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A síndrome de DRESS (drug rash with eosinophlia and systemic symptoms) trata-se de uma reação de hipersensibilidade induzida por fármacos, rara, complexa e potencialmente fatal. Geralmente evolui com erupção cutânea, alterações hematológicas, linfadenopatia, com envolvimento de órgãos. Os autores apresentam o caso clínico de um homem caucasiano de 79 anos que deu entrada no serviço de urgência devido a uma queimadura no tórax e abdómen após férias e exposição solar sem proteção solar. A sua medicação habitual há 2 anos é: perindopril+amlodipina, sinvastatina e alopurinol. Apresentava também um eritema maculopapular pruriginoso no dorso e erupção eritematosa confluente nos membros inferiores, semelhantes a lesões purpúricas. Dados laboratoriais demonstraram linfopenia e elevação das enzimas hepáticas. De acordo com o score RegiSCAR, este caso classifica-se como provável síndrome de DRESS. O alopurinol foi suspenso imediatamente e foi iniciada prednisolona. Foi observado um mês depois, com melhoria progressiva das lesões. O diagnóstico da síndrome de DRESS é desafiante e deve-se suspeitar do seu diagnóstico num doente sob fármacos de alto risco com clínica característica. A abordagem inicial consiste no tratamento de suporte e na suspensão imediata do fármaco. No caso apresentado, o doente queixava-se de queimadura, mas apresentava uma toxidermia por alopurinol que se manifestou de forma bizarra.

Introduction: ANCA associated vasculitis commonly affects the kidneys. The intense inflammatory damage disrupts the glomerular architecture. Induction immunosuppressive therapy is responsible for a large part of the morbidity and mortality of these patients, due to infectious complications. This highlights the importance of defining risk factors associated with a worse renal prognosis in order to select the patients who would benefit the most from immunosuppressive therapy when it comes to renal limited vasculitis. Methods: Retrospective collection of data from patients admitted to the Coimbra’s University Hospital Nephrology Department with the diagnosis of de novo ANCA vasculitis, between 01-06-2009 and 01-06-2019. Data were analysed with SPSS v26® using parametric and nonparametric tests, Kaplan Meyer survival and ROC curve analysis. Results: There were 81 cases of de novo vasculitis, mainly due to anti-MPO antibody associated vasculitis (N=69; 85.2%). Mean age at diagnosis was 67.4 ± 15.7 years and most patients were male (N=47; 58%). At admission, patients had a mean serum creatinine (sCr) of 6.8 ± 4.0 mg/dL. Dialysis was required in 23 (28.4%) patients at admission and 44.4% were dependent on renal replacement therapy at discharge. Among dialysis-dependent patients at discharge treated with immunosuppression for at least 3 months (N=15) we observed partial kidney recovery in 2 (13.3%). Deaths were mostly (N=8/11; 72.7%) caused by infections. Discussion: Our results call into question the need for aggressive induction treatment in dialysis-dependent patients without extrarenal manifestations.

Este artigo apresenta os resultados de uma investigação sobre o processo de negociação biográfica a partir de quatro diferentes biografias do líder comunista Luiz Carlos Prestes. Observaremos a disputa por memórias na construção da biografia do “Cavaleiro da Esperança” enquanto reflexo dos meandros das investidas biográficas que partem dos respectivos tempos e lugares de produção de seus autores, a saber: Jorge Amado, Boris Koval, Daniel Aarão Reis Filho e Anita Leocadia Prestes.

Objetivou-se avaliar a ocorrência de parasitas gastrintestinais em galinhas de raças ornamentais de um criatório particular localizado em Juiz de Fora, Minas Gerais. Foram coletadas amostras fecais dos animais, de forma individual, coletando as fezes logo após defecação. As coletas foram realizadas no mês de setembro de 2018. As amostras foram acondicionadas em recipientes de plástico estéreis, identificadas e encaminhadas ao Laboratório de Parasitologia e Doenças Parasitárias do Centro Universitário de Valença (UNIFAA), para análise pela técnica de centrífugo-flutuação simples. Foram identificados dois gêneros de helmintos, Capillaria spp. e Ascaridia spp., e o protozoário Eimeria spp. Pode-se concluir que os parasitas gastrintestinais encontrados nas galinhas ornamentais estudadas não diferiram dos endoparasitas encontrados em galinhas caipiras convencionais. Exames coproparasitológicos são um excelente meio, rápido e barato de verificar/identificar formas parasitárias, que uma vez diagnosticadas devem ser combatidas para que não comprometam a saúde dos animais, principalmente em casos de aves ornamentais que por apresentarem menor rusticidade, podem ser mais sensíveis as parasitoses.

