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INTRODUCTION: Diabetes Mellitus (DM) is a metabolic disorder characterized by persistent hyperglycemia and/or insulin resistance. If left uncontrolled, it can lead to a combination of cardiac and renal alterations known as cardiorenal syndrome. Additionally, oxidative stress and inflammation contribute to tissue damage, thereby reducing the life expectancy of individuals with diabetes. AIM: The aim of this study was to identify early molecular markers associated with cardiorenal syndrome, oxidative stress, and inflammation, and to investigate their correlation with the duration of exposure to DM. METHODS: An experimental DM model was employed using Wistar rats. The rats were divided into four groups: diabetic rats at 7 days (DM7), diabetic rats at 30 days (DM30), control sham at 7 days (CS7), and control sham at 30 days (CS30). Blood and brain tissue from the brainstem region were collected at 7 and 30 days after confirming DM induction. Gene expression analysis of Bnp, Anp, Cat, Gpx, Sod, Tnf-α, and Il-6 was performed. RESULTS: The analysis revealed lower expression values of Cat in the brainstem tissue of the DM7 group compared to the NDS7 group. Moreover, diabetic animals exhibited statistically lower levels of Tnf-α in their peripheral blood compared to the control animals. CONCLUSION: This study concluded that DM alters the oxidative balance in the brainstem after 7 days of DM induction, resulting in lower Cat expression levels. Although some genes did not show statistical differences after 30 days of DM induction, other genes exhibited no expression values, indicating possible gene silencing. The study identified an imbalance in the studied pathways and concluded that the organism undergoes a compensatory state in response to the initial metabolic alterations caused by DM.

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The use of the brine shrimp Artemia salina (Leach) in acute toxicity assays has great potential due to its simplicity, low cost and reproducibility. In the current study, some of the variables that can influence the reliability of the assay in terms of test organism survival, were evaluated as part of its implementation in our laboratory. The quality and type of water used, the buffer components and other parameters (salinity, pH and dissolved oxygen level), were all evaluated for optimisation purposes. DMSO (dimethyl sulphoxide) was used as the test substance in the toxicity assay, to evaluate the concentration limits as a solvent in sample preparation. Regarding the buffer salinity, pH and dissolved oxygen level, we found that a 25% to 30% deviation from the standard values did not affect the survival of the nauplii (the first-instar larval stage) under assay conditions. In summary, we corroborate the potential use of this model for the prediction of the toxic potential of substances, to inform future testing strategies.

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INTRODUCTION AND AIM: Vitamin D is the name given to a group of lipid-soluble steroidal substances of physiological importance in the body, especially in bone metabolism. The active form of vitamin D is believed to have immunomodulatory effects on immune system cells, especially T lymphocytes, as well as on the production and action of several cytokines and on the expression of potent antimicrobial peptides in epithelial cells that line the respiratory tract, playing an important role in protecting the lung from infections. The aim of this study was to assess vitamin D levels in patients with COVID-19 in healthcare service and to verify that these levels are adequate to protect the progression of this infection. METHODS: The aim of this observational study was to evaluate the serum concentration of vitamin D in 300 patients suspected of being infected with COVID-19, treated at Basic Health Units (BHUs) and at the Hospital Complex in the municipality of São Bernardo do Campo. RESULTS: 294 patients were included, 195 (66%) of which tested positive for COVID-19 and 99 (34%) negative for COVID-19. Among the patients in the positive group, 163 patients were in the mild group (84%); 22 patients in the moderate group (11%); 8 patients in the severe group (4%), and 2 patients in the deceased group (1%). CONCLUSION: For the patients in this study, no association was observed for the protective factor of vitamin D against COVID-19 infection, and its role in controlling the clinical staging of the disease was not verified.

