Brazilian Journal of Medical and Biological Research最新文献

This study evaluated prevalence, incidence, and progression of carotid intima-media thickness (cIMT) and carotid artery plaques (CAP) in rheumatoid arthritis (RA) patients compared with controls during 8 years of follow-up. A case-cohort analysis of data from the ELSA-Brasil cohort was conducted, with cIMT and CAP measured by carotid ultrasound at baseline and follow-up. Linear regression was used to estimate cIMT mean and progression (ΔcIMT). Logistic regression was used to estimate odds ratios (OR) for elevated cIMT (≥75th percentile), CAP prevalence, incidence, and progression. Models were adjusted for sociodemographic and cardiovascular risk factors, excluding participants with prior cardiovascular disease. A total of 1,289 participants (188 RA, 1,101 controls) were included in the cIMT analysis and 585 (93 RA, 492 controls) in the CAP analysis. RA was not associated with baseline cIMT (β=0.00; 95%CI: -0.02-0.02; P=0.930), high cIMT (OR=1.04; 95%CI: 0.69-1.57; P=0.864), or ΔcIMT (β=0.00; 95%CI: -0.01-0.02; P=0.688). Incidence of elevated cIMT showed a non-significant trend toward higher risk in RA (OR=2.01; 95%CI: 0.88-4.59; P=0.098). No associations were found for CAP prevalence at baseline (OR=1.64; 95%CI: 0.92-2.91; P=0.090), prevalence at follow-up (OR=0.75; 95%CI: 0.41-1.36; P=0.342), incidence (OR=0.78; 95%CI: 0.37-1.63; P=0.508), or progression (β=-0.33; 95%CI: -0.72-0.07; P=0.102). This study found no independent association between RA and cIMT or CAP.

Schistosomiasis can lead to vascular damage resulting in pulmonary arterial hypertension (PAH). Although its pathophysiology remains unclear, cytokine imbalance is known to play a key role. This study aimed to evaluate serum mediators in association with hemodynamic, echocardiographic, and histological parameters in a murine model of Schistosoma mansoni-induced pulmonary hypertension (Sch-PH). Twenty male C57BL/6 mice were randomized into infected group and non-infected control group. Sch-PH was induced by intraperitoneal inoculation of S. mansoni eggs (240 eggs/g body weight), followed by intravenous administration (175 eggs/g). After 21 days, systolic pulmonary artery pressure was measured by right ventricular catheterization (RHC), and cardiac function was assessed by transthoracic echocardiography. Animals were then euthanized for collection of lungs and heart for histopathology, and blood samples were obtained for quantification of interleukin (IL)-6, IL-10, and tumor necrosis factor (TGF)-β1 by ELISA. The Sch-PH group had significantly lower tricuspid annular plane systolic excursion and pulmonary artery acceleration time/pulmonary ejection time ratio (P<0.05), and increased pulmonary artery peak flow, tricuspid and pulmonary regurgitation, IL-6, and TGF-β1 levels (P<0.05). IL-10 was undetectable. Lung tissue showed inflammatory infiltrates, alveolar and perivascular granulomas, and S. mansoni eggs. Pulmonary arteries exhibited intimal thickening, medial hypertrophy, and fibrosis. Cardiac tissue presented inflammatory foci, fibroblast proliferation, and thickening of connective septa. IL-6 and TGF-β1 were elevated in Sch-PH and correlated with echocardiographic and hemodynamic alterations. These findings suggest a role for these mediators in Sch-PH pathogenesis and highlight the potential for targeting inflammatory pathways in this condition.

