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Introduction: Body Mass Index (BMI) is a widely accepted measure by the World Health Organization for assessing body composition, as it provides critical insights into health risks, life expectancy, and quality of life. However, in resource-limited settings, access to weighing scales is often inadequate, and environmental conditions, such as unstable terrain, may hinder accurate weight measurements. In these contexts, alternative methods for estimating BMI become essential for effective health assessment. This study aimed to develop and validate equations to estimate BMI without relying on body weight, providing a practical tool for nutritional assessment where traditional methods are not feasible. Materials and methods: Adults aged 18 to 59 of both sexes were included. Variables like waist circumference, height, hip circumference, age, and weight were used for equation development and validation. Participants were divided by sex, with regression and validation subgroups for each. Statistical tests included Student's t-tests, Pearson correlation, Stepwise Regression, Intraclass Correlation Coefficient, Weighted Kappa Coefficient, and Bland-Altman statistics. Results: The study included 810 adults, with 63% (576) women. No significant differences were found in paired comparisons between regression and validation subgroups for both sexes (p > 0.05). Four equations were proposed for BMI estimation: EM2 and EM3 for males, and EF2 and EF3 for females. All equations showed strong positive correlations (r > 0.90), significant at p < 0.05. Regression analysis revealed R2 values between 0.861 and 0.901 (p < 0.000). Intraclass Correlation Coefficient values indicated agreement of 0.961 and 0.972 (p < 0.05), with Weighted Kappa values showing substantial agreement of 0.658 and 0.711 for both sexes (p < 0.05). Conclusion: Adopting the proposed equations for estimating BMI in adults without using body weight is safe and effective for measuring this body measure in this population, particularly when weighing these individuals is not feasible. [ABSTRACT FROM AUTHOR]

Ischemia/reperfusion injury (I/R) is a leading cause of acute kidney injury (AKI) in conditions like kidney transplants, cardiac surgeries, and nephrectomy, contributing to high global mortality and morbidity. This study aimed to analyze the protective effects of 2′-hydroxychalcones in treating I/R-induced AKI by targeting key pathological pathways. Considering strong antioxidant action along with other pharmacological roles of chalcone derivatives, six 2′-hydroxychalcones were synthesized via Claisen-Schmidt condensation and analyzed for their protective effects in an I/R induced AKI model using HK-2 cells. Among six 2′-hydroxychalcones, chalcone A4 significantly increased the HK-2 cells viability compared to I/R group. Chalcone A4 reduced the cell death events by reducing generation of cytoplasmic ROS and mitochondrial transmembrane potential. It also increased GSH and SOD activity while reducing TBARS levels, indicating strong antioxidant action. Scanning electron microscope images showed that chalcone A4 reversed I/R-induced morphological changes in HK-2 cells, including apoptotic blebbing and cytoplasmic fragmentation. Furthermore, in silico studies revealed interactions with NADPH oxidase 4, further supporting its protective role in I/R-induced AKI. These results showed that chalcone A4 possess potential protective action against I/R induced cellular damage possibly due to its strong antioxidant action and potential interaction with NOX4 subunit of NADPH oxidase. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this was to evaluate the function of vascular biomarkers to predict the need for hemodialysis in critically ill patients with COVID-19. Methods: This is a prospective study with 58 critically ill patients due to COVID-19 infection. Laboratory tests in general and vascular biomarkers, such as VCAM-1, syndecan-1, angiopoietin-1, and angiopoietin-2, were quantified on intensive care unit (ICU) admission. Results: There was a 40% death rate. VCAM and Ang-2/Ang-1 ratio on ICU admission were associated with the need for hemodialysis. Vascular biomarkers (VCAM-1, syndecan-1, angiopoietin-2/angiopoietin-1 ratio) were predictors of death and their cutoff values were useful to stratify patients with a worse prognosis. In the multivariate cox regression analysis with adjusted models, VCAM-1 (OR 1.13 [CI 95%: 1.01–1.27]; p = 0.034) and Ang-2/Ang-1 ratio (OR 4.87 [CI 95%: 1.732–13.719]; p = 0.003) were associated with the need for dialysis. Conclusion: Vascular biomarkers, mostly VCAM-1 and Ang-2/Ang-1 ratio, showed better efficiency to predict the need for hemodialysis in critically ill COVID-19 patients. Plain Language Summary: This study reports the use of endothelial biomarkers as useful tools to predict the first dialysis requirement during the ICU stay in patients with severe COVID-19. Endothelial dysfunction is an important mechanism to explain the pathophysiology of acute kidney injury caused by severe acute respiratory syndrome coronavirus 2 infection. [ABSTRACT FROM AUTHOR]

