• Open Access close
• Closed Access close
• Open Source close
• Publications close
• Research data close
• Other research products close
• 3. Good health close
• BR close
• English close

Purpose: To explore pituitary tumors by methylome and transcriptome signatures in a heterogeneous ethnic population. Design: Retrospective cross-sectional study. Patients and Methods: Clinicopathological features, methylome, and transcriptome were evaluated in pituitary tumors from 77 patients (61% women, age: 12-72 years)followed due to functioning (FPT: GH-secreting n=18, ACTH-secreting n=14) and non-functioning pituitary tumors (NFPT, n=45) at Ribeirao Preto Medical School, University of Sao Paulo. Results: Unsupervised hierarchical clustering analysis (UHCA) of methylome (n=77) and transcriptome (n=65 out of 77) revealed three clusters each: one enriched by FPT, other by NFPT, and another by ACTH-secreting and NFPT. Comparison between each omics-derived cluster identified 3,568 and 5,994 differentially methylated and expressed genes, respectively, which were associated with each other, with tumor clinical presentation, and with 2017 and 2022 WHO classifications. UHCA considering 11 transcripts related to pituitary development/differentiation also supported three clusters: POU1F1-driven somatotroph, TBX19-driven corticotroph, and NR5A1-driven gonadotroph adenomas, with rare exceptions (NR5A1 expressed in few GH-secreting and corticotroph-silent adenomas; POU1F1 in few ACTH-secreting adenomas; and TBX19 in few NFPTs). Conclusions: This large heterogenic ethnic Brazilian cohort confirms that integrated methylome and transcriptome signatures classify FPT and NFPT, which are associated with clinical presentation and tumor invasiveness. Moreover, the cluster NFPT/ACTH-secreting adenomas raises interest regarding tumor heterogeneity, supporting the challenge raised by the 2017 and 2022 WHO definitions regarding the discrepancy, in rare cases, between clinical presentation and pituitary lineage markers. Finally, making our data publicly available enables further studies to validate genes/pathways involved in pituitary tumor pathogenesis and prognosis.

Dataset of a Neurocritical Brazil cohort study whose summary is described below. Abstract Objective: To describe a cohort of neurocritical patients and their differences based on primary neurological diagnoses and identify predictors of mortality and unfavorable outcome along with the disease burden of each neurological condition on intensive care unit (ICU) admission. Methods: Prospective cohort study including patients admitted to 36 ICUs in Brazil and followed up for 30 days. Results: Of 4245 patients admitted to the participating ICUs during the study period, 1194 (28.1%) were neurocritical patients and were included in the study. Neurocritical patients had a mean mortality rate 1.7 times higher than non-neurocritical patients admitted to the same ICUs (17.21% versus 10.1%, respectively). The most frequent primary neurological diagnoses on ICU admission were postoperative care of elective neurosurgery, traumatic brain injury, ischemic stroke, and encephalopathy. The estimated total disability-adjusted life-years (DALYs) were 4482.94 in the overall cohort, and the diagnosis with the highest DALYs was traumatic brain injury (1634.42). DALYs were significantly impacted by the patients’ primary neurological diagnosis, sex, age group, and number of secondary neurological injuries. Conclusion: We accurately described the epidemiology of neurocritical patients and estimated their overall and relative disease burden. The findings of this study are important to direct policies regarding education, prevention, and treatment of severe neurocritical diseases.

This is the dataset of manuscript titled "In which journals do family and community physicians in Brazil publish? The Trajetórias MFC project". There are two spreadsheets: the dataset proper and the data dictionary. See the manuscript for background. All spreadsheets are in the CSV (comma-separated values) format, delimited with semicolons and encoded in UTF-8 with the byte-order mark (BOM). The spreadsheets can be opened with desktop or Web application software (LibreOffice Calc, Microsoft Excel, Google Sheets) or with statistical software such as R. A previous version of this dataset was used in a preprint. This version should be cited by an upcoming article. See also the article, dataset and supplementary table for an earlier milestone, about the postgraduate education of family and community physicians in Brazil.

