ASSOCIAÇÃO ENTRE TIPO SANGUÍNEO ABO E RESULTADO DO RT-PCR PARA SARS-COV-2

Introdução

Estudos apontam relação entre grupos sanguíneos e diversas condições clínicas como, por exemplo, eventos trombóticos, doença de von Willebrande doenças infecciosas como SARS-CoV-1, H. pylori entre outros. Associação entre maior susceptibilidade à COVID-19 e pior evolução em indivíduos do grupo sanguíneo A vem sendo estudada por diversos grupos.

Objetivo

Neste estudo, analisamos a correlação entre os grupos sanguíneos ABO e resultado do teste para o vírus SARS-CoV-2 por RT-PCR em um laboratório de análises clínicas com grande fluxo de amostras representativas das cinco regiões do Brasil.

Material e métodos

Os dados foram obtidos do banco de dados do laboratório referente a 20 anos de registro, analisados de forma anonimizada e de acordo com as regras que regem a lei geral de proteção de dados (LGPD). Os registros possuem um identificador numérico único que leva em conta CPF e data de nascimento e todas as análises foram feitas considerando-se esta identificação. Foram obtidas as tipagem sanguínea ABO/Rh e os resultados de RT-PCR para SARS-CoV-2. Para este último, os indivíduos foram classificados “covid-positivo”quando ao menos um exame resultou positivo. Os demais foram considerados “covid-negativo”. As análises foram realizadas no banco de dados obtido do cruzamento do banco de indivíduos únicos com tipagem sanguínea e ao menos um teste para COVID-19. Análise estatística foi realizada do teste chi-quadrado de Pearson e V-quadrado de Cramér.

Resultados e discussão

Foram identificados 66.181 indivíduos que realizaram tipagem sanguínea e ao menos um teste para SARS-CoV-2. A distribuição global dos grupos ABO é a que segue: grupo O 44%, grupo A 41%, grupo B 11% e grupo AB 4%, compatível com a distribuição dos grupos no Brasil (O 45%, A 42%, B 10% e AB 3%).Do total de indivíduos estudado, 21% (13.617) apresentou ao menos um resultado positivo para SARS-CoV-2, distribuídos da seguinte forma por grupo sanguíneo: tipo O 42%, A 42%, B 12% e AB 4%. A distribuição dos grupos sanguíneos entre os indivíduos negativos para SARS-CoV-2 foi: tipo O 44%, A 41%, B 11% e AB 4%. As análises consideraram grupo ABO e Rh. Foi realizado um teste chi-quadrado de independência de variáveis e verificou-se associação positiva entre o tipo sanguíneo e a infecção por COVID-19 (χ2 = 27,273, df = 7, p = 0,0002975).O teste pós-hoc de comparação entre status de COVID-19 e tipo sanguíneo sugere associação entre o tipo B- e infecção por COVID-19 (p = 0.0407700).Entretanto, este dado não foi confirmado por análise adicional pelo teste V de Cramér, sugerindo que o efeito observado está provavelmente associado ao grande número de amostras do que uma associação real entre as variáveis.Sabe-se que a testagem para COVID-19 pode resultar em falso negativo quando realizada fora da janela de maior sensibilidade para detecção do vírus. Deve-se considerar que, na presente análise, a informação sobre início dos sintomas e data de realização do teste não está disponível. Entretanto, o grande número de casos analisados diminui o impacto da ausência desta informação. Outro ponto importante a ser considerado é que não foram avaliados parâmetros de evolução clínica dos pacientes, sendo os dados restritos à presença ou não de diagnóstico positivo para COVID-19.

Conclusão

Não foi demonstrada associação entre o tipo sanguíneo e a suscetibilidade a infecções por COVID-19 no grupo analisado.

Materialist and post-materialist concerns and the wish for a strong leader in 27 countries

There is evidence that democracies are under threat around the world while the quest for strong leaders is increasing. Although the causes of these developments are complex and multifaceted, here we focus on one factor: the extent to which citizens express materialist and post-materialist concerns. We explore whether objective higher levels of democracy are differentially associated with materialist and post-materialist concerns and, in turn, whether this is related to the wish for a strong leader. Testing this hypothesis across 27 countries (N = 5,741) demonstrated a direct negative effect of democracies’ development on the wish for a strong leader. Further, multi-level mediation analysis showed that the relation between the Democracy Index and the wish for a strong leader was mediated by materialist concerns. This pattern of results suggests that lower levels of democracy are associated with enhanced concerns about basic needs and this is linked to greater support for strong leaders.

