-2) was declared a pandemic, health care was one of the fields that underwent significant changes. Telemedicine, that uses technological and communication resources to provide health care, was deemed a safe alternative to continue patient care while quarantine and social isolation measures were in place. Objective To analyze the perception of women treated at an outpatient clinic in relation to remote health care implemented during the COVID-19 pandemic. Methods Descriptive research conducted at the Women's Physiotherapy Outpatient Clinic of the Prof. Fernando Figueira Comprehensive Medicine Institute (IMIP) in Recife, Pernambuco state, Brazil. The study included women above the age of 18 years who were being remotely treated and excluded those who discontinued treatment. Data were collected from November 2020 to July 2021, using a questionnaire which was sent to the participants via WhatsApp. Results Twenty-six women with an average age of 52 ± 10.1 years were interviewed. Most (61.54%) were being treated for urinary incontinence at the outpatient clinic and 38.5% had been undergoing physiotherapy for at least six months. A total of 92.3% of the participants reported feeling safe with remote health care and 70.4% noticed an improvement in their symptoms. Conclusion Most patients noticed an improvement in their symptoms, felt comfortable and safe with teleservices and would agree to continue even after returning to in-person care. However, to ensure more effective results, patients need to be well informed and have some prior knowledge about the proposed treatment.
Resumo Introdução Desde que foi declarada a pandemia do novo coronavírus (SARS-CoV-2), a área da saúde foi um dos campos que sofreu significativas modificações. O teleatendimento em saúde, que consiste na utilização de recursos tecnológicos e de comunicação para prestar assistência em saúde, foi uma alternativa encontrada para continuar, de maneira segura, o cuidado com os pacientes enquanto vigoravam as medidas de quarentena e isolamento social. Objetivo Analisar a percepção de mulheres assistidas em um hospital-escola do nordeste do Brasil referente ao teleatendimento implantado durante a pandemia de COVID-19. Métodos Estudo descritivo transversal realizado no Ambulatório de Fisioterapia da Mulher do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), em Recife/PE. Foram incluídas mulheres maiores de 18 anos, em assistência remota via teleatendimento, excluindo aquelas que não deram continuidade ao atendimento por telessaúde. Para a coleta de dados, realizada de novembro de 2020 a julho de 2021, utilizou-se um questionário próprio, que foi enviado via WhatsApp para as participantes do estudo. Resultados Foram entrevistadas 26 pacientes com idade média de 52 ± 10,1 anos. A maioria (61,5%) foi atendida no ambulatório para tratar incontinência urinária e 38,5% estavam em tratamento fisioterapêutico há pelo ao menos seis meses. A maioria (92,3%) relatou se sentir segura com a assistência remota e 70,4% perceberam melhora dos sintomas. Conclusão A maior parte das participantes percebeu melhora dos sintomas, sentindo-se confortável e segura com o teleatendimento, e aceitaria continuar com o tratamento à distância mesmo após o retorno das atividades presenciais. Para uma resposta mais efetiva, contudo, as pacientes precisam ser bem orientadas e ter algum conhecimento prévio acerca do tratamento a ser proposto pela fisioterapia.
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In recent years, the incidence of tuberculosis (TB) has declined worldwide, although this disease still occurs at relatively high rates in Amerindian populations. This suggests that the genetic ancestry of Amerindians may be an important factor in the development of infections, and may account for at least some of the variation in infection rates in the different populations. The present study investigated the potential influence of Amerindian genetic ancestry on susceptibility to tuberculosis in an Amazon population. The study included 280 patients diagnosed with tuberculosis and 138 asymptomatic hospital employees with no history of TB, but who were in contact with bacterially active TB patients. Ancestry analysis was run on a set of 61 Ancestry-Informative Markers to estimate European, African, and Amerindian genetic ancestry using STRUCTURE v2.2. The TB group had significantly higher Amerindian ancestry in comparison with the control group, and significantly lower European ancestry. Amerindian ancestry in the 20-60% range was found to be the principal risk factor for increased susceptibility to TB. The results of the study indicate that Amerindian ancestry is an important risk factor for susceptibility to TB in the admixed population of the Brazilian Amazon region.