Objective: The goal of this prospective observational present study was to identify adverse events (AEs) related to the use of intravenous access sites for infective endocarditis (IE) treatment in a tertiary care hospital that can occur during patient care that cannot be attributed to the underlying disease and may result in lengthening of hospital stay or death. Design: This is an observational, analytical and prospective study on AEs resulting from the use of intravenous access sites in patients under antimicrobial treatment for IE. Patients enrolled in the International Collaboration on Endocarditis (ICE) study had their peripheral, short term central catheters (CVC) and peripherally inserted central catheters (PICC) monitored for AEs. Setting: Tertiary care hospital for cardiac surgery in Rio de Janeiro, Brazil. Patients: Patients over 18 years of age, hospitalized in 2009 and 2010 with definite criteria for IE by the modified Duke criteria were included. Main outcome measures: Adverse events related to intravenous catheters: erythema and infiltration, fever, obstruction, externalization and blood stream infection. Results: Thirty-seven episodes of IE in 35 patients were studied. Mean age was 44.32 ± 15.2 years; 22 (63%) were male. 253 vascular catheters were studied, 148 peripheral, 85 CVC (21 of which for haemodialysis) and 20 PICC. The most frequent AEs were “erythema” and “infiltration” for peripheral catheters, “fever” for CVCs, and “obstruction” and “externalization” for PICCs. The number of catheter-days was 360 for peripheral catheters, 1.156 for CVC and 420 for PICC. Kaplan Meier curves for CVC and PICC showed statistical difference for obstruction (p<0.001) in PICCs. More bacteraemia occurred in CVC compared to PICC. Conclusion: The choice of intravenous access sites is critical in the treatment of IE. Close observation for adverse events and stricter implementation of infection control measures and better manipulation of catheters are suggested. tabel hospitalization per episodeWe prepared a database in Access 2003 (Microsoft Corporation) for insertion of data collected. Later these data were transported to a table Excel (Microsoft Corporation) l. The patient-related variables were: age, sex, comorbidities (diabetes, hypertension, rheumatic fever, cancer, HIV and others), allergies, type of microorganism responsible for IE, type of valve at the beginning of the episode, presence of pacemaker or device as internal defibrillator, history of EI, source of acquisition of IE, echocardiographic data (evidence of vegetation, perforation, abscess and fistula), clinical data, date of commencement of treatment, total days planned for the end of treatment, antibiotics, indication for surgery and patient's fate.tabel venous accessWe prepared a database in Access 2003 (Microsoft Corporation) for insertion of data collected. Then the data were transported to a table of type Excel (Microsoft Corporation). The data collected were related to intravenous access: access types (peripheral, deep or hemodialysis), type of catheter, number of catheter lumens, number of insertion attempts, insertion date, date of removal, location of the insertion site, types of coatings (joint tape, hypoallergenic surgical tape, transparent dressing or tape), complications, cause for removal and professional responsible for the puncture.

Data and metadata for the publication: "Pathogen-selected polymorphisms in the PKLR gene are associated with mycobacterial susceptibility in Brazilian and African populations" by Bezerra et al. 2020. Please, see README.rmd for more information. Search engine additional keywords: rs11264355, rs1052176, rs4620533, rs4971072, rs11264359, leprosy, TaqMan SNP Genotyping

Cognitive impairments are a common consequence of traumatic brain injury (TBI). The hippocampus is a subcortical structure that plays a key role in the formation of declarative memories and is highly vulnerable to TBI. The α7 nicotinic acetylcholine receptor (nAChR) is highly expressed in the hippocampus and reduced expression and function of this receptor are linked with cognitive impairments in Alzheimer’s disease and schizophrenia. Positive allosteric modulation of α7 nAChRs with AVL-3288 enhances receptor currents and improves cognitive functioning in naïve animals and healthy human subjects. Therefore, we hypothesized that targeting the α7 nAChR with the positive allosteric modulator AVL-3288 would enhance cognitive functioning in the chronic recovery period of TBI. To test this hypothesis, adult male Sprague Dawley rats received moderate parasagittal fluid-percussion brain injury or sham surgery. At 3 months after recovery, animals were treated with vehicle or AVL-3288 at 30 min prior to cue and contextual fear conditioning and the water maze task. Treatment of TBI animals with AVL-3288 rescued learning and memory deficits in water maze retention and working memory. AVL-3288 treatment also improved cue and contextual fear memory when tested at 24 hr and 1 month after training, when TBI animals were treated acutely just during fear conditioning at 3 months post-TBI. Hippocampal atrophy but not cortical atrophy was reduced with AVL-3288 treatment in the chronic recovery phase of TBI. AVL-3288 application to acute hippocampal slices from animals at 3 months after TBI rescued basal synaptic transmission deficits and long-term potentiation (LTP) in area CA1. Our results demonstrate that AVL-3288 improves hippocampal synaptic plasticity, and learning and memory performance after TBI in the chronic recovery period. Enhancing cholinergic transmission through positive allosteric modulation of the α7 nAChR may be a novel therapeutic to improve cognition after TBI.