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BACKGROUND: The diagnosis of Type 2 Diabetes Mellitus (T2DM) is made by demonstrating the hypoglycemic condition, which involves the determination of plasma glucose, and the follow-up of hypoglycemic treatment is performed by assessing the glycated hemoglobin (HbA1c) concentration. AIM: The aim of this study was to evaluate the saliva as an alternative sample in assessing the adherence to treatment with oral hypoglycemic agents in patients with Type 2 Diabetes. METHODS: We selected 68 patients with T2DM, who were subjected to venous blood and saliva collection, in addition to answering a standardized questionnaire on adherence to hypoglycemic treatment. Laboratory tests performed on saliva, whole blood, serum or plasma included assessment of glycemia, urea, creatinine, uric acid, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, and glycated hemoglobin. RESULTS: It was concluded that 82% of the patients adhered to hypoglycemic treatment based on glycated hemoglobin concentration (cut-off value of 7.0%). Comparing the groups that adhered to hypoglycemic treatment and those that did not adhere, statistical differences (P<0.05) were observed in the glucose, HDL-cholesterol, triglycerides, and insulin use (insulin therapy) parameters. Plasma glucose and urea serum concentration showed positive correlations when compared to saliva samples. Regarding the questionnaire, it was found that 35% of the patients presented positive screening for belief barriers and 83% positive score for recall barriers, and the positive screening correlated with glycated hemoglobin. CONCLUSION: Data have shown that it is possible to use saliva as an alternative sample to the laboratory assessment of hypoglycemic treatment adherence in T2DM patients.

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INTRODUCTION: Brazil has been facing the pandemic of COVID-19 since march 2020. More than 540,000 people have died from this disease in the country. Some estimates indicate that the population exposed to SARS-CoV-2 represents 1 to 20%. However, these data are questionable due to the number of asymptomatic and untested individuals. As a result, vaccination for COVID- 19 has become the main means of achieving herd immunity. OBJECTIVES: To demonstrate, through local sampling, that broad and rapid vaccination may decrease the rate of COVID-19 detection in individuals potentially exposed to the SARS-CoV-2 virus. METHODS: A total of 1,128 individuals were studied, including students and health professionals from Centro Universitário FMABC, who received the two doses of the vaccine for COVID-19 (Oxford/Astrazeneca ® and CoronaVac®). RESULTS: In the studied period, there was a 41% reduction in the demand for RT-PCR tests after vaccination. And a 78.3% reduction in positive results after vaccination started. CONCLUSION: The results of this study showed that even vaccinating a population with higher exposure to the risk of contamination significantly reduced test positivity and the demand to perform these tests. This emphasizes that vaccination is the best strategy to achieve herd immunity and reduce the spread of the disease.

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IMPORTANCE: Since the beginning of the COVID-19 pandemic, numerous metabolic alterations have been observed in individuals with this disease. It is known that SARS-CoV-2 can mimic the action of hepcidin, altering intracellular iron metabolism, but gaps remain in the understanding of possible outcomes in other pathways involved in the iron cycle. OBJECTIVE: To profile iron, ferritin and hepcidin levels and transferrin receptor gene expression in patients diagnosed with COVID-19 between June 2020 and September 2020. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study that evaluated iron metabolism markers in 427 participants, 218 with COVID-19 and 209 without the disease. EXPOSURES: The primary exposure was positive diagnose to COVID-19 in general population of Santo André and São Bernardo cities. The positive and negative diagnose were determinate through RT-qPCR. MAIN OUTCOMES AND MEASURES: Devido a evidências de alterações do ciclo do ferro em pacientes diagnosticados com COVID-19 e devido a corregulação entre hepcidina e receptor de transferrina, uma análise da expressão gênica deste último, poderia trazer insights sobre o estado de ferro celular. A hipótese foi confirmada, mostrando aumento da expressão de receptor de transferrina concomitante com redução do nível de hepcidina circulante. RESULTS: Serum iron presented lower values in individuals diagnosed with COVID-19, whereas serum ferritin presented much higher values in infected patients. Elderly subjects had lower serum iron levels and higher ferritin levels, and men with COVID-19 had higher ferritin values than women. Serum hepcidin was lower in the COVID-19 patient group and transferrin receptor gene expression was higher in the infected patient group compared to controls. CONCLUSIONS AND RELEVANCE: COVID-19 causes changes in several iron cycle pathways, with iron and ferritin levels being markers that reflect the state and evolution of infection, as well as the prognosis of the disease. The increased expression of the transferrin receptor gene suggests increased iron internalization and the mimicry of hepcidin action by SARS-CoV-2, reduces iron export via ferroportin, which would explain the low circulating levels of iron by intracellular trapping.

