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Introdução: A tuberculose (TB) é uma das infecções que mais causa mortes em dimensão mundial, sendo a 3° relacionada com patologias respiratórias. No Amazonas, a prevalência ainda é significativa. O causador dessa doença é o Mycobacterium tuberculosis e esta é considerada um agravo de saúde pública. A TB afeta prioritariamente os pulmões, embora possa acometer outros órgãos e/ou sistemas. A importância deste estudo deve-se à exiguidade bibliográfica acerca da temática, principalmente, quando se trata do aumento do acometimento do Bacilo de Koch na região Norte do país. Objetivo: Realizar a análise quantitativa de indivíduos com tuberculose por forma clínica no período de 2019 a 2023 em Manaus, Amazonas. Método: Fora delineado um estudo descritivo, transversal, com coleta retrospectiva de dados dos casos notificados de Tuberculose de todas as formas clínicas, em indivíduos de todas as idades, no período de 2019 a 2023, no Sistema de Informação de Agravos de Notificação (SINAN), com busca e coleta concomitante no Sistema de Informação de Mortalidade (SIM). Resultados: : No período deste estudo, foram diagnosticados e notificados 2.019 casos de tuberculose, com 34 (1,7%) óbitos, o que corresponde a uma taxa de letalidade de 1,7%. Dentre estes casos, 1.247 (61,7%) apresentaram-se na forma pulmonar, 245(12,1%) na forma extrapulmonar e 527 (26,1%) nas formas pulmonar e extrapulmonar simultaneamente. Em relação à coinfecção TB+Hiv/AIDS foram registrados 1.774 (87,8%) casos, desses, 15 evoluíram ao óbito, correspondendo a uma taxa de letalidade de 0,8%. O ano de maior registro foi 2023 com 470 (23%) casos e 2020 o menor, com 358 (18%) casos. Conclusão: Houve um aumento significativo dos casos no ano de 2023 em relação ao ano de 2022. Notou-se que no ano de 2020, durante o período da pandemia do COVID-19, houve uma redução significativa de notificações em relação à 2019. Notou-se, ainda que a forma pulmonar foi a mais notória em todos os anos. Observou-se que 100% de pacientes com coinfecção TB/HIV evoluíram para a Síndrome de Imunodeficiência Adquirida (Aids). Os achados deste estudo ratificam a relevância dos levantamentos epidemiológicos de forma contínua e sistemática para melhor entendimento dos aspectos biológicos do bacilo e das abordagens clínicas na vigilância de doenças com grande potência de disseminação, como é o caso da tuberculose.

Objectives: To verify the analytical performance of the HepatoPredict kit, a novel tool developed to stratify Hepatocellular Carcinoma (HCC) patients according to their risk of relapse after a Liver Transplantation (LT). Methods: The HepatoPredict tool combines clinical variables and a gene expression signature in an ensemble of machine-learning algorithms to forecast the benefit of a LT in HCC patients. To ensure the accuracy and reliability of this method, extensive analytical validation was conducted to verify its specificity and robustness. The experiments were designed following the guidelines for multi-target genomic assays such as ISO201395-2019, MIQE, CLSI-MM16, CLSI-MM17, and CLSI-EP17-A. The validation process included reproducibility between operators and between RNA extractions and RT-qPCR runs, and interference of input RNA levels or varying reagent levels. A recently retrained version of the HepatoPredict algorithms was also tested. Results: The validation process demonstrated that the HepatoPredict kit met the required standards for robustness (p > 0.05), analytical specificity (inclusivity of 95 %), and sensitivity (LoB, LoD, linear range, and amplification efficiency between 90 and 110 %). The operator, equipment, input RNA, and reagents used had no significant effect on the HepatoPredict results. Additionally, the testing of a recently retrained version of the HepatoPredict algorithm, showed that this new version further improved the accuracy of the kit and performed better than existing clinical criteria in accurately identifying HCC patients who are more likely to benefit LT. Conclusions: Even with the introduced variations in molecular and clinical variables, the HepatoPredict kit's prognostic information remains consistent. It can accurately identify HCC patients who are more likely to benefit from a LT. Its robust performance also confirms that it can be easily integrated into standard diagnostic laboratories.

