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Gastrointestinal stromal tumors (GISTs) are sarcomas affecting the stomach and small intestine, with a rare subtype characterized by succinate dehydrogenase B (SDHB)-loss posing significant diagnostic and therapeutic challenges. A 62-year-old man with weight loss and abdominal pain was diagnosed with a gastric GIST showing SDHB-loss. Initial treatment with Imatinib reduced the tumor size, but surgery revealed no residual tumor. Despite adjuvant Imatinib, recurrence occurred, necessitating further surgical intervention. While GISTs typically benefit from surgery and tyrosine kinase inhibitors (TKIs), those with SDHB-loss are resistant to TKIs, requiring a different management approach. This case emphasizes the importance of surgical intervention for SDHB-deficient GISTs and the need for ongoing research into effective treatments for this subtype.
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Abstract Objective To investigate the epidemiology of injury types among jiu-jitsu practitioners, as well as the incidence regarding different skill and experience levels, through the question: "What are the characteristics and prevalence of musculoskeletal injuries in Jiu-Jitsu practitioners?". Methods Since the beginning of the study, in August 2020, we conducted a search on the MEDLINE, LILACS, and SciELO electronic databases. We included cross-sectional studies published between 2018 and 2023 on the epidemiology of the types of injuries among jiu-jitsu practitioners that compared their incidence regarding different levels of ability and experience. Two independent researchers performed the data extraction and assessed the risk of bias. Results Seven studies were included. The common outcomes involved 2,847 jiu-jitsu practitioners. A high prevalence in the knee joint and chest and rib areas was reported. Considering the difference in experience level among the practitioners, we could observe that most of the individuals included were beginners. Among the age groups observed, male practitioners older than 30 years of age were the ones who presented the highest rate of musculoskeletal injury, especially during training sessions. Conclusion There is a high prevalence of musculoskeletal injuries among jiu-jitsu practitioners. The most affected anatomical segments are the knee joint, the chest, and the rib region, followed by the shoulder joint. The related factors change according to certain variables, being more common during training in male individuals over 30 years of age and beginners in the sport.
Resumo Objetivo Investigar a epidemiologia dos tipos de lesões entre praticantes de jiu-jitsu e sua incidência em diferentes níveis de habilidade e experiência por meio da questão: "Quais as características e a prevalência das lesões musculoesqueléticas em praticantes de jiu-jitsu?" Métodos Desde o início do estudo, em agosto de 2020, foram pesquisados os bancos de dados MEDLINE, LILACS e SciELO. Foram incluídos estudos transversais, publicados entre 2018 e 2023, que investigaram a epidemiologia dos tipos de lesões ocorridas entre praticantes de jiu-jitsu e compararam sua incidência em diferentes níveis de habilidade e experiência. Para tanto, dois pesquisadores independentes realizaram a extração dos dados e avaliaram o risco de viés. Resultados Sete estudos foram incluídos. Os resultados comuns envolveram 2.847 praticantes de jiu-jitsu. Houve uma alta prevalência de lesão na articulação do joelho e nas áreas do tórax e das costelas. Considerando a diferença de nível de experiência entre os praticantes, pôde-se observar que a maioria dos indivíduos incluídos eram iniciantes. Entre as faixas etárias observadas, homens acima de 30 anos de idade foram os que mais apresentaram lesões musculoesqueléticas, principalmente durante os treinos. Conclusão Houve uma alta prevalência de lesões musculoesqueléticas entre os praticantes de jiu-jitsu. Os segmentos anatômicos mais acometidos foram a articulação do joelho, o tórax e a região das costelas, seguidos da articulação do ombro. Os fatores relacionados mudaram de acordo com algumas variáveis, sendo mais comuns durante o treinamento em indivíduos do sexo masculino com mais de 30 anos e iniciantes na modalidade.
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Objective To investigate the epidemiology of injury types among jiu-jitsu practitioners, as well as the incidence regarding different skill and experience levels, through the question: "What are the characteristics and prevalence of musculoskeletal injuries in Jiu-Jitsu practitioners?". Methods Since the beginning of the study, in August 2020, we conducted a search on the MEDLINE, LILACS, and SciELO electronic databases. We included cross-sectional studies published between 2018 and 2023 on the epidemiology of the types of injuries among jiu-jitsu practitioners that compared their incidence regarding different levels of ability and experience. Two independent researchers performed the data extraction and assessed the risk of bias. Results Seven studies were included. The common outcomes involved 2,847 jiu-jitsu practitioners. A high prevalence in the knee joint and chest and rib areas was reported. Considering the difference in experience level among the practitioners, we could observe that most of the individuals included were beginners. Among the age groups observed, male practitioners older than 30 years of age were the ones who presented the highest rate of musculoskeletal injury, especially during training sessions. Conclusion There is a high prevalence of musculoskeletal injuries among jiu-jitsu practitioners. The most affected anatomical segments are the knee joint, the chest, and the rib region, followed by the shoulder joint. The related factors change according to certain variables, being more common during training in male individuals over 30 years of age and beginners in the sport.
