Valentine Campana

Liver involvement is an unusual yet frequently overlooked dengue complication. Pivotal for an efficient clinical management, the early diagnosis of dengue-associated liver involvement relies on an accurate description of its clinical and biological characteristics, its prognosis factors, its association with severe dengue and its clinical management. We conducted a systematic review by searching PubMed and Web of Science databases for original case reports, cohort and cross-sectional studies reporting the clinical and/or biological features of dengue-associated liver involvement. The study was registered in PROSPERO (CRD42021262657). Of the 2552 articles identified, 167 were included. Dengue-associated liver involvement was characterised by clinical features including abdominal pain, hepatomegaly, jaundice, nausea/vomiting, and an echogenic liver exhibiting hepatocellular necrosis and minimal inflammation. Elevated Aspartate Aminotransferase and Alanine Aminotransferase but also elevated bilirubin, Alkaline Phosphatase, gamma-glutamyl transferase, increased International Normalised Ratio, creatinine and creatine kinase, lower albumin and prolonged prothrombin and activated partial thromboplastin time were prevalent in dengue-associated liver involvement. Cardiovascular and haematological systems were frequently affected, translating in a strong association with severe dengue. Liver involvement was more common in males and older adults. It was associated with dengue virus serotype-2 and secondary infections. Early paracetamol intake increased the risk of liver involvement, which clinical management was mostly conservative. In conclusion, this systematic review demonstrates that early monitoring of transaminases, clinical assessment, and ultrasound examination allow an efficient diagnosis of dengue-associated liver involvement, enabling the early identification and management of severe dengue.

Aim: To investigate association between soluble urokinase plasminogen activator receptor (suPAR) plasma levels at admission and incidence of complications in COVID-19 patients. Patients & methods: We considered Afro-Caribbean patients (n = 64) admitted to the hospital between 1 February 2020 and 28 February 2021. Primary outcome was time from the hospital admission until intensive care unit care or death. Results: Primary outcome (hazard ratio, HR [95%CI]) was associated with higher CT scan severity score (3.18 [1.15–8.78], p = 0.025), National Early Warning Score (NEWS2; 1.43 [1.02–2.02], p = 0.041) and suPAR (1.28 [1.06–2.06], p = 0.041). Kaplan–Meier analysis indicated patients with suPAR level above 8.95 ng/ml had a worse outcome (7.95 [3.33–18.97], p < 0.001). Conclusion: Our study suggests that COVID-19 patients with increased baseline suPAR levels are at a high risk of complications.

Coronavirus disease-2019 (COVID-19) has devastated healthcare systems and public health globally [1]. Many patients develop a wide spectrum of persisting or new symptoms 3 months after the acute COVID-19 illness (long-COVID-19), and these symptoms can persist for at least 2 months [2, 3]. There is significant variability in the definitions with the lack of standardization and hence the reported frequency of long-COVID-19 also varies.

Este artigo apresenta a construção de um laboratório virtual que permite a visualização de fenômenos associados à gravitação no sistema solar a partir de simulação em um ambiente computacional com gráficos em 3D no intuito de melhorar o processo de ensino e aprendizagem de Física através da utilização de simulações animadas como recurso complementar para professores de Física do ensino médio. O trabalho apresentado aqui é fruto de um projeto de iniciação científica que envolveu estudantes e educadores tanto no processo de especificação da tecnologia utilizada na implementação do software, quanto nos requisitos de funcionalidades da ferramenta, sendo validada por especialistas na área.

Le virus Zika, de la famille des Flaviviridae, est un arbovirus (arthropod-borne virus), inocule par la piqure d'un moustique de l'espece Aedes mais aussi transmis par voie sexuelle ou de la mere a l'enfant. Le virus est decouvert en 1947 et sa premiere epidemie est observee en 2007 en Micronesie. Le 1er fevrier 2016, l'augmentation de microcephalies possiblement associees au virus Zika est declaree comme Urgence de sante publique de portee internationale par l'Organisation mondiale de la sante (OMS), dans le cadre du Reglement sanitaire international. L'OMS a pour role notamment de lutter contre la propagation des maladies dans le monde. En 2014, celle-ci est mise a rude epreuve lors de l'epidemie d'Ebola en Afrique de l'Ouest. La remise en question de l'Organisation suite a cet episode a permis de faire evoluer son programme de preparation et de riposte aux situations d'urgence. La flambee epidemique de la maladie a virus Zika arrive apres cette refonte. La reponse de l'OMS face au virus Zika reste discutable mais montre d'indeniables progres en matiere de crise sanitaire. Cependant elle a revele des failles sur le role de leader de l'Organisation notamment en ce qui concerne les recommandations faites aux femmes enceintes ou les influences politiques. Poursuivre la lutte contre les arboviroses emergentes est la prochaine etape pour une OMS innovante mais les pays sont encore mal prepares. La recherche est essentielle pour comprendre et anticiper les menaces potentielles. Cependant, le manque de financement est au cœur de chaque problematique. Les virus emergents restent des urgences a long terme et un defi pour la communaute internationale.