Search

aime Guedes,1,2 Sacha Fernandes Pereira,3 Dillan Cunha Amaral,4 Larissa C Hespanhol,5 Adriano Cypriano Faneli,6 Ricardo Danilo Chagas Oliveira,2,7 Denisse J Mora-Paez,1 Bruno M Fontes21Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; 2Ophthalmology, Opty Group, Rio de Janeiro, RJ, Brazil; 3Faculty of Medical Sciences of Paraiba, AFYA, João Pessoa, PB, Brazil; 4Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; 5Faculty of Medicine, Federal University of Campina Grande, Campina Grande, PB, Brazil; 6Faculty of Medicine, Bahiana School of Public Health and Medicine, Salvador, BA, Brazil; 7Ophthalmology, Federal University of Bahia, Salvador, BA, Brazil Correspondence: Jaime Guedes, Email [email protected] Background: Cataract surgery is one of the most frequently performed eye surgeries worldwide, and among several techniques, phacoemulsification has become the standard of care due to its safety and efficiency. We evaluated the advantages and disadvantages of two phacoemulsification techniques: phaco-chop and divide-and-conquer. Methods: PubMed, Cochrane, Embase, and Web of Science databases were queried for randomized controlled trial (RCT), prospective and retrospective studies that compared the phaco-chop technique over the divide-and-conquer technique and reported the outcomes of (1) Endothelial cell count change (ECC); (2) Ultrasound time (UST); (3) Cumulated dissipated energy (CDE); (4) Surgery time; and (5) Phacoemulsification time (PT). Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity. Results: Nine final studies, (6 prospective RCTs and 3 observational), comprising 837 patients undergoing phacoemulsification. 435 (51.9%) underwent the phaco-chop technique, and 405 (48.1%) underwent divide-and-conquer. Overall, the phaco-chop technique was associated with several advantages: a significant difference in ECC change postoperatively (Mean Difference [MD] − 221.67 Cell/mm2; 95% Confidence Interval [CI] − 401.68 to − 41.66; p < 0.02; I2=73%); a shorter UST (MD − 51.16 sec; 95% CI − 99.4 to − 2.79; p = 0.04; I2=98%); reduced CDE (MD − 8.68 units; 95% CI − 12.76 to − 4.60; p < 0.01; I2=84%); a lower PT (MD − 55.09 sec; 95% CI − 99.29 to − 12.90; p = 0.01; I2=100). There were no significant differences in surgery time (MD − 3.86 min; 95% CI − 9.55 to 1.83; p = 0.18; I2=99%). Conclusion: The phaco-chop technique proved to cause fewer hazards to the corneal endothelium, with less delivered intraocular ultrasound energy when compared to the divide-and-conquer technique. [ABSTRACT FROM AUTHOR]

This systematic review aims to give an overview of the diversity of research areas related to human biometeorology in Brazil. The main focus of this paper addresses research trends, represented by published papers with national and international authorship, main contributions and shortcomings, as well as challenges and prospects of research in this area of study. An extensive literature search was conducted in the Scopus, Web of Science, and Science Direct databases so as to identify relevant publication output up to July 2021 related to the research area. The screening resulted in 96 studies chosen for full-text reading. Overall, results indicated a reduced amount of articles on the subject matter published internationally, with noticeable gaps in research in some regions of the country, such as the Amazon region and in the Brazilian Midwest region. Research gaps in relevant areas have been identified with limited output in the climate dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers. Such gaps should further encourage researchers to engage in research focused on those areas. [ABSTRACT FROM AUTHOR]