Evelise Brizola,1 Temis M F&eacute;lix,2 Jay R Shapiro3 1Bone and Osteogenesis Imperfecta Department, Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA; 2Medical Genetics Service, Hospital de Cl&iacute;nicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; 3Osteoporosis and Metabolic Bone Disorders Center, Bethesda, MD, USAAbstract: Osteogenesis imperfecta (OI) is a rare, heritable systemic disorder of bone and connective tissue, which in almost 90% of cases is due to mutations affecting the normal synthesis of type I collagen. In 1979, four OI phenotypes were categorized which were inherited as autosomal dominant characteristics. Individuals with OI present both genetic and phenotypic variabilities. Major characteristics of OI are bone fragility, blue sclerae, dentinogenesis imperfecta, short stature, scoliosis, and joint hyperextensibility. Both autosomal dominant and recessive inheritance are now recognized. Advances in molecular diagnosis have led to a major expansion in our understanding of the genetic basis for different OI phenotypes. To date, sequence variants in 17 genes are described as causative of OI. These genes regulate the synthesis of type I collagen pro-alpha polypeptide chains, proteins involved in type I collagen processing in the endoplasmic reticulum and proteins involved in osteoblast function. These new genetic associations have also led to uncertainty with regard to the current classification of OI phenotypes. Bisphosphonates have been widely used to improve bone mass and decrease fractures in both children and adults with OI. While effective in many but not all children when administered for 2&ndash;4 years, bisphosphonates have not proven effective in adults with OI. Studies are limited for treatment of adults with teriparatide and denosumab. Advances have been reported in the surgical management of OI. Although the role of physical therapy in the management of children and adults was previously described, this important treatment modality is significantly underutilized. Keywords: osteogenesis imperfecta, sequence variants, collagen, bisphosphonates, bone, treatment

The objective of this study was to evaluate the association between income inequality at a lagged time of 2 and 11 years with two short latency outcomes (untreated dental caries and gingivitis) and two long latency outcomes (edentulism and periodontal attachment loss > 8mm). We used data from the Brazilian oral health survey in 2002-2003. Our analysis included 13,405 subjects aged 35-44 years. Different lagged Gini at municipal level were fitted using logistic and negative binomial multilevel analyses. Covariates included municipal per capita income, equivalized income, age, sex, time since last dental visit and place of residence (rural versus urban). Crude estimates showed that only untreated dental caries was associated with current and lagged Gini, but in adjusted models only current Gini remained significant with a ratio of 1.19 (95%CI: 1.09-1.30) for every ten-point increase in the Gini coefficient. We conclude that lagged Gini showed no association with oral health; and current income Gini was associated with current dental caries but not with periodontal disease.Avaliar a associação entre desigualdade de renda (Gini municipal) defasada em 2 e 11 anos com dois desfechos de curta latência (cárie dentária não tratada e gengivite) e dois de longa latência (edentulismo e perda de inserção periodontal > 8mm). Foram utilizados dados do inquérito brasileiro de saúde bucal em 2002-2003. A análise incluiu 13.405 indivíduos com idades entre 35-44 anos. Foram usados modelos de regressão multinível. Covariáveis incluídas: renda municipal per capita, renda domiciliar equivalente, idade, sexo, tempo decorrido desde a última consulta odontológica e local de residência (rural versus urbano). Estimativas brutas mostraram que apenas cárie dental não tratada estava associada ao Gini (atual e defasado no tempo), mas em modelos ajustados apenas Gini atual manteve uma relação significativa com razão de 1,19 (IC95%: 1,09-1,30) para cada dez pontos de aumento no coeficiente de Gini. Concluímos que o Gini defasado no tempo não mostrou associação com saúde bucal e o Gini atual esteve associado com cárie dentária, mas não com doença periodontal.