The National Institute of Science and Technology for Energy and Environment (INCT E&A) is a virtual network of scientific-institutional cooperation focused on research for energy sustainable use and environmental preservation. This article aimed to identify production and articulations of researchers affiliated to INCT E&A in biodiesel research in the period from 2009 to 2020, based on scientometric, and social and complex network analysis. Altogether 76 articles involving biodiesel theme were analysed and a network of 212 authors from 48 institutions with a high level of collaboration was identified. Network topological properties were calculated, making it possible to find central researchers and affirm that it presents the small world phenomenon. It was also possible to observe that scientific production by the researchers occurred especially between the years 2009 and 2014. After this period, biodiesel theme stopped attracting INCT E&A researcher’s attention, demobilizing a network at a moment when Brazil chose biofuels as a decarbonizing strategy for transport matrix through the National Biofuels Policy (RenovaBio).

Marine sponges are highly efficient in removing organic pollutants and their cultivation, adjacent to fish farms, is increasingly considered as a strategy for improving seawater quality. Moreover, these invertebrates produce a plethora of bioactive metabolites, which could translate into an extra profit for the aquaculture sector. Here, we investigated the chemical profile and bioactivity of two Mediterranean species (i.e., Agelas oroides and Sarcotragus foetidus) and we assessed whether cultivated sponges differed substantially from their wild counterparts. Metabolomic analysis of crude sponge extracts revealed species-specific chemical patterns, with A. oroides and S. foetidus dominated by alkaloids and lipids, respectively. More importantly, farmed and wild explants of each species demonstrated similar chemical fingerprints, with the majority of the metabolites showing modest differences on a sponge mass-normalized basis. Furthermore, farmed sponge extracts presented similar or slightly lower antibacterial activity against methicillin-resistant Staphylococcus aureus, compared to the extracts resulting from wild sponges. Anticancer assays against human colorectal carcinoma cells (HCT-116) revealed marginally active extracts from both wild and farmed S. foetidus populations. Our study highlights that, besides mitigating organic pollution in fish aquaculture, sponge farming can serve as a valuable resource of biomolecules, with promising potential in pharmaceutical and biomedical applications.

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Mathematics anxiety has been the subject of growing academic interest, as it can significantly impact academic performance and individuals' relationship with mathematical content throughout their lives. This narrative review aims to understand the conceptual evolution, causes and possible interventions associated with mathematics anxiety. Using a bibliographic methodology, articles, books and reports published in renowned academic databases were analyzed. As the main theoretical framework, the cognitive-behavioral perspective was adopted, which understands mathematical anxiety as a result of interactions between cognitive, behavioral and environmental processes. The results point to a multifaceted understanding of the phenomenon, highlighting not only individual factors, such as self-efficacy and past experiences, but also external factors, such as teaching methods and teachers' attitudes. Interventions aimed at reducing mathematics anxiety have focused on both pedagogical strategies and psychotherapeutic approaches, demonstrating the need for an interdisciplinary approach to tackle the problem. This work contributes to the literature by consolidating dispersed knowledge and indicating future paths for educational research and practice. [ABSTRACT FROM AUTHOR]

ABSTRACT Background: This study aimed to describe the kinetics of Leishmania parasite load determined using kinetoplast DNA (kDNA)-based quantitative polymerase chain reaction (qPCR) in visceral leishmaniasis (VL) patients. Methods: Parasite load in blood was assessed by qPCR at five time points, up to 12 months post-diagnosis. Sixteen patients were followed up. Results: A significant reduction in the parasite load was observed after treatment (P < 0.0001). One patient had an increased parasite load 3 months post-treatment and relapsed clinically at month six. Conclusions: We have described the use of kDNA-based qPCR in the post-treatment follow-up of VL cases.

Background: Palliative care (PC) corresponds to an approach that enhances the quality of life for patients facing life-threatening diseases, such as cancer, as well as for their families. There are various models for providing palliative care. Early referral to PC of patients with advanced cancer has a significant positive impact on their quality of life. However, the criteria for early referral still remain controversial. Objectives: To evaluate patients' symptomatic intensity and perception of quality of life on admission to a PC unit and to analyze these two variables according to different models of approach (outpatient and inpatient care). Methods: A cross-sectional, descriptive, and correlational study was conducted with a sample of 60 patients sequentially admitted to a PC unit from palliative outpatient consultations or other inpatient services in a tertiary hospital dedicated to oncology care. The evaluation protocol included a sociodemographic and medical questionnaire, the Edmonton Symptom Assessment Scale (ESAS), and the Palliative Care Outcome Scale (POS) completed by patients within the first 24 h after admission. Results: The participants were mostly male (61.7%), with a median age of 72 years. The majority of patients (n = 32; 53.3%) were undergoing outpatient treatment, while the remaining individuals (n = 28; 46.7%) were transferred from other hospital services (inpatient care). In the outpatient care group, higher scores for fatigue and dyspnea were observed. Conversely, in the inpatient care group, higher scores were observed for pain, depression, and anxiety. There were significant differences between the two groups regarding the POS dimensions of meaning of life, self-feelings, and lost time. In the inpatient group, there was a longer time between diagnosis and referral to PC; however, it was also in the inpatient group that there was less time between PC referral and first PC evaluation, between PC referral and PC unit admission, and between PC referral and death. There were no significant correlations between referral times and ESAS/POS scores in the inpatient and outpatient groups. Conclusions: The patients admitted to the Palliative Care Unit presented a high symptom burden and changes in the perception of quality of life. However, there are no statistically significant differences between one model of approach in relation to the other. It was found that poorer symptom control and quality of life were associated with a shorter referral time for PC, because this was only initiated after curative care was suspended, particularly in our institutional context. Early referrals to the PC team are essential not only to relieve symptom-related distress but also to improve treatment outcomes and quality of life for people with cancer. [ABSTRACT FROM AUTHOR]