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The aim of this study was to investigate whether the habitat of older adults living in the urban and rural areas is a contributing factor to altered serum 25(OH)D levels. An analytical, cross-sectional research with a quantitative approach was conducted in the upper backwoods of Paraíba with older adults registered at the Reference Center for Social Assistance (CRAS), addressing residents of both rural area (n = 41) and urban area (n = 43) who were randomly chosen to participate in the study. Data collection took place between January and February 2020. Higher rates of handgrip strength were observed in rural older adults (29.22 ± 8.92 Kgf) with serum 25(OH)D levels in the range of 30 to 40 ng/mL when compared to older adults with concentrations below 30 ng/mL (21.82 ± 5.00 Kgf) and above 40 ng/mL (23.47 ± 6.88 Kgf). Older people living in the urban area, with 25(OH)D levels above 40 ng/mL, presented a lower muscle power index when compared to individuals with vitamin levels from 21 to 29 ng/mL (17.40 ± 6.34 s; 15.33 ± 2.00 s). The urbanization associated with 25(OH)D levels can cause changes in skeletal and respiratory muscle strength, because the habitat associated with 25(OH)D levels affects the parameters of muscle strength of the upper limbs for older adults living in a rural area and the muscle strength of the lower limbs for those living in an urban area.

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ABSTRACT Lung cancer is the first in terms of incidence and mortality, being responsible worldwide for about 1.8 million deaths. In Brazil 31,270 new cases were diagnosed in 2018, 18,740 in men and 12,350 in women. One of the main challenges about lung cancer is performing an early diagnosis, in most cases the disease is detected in the late stages, which implies in poor prognoses. Tumor biomarkers are hugely relevant in early diagnosis, understanding of carcinogenesis, prognostic determination and therapeutic choice. The present paper reviews non-small cell lung cancer biomarkers described in the literature and their diagnostic, prognostic and therapeutic applications, intervention and therapeutic control for individualized therapy. Although there is still a vast universe to be explored, studies reveal a promising future for lung cancer treatment with increasingly personalized and assertive therapies that increase the chances of progression-free survival.

RESUMO O câncer de pulmão é o primeiro em incidência e mortalidade, sendo responsável mundialmente por cerca de 1,8 milhão de mortes. No Brasil, 31.270 casos novos foram diagnosticados em 2018, sendo 18.740 em homens e 12.350 em mulheres. Um dos principais desafios do câncer de pulmão é o diagnóstico precoce, na maioria das vezes a doença é detectada em fases tardias, o que implica em mau prognóstico. Os biomarcadores tumorais são extremamente relevantes no diagnóstico precoce, compreensão da carcinogênese, determinação do prognóstico e escolha terapêutica. O presente trabalho revisa biomarcadores de câncer de pulmão de células não pequenas descritos na literatura e suas aplicações diagnósticas, prognósticas e terapêuticas, intervenção e controle terapêutico para terapia individualizada. Embora ainda exista um vasto universo a ser explorado, estudos revelam um futuro promissor para o tratamento do câncer de pulmão com terapias cada vez mais personalizadas e assertivas que aumentam as chances de sobrevida livre de progressão.

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INTRODUCTION: With the arrival of the SARS-CoV-2 (Coronavirus 2 of severe acute respiratory syndrome) pandemic in Brazil, especially in the city of São Paulo, there was a need to apply social isolation policies associated with testing, covering all municipalities. The Clinical Analysis Laboratory of Centro Universitário FMABC was one of the first laboratories to receive certification and qualification to perform RT-PCR (reverse transcriptase reaction followed by polymerase chain reaction) tests in the metropolitan region of São Paulo OBJECTIVE: Aim to analyze the influence of adopting social isolation on the incidence of positivity in COVID-19 tests in the metropolitan region of São Paulo, Brazil METHODS: a descriptive study carried out from March to May 2020, epidemiological data were collected from each unit served and organized by the data controllership team of the Clinical Analysis Laboratory of FMABC. Epidemiological, demographic, and laboratory data were extracted from the Matrix® outpatient data management system. Clinically suspected cases and confirmed by laboratory tests (RT-PCR and serological tests) were entered. The tests were divided into serological tests using the RT-PCR molecular test, on samples of nasopharyngeal mucosal scrapings collected with sterile Swab RESULTS: It were evaluated PCR test and antibody presence (IgA, IgM and IgG) in blood samples of 16.297 patients. 22.718 tests were performed for the diagnosis of COVID-19, both RT-PCR (10.410 tests) and serological tests to detect anti-SARS-CoV-2 antibodies, IgA, IgM and IgG, a total of 16.297 patients were assessed, 63% women and 37% men. It was observed that the social isolation policies adopted during this period contained the massive expansion of contamination, at least while the social isolation rates were above 55% CONCLUSION: The data of this study demonstrated the effectiveness of social isolation in containing the positive contamination of SARS-CoV-2 in the metropolitan region of São Paulo, at least for the first three months