Astrocytes play critical roles in the physiological responses of the central nervous system (CNS). Located near pre- and postsynaptic sites, they detect released neurotransmitters and gliotransmitters that modulate neuronal function. Astrocytic responses to neurotransmitter excitation often involve increases in cytoplasmic calcium, triggering the release of gliotransmitters that further influence neuronal activity. The nucleus of the solitary tract (NTS), a brainstem region integrating diverse physiological functions such as cardiovascular, respiratory, digestive, and metabolic reflexes, is modulated by astrocytic activity. To better understand the dynamics and diversity of calcium responses in NTS astrocytes to the primary excitatory neurotransmitter glutamate, we investigated individual subpostremal NTS astrocytes in brainstem slices from mice using the calcium fluorescent dye Fluo-4. We observed that only a subset of astrocytes exhibited an increase in cytoplasmic calcium in response to glutamate, while a smaller fraction showed a decrease in cytoplasmic calcium. Interestingly, in the presence of tetrodotoxin, which inhibits action potentials, the proportion of astrocytes with increased calcium levels was halved, and most astrocytes instead exhibited decreased calcium levels. Further analysis revealed that response peaks were correlated with total calcium levels after glutamate application, whereas response latencies and widths of positive calcium signals were not correlated with peak values. Negative peaks have distinct kinetics from positive peaks, corroborating that they represent different processes. These findings demonstrate that NTS astrocytes constitute a heterogeneous population with diverse responses to extracellular glutamate, highlighting their complexity in modulating brainstem functions.

Microbiology education is traditionally lecture-based, with few studies exploring active methodologies such as serious games. In this context, this study aimed to develop a serious card game, 'Bakterion', as a teaching tool for antimicrobial education. The game was designed based on Game Design Thinking, following the stages of Empathy, Ideation, and Implementation. Inspired by the game Munchkin®, Bakterion includes a rulebook, markers, and 200 cards featuring illustrations based on electron microscopy and laboratory materials. The cards were designed to be easy to use, allowing players to correlate elements even without prior specialized knowledge. The game presents an innovative approach to microbiology education, fostering student engagement and active participation. Bakterion may serve as a promising tool for teaching microbiology and antimicrobial resistance, complementing traditional methods. Future studies should assess the impact of Bakterion on student learning.

According to the most recent Global Status Record of Road Traffic, the number of road traffic deaths continues to rise. The risk of a road traffic death is more than 3 times higher in low-income countries than in high-income countries. However, the effect of time of day on road accidents is barely considered in public policies to reduce the chance of an accident. This study aimed to estimate the chance of an accident for every hour of the day in Brazil. From the raw data on accidents, their hourly distribution was derived, with a one-hour resolution. The data on the flow of vehicles on the highways was similarly organized. In the specific case of the flow, the total average flow for all sensors on Brazilian highways from 2015 to 2017 was used. It was clearly observed that the chance of an accident, in general, is on average 3-3.5 times higher between 02:00 and 04:00 h than during 07:00-19:00 h. Two other peaks were also noticed, the first one at around 07:00 h and a second one around 18:00 h, which were linked to an excess of vehicle traffic (rush hours) but were lower when compared to the chance during the night. The chance of a road accident in the middle of the night was higher compared to the rest of the 24 hours, similar to high-income countries.

This in vitro and in vivo study assessed dealcoholized red wine (DRW) effects on cytokine profile in macrophage (MQ)-periodontal ligament fibroblast (PDLFs) co-cultures and its impact on blood parameters, inflammatory/bone markers, cytokine expression, and periapical bone loss in rat apical periodontitis (AP). A MQ-PDLFs co-culture and Wistar rats with induced AP were exposed to DRW or red wine (W), with DMEM or water as controls (C). Cell cultures were analyzed for cytokine profile using a multiplex immunoassay. Rats underwent blood profiling, radiography, qRT-PCR, and histometric analysis of AP. Statistical significance was set at 5%. Multiplex analysis of the co-culture revealed that DRW induced lower interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels compared to C and W, higher IL-10 level than C, and lower IL-1β level only compared to W (P<0.05). Radiographic images confirmed AP development in rats. DRW showed a reduced monocyte count compared to C (P<0.05), but the inflammatory/bone markers in plasma were similar (P>0.05). Additionally, DRW showed lower IL-1β expression than C, and higher IL-10 expression only compared to W in AP (P<0.05). Periapical bone loss was similar among groups (P>0.05). In conclusion, DRW promoted an anti-inflammatory profile in co-cultures and in vivo. However, these effects did not translate into differences in lesion size or bone loss within the experimental model evaluated.