Background: Recently developed immunosuppressive drugs, especially TNF antagonists, may enhance the risk of granulomatous infections, including leprosy. We aimed to evaluate the leprosy detection rate in patients under immunosuppression due to rheumatological, dermatological and gastroenterological diseases.Methods: We performed a systematic review of the literature by searching the PubMed, EMBASE, LILACS, Web of Science and Scielo databases through 2018. No date or language restrictions were applied. We included all articles that reported the occurrence of leprosy in patients under medication-induced immunosuppression.Results: The search strategy resulted in 15,103 articles; finally, 20 articles were included, with 4 reporting longitudinal designs. The detection rate of leprosy ranged from 0.13 to 116.18 per 100,000 patients/year in the USA and Brazil, respectively. In the meta-analysis, the detection rate of cases of leprosy per 100,000 immunosuppressed patients with rheumatic diseases was 84 (detection rate = 0.00084; 95% CI = 0.0000-0.00266; I2 = 0%, p = 0.55).Conclusion: Our analysis showed that leprosy was relatively frequently detected in medication-induced immunosuppressed patients suffering from rheumatological diseases, and further studies are needed. The lack of an active search for leprosy in the included articles precluded more precise conclusions.Trial Registration: This review is registered in PROSPERO with the registry number CRD42018116275 . [ABSTRACT FROM AUTHOR]

Microbial keratinase research has been on an upward trajectory due to the robustness and efficiency of the enzyme toward various green technological processes that promote economic development and environmental sustainability. A compendium of research progression and advancement within the domain was achieved through a bibliometric study to understand the trend of research productivity, scientific impacts, authors' involvement, collaboration networks, and the advancement of knowledge gaps for future research endeavours. A three-decade (1990 to 2019) scholarly published articles were retrieved from the web of science database using a combination of terms "keratinas* or keratinolytic proteas* or keratinolytic enzym*", and subsequently analyzed for bibliometric indicators. A collection of 330 peer-reviewed, research, articles were retrieved for the survey period and authored by 1063 researchers with collaboration index of 3.27. Research productivity was most in 2013 with total research output of 28 articles. The top three authors' keywords were keratinase, keratin and protease with a respective frequency of 188, 26 and 22. India, China and Brazil ranked top in terms of keratinase research outputs and total citation with respective article productivity (total citations) of 85 (1533), 57 (826), and 36 (764). This study evaluated the trend of keratinase research outputs, scientific impact, collaboration networks and biotechnology innovations. It has the potentials to influence positively decision making on future research direction, collaborations and development of products for the bio-economy. [ABSTRACT FROM AUTHOR]

• The cases of a total of 3530 patients with histoplasmosis in Brazil have been published (1939–2018). • Histoplasma capsulatum was found in the environment and causing human and animal disease. • Disseminated disease was the most common form of histoplasmosis. • HIV infection was a common underlying condition for histoplasmosis in Brazil. • Histoplasmosis is widespread across all of the Brazilian territory. Histoplasmosis is a systemic disease caused by the dimorphic fungus Histoplasma capsulatum. Diagnosis is often delayed, or it is misdiagnosed as tuberculosis. In Brazil, the infection is common and cases of histoplasmosis have been described in all regions of the country; however, the real problem is underestimated since notification of histoplasmosis is not mandatory. Human histoplasmosis cases diagnosed in Brazil and published up to December 2018 were identified through a search conducted in the PubMed/MEDLINE, SciELO, and Web of Science databases. Moreover, the isolation of H. capsulatum from animals or environmental sources in Brazil was also evaluated. A total of 207 articles fulfilled the inclusion criteria and were evaluated, involving a total of 3530 patients with a diagnosis of histoplasmosis during the period studied. Of these patients, 78.3% were male, giving a male-to-female ratio of approximately 4:1. Histoplasmosis presented a higher frequency in individuals between the fourth and fifth decades of life. Disseminated disease was the most common form of histoplasmosis. Isolation of H. capsulatum on culture media and histopathology using staining methods were the diagnostic methods with the best efficiency. The best results in the identification of the H. capsulatum were achieved for samples from mononuclear phagocyte system components, skin and mucosa, and hematological samples. Regarding predisposing factors for histoplasmosis, HIV infection was the most common underlying condition. The overall mortality rate was 33.1%. This study represents the first available systematic review demonstrating Brazilian cases of histoplasmosis in the literature and highlights that the disease is more widespread in the Brazilian territory than has previously been thought. [ABSTRACT FROM AUTHOR]