O presente estudo teve como objetivo identificar diferentes concentrações de tensão residual de superfícies da cerâmica de revestimento (CR) de próteses parciais fixas de zircônia de 3 elementos (PPFs) com desenho da infraestrutura de espessura mínima e modificada (cinta lingual conectada aos postes proximais com 12 mm2 de área de conector) pelo método de nanoindentação. Vinte e três PPFs repondo segundo premolar (PM) foram confeccionados e o carregamento dinâmico foi aplicado em vinte PPFs. As PPFs fraturadas, suspensas e não fadigadas foram selecionadas e divididas (n=3/cada) nos seguintes grupos: 1) Fraturadas com espessura mínima (ZrEvenF); 2) Suspensas com espessura mínima (ZrEvenS); 3) Fraturadas com infraestrutura modificada (ZrModF); 4) Suspensas com infraestrutura modificada (ZrModS); 5) Não fadigadas com espessura mínima (Controle). Além disso, as superfícies do grupo controle foram divididas (n=3/cada) nos seguintes grupos: 6) Mesial do pilar PM (MPMa); 7) Distal do pilar PM (DPMa); 8) Vestibular do pilar PM (BPMa); 9) Lingual do pilar PM (LPMa); 10) Mesial do pôntico PM (MPMp); 11) Distal do pôntico PM (DPMp); 12) Vestibular do pôntico PM (BPMp); 13) Lingual do pôntico PM (LPMp); 14) Mesial do pilar molar (MMa); 15) Distal do pilar molar (DMa); 16) Vestibular do pilar molar (BMa); 17) Lingual do pilar molar (LMa). As superfícies da CR foram nanoendentadas nas regiões de interesse (ROI) 1, 2 e 3, a qual a distância da superfície externa da CR no sentido da interface CR/infraestrutura era de 0,03 mm, 0,35 mm e 1,05 mm, respectivamente. Cada ROI recebeu 5 nanoendentações com espaço mínimo de 10 m para carregar até 4 N. O teste modelo linear misto com diferença estatística mínima (95%) foi executado usando os valores de dureza. A análise estatística entre os grupos ZrEvenF, ZrEvenS, ZrModF, ZrModS, e Control apresentou diferenças (p=0.000) exceto para a comparação entre os grupos ZrModS e Control (p=0.371). Também, ROI 1, 2 e 3 foram diferentes (p<0.001). A comparação entre coroas mostrou que o pôntico foi diferente dos pilares pré-molar (p=0,001) e molar (p=0,007), sempre apresentando os maiores níveis de tensão. Quando os grupos das cristas marginais (MPMa, DPMa, MPMp, DPMp, MMa, DMa) foram comparadas, o grupo DMa foi diferente dos grupos DPMp (p=0,004) and MPMa (p=0,00), enquanto que o grupo MPMa foi diferente de todos os grupos. A tensão residual da cerâmica de revestimento foi diferente entre: PPFs fraturadas e suspensas independente do desenho da infraestrutura; ROI 1, 2 e 3; e pônticos e pilares. Além disso, as áreas proximais apresentaram a maior concentração de tensão residual. The present study aimed to identify different concentrations of residual stress of surfaces of porcelain veneer (PV) fused to zirconia 3-unit fixed dental prostheses (FDPs) with even thickness and modified (lingual collar connected to proximal struts presenting 12 mm2 connector area) framework designs by nanoindentation method. Twenty-three FDPs replacing second premolar (PM) were fabricated and the cyclic loading was applied on twenty FDPs. Fractured, suspended and non-fatigued FDPs were selected and divided (n=3/each) into: 1) Fractured even thickness (ZrEvenF); 2) Suspended even thickness (ZrEvenS); 3) Fractured with modified framework (ZrModF); 4) Suspended with modified framework (ZrModS); 5) Non-fatigued even thickness (Control). Moreover, the control group surfaces could be divided (n=3/each) into: 6) Mesial PM abutment (MPMa); 7) Distal PM abutment (DPMa); 8) Buccal PM abutment (BPMa); 9) Lingual PM abutment (LPMa); 10) Mesial PM pontic (MPMp); 11) Distal PM pontic (DPMp); 12) Buccal PM pontic (BPMp); 13) Lingual PM pontic (LPMp); 14) Mesial molar abutment (MMa); 15) Distal molar abutment (DMa); 16) Buccal molar abutment (BMa); 17) Lingual molar abutment (LMa). The PV surfaces were nanoindented in regions of interest (ROI) 1, 2 and 3, which were 0.03 mm, 0.35 mm and 1.05 mm from outer PV surface surface towards the PV/framework interface, respectively. Each ROI received 5 nanoindentations with 10 m of minimum separation loaded to a peak load 4 N. The Linear Mixed Model test and Least Significant Difference (95%) were used. The statistical analysis among ZrEvenF, ZrEvenS, ZrModF, ZrModS, and Control groups showed differences (p=0.000) except for the comparison between ZrModS and Control group (p=0.371). Also, ROI 1, 2, and 3 were different (p<0.001) with higher residual stresses in outer PV regions relative to those closer to the framework. The comparison among crowns showed that pontic was different from premolar (p=0,001) and molar (p=0,007) abutments, always showing higher residual stress levels. When marginal ridges groups (MPMa, DPMa, MPMp, DPMp, MMa, DMa) were compared, the DMa group was different from DPMp (p=0,004) and MPMa (p=0,00) group, whereas MPMa was different among all groups. The residual stress of porcelain veneer FDPs was different between: fractured and suspended FDPs regardless of the framework design; ROI 1, 2 and 3; and pontic and abutment crowns. Moreover, the proximal areas presented the highest concentration of residual stress.