INTRODUÇÃO: com a chegada da pandemia de SARS-CoV-2 (Coronavirus 2 da síndrome respiratória aguda grave) ao Brasil, especialmente na cidade de São Paulo, houve a necessidade de aplicar medidas de distanciamento social associado a testagem, que abrangesse todos os municípios. A região metropolitana de São Paulo compreende 39 municípios e possui uma rede de laboratórios habilitados a realizar a testagem para a detecção do coronavírus, tanto testes sorológicos quanto moleculares. O Laboratório de Análises Clínicas do Centro Universitário ABC/FMABC foi um dos primeiros laboratórios a receber a certificação e habilitação para realizar os testes RT-PCR (reação da transcriptase reversa seguida pela reação em cadeia da polimerase) na região metropolitana de São Paulo OBJETIVO: analisar a influência da adoção do isolamento social na incidência de positividade nos testes de COVID-19 em região metropolitana de São Paulo, Brasil MÉTODO: estudo descritivo realizado no período de março a maio de 2020, os dados epidemiológicos foram coletados de cada unidade atendida e organizada pela equipe de controladoria de dados do Laboratório de Análises Clínicas da FMABC. Os dados epidemiológicos, demográficos e laboratoriais foram extraídos do sistema Matrix® de gerenciamento de dados ambulatoriais. Foram inseridos os casos clinicamente suspeitos e confirmados por testes de laboratório (RT-PCR e testes sorológicos). Os testes foram divididos em testes sorológicos no teste molecular RT-PCR, em amostras de raspado de mucosa nasofaríngea coletada com Swab estéril RESULTADOS: foram avaliados o teste de RT-PCR e a presença de anticorpos (IgA, IgM e IgG) em amostras de sangue de 16.297 pacientes. Foram realizados 22.718 testes para o diagnóstico de COVID-19, tanto RT-PCR (10.410 testes), quanto testes sorológicos para detecção de anticorpos anti-SARS-CoV-2, IgA, IgM e IgG, um total de 16.297 pacientes foram avaliados, 63% mulheres e 37% homens. Observou-se que as políticas de isolamento social adotadas nesse período continham a expansão massiva da contaminação, pelo menos enquanto as taxas de isolamento social eram superiores a 55% CONCLUSÃO: nossos dados demonstraram a efetividade do isolamento social na retenção da positividade da contaminação do SARS-CoV-2 nas cidades contempladas pelo serviço de testagem do Centro Universitário Saúde ABC, pelo menos nos três primeiros meses

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OBJECTIVE: To verify if there is an increase in frequency of type 2 diabetes mellitus (DM2) and glucose intolerance in children and adolescents who are overweight and obese. METHODS: This was a cross-sectional survey. The study population consisted of 2757 students of both sexes (1415 girls and 1342 boys) attending public schools in São Paulo state, Brazil,aged 10-19 years, from 2011 to 2012. Students not within this age range and those with type 1 diabetes mellitus were excluded. Upon interview, anthropometry, capillary blood glucose testing, fasting glucosemia (FG) and glucosemia 2 hours after 75 g of dextrose (AD) variables were obtained. We emphasize that, inspite of the 2757 students included in the next stage, only 88 students agreed to participate, and low compliance of those participants is due to the fact that they were children and adolescents who depend on the authorization of their parents or tutors, who have demonstrated deficient knowledge of familial chronic diseases such as obesity and its consequences, and the risk of DM2. RESULTS: More often girls, 1415 (51.3%). A total of 27.3% was overweight/obese/severely obese. Capillary blood glucose testing was performed in 88 (3.2%) children and adolescents with low values of glycemic results after the glucose load. There was no statistical significance between sex and glucosemia, with an average FG and AD of 92.8 mg/dL (male), 91.8 mg/dL (female) and 89.1 mg/dL (male) and 88.9 mg/dL (female), respectively. CONCLUSION: This survey emphasizes that more attention should be paid to diet interventions and practicing of physical activities demanding habit changes and acquisition of special behaviour for self-care, and provision of a better educational health program, suggesting the effective participation of the family.