Background: In Brazil, the most relevant scorpions for public health are species of the genus Tityus: T. serrulatus, T. bahiensis, T. obscurus and T. stigmurus, the latter occurring mainly in Ceará, showing that severe cases affect more the population at risk, children under 14 years old. Objectives: The survey aims to identify what are the clinical and laboratory changes in children and teenagers affected by scorpion bites, as well as predictive factors in severe cases. Methods: This is an observational, retrospective and quantitative study of poisoning by scorpion accidents attended and notified by the Toxicological Assistance Center of Fortaleza (CIATOX / CE) from January to December 2019. Results: 820 records were diverted, in which 425 (51.83%) women were killed, of which only 3 (0.37%) were pregnant. Regarding the age group, 1-3 years old is more frequent, 183 (22.32%). The species T. stigmurus 534 cases, (65.12%), the feet region 271 cases (33.04%); the origin of the municipality of Fortaleza 773 (94.15%) and the regional II 122 cases (15.78%) had higher occurrences. Of the 820 cases, only 12 underwent laboratory tests, showing changes such as leukocytosis leukocytosis (72.7%), platelets (63.6%), hyperglycemia (83.3%), TGO (100%), LDH (100%), CK - MB (100%) and Amylase (30%). Conclusion: It was found that the epidemiological, clinical and laboratory profile of children and adolescentes is associated with the severity of scorpionism, which indicates an emergency characteristic, especially when it affects children. [ABSTRACT FROM AUTHOR]

HIV-infected patients are at high risk for developing critical diseases, including opportunistic infections (OI), with consequent admission in intensive care units (ICU). Renal disfunctions are risk factors for death in HIV/AIDS patients, and survival rates in patients undergoing hemodialysis are smaller than the ones observed in the general population. In this context, this study aimed to investigate death-related factors in HIV/AIDS patients in an intensive care setting. This is a retrospective cross-sectional study performed through the analysis of medical records from 271 HIV/AIDS-diagnosed patients hospitalized in an intensive care unit of an infectious disease hospital, in Fortaleza, Ceara State, Brazil. Patients were divided into two groups: those who underwent dialysis during hospitalization and those who did not. Clinical and demographic parameters that could be associated with death were evaluated. Results indicated a prevalence of death of 19.1% (CI 95%: 14.8-24.3). The median age of patients was 47 years, with a male predominance (71.3%). The main causes of admission were pulmonary tuberculosis (16.9%), followed by neurotoxoplasmosis (14.9%). In the bivariate analysis, for those that did not undergo dialysis, age, fever, dyspnea, oliguria, disorientation, kidney injury, use of lamivudine and efavirenz, length of hospitalization, CD4 count, WBC count, platelet count, urea, sodium and LDH levels were the associated variables. In those who needed dialysis, the use of stavudine, abacavir and ritonavir, and the length of hospitalization were associated factors. Renal toxicity by the antiretroviral agents and length of hospitalization increased the risk of death among HIV patients under dialysis. [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bothrops erythromelas are serpents that belong to the Viperidae family, which are the main species responsible for human snakebites in Ceara State, Northeast Brazil. Thrombotic microangiopathy (TMA) is an uncommon group of disorders characterized by microangiopathic hemolytic anemia (MAHA), thrombocytopenia and acute kidney injury (AKI), and occurrence after snakebites have been rarely reported. In this report, we described the case of a 57 year-old-man without comorbidities who was bitten by a Bothrops erythromelas on his right ankle. He presented with pain, edema and local bleeding. Symptomatology and laboratory tests were compatible with the diagnosis of TMA. He received specific antivenom and fluids replacement without any anaphylactic reaction. The conservative treatment was effective and there was no need for red blood cells transfusion or plasmapheresis. The aim of this report was to describe the first case of thrombotic microangiopathy following Bothrops erythromelas envenoming in the Northeast Brazil, providing insights about important mechanistic pathways of Bothrops snakebite-associated TMA and how to change the prognosis of the disease. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Movimenta is the property of Universidade Estadual de Goias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives. Visceral leishmaniasis (VL) is endemic in Brazil and appears to occur in epidemic form in the state of Ceará. Few epidemiologic studies have been done on VL in this state. The aim of this study is to establish the epidemiologic pattern of VL in Fortaleza City and to show how urbanization has occurred in recent years. Methods. Data were obtained from the State Health Department of Fortaleza, Ceará, and included all cases of VL registered in Fortaleza from January 2001 to December 2006. Results. There were a marked increase and an elevated incidence of cases of VL in urban areas. Children and young people were the most affected group. Conclusion. The epidemic occurrence of VL in the region must convince authorities to adopt more adequate policies of disease control. [ABSTRACT FROM AUTHOR]

