Search

El síndrome de hipoplasia de ventrículo izquierdo (SHVI) es una cardiopatía congénita de baja prevalencia y alta letalidad. Objetivo: determinar la evolución perinatal y sobrevida al año y cinco años de fetos con diagnóstico prenatal de SHVI. Pacientes y Método: Estudio de cohorte prospectivo de todos los fetos con SHVI ingresados al Centro de Referencia Perinatal (CERPO) nacidos entre enero 2008 y diciembre 2017. Se obtuvieron datos demográficos y clínicos perinatales de la base de datos de CERPO. Al año y quinto año de edad, se realizó encuesta telefónica para conocer el tratamiento quirúrgico y sobrevida. Resultados: Se ingresaron 1.573 pacientes a CERPO, 899 con cardiopatías congénitas, confirmándose diagnóstico prenatal de SHVI en 7% (110/1.573). El promedio de edad gestacional al diagnóstico y la mediana al ingreso fue 26+3 y de 32+3 semanas respectivamente. 89% nacieron vivos, 90% a término y 57% por cesárea. La mediana de peso al nacer fue 3.128 gramos. 89% sobrevivió al periodo prenatal, 50% al periodo neonatal precoz, 33% al periodo neonatal tardío, 19% el primer año y 17% a los 5 años. Conclusiones: En este centro, la sobrevida al año y cinco años de fetos con diagnóstico prenatal de SHVI fue 19% y 17% respectivamente. Es importante que la consejería prenatal considere publicaciones basadas en casuísticas locales, con diagnóstico prenatal, postnatal y de aquellos que alcanzan la cirugía, para entregar información más precisa a los padres.

Complications arising from COVID-19 reflect an abnormal immune response in people previously diagnosed with chronic, non-communicable diseases (NCD), such as cardiovascular, metabolic and pulmonary conditions. Physical inactivity is recognized as a condition that affects the development of chronic low-grade inflammation, NCD, and susceptibility to cell infections. Anxiety and mental stress, poor nutritional status, drug use and circadian rhythm disturbances can further aggravate the harm caused by physical inactivity. Therefore, the purpose of the review is to invite health professionals, their respective regulatory boards, universities, research promotion foundations, media, political authorities and lay citizens to raise awareness of immunity and health in the medium- to long-term control of the current pandemic. Level of evidence V; Expert opinion. RESUMO As complicações decorrentes da COVID-19 refletem uma resposta imune irregular em pessoas previamente acometidas por doenças crônicas não transmissíveis (DCNT), como por exemplo, cardiovasculares, metabólicas e pulmonares. A inatividade física é reconhecidamente uma condição que impacta o desenvolvimento de inflamação crônica de baixo grau, DCNT e suscetibilidade a infecções celulares. Ansiedade e estresse mental, estado nutricional deficiente, consumo de drogas e ritmo circadiano perturbado podem agravar ainda mais os prejuízos da inatividade física. Sendo assim, o objetivo da revisão é convidar profissionais da área da saúde, seus respectivos conselhos regulatórios, universidades, fundações de amparo à pesquisa, mídia, autoridades políticas e cidadãos leigos para a conscientização sobre imunidade e saúde no controle em médio a longo prazo da atual pandemia. Nível de evidência V; Opinião do especialista. RESUMEN Las complicaciones derivadas del COVID-19 reflejan una respuesta inmune irregular en personas previamente afectadas por enfermedades crónicas no transmisibles (ECNT) como, por ejemplo, cardiovasculares, metabólicas y pulmonares. La inactividad física es reconocidamente una condición que impacta en el desarrollo de inflamación crónica de bajo grado, ECNT y susceptibilidad a infecciones celulares. La ansiedad y el estrés mental, el estado nutricional deficiente, el consumo de drogas y el ritmo circadiano alterado pueden agravar aún más los perjuicios de la inactividad física. Por lo tanto, el objetivo de la revisión es invitar a profesionales del área de la salud, a sus respectivos consejos reguladores, universidades, fundaciones de apoyo a la investigación, medios de comunicación, autoridades políticas y ciudadanos laicos para la concienciación sobre inmunidad y salud en el control a mediano y largo plazo de la actual pandemia. Nivel de evidencia V; Opinión del especialista.