With the emergence and rise of the COVID-19 pandemic in 2020, many health services were interrupted and reallocated due to system overload. Tuberculosis (TB) care was one of the affected services during this period, especially in regions with greater social vulnerabilities. Thus, this study aimed to describe the distribution of TB cases before and during the COVID-19 pandemic on an island in the Brazilian Amazon. This quantitative descriptive retrospective study evaluated the distribution of 797 new confirmed and notified cases of TB in residents of the sixteen municipalities in the region of Marajó Island (Pará, Brazil), from 2017 to 2022. The data were obtained from the Development and Administration Company of the Metropolitan Area of Belém and Google Earth, using the ArcGIS and TerraView software for georeferencing notification points in each municipality of the archipelago. The Kernel density estimator and scan statistics were used to analyze the point patterns. Almost all municipalities in the archipelago showed variations during the study years. The scan statistics showed a greater number of cases in the pre-pandemic years of 2017-2019. These data indicated that the factors related to the increase and decrease in the number of cases must be analyzed, as the decrease may be related to the underreporting of patients due to the lack of access to health resources in more isolated areas.

One of the most serious clinical manifestations of tuberculosis (TB) is the central nervous system (CNS) presentation, which results in neurological disorders and cognitive impairments that may lead to reduced social skills. Few studies have assessed TB neuropsychological symptoms after infection. This review article investigated the incidence and spectrum of cognitive impairment related to complications in patients with CNS-TB and compiled data on the pathophysiology, diagnosis, and treatment of the disease. An extensive literature review was performed, and a total of 286 published studies were selected for manual screening. For analysis purposes, 43 studies were included in this review. CNS-TB mainly affects young children and is fatal in over 50% of cases, with survivors showing high morbidity. The characteristics of this disease include meningitis and brain tissue granulomas. This leads to extensive neurological involvement, resulting in a complex mechanism that alters the structure and composition of cells in the brain including the cerebellum and spinal cord. It also impairs language development, reading, and learning complex tasks, and therefore affects the patient's social adjustment. The results of our review provide information connecting the basis of neuroscience and clinical medicine, especially childcare. Furthermore, early diagnosis is imperative to prevent serious cognitive consequences of TB in the developing CNS.

Volemic control is essential for maintaining tissue perfusion and fluid homeostasis, with cardiorenal and endothelial mediators regulating intravascular composition, often impaired in pathological states. Notably, intestinal epithelial cells are highly sensitive to volume fluctuations, resulting in changes in intestinal permeability that may not be detected by current diagnostic methods. This review offers a comprehensive description of the main mediators involved in volemic regulation, their impact on intestinal morphofunctionality, and specific details regarding epithelial cells. Additionally, key biomarkers - especially lactulose/mannitol - for assessing intestinal barrier disruption are highlighted, and a novel approach is proposed using liquid chromatography-mass spectrometry to investigate gut alterations in heart failure and exercise-induced stress, which are silent and neglected conditions with significant repercussions on intestinal barrier function.

Antiretroviral therapy (ART) has transformed HIV from a life-limiting infection into a manageable chronic condition, shifting attention toward the emerging challenges faced by the growing population of adults aged 50 years or older living with HIV. This observational cohort study tracked 1,018 individuals treated in the medical system in Brazil, a middle-income country, to better understand the effectiveness of traditional and simplified ART regimens in older adults living with HIV (OALH), a frequently underrepresented group in clinical studies. Older adults, those aged 50 and above, living with HIV achieved significantly higher rates of undetectable viral load (89.4 vs 83.2%, P<0.006) and fewer cases of virological failure, defined as HIV-RNA >500 copies/mL (2.5 vs 10.1%; P<0.0001) than younger adults aged 18-49, and demonstrated superior immune recovery through significantly greater CD4+ T-cell counts (P=0.0012). The multivariate analysis found that improved clinical outcomes (undetectable viral load) were most highly correlated with the simplified treatment regime and more years of treatment duration. These findings highlight the value of simplified ART regimens and sustained treatment duration, which were observed to be more frequent in OALH.