How Fair is Economic Inequality? Belief in a Just World and the Legitimation of Economic Disparities in 27 European Countries

This article aims to examine the role of Belief in a Just World (BJW) in the legitimation of economic inequality. Using data from 27 European countries (N=47,086), we conducted multilevel analyses and found that BJW positively predicted the legitimation of economic inequality, measured by three indicators: the perceived fairness of the overall wealth inequality, and the fairness of the earnings made by the Top 10% and the Bottom 10% of society. These results persisted after controlling for individual- and country-level variables. Moreover, the BJW effect was stronger on the legitimation of the Bottom 10% incomes, compared to the legitimation of the Top 10%. We also found that economic inequality at the country-level reduced the BJW effect on legitimation of inequality. Finally, BJW displayed a negative indirect effect on support for redistribution, via the legitimation of economic inequalities.

Clear-Cut Terms and Culture-Sensitive Characteristics of Distinctive Casual Sexual Relationships in Portuguese Emerging Adults

Casual sexual relationships (CSR) are increasingly common but limited empirical research has addressed their terminology and distinctive characteristics. This study sought to identify the most clear-cut terms and to consider how culture-sensitive characteristics distinguish casual sexual relationships among Portuguese emerging adults (N = 262, 18-29 years old). We combined two qualitative studies - one by association and another by free recall - to ascertain the clarity of the terms, plus a quantitative study to further characterize and differentiate them. Participants were asked to match descriptions of CSRs with the respective terms by which they are known (Study 1). The same was investigated using an evocation task requesting that participants produce the terms by which the described CSRs are known (Study 2). Binary logistic regressions were performed to analyze the associations between encounters and labels chosen, taking the effect of gender and age into account. In the third study, participants rated the degree to which eight characteristics were present in the types of CSR, a simultaneous task that led to greater understanding of their descriptive and differentiating characteristics. Multivariate analysis of variance was used, with gender and age as covariates. We conclude that two types of CSR - friends with benefits and one-night stand - and, to a lesser extent, making out, are understood and associated with consensual labels, also found by free-recall. These CSRs proved to be distinct, as they are understood as more different than similar in a set of psychoemotional, behavioral, and sexual characteristics.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12119-021-09859-0.

Self-regulation in oral hygiene behaviours in adults with gingivitis: The mediating role of coping planning and action control

AIM

This study investigates the joint role of volitional predictors of oral hygiene behaviours of flossing and brushing in adults with gingivitis, framed by the Health Action Process Approach model (HAPA).

MATERIALS AND METHODS

In a longitudinal online survey, 201 participants aged 18-75, of which 56.7% were women, completed assessments at baseline(T1), 2 weeks(T2) and 4 months(T3). Oral hygiene behaviours(OH) (brushing and flossing) and social cognitive determinants of behaviour in the HAPA: action and maintenance self-efficacy(ASE & MSE), intention(INT), coping planning(CP) and action control(AC) were evaluated. Structural equation modelling was used to test a series of three nested models. In Model 1, action self-efficacy would determine MSE and INT, and INT would determine OH; in Model 2, INT would determine both CP and AC and the two OH behaviours; and in Model 3, CP and AC would be sequential mediators between INT and OH.

RESULTS

Model 3, predicting a mediating process from intention to behaviour via coping planning and action control, showed the best fit according to the fit indices and explained more of the variance in dental hygiene. The mediating role of coping planning and action control between intention and oral hygiene behaviours was thus confirmed. Importantly, coping planning did not mediate between intention and oral hygiene behaviours, which means that oral hygiene intention influences action control through coping planning, and both sequentially mediate this influence on behaviour.

CONCLUSIONS

For individuals who are not yet following the recommendations for specific oral hygiene behaviours, coping planning and action control represent psychological mechanisms by which intentions are put into practice.

Pathways between BMI and adherence to weight management in adolescence

BACKGROUND

In order to understand the mechanisms involved in how overweight adolescents adhere to weight management and perceive its benefits, a few variables have been identified, namely, body mass index (BMI), body self-esteem (BSE) and positive perspective of life (PPL).

METHODS

In a sample of 112 adolescents, we investigated whether BMI would predict adolescents' self-efficacy/adherence (SEA) to weight management and perception of its benefits. A structural equation modeling approach was chosen. We hypothesized that perceived quality of life (PQL) would mediate the relationships between BMI and SEA and between BMI and perception of benefits (PB).

RESULTS

The results suggested that BMI is not directly associated with SEA and PB. However, PQL was identified as a mediator between BMI and SEA and PB.