Introduction: The role of temporomandibular joint (TMJ) surgery is not well defined due to a lack of quality randomized controlled clinical trials, comparing different TMJ surgical treatments with medical and placebo interventions. The temporomandibular joint interposal study (TEMPOJIMS) is a rigorous preclinical trial divided in 2 phases. In phase 1 the authors investigated the role of the TMJ disc and in phase 2 the authors evaluated 3 different interposal materials. The present work of TEMPOJIMS - phase 1, aims to evaluate histopathologic and imaging changes of bilateral discectomy and discopexy in Black Merino sheep TMJ, using a high-quality trial following the ARRIVE guidelines., Material and Methods: This randomized, blinded and controlled preclinical trial was conducted in 9 Black Merino sheep to investigate histopathologic (primary outcome), imaging and body weight (secondary outcomes) changes after bilateral discectomy, discopexy and sham surgery., Results: Significant changes were noticed in discectomy group, both in imaging and histopathologic analyses. Body weight changes were most pronounced in the discectomy group in the first 4 months after surgery with recovery to baseline weight 6 months after surgery. Discopexy induced nonsignificant changes in histopathologic, imaging and body weight analyses., Conclusions: This study reinforces the importance of developing an effective interposal material to substitute the TMJ disc and the need to explore the molecular mechanisms that underlie TMJ cartilage degeneration. The study design proposed in TEMPOJIMS represents an important progress towards future rigorous TMJ investigations., (Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.)

Background: The temporomandibular joint interposal study (TEMPOJIMS) is a rigorous preclinical trial divided in 2 phases. In phase 1 the authors investigated the role of the TMJ disc and in phase 2 the authors evaluated 3 different interposal materials. The present work of TEMPOJIMS - phase 1, investigated the effects of bilateral discectomy and discopexy in sheep mastication and rumination., Methods: This randomized, blinded and controlled preclinical trial (in line with the ARRIVE guidelines) was conducted in 9 Black Merino sheep to evaluate changes in mastication and rumination after bilateral discectomy and bilateral discopexy, by comparing with a sham surgery control group. The outcomes evaluated were: (1) absolute masticatory time; (2) ruminant time per cycle; (3) ruminant kinematics, and (4) ruminant area. After baseline evaluation and surgical interventions, the outcomes were recorded over 3 successive days, every 30 days, for 6 months., Results: The first month after intervention seemed to be the critical period for significant kinematic changes in the discectomy and discopexy groups. However, 6 months after the bilateral interventions, no significant changes were noticed when compared with the control group., Conclusions: In this study, bilateral discectomy and discopexy had no significant effect in mastication and ruminatory movement. The introduction of kinematic evaluation presents a new challenge that may contribute to the improvement of future studies on the TMJ domain., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: The Hepatitis C virus (HCV) infection is associated with various extrahepatic manifestations, being the Central Nervous System (CNS) rarely involved., Case Report: We report a case of a 54 year-old black man with arterial hypertension who presented with progressively worsening headaches, apathy, somnolence and left hemiparesis. Brain MRI showed an acute ischemic lesion in the left anterior cerebral artery (ACA) and an old ischemic infarct in the right ACA territory. Brain MRI with gadolinium revealed mural thickening and contrast enhancement of the A1 and A2 segments of the ACAs, of the middle and distal basilar artery and of the P1 segment of the left posterior cerebral artery, suggesting active vasculitis. Digital angiography confirmed those irregularities and stenosis. Laboratory evaluation revealed ESR (73 mm/h), transaminase elevation, elevated HCV viral load genotype 2, positive IGRA, negative cryoglobulins, CSF protein elevation with oligoclonal bands (mirror pattern) and no pleocytosis; investigation excluded other infectious causes. Pegylated interferon alpha-2a and ribavirin, corticotherapy and tuberculosis prophylaxis were started with clinical and imagiological improvement., Conclusion: The typical inflammation signs of the vascular wall demonstrated by the gadolinium-enhanced MRI strengthened the hypothesis of CNS vasculitis. The association with HCV infection is rare but should be investigated once specific therapeutic is required., (© 2013.)