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Fungicides are pesticides that are frequently used in agriculture because of their action against fungal diseases. However, the widespread application of pesticides around the world raises environmental and public health concerns, since these compounds are toxic and can pose risks to ecosystems and human health. The aim of this study was to evaluate the phytotoxic, cytogenotoxic, and biochemical effects of azoxystrobin and carbendazim on Lactuca sativa L. and their physiological effects on Phaseolus vulgaris L. by analyzing the cell cycle and chromosomal and nuclear alterations in L. sativa; the biochemical effects of azoxystrobin and carbendazim on Phaseolus vulgaris L. and their physiological effects on Phaseolus vulgaris L. by analyzing the cell cycle and chromosomal and nuclear alterations in L. sativa; the biochemical effects by analyzing the activity of antioxidant enzymes in L. sativa; and the physiological effects by analyzing chlorophyll content and chlorophyll a fluorescence in P. vulgaris. It was observed that both fungicides were phytotoxic and cytotoxic, reducing root growth and the mitotic index, cytogenotoxic, increasing the occurrence of chromosomal alterations, as well as inducing oxidative stress and an increase in chlorophyll fluorescence emission and altered energy absorption in the plants used as a test system. In view of this, studies such as the one presented here indicate that the use of pesticides, even in small quantities, can lead to damage to the metabolism of plant organisms.
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Benzimidazóis , Carbamatos , Fungicidas Industriais , Lactuca , Phaseolus , Estrobilurinas , Phaseolus/efeitos dos fármacos , Estrobilurinas/toxicidade , Benzimidazóis/toxicidade , Fungicidas Industriais/toxicidade , Carbamatos/toxicidade , Lactuca/efeitos dos fármacos , Pirimidinas/toxicidade , Clorofila/metabolismoRESUMO
The monkeypox virus (MPXV) outbreak, primarily endemic to Africa, has spread globally, with Brazil reporting the second-highest number of cases. The emergence of MPXV in non-endemic areas has raised concerns, particularly due to the co-circulation of other exanthematous viruses such as varicella-zoster virus (VZV) and molluscum contagiosum virus (MOCV). To perform an accurate differential diagnosis of MPXV during the ongoing outbreak in Minas Gerais, Brazil, a 5PLEX qPCR assay targeting orthopoxviruses (OPV), VZV, and MOCV was used to retrospectively analyze all clinical samples that tested negative for MPXV in the initial screening conducted at Funed. In summary, our study analyzed 1,175 clinical samples received from patients suspected of MPXV infection and found a positivity rate of 33.8% (397 samples) for MPXV using the non-variola qPCR assay. Testing the 778 MPXV-negative clinical samples using the 5PLEX qPCR assay revealed that 174 clinical samples (22.36%) tested positive for VZV. MOCV DNA was detected in 13 and other OPV in 3 clinical samples. The sequencing of randomly selected amplified clinical samples confirmed the initial molecular diagnosis. Analysis of patient profiles revealed a significant difference in the median age between groups testing positive for MPXV and VZV and a male predominance in MPXV cases. The geographic distribution of positive cases was concentrated in the most populous mesoregions of Minas Gerais state. This study highlights the challenges posed by emerging infectious diseases. It emphasizes the importance of epidemiological surveillance and accurate diagnosis in enabling timely responses for public health policies and appropriate medical care. IMPORTANCE: Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions.