CONCLUSION

These findings bring important implications for understanding overweight adolescents' adherence to weight management. There is evidence that adolescents' adherence to weight management and PB are not predicted by their BMI. However, it has been shown that PQL mediates this process. For a long time, health professionals have been too focused on BMI. Time has come to be more focused on quality of life and how to improve it.

A multilevel perspective to explain recycling behaviour in communities

Previous research on the motivation for environmentally responsible behaviour has focused mainly on individual variables, rather than organizational or collective variables. Therefore, the results of those studies are hardly applicable to environmental management. This study considers individual, collective, and organizational variables together that contribute to the management of environmental waste. The main aim is to identify, through the development of a multilevel model, those predictive variables of recycling behaviour that help organizations to increase the recycling rates in their communities. Individual (age, gender, educational level, self-efficacy with respect to residential recycling, individual recycling behaviour), organizational (satisfaction with the quality of the service provided by a recycling company), and collective (community recycling rates, number of inhabitants, community efficacy beliefs) motivational factors relevant to recycling behaviour were analysed. A sample of 1501 residents from 55 localities was surveyed. The results of multilevel analyses indicated that there was significant variability within and between localities. Interactions between variables at the level of the individual (e.g. satisfaction with service quality) and variables at the level of the collective (e.g. community efficacy) predicted recycling behaviour in localities with low and high community recycling rates and large and small populations. The interactions showed that the relationship between self-efficacy and recycling is stronger in localities with weak community efficacy beliefs than in communities with strong beliefs. The findings show that the relationship between satisfaction with service quality and recycling behaviour is stronger in localities with strong community efficacy beliefs than in communities with weaker beliefs and a smaller population. The results are discussed accordingly in relation to theory and possible contribution to waste management. Those findings may be incorporated in national and international environmental policies in order to promote environmentally responsible behaviour in citizenship.

Embryonic and larval development of Jundiá (Rhamdia quelen, Quoy & Gaimard, 1824, Pisces, Teleostei), a South American Catfish

The jundiá (Rhamdia quelen, Quoy & Gaimard) is an endemic South American fish species. Because this species supports cold winters and grows faster during warm months, it has begun to be viewed as an ideal species for fish production in southern South America. In the present study, jundiá oocytes used were obtained by extrusion from females after hormone injection. Soon after hydration, the eggs were transferred to 50 L conic glass incubators, with constant and controlled water influx. Samples of fertilized eggs were transferred to Petri dishes and, examined under a stereoscopic microscope, were spherical, demersal, and non-adhesive with defined perivitelline space and resistant chorion. Cleavage stages occurred during the first 3.5 h. After hatching, larvae were transferred to 200 L glass fiber incubators. First signs of embryo movement were observed 21 h after fertilization; larval eclosion occurred 30.5 h after fertilization. Present findings may provide a basis for studies aimed at determining the complete ontogeny of jundiá and may be useful in eco-toxicological studies.

Risk factors for nosocomial infections in critically ill newborns: a 5-year prospective cohort study

BACKGROUND

Nosocomial infections (NIs) are one of the most important causes of morbidity in neonatal intensive care units (NICUs). The aim of this study was to identify risk factors (RFs) for NIs among critically ill newborn patients in a Brazilian NICU.

METHODS

This 5-year prospective cohort study in an 8-bed NICU included all infants born in the hospital and admitted to the NICU from 1993 to 1997. Exposure variables were maternal and newborn data prospectively collected from patient records. Univariate and multivariate analyses were used to determine independent RFs associated with NIs.

RESULTS

Univariate analysis indicated gestational age, congenital abnormality, premature rupture of membranes, maternal illness, birth weight, mechanical ventilation, central venous catheter, total parenteral nutrition, peripheral venous catheter, and length of stay as possible RFs. Multivariate analysis identified 5 independent RFs for NIs: premature rupture of membranes (hazard ratio [HR] = 1.51 [95% CI, 1.15-1.99]), maternal disease (HR = 1.57 [95% CI, 1.18-2.07]), mechanical ventilation (HR = 2.43 [95% CI, 1.67-3.53]), central venous catheter (HR = 1.70 [95% CI, 1.21-2.41]), and total parenteral nutrition (HR = 4.04 [95% CI, 2.61-6.25]).

CONCLUSION

The recognition of RFs for NIs is an important tool for the identification and development of interventions to minimize such risks in the NICU.

Low frequency of replication errors in primary nervous system tumours

OBJECTIVES

Automated DNA technology was used to analyze the incidence of microsatellite instability (MIN) among the most frequent types of adult primary CNS tumours and to determine its relation with clinicopathological characteristics.