Studies investigating physiological deviations from normality in newborn calves derived from in vitro fertilization procedures remain important for the understanding of factors that reduce calf survival after birth. The aim of this study was to investigate parameters affecting health and welfare of newborn Flemish calves derived from in vitro embryo production (IVP) in the first hours of life in comparison to in vivo‐derived calves. Physical traits of newborn calves and fetal membranes (FM) were recorded soon after birth. Newborn venous blood samples were collected at several time points within the first 24 h of life for analyses of energy substrates, electrolytes, blood gases, acid–base balance, blood chemistry, and haematology. A liver biopsy was taken within the first hour after birth for analysis of gene expression of key enzymes of the fructolytic and glycolytic pathways. Newborn IVP calves were heavier and larger at birth, which was associated with heavier FM. At several time points during the first 24 h of life, IVP‐derived calves had altered rectal temperature, blood gases, electrolyte concentrations, blood parameters for liver, kidney and muscle function, and acid–base balance, plasma lipid metabolism, and hemogram parameters. The relative mRNA abundances for triokinase and lactate dehydrogenase‐B were greater in IVP calves. In summary, IVP‐derived newborn calves were at higher risk of clinical problems after birth, which was markedly greater in heavier and larger calves. Such animals take longer to adapt to extrauterine life and should receive a special attention during the immediate neonatal period. [ABSTRACT FROM AUTHOR]

Besides the importance of our oceans as oxygen factories, food providers, shipping pathways, and tourism enablers, oceans hide an unprecedented wealth of opportunities [...]

Marine environments represent an enormous biodiversity reservoir due to their numerous different habitats, being abundant in microorganisms capable of producing biomolecules, namely exopolysaccharides (EPS), with unique physical characteristics and applications in a broad range of industrial sectors. From a total of 67 marine-derived bacteria obtained from marine sediments collected at depths of 200 to 350 m from the Estremadura Spur pockmarks field, off the coast of Continental Portugal, the Brevundimonas huaxiensis strain SPUR-41 was selected to be cultivated in a bioreactor with saline culture media and glucose as a carbon source. The bacterium exhibited the capacity to produce 1.83 g/L of EPS under saline conditions. SPUR-41 EPS was a heteropolysaccharide composed of mannose (62.55% mol), glucose (9.19% mol), rhamnose (19.41% mol), glucuronic acid (4.43% mol), galactose (2.53% mol), and galacturonic acid (1.89% mol). Moreover, SPUR-41 EPS also revealed acyl groups in its composition, namely acetyl, succinyl, and pyruvyl. This study revealed the importance of research on marine environments for the discovery of bacteria that produce new value-added biopolymers for pharmaceutical and other biotechnological applications, enabling us to potentially address saline effluent pollution via a sustainable circular economy.

The production of second-generation biodiesel is seen as more sustainable than first-generation biodiesel as it is produced from residues such as animal fats, a by-product of the meat industry. In Brazil, the biodiesel sector has become the main market for animal fats, absorbing around 712 thousand tons in 2018, equivalent to 38% of the fat produced. In order to reach this level, research and development were carried out supported by the Brazilian government through the Brazilian Biodiesel Technology and Innovation Network. The objective of this study is to map the scientific networks formed by Brazilian organizations that have collaborated to solve research problems regarding animal fats for biodiesel production through Social Networks Analysis and The Theory of Complex Networks. An exploratory-descriptive study was conducted in the main collection of Web of Science (WoS). It was observed that research started in 2008 and involved more than 80 institutions. The institutional network formed was of a small-world type, composed of 20 clusters. The research was indexed in 19 knowledge areas, with an emphasis on Chemistry, Energy and Fuels, and Engineering and 70% of them received some type of funding to conduct the research.