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Surtos de Doenças , Humanos , Brasil/epidemiologia , Estudos Retrospectivos , Masculino , Feminino , Adulto , Diagnóstico Diferencial , Criança , Adolescente , Mpox/diagnóstico , Mpox/epidemiologia , Mpox/virologia , Adulto Jovem , Pré-Escolar , Pessoa de Meia-Idade , Monkeypox virus/genética , Monkeypox virus/isolamento & purificação , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/isolamento & purificação , Lactente , Idoso , Exantema/virologia , Exantema/epidemiologia , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Immunosenescence is a phenomenon caused by changes in the immune system, and part of these changes involves an increase in circulating immunological biomarkers, a process known as "Inflammaging." Inflammaging can be associated with many diseases related to older people. As the older population continues to grow, understanding changes in the immune system becomes essential. While prior studies assessing these alterations have been conducted in countries with Caucasian populations, this investigation marks a pioneering effort. The object of the study is to describe for the first time that the distribution of cytokines, chemokines, and growth factors serum levels, assessed by Luminex platform, has been examined in a Brazilian population-based study of older adult females and males by age. Blood samples from 2111 participants (≥50 years old) were analyzed at the baseline (2015/2016) of the ELSI-Brazil study. The exploratory variables considered in the study were age, sex, educational level, residence area, geographic region, alcohol and smoking consumption, physical activity, and self-reported medical diagnoses of hypertension, diabetes, asthma, arthritis, and cancer. The association between serum biomarker levels and age was assessed by a quantile regression model adjusted in the total population and stratified by sex. The significance level considered in the analysis was 0.05. The mean age of the participants was 62.9 years, with a slight majority of female (52.7 %). Differences were found between the sexes in the median circulating levels of the CCL11, CXCL10, and FGF biomarkers. Eight biomarkers showed significant associations with age, including the pro-inflammatory CXCL10, TNF-α, IL-6, IL-17, and IL-2; and type 2/regulatory CCL11 and IL-4, showing positive associations, and anti-inflammatory IL-1Ra showing a negative association. The results suggest similar associations between the sexes, revealing an inflammatory profile characterized by types 1 and 2. Remarkably, these findings reinforce the concept of the Inflammaging process in Brazilian population. These findings add novel insights to about the immunosenescence aspects in middle-income countries and help define biomarkers capable of monitoring inflammation in older adults.
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Biomarcadores , Citocinas , Imunossenescência , Humanos , Masculino , Feminino , Brasil/epidemiologia , Biomarcadores/sangue , Idoso , Pessoa de Meia-Idade , Citocinas/sangue , Envelhecimento/imunologia , Envelhecimento/sangue , Idoso de 80 Anos ou mais , Inflamação/sangue , Quimiocinas/sangueRESUMO
This case report aimed to evaluate the swallowing capacity and the severity of the risk of laryngotracheal aspiration of a 52-year-old female patient with atypical and rare stroke, with major injury in the cerebellar pathway. In order to measure swallowing capacity and risk of aspiration a routine clinical assessment used in the speech therapy clinic was performed and two valid clinical tests were used: Massey Bedside Swallowing Screen (MBSS) and Gugging Swallowing Screen (GUSS). After evaluation with the clinical tests, it was observed that the patient had reduced swallowing capacity, performance characterized as pathological, 100% dysfunction in the water swallowing test (MBSS), presence of choking, coughing, change in vocal quality and anterior escape. In the assessment of risk of aspiration with the GUSS, the patient presented moderate dysphagia and risk of laryngotracheal aspiration.This case report demonstrated that moderate dysphagia is found in a stroke patient with lesions that affect the cerebellum. Standardized and validated clinical tests such as GUSS and MBSS should also be used to assess the risk of dysphagia after stroke at ambulatory care.
Esse relato de caso teve o objetivo de avaliar a capacidade de deglutição e a gravidade do risco de aspiração laringotraqueal de uma paciente, 52 anos, com Acidente Vascular Encefálico (AVE) atípico, com comprometimento na via cerebelar. Para mensurar a capacidade de deglutição e do risco de aspiração foram utilizados a avaliação de rotina na clínica de fonoaudiologia e dois testes clínicos validados: o Massey Bedside Swallowing Screen (MBSS) e o Gugging Swallowing Screen (GUSS). Após a avaliação com os testes clínicos, foi observado que a paciente apresentou capacidade de deglutição diminuída, desempenho caracterizado como patológico e de risco, com 100% de alteração no teste de deglutição de água pelo MBSS, presença de engasgo, tosse, alteração na qualidade vocal e escape anterior de alimento. Já na avaliação do risco de aspiração com o GUSS, a paciente apresentou disfagia moderada e com risco de aspiração laringotraqueal. A disfagia pode estar presente em casos de AVE com lesão anatômica comprometendo o cerebelo e suas vias, o que sugere a importância de avaliação específica da deglutição nesses casos. Os testes GUSS e o MBSS podem ser utilizados para avaliação de casos atípicos de AVE em fase ambulatorial, com objetivos de avaliar o risco de aspiração e a capacidade de deglutição.