Rhabdomyolysis is defined as a skeletal muscle injury, with subsequent release of cellular constituents into the extracellular fluid and the circulation. Several conditions can lead to rhabdomyolysis, and new causes are constantly expanded with new case reports. The aim of this paper is to report on a case of acute kidney injury (AKI) induced by rhabdomyolysis due to alcohol abuse and physical agression. A 48-year-old man was admitted to the emergency room with dyspnea, lower limbs edema, weakness, oliguria and dark brown urine. Four days before admission he was physically attacked, after drinking almost 2.5 liters of beer. The diagnosis of AKI due to rhabdomyolysis was made through clinical and laboratory findings (creatine kinase 184,376 IU/l, serum urea 275 mg/dL, creatinine 14.6 mg/ dL, potassium 7.9 mEq/L). Urgency hemodyalisis was started due to anuria, refractory hiperkalemia and hypercatabolism. Recovery of renal function was recorded, after fourteen hemodialysis sessions. Patients with rhabdomyolysis are common in the emergency room. Initial therapy of fluid replacement is essential to prevent progression to renal failure. Once established, the dialysis is indicated early. The prognosis is good, when early supportive therapy is adequate. [ABSTRACT FROM AUTHOR]

Background: The clinical picture of coronavirus disease 2019 (COVID-19)-associated sepsis is similar to that of sepsis of other aetiologies. The present study aims to analyse the role of syndecan-1 (SDC-1) as a potential predictor of septic shock in critically ill patients with COVID-19., Methods: This is a prospective study of 86 critically ill patients due to COVID-19 infection. Patients were followed until day 28 of hospitalization. Vascular biomarkers, such as vascular cell adhesion protein-1, SDC-1, angiopoietin-1 and angiopoietin-2, were quantified upon admission and associated with the need for vasopressors in the first 7 d of hospitalization., Results: A total of 86 patients with COVID-19 (mean age 60±16 y; 51 men [59%]) were evaluated. Thirty-six (42%) patients died during hospitalization and 50 (58%) survived. The group receiving vasopressors had higher levels of D-dimer (2.46 ng/ml [interquartile range {IQR} 0.6-6.1] vs 1.01 ng/ml [IQR 0.62-2.6], p=0.019) and lactate dehydrogenase (929±382 U/l vs 766±312 U/l, p=0.048). The frequency of deaths during hospitalization was higher in the group that received vasoactive amines in the first 24 h in the intensive care unit (70% vs 30%, p=0.002). SDC-1 levels were independently associated with the need for vasoactive amines, and admission values >269 ng/ml (95% CI 0.524 to 0.758, p=0.024) were able to predict the need for vasopressors during the 7 d following admission., Conclusions: Syndecan-1 levels predict septic shock in critically ill patients with COVID-19., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Renal lesions in leprosy have been extensively described, including amyloidosis, glomerulonephritis, nephrosclerosis, tubulointerstitial nephritis and granulomas., Material and Methods: A retrospective study was designed to detect renal function abnormalities in 461 leprosy patients, without any co-morbidity, seen in a university hospital in northeast Brazil. The laboratory test results concerning renal function were examined in the patients' medical records., Results: The mean age was 39 +/- 18 years and 217 (47%) were male. The mean duration of disease was 21 +/- 38 months. Levels of creatinine above 1.4 mg/dL had been detected in 40 patients (8.6%). The levels of creatinine and urea were higher in lepromatous leprosy patients. Proteinuria, hematuria and hemoglobinuria were significantly more frequent in this presentation of leprosy. Nephrotic levels of proteinuria (>3.5 mg/dL) were found in three (2.1%) of 138 lepromatous leprosy patients. A positive association was found between duration of disease and high levels of creatinine in the general sample and in the lepromatous leprosy patients. There was no association between time of treatment and high levels of creatinine., Conclusion: Renal involvement in leprosy seems to be related to the quantity of bacilli present in the body. It is important to evaluate the renal function in all leprosy patients in order to detect any abnormality and prevent renal failure, which is still a potential cause of death in this disease.

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 +/- 34 days). The time until death ranged from one to nine days (mean 3.3 +/- 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > or = 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

Two clinical cases of patients who survived after numerous attacks of Africanized bees (600 and 1500 bee stings, respectively) are reported. Clinical manifestation was characterized by diffuse and widespread edema, a burning sensation in the skin, headache, weakness, dizziness, generalized paresthesia, somnolence and hypotension. Acute renal failure developed and was attributed to hypotension, intravascular hemolysis, myoglobinuria due to rhabdomyolysis and probably to direct toxic effect of the massive quantity of injected venom. They were treated with antihistaminic, corticosteroids and fluid infusion. One of them had severe acute renal failure and dialysis was required. No clinical complication was observed during hospital stay and complete renal function recovery was observed in both patients. In conclusion, acute renal failure after bee stings is probably due to pigment nephropathy associated with hypovolemia. Early recognition of this syndrome is crucial to the successful management of these patients.