Complications arising from COVID-19 reflect an abnormal immune response in people previously diagnosed with chronic, non-communicable diseases (NCD), such as cardiovascular, metabolic and pulmonary conditions. Physical inactivity is recognized as a condition that affects the development of chronic low-grade inflammation, NCD, and susceptibility to cell infections. Anxiety and mental stress, poor nutritional status, drug use and circadian rhythm disturbances can further aggravate the harm caused by physical inactivity. Therefore, the purpose of the review is to invite health professionals, their respective regulatory boards, universities, research promotion foundations, media, political authorities and lay citizens to raise awareness of immunity and health in the medium- to long-term control of the current pandemic. Level of evidence V; Expert opinion.

RESUMEN INTRODUCCIÓN: La anemia fetal es una importante causa de morbilidad y mortalidad perinatal. En la actualidad la principal herramienta terapéutica es la transfusión fetal intrauterina, permitiendo una mejoría en el pronóstico y sobrevida en fetos con anemia severa. El objetivo de este estudio fue reportar los resultados obtenidos en el Centro de Referencia Perinatal Oriente (CERPO). MÉTODO: Se realizó un análisis descriptivo retrospectivo de los casos de anemia fetal que requirieron transfusión intrauterina en CERPO entre los años 2003-2019. RESULTADOS: Se incluyeron 17 embarazos, con un total de 27 procedimientos. La sobrevida perinatal fue de 82%, con un 18% de mortalidad perinatal. Se reporta una tasa de mortalidad de 3,7% asociado al procedimiento. CONCLUSIÓN: Los resultados observados son similares a lo publicado, con una tasa de complicaciones similar a lo reportado en la literatura internacional y nacional. SUMMARY INTRODUCTION: Fetal anemia is an important cause of perinatal morbidity and mortality. At present, the main therapeutic tool is intrauterine fetal transfusion, allowing an improvement in the prognosis and survival in fetuses with severe anemia. The objective of this study was to report the results obtained in Centro de Referencia Perinatal Oriente (CERPO). METHOD: A retrospective descriptive analysis of the cases of fetal anemia that required intrauterine transfusion in CERPO between 2003-2019. RESULTS: There were 17 pregnancies included, with a total of 27 procedures. Perinatal survival was 82%, with 18% perinatal mortality; a mortality rate of 3.7% is reported per procedure. CONCLUSION: The observed results agree with previous reports.

Physical exercise has been described as an important tool in the prevention and treatment of numerous diseases as it promotes a range of responses and adaptations in several biological systems, including the immune system. Studies on the effect of exercise on the immune system could play a critical role in improving public health. Current literature suggests that moderate intensity exercise can modulate the Th1/Th2 dichotomy directing the immune system to a Th1 cellular immune response, which favors the resolution of infections caused by intracellular microorganisms. Leishmaniasis is a group of diseases presenting a wide spectrum of clinical manifestations that range from self-limiting lesions to visceral injuries whose severity can lead to death. The etiological agents responsible for this group of diseases are protozoa of the genus Leishmania. Infections by the parasite Leishmania major in mice (Balb/c) provide a prototype model for the polarization of CD4+ T cell responses of both Th1 (resistance) or Th2 (susceptibility), which determines the progression of infections. The aim of this study was to evaluate the effect of exercise on the development of L. major experimental infections by scanning the pattern of immune response caused by exercise. Groups of Balb/c mice infected with L. major were divided into groups that preformed a physical exercise of swimming three times a week or were sedentary along with treatment or not with the reference drug, meglumine antimoniate. Animals in groups submitted to physical exercise did not appear to develop lesions and presented a significantly lower parasite load independent of drug treatment. They also showed a positive delayed hypersensitivity response to a specific Leishmania antigen compared to control animals. The IFN-γ/IL-4 and IFN-γ/IL10 ratios in trained animals were clearly tilted to a Th1 response in lymph node cells. These data suggest that moderate intensity exercise is able to modulate the Th1 response that provides a protective effect against the development of leishmanial lesions.

Background: Inflammatory cytokines and acute phase proteins increase with aging, promoting a chronic low-grade inflammation. Studies have shown a positive effect of exercise on inflammatory markers in older persons. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) are the main biomarkers investigated. However, it is unclear if exercise could decrease all these biomarkers. Purpose: The aim was to analyze the effect of chronic exercise on IL-6, TNF-α, and CRP levels in older persons. Methods: Preferred Reporting Items in Systematic Reviews and Meta-analyses guidelines were adopted. Original articles that investigated the effect of chronic exercise on inflammatory profile of the elderly persons were eligible for this review. The databases PubMed, PEDro, EBSCO, and BioMed Central were searched. Three reviewers evaluated each publication for reducing bias. Data about IL-6, TNF-α, and CRP were collected and analyzed. A standardized mean difference based on estimated pooled effect size was calculated considering heterogeneity index (I2) and random effect. Results: Seventy-six studies were retrieved from databases, and 8 of them were analyzed. IL-6 and CRP levels decreased after chronic exercise (overall effect P Conclusion: Regular exercise decreases IL-6 and CRP levels in older persons. The effect of exercise on TNF-α remains unclear.