METHODS

Fifty six gliomas, 32 meningiomas and 11 schwannomas were screened for size changes at eight microsatellite loci using fluorescent polymerase chain reaction (PCR) followed by fragment analysis in an automated sequencer. A tumour was considered as MIN+ when a different electrophoretic pattern between constitutional and tumour DNA was evidenced in one or more microsatellite markers and as replication error positive (RER+) when at least 25% of the markers analyzed (2/8) showed instability. The MIN phenotype was correlated with relevant clinical and pathological parameters.

RESULTS

Globally, instability was found in 19/767 analyses (2.47%), with a higher rate among tetranuceotide than dinucleotide repeats (chi(2) test, p=0.018). Ten gliomas (17.9%), two meningiomas (6.3%), and two schwannomas (18.2%) were MIN+, whereas one glioma (1.8%), two meningiomas (6.3%), and one schwannoma (9.1%) were classified as RER+. A possible association between microsatellite instability and a shorter duration of clinical course was found in meningiomas. The MIN+ phenotype was more frequent in spinal than intracranial schwannomas (Fisher's exact test, p=0.018). No other significant association with clinical or histological features was detected.

CONCLUSIONS

Although microsatellite instability can be demonstrated at a low rate in some primary CNS tumours, a true replication error phenotype (revealed by widespread microsatellite instability at numerous loci) is uncommon and unlikely to play an important part in the pathogenesis of these neoplasms. This form of instability was more frequent in tetranucleotide than in dinucleotide repeats. To our knowledge, this is the first report of MIN in schwannomas, where it was associated with the spinal localisation of the tumour.

Inhaled nitric oxide in the management of persistent pulmonary hypertension of the newborn: a meta-analysis

OBJECTIVES

To evaluate the use of inhaled nitric oxide (NO) in the management of persistent pulmonary hypertension of the newborn.

METHODS

Computerized bibliographic search on MEDLINE, CURRENT CONTENTS and LILACS covering the period from January 1990 to March 1998; review of references of all papers found on the subject. Only randomized clinical trials evaluating nitric oxide and conventional treatment were included. OUTCOMES STUDIED: death, requirement for extracorporeal membrane oxygenation (ECMO), systemic oxygenation, complications at the central nervous system and development of chronic pulmonary disease. The methodologic quality of the studies was evaluated by a quality score system, on a scale of 13 points.

RESULTS

For infants without congenital diaphragmatic hernia, inhaled NO did not change mortality (typical odds ratio: 1.04; 95% CI: 0.6 to 1.8); the need for ECMO was reduced (relative risk: 0.73; 95% CI: 0.60 to 0.90), and the oxygenation was improved (PaO2 by a mean of 53.3 mm Hg; 95% CI: 44.8 to 61.4; oxygenation index by a mean of -12.2; 95% CI: -14.1 to -9.9). For infants with congenital diaphragmatic hernia, mortality, requirement for ECMO, and oxygenation were not changed. For all infants, central nervous system complications and incidence of chronic pulmonary disease did not change.

CONCLUSIONS

Inhaled NO improves oxygenation and reduces requirement for ECMO only in newborns with persistent pulmonary hypertension who do not have diaphragmatic hernia. The risk of complications of the central nervous system and chronic pulmonary disease were not affected by inhaled NO.

Risk factors for nosocomial infections in a critically ill pediatric population: a 25-month prospective cohort study

We studied risk factors for nosocomial infections among 500 critically ill children who were admitted to a pediatric intensive care unit from August 1994 through August 1996 and who were prospectively followed until death, transfer, or discharge. Age, gender, postoperative state, length of stay, device-utilization ratio, pediatric risk of mortality score, and total parenteral nutrition were the risk factors studied. Through multivariate analysis, we identified three independent risk factors for nosocomial infection: device-utilization ratio (odds ratio [OR], 1.6; 95% confidence interval [CI95], 1.10-2.34), total parenteral nutrition (OR, 2.5; CI95, 1.05 5.81) and length of stay (OR, 1.7; CI95, 1.31-2.21).