Background: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1–3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil. We aim to evaluate the cost-effectiveness of ODX across strata of clinical risk groups using data from a dataset of patients from Brazilian institutions. Methods: Clinicopathologic and ODX information were analyzed for patients with T1–T3, N0–N1, HR+/HER2− eBC who had an ODX performed between 2005 and 2020. Projections of CT indication by clinicopathologic criteria were based on binary clinical risk categorization based on the Adjuvant! Algorithm. The ODX score was correlated with the indication of CT according to TAILORx and RxPONDER data. Two decision-tree models were developed. In the first model, low and high clinical risk patients were included while in the second, only high clinical risk patients were included. The cost for ODX and CT was based on the Brazilian private medicine perspective. Results: In all, 645 patients were analyzed; 411 patients (63.7%) had low clinical risk and 234 patients (36.3%) had high clinical risk disease. The ODX indicated low (25) risk in 119 (18.4%), 415 (64.3%), and 111 (17.2%) patients, respectively. Among 645 patients analyzed in the first model, ODX was effective (5.6% reduction in CT indication) though with an incremental cost of United States Dollar (US$) 2288.87 per patient. Among 234 patients analyzed in the second model (high clinical risk only), ODX led to a 57.7% reduction in CT indication and reduced costs by US$ 4350.66 per patient. Conclusions: Our study suggests that ODX is cost-saving for patients with high clinical risk HR+/HER2− eBC and cost-attractive for the overall population in the Brazilian private medicine perspective. Its incorporation into routine practice should be strongly considered by healthcare providers.

Leucocytoclastic vasculitis refers to a small vessel vasculitis caused by immune complexes, infections and medications. IgA or IgM/IgG immune complexes can be found in direct immunofluorescence studies suggesting specific forms of leucocytoclastic vasculitis. Some authors suggested that IgA vasculitis and IgA nephropathy were two clinical mani- festations of the same disease. From a histological point of view, it is not possible to distinguish a glomerulonephritis as part of an IgA vasculitis from an IgA nephropathy. The authors present a case of a 50-year-old woman diagnosed with vitiligo ad immune thrombocytopenic purpura (ITP). ITP was diagnosed 2 years before the present case. She presented to the autoimmune diseases’ appointment with a pruriginous rash of the lower extremities over the last 3 months. Skin biopsy was suggestive of leukocytoclastic vasculitis, revealing deposits of C3, IgG (less intensity) and IgA. IgA vasculitis was then assumed. After a few weeks, she kept peripheral edema, but an increasing decline in renal function was detected. Therefore, a renal biopsy was performed, which revealed endocapilar proliferative glomerulonephritis and predominantly C3 mesangial deposits, with IgA and vestigial IgM. These results were compatible with a C3 glomerulonephritis. The patient was started on systemic steroid treatment with prednisolone 1 mg/kg/day and ramipril 2.5 mg/day with progressive normalization of renal function. With this case, the authors emphasize the possibility that all these manifestations could be part of the same disease spectrum, but also, the importance of complement activation. So, this case may constitute additional evidence of the complement activation in pathogenesis of this vasculitis, however, further investigation is need, particularly to understand C3 glomerulonephritis, a rare kidney disease.

Eosinophilic gastroenteritis (EGE) is a rare gastrointestinal disease characterized by generalized abdominal pain, nausea, vomiting, diarrhea, gastrointestinal bleeding and weight loss. The etiology and pathogenesis are not well understood and mostly based on case reports. Clinical presentation may vary depending on sites and depth of involvement of the gastrointestinal tract. The diagnosis is usually confirmed by histology that shows eosinophilic infiltration and the absence of secondary cause of eosinophilia. The authors present a case report of a 47-year-old woman that was diagnosed with dyslipidemia, obesity and allergic rhinitis. She had no significant family history. She was admitted in internal medicine department with 2 weeks of abdominal pain, nausea, vomiting, diarrhea and weight loss (> 10%). Further study revealed increased eosinophil count, normocytic anemia, elevated erythrocyte sedimentation rate and normal Ig E levels. Digestive endoscopic study was performed, and multiple biopsy specimens showed moderate eosinophilic infiltration in stomach and duodenal mucosa. The patient was started on prednisolone, with clinical improvement. Follow-up go the patient twenty years after the beginning of this treatment showed stabilization of clinical symptoms and laboratory tests. So, eosinophilic gastroenteritis is characterized by three criteria - presence of gastrointestinal symptoms, histologic evidence of eosinophilic infiltration and exclusion of other causes of tissue eosinophilia. The treatment is based on the severity of symptoms. Corticosteroids are the mainstay of therapy, so the usual dose of prednisolone/prednisone is 20-40 mg daily for two weeks with tapering thereafter. In the literature, the use of montelukast and biologic agents have been reported.