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Transtornos de Deglutição , Acidente Vascular Cerebral , Feminino , Humanos , Pessoa de Meia-Idade , Deglutição , Transtornos de Deglutição/etiologia , Acidente Vascular Cerebral/complicaçõesRESUMO
Pesticides are compounds with several chemical or biological agents developed to potentiate the biocide action. Their use is associated with increased economic and agricultural productivity worldwide but can harm health and the environment, damaging existing biota. Clethodim is a systemic post-emergent herbicide for grasses, highly selective for cotton, coffee, onions, carrots, soybeans, etc. Therefore, this work aimed to evaluate the harmful effect of the herbicide Clethodim with the model plant Allium cepa. A series of tests were conducted to evaluate the effects of the herbicide under study. Germination tests, root growth, cell, and nucleolar cycle analysis, as well as oxidative stress assessment and histological analysis of the roots, were performed. The results indicated that the herbicide demonstrated phytotoxicity, inhibiting germination at C1 (1.92 g/L) and C3 (0.84 g/L), and root growth at all concentrations, presenting mutagenicity at C1 (1.92 g/L) and C4 (0.24 g/L), evidenced by the increased frequency of micronuclei. In addition, changes were observed in the enzymatic activity of the enzymes catalase at concentrations C1 (1.92 g/L) and C2 (0.96 g/L) and ascorbate peroxidase at concentrations C1 (1.92 g/L), C2 (0. 96 g/L), and C3 (0.48 g/L) and in cell elongation at concentrations C1 (1.92 g/L) and C3 (0.48 g/L), demonstrated in histological analyses of the root apex.
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Herbicidas , Cebolas , Herbicidas/metabolismo , Raízes de Plantas/metabolismo , Toxicogenética , Dano ao DNARESUMO
The current case study focuses on the Environmental Sensitivity Index (ESI) mapping of Guanabara Bay, Rio de Janeiro, Brazil - a region at risk from petroleum sector pollution. By mapping 981.5 km of coastline and classifying it in 10 oil sensitivity indices, we integrated biotic resources, socioeconomic attributes, and geoenvironmental diversity into a georeferenced database. Results reveal a high oil sensitivity of the bay, with approximately 89 % of the mapped coast scoring ESI 8 and ESI 10. These scores comprise, respectively, estuarine and solid substrate habitats that are sheltered from wave action. Notably, numerous manufacturing and oil handling plants, along with intensive urbanization, also contribute to the bay's oil sensitivity. Additionally, the rich biotic diversity in the study area, particularly in protected areas housing 79 conservation units, further amplifies its environmental vulnerability. This study aims to serve as a reference for detailed ESI mapping of coastal areas in tropical rainy zones with significant environmental diversity, industrial development, and a dense population.
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Poluição por Petróleo , Brasil , Monitoramento Ambiental/métodos , Ecossistema , Bases de Dados FactuaisRESUMO
OBJECTIVE: To assess the utility of the Curaçao criteria by age over time in children with hereditary hemorrhagic telangiectasia (HHT). STUDY DESIGN: This was a single-center, retrospective analysis of patients attending the HHT clinic at the Hospital for Sick Children (Toronto, Canada) between 2000 and 2019. The evaluation of the Curaçao criteria was completed during initial and follow-up visits. Screening for pulmonary and brain arteriovenous malformations was completed at 5 yearly intervals. RESULTS: A total of 116 patients with genetic confirmation of HHT were included in the analysis. At initial screening at a median (IQR) age of 8.4 (2.8, 12.9) years, 41% met criteria for a definite clinical diagnosis (≥3 criteria). In children <6 years at presentation, only 23% fulfilled at least 3 criteria initially. In longitudinal follow-up, 63% reached a definite clinical diagnosis, with a median (IQR) follow-up duration of 5.2 (3.2, 7.9) years (P = .005). Specifically, more patients met the epistaxis and telangiectasia criteria at last visit compared with initial (79% vs 60%; P = .006; 47% vs 30%; P = .02) but not for the arteriovenous malformation criterion (59% vs 57%; P = .65). CONCLUSIONS: In the pediatric population, most patients do not meet definite clinical criteria of HHT at initial presentation. Although the number of diagnostic criteria met increased over time, mainly due to new onset of epistaxis and telangiectasia, accuracy remained low during follow-up visits. Relying solely on clinical criteria may lead to underdiagnosis of HHT in children.