[Tubular duplication of the colon: a case report and review of the literature]

Among Gastrointestinal Duplications, colonic duplications are the less common. The case presented here consist of a duplication of the transverse colon, difficult to diagnose, which had abdominal distension as the main symptom. A 4-year-old child was referred to the Unity of Pediatric Surgery, Hospital de Base, Brasilia, DF with a history of progressive abdominal distension. Plain X-Rays of the abdomen demonstrated a large fecaloma, which demanded removal. A Barium Enema was done suggesting Congenital Megacolon. A rectal biopsy was performed under general anesthesia, demonstrating normal ganglion cells. Medical treatment was instituted for chronic constipation in the Pediatric Gastroenterology clinic. The patient returned three months later with the same complaints. A new rectal biopsy was done; normal ganglion cells were described, ruling out Hirschsprung's disease. The parents were told to insist on the medical treatment diets. Four years later the patient was seen in the Emergency Room with signs and symptoms of low intestinal obstruction. Exploratory Laparotomy was undertaken as an emergency and the findings were complete volvulus of the large bowel involving the transverse colon up to the splenic flexure, demonstrating a large duplication of the transverse colon. A resection of the duplication and end-to-end colonic anastomosis was performed with an uneventful postoperative care. Discharged on excellent conditions.

[Megacystis-microcolon-intestinal hypoperistalsis syndrome. A case report]

A case of intestinal pseudo-obstruction in the neonatal period is presented. It is known as Megacistis-microcolon-intestinal Hypoperistalsis Syndrome and is a rare cause of intestinal dismotility.A white female newborn weighing 3,110 g was admitted to the Neonatal Surgical Unit of the Hospital de Base with a small omphalocele and a history of biliary vomit. Abdominal X-rays revealed complete absence of intestinal gas. Exploratory laparotomy was carried out, and the findings were great distension of the bladder, a short poorly developed and malrotated bowel with a non-fixed cecum. Surgical treatment consisted of gastrostomy, sigmoid colostomy, vesicostomy and repair of the omphalocele. Multiple biopsies were done in the small and large bowel. Ganglion cells were present in all specimens. The patient did not tolerate enteral feeding, and total parenteral nutrition was readily initiated. Nonetheless, death occurred on the 51st postoperative day. This is a rare syndrome which presents itself at birth as chronic intestinal obstruction. A postmortem examination confirmed the diagnosis.

Selective surveillance for nosocomial infections in a Brazilian hospital

OBJECTIVE

To devise a system for surveying the frequency of nosocomial infections in a tertiary care hospital in a developing country.

DESIGN

Prospective selective surveillance by nurses of the charts of patients at high risk for nosocomial infections, as identified by a form completed by resident physicians. The sensitivity, specificity, and predictive value of this method of selective surveillance were compared with those for total prospective chart review by two infectious disease specialists.

SETTING

A university hospital in northeastern Brazil.

PATIENTS

All patients hospitalized for more than 72 hours with an identified risk factor for nosocomial infection.

RESULTS

The ratio of nosocomial infections to 100 discharges was 13.4 and the incidence density was 11.2/1,000 patient days. The surveillance method demonstrated a sensitivity of 74% and a specificity of 99.7%. Positive predictive value was 93%, negative predictive value was 99%, and overall accuracy was 98%.

CONCLUSIONS

This method of selective surveillance for nosocomial infections based on risk factors identified by physicians demonstrated excellent predictive value and overall accuracy and may be of use to other hospitals that lack a nursing care plan book such as the Kardex. The relative frequency of nosocomial infections significantly exceeded the rates reported from hospitals in developed countries.

Studies of the acetate kinase-phosphotransacetylase and the butanediol-forming systems in Aerobacter aerogenes

Mutants of Aerobacter aerogenes devoid of acetate kinase and phosphotransacetylase activities were isolated by selection for resistance to fluoroacetate on lactate medium. The mutants were used to study the role of the acetate kinase-phosphotransacetylase system in growth on acetate and glucose. Acetate kinase-negative and phosphotransacetylase-negative mutants were unable to grow on acetate minimal medium. Their growth rates on glucose minimal medium were identical with that of the parent strain under aerobic conditions, but lower growth rates were observed in the mutant strains during anaerobic growth on glucose medium. The mutants were unable to incorporate [2-(14)C]-acetate rapidly while growing on glycerol. Variations in acetate kinase and phosphotransacetylase levels during growth on glucose were studied. The specific activities of the enzymes increased approximately fivefold during aerobic growth on glucose in batch culture. The enzyme levels were also studied during anaerobic growth on glucose at constant pH (pH 5.8 and 7.0). Smaller increases in specific activities were found under these conditions. The role of acetate in the induction of the diacetyl (acetoin) reductase was investigated using a mutant deficient in both acetate kinase and phosphotransacetylase. The effect of pH on the induction of this enzyme during growth on glucose under anaerobic conditions was tested. The data support the idea that free acetic acid is the inducer for the enzymes of the butanediol-forming pathway in A. aerogenes.