The intracellular protozoaLeishmaniaspp. andTrypanosoma cruziand the causative agents of Leishmaniasis and Chagas disease, respectively, belong to the Trypanosomatidae family. Together, these two neglected tropical diseases affect approximately 25 million people worldwide. Whether the host can control the infection or develops disease depends on the complex interaction between parasite and host. Parasite surface and secreted molecules are involved in triggering specific signaling pathways essential for parasite entry and intracellular survival. The recognition of the parasite antigens by host immune cells generates a specific immune response.Leishmaniaspp. andT. cruzihave a multifaceted repertoire of strategies to evade or subvert the immune system by interfering with a range of signal transduction pathways in host cells, which causes the inhibition of the protective response and contributes to their persistence in the host. The current therapeutic strategies in leishmaniasis and trypanosomiasis are very limited. Efficacy is variable, toxicity is high, and the emergence of resistance is increasingly common. In this review, we discuss the molecular basis of the host-parasite interaction ofLeishmaniaandTrypanosoma cruziinfection and their mechanisms of subverting the immune response and how this knowledge can be used as a tool for the development of new drugs.

Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T18:50:03Z No. of bitstreams: 1 Pedro Jose Falci Alves - Dissertacao.pdf: 3235033 bytes, checksum: fb8efb4eb2d3a76ae0c68c1ffa63e64e (MD5) Made available in DSpace on 2021-01-05T18:50:03Z (GMT). No. of bitstreams: 1 Pedro Jose Falci Alves - Dissertacao.pdf: 3235033 bytes, checksum: fb8efb4eb2d3a76ae0c68c1ffa63e64e (MD5) Previous issue date: 2019-09-03 Exercise can bring health benefits through responses and adaptations promoted in various biological systems, including the immune system. Moderate intensity exercise can reduce the risk of infection by intracellular microorganisms by directing the immune response to a Th1 type pattern. Strenuous physical exercise can lead to immune cell targeting, causing an immune window that can make the body susceptible to infection through the prevalence of a Th2-type response. This study investigates the effect of a single exercise session, acute, moderate or strenuous, on nitric oxide production by peritoneal macrophages of Balb / C mice. The mice were divided into 3 groups for acute exercise (sedentary control, moderate exercise and strenuous exercise). The acute exercise consisted of a single moderate session and a single strenuous session. A single session of moderate (acute) exercise promoted a significant increase in NO production in LPS-stimulated macrophages infected with Leishmania major or Leishmania braziliensis. A single session of moderate and strenuous exercise promoted a decrease in the Leishmania / Macrophage association index in in vitro Leishmania major and Leishmania braziliensis infection. These data suggest that acute exercise promotes an improvement in macrophage microbicidal capacity, which facilitates the resolution of infections by intracellular microorganisms, but further studies are needed to better understand such mechanisms O exercício físico pode trazer benefícios para saúde através de respostas e adaptações promovidas nos diversos sistemas biológicos, incluindo o sistema imunológico. Exercício físico de intensidade moderada pode reduzir o risco de infecção por microrganismos intracelulares, através do direcionamento da resposta imune para um padrão do tipo Th1. Exercício físico extenuante pode gerar um direcionamento das células imunes, causando uma janela imunológica , podendo deixar o organismo suscetível a infecções, através da prevalência de uma resposta do tipo Th2. Este estudo investiga o efeito de uma única sessão de exercício, agudo, moderado ou extenuante, na produção de óxido nítrico por macrófagos peritoneais de camundongos Balb/C. Os camundongos foram divididos em 3 grupos para o exercício agudo (controle sedentário, exercício moderado e exercício extenuante). O exercício agudo consistiu de uma única sessão moderada e uma única sessão extenuante. Uma única sessão de exercício moderado (agudo) promoveu aumento significativo na produção NO em macrófagos estimulados por LPS e infectados por Leishmania major ou por Leishmania braziliensis. Uma única sessão de exercício moderado e extenuante promoveu a diminuição do índice de associação Leishmania/Macrófago na infecção in vitro por Leishmania major e Leishmania braziliensis. Estes dados sugerem que exercício físico agudo promove uma melhora na capacidade microbicida de macrófagos, o que facilita a resolução de infecções por microrganismos intracelulares, porém, há a necessidade de mais estudos para melhor entender tais mecanismos