The Study of Bluetongue Virus (BTV) and Epizootic Hemorrhagic Disease Virus (EHDV) Circulation and Vectors at the Municipal Parks and Zoobotanical Foundation of Belo Horizonte, Minas Gerais, Brazil (FPMZB-BH).

Bluetongue Virus (BTV) and Epizootic Hemorrhagic Disease Virus (EHDV) are Orbiviruses primarily transmitted by their biological vector, Culicoides spp. Latreille, 1809 (Diptera: Ceratopogonidae). These viruses can infect a diverse range of vertebrate hosts, leading to disease outbreaks in domestic and wild ruminants worldwide. This study, conducted at the Belo Horizonte Municipal Parks and Zoobotany Foundation (FPMZB-BH), Minas Gerais, Brazil, focused on Orbivirus and its vectors. Collections of Culicoides spp. were carried out at the FPMZB-BH from 9 December 2021 to 18 November 2022. A higher prevalence of these insects was observed during the summer months, especially in February. Factors such as elevated temperatures, high humidity, fecal accumulation, and proximity to large animals, like camels and elephants, were associated with increased Culicoides capture. Among the identified Culicoides spp. species, Culicoides insignis Lutz, 1913, constituted 75%, and Culicoides pusillus Lutz, 1913, 6% of the collected midges, both described as competent vectors for Orbivirus transmission. Additionally, a previously unreported species in Minas Gerais, Culicoides debilipalpis Lutz, 1913, was identified, also suspected of being a transmitter of these Orbiviruses. The feeding preferences of some Culicoides species were analyzed, revealing that C. insignis feeds on deer, Red deer (Cervus elaphus) and European fallow deer (Dama dama). Different Culicoides spp. were also identified feeding on humans, raising concerns about the potential transmission of arboviruses at the site. In parallel, 72 serum samples from 14 susceptible species, including various Cervids, collected between 2012 and 2022 from the FPMZB-BH serum bank, underwent Agar Gel Immunodiffusion (AGID) testing for BTV and EHDV. The results showed 75% seropositivity for BTV and 19% for EHDV. Post-testing analysis revealed variations in antibody presence against BTV in a tapir and a fallow deer and against EHDV in a gemsbok across different years. These studies confirm the presence of BTV and EHDV vectors, along with potential virus circulation in the zoo. Consequently, implementing control measures is essential to prevent susceptible species from becoming infected and developing clinical diseases.

Rotavirus A and D circulating in commercial chicken flocks in southeastern Brazil.

Rotavirus (RV) outbreaks can cause significant economic losses in the livestock and poultry industries. Stool samples were collected from asymptomatic laying and broiler chickens from commercial poultry farms in the states of Rio de Janeiro and Espírito Santo in southeastern Brazil for detection of RV species A and D (RVA and RVD, respectively) by reverse transcription polymerase chain reaction. RV was detected in 10.5% (34/325) of samples: 22 (64.7%) were positive for RVA and nine (26.5%) for RVD, while three (8.8%) exhibited coinfections with both viruses. Sequence analysis of a VP6 fragment from seven RVA-positive samples identified the I11 genotype in all samples. Information regarding avian RV epidemiology is still scanty, despite the high prevalence of RV infections in several bird species and subsequent economic impact. Consequently, monitoring infections caused by avian RVs, especially in commercial birds, is essential not only to provide new and relevant information regarding the biology, epidemiology, and evolution of these viruses, but also to facilitate the implementation of preventive measures.

Molecular Characterization of Avian Rotaviruses F and G Detected in Brazilian Poultry Flocks.

Avian rotaviruses (RVs) are important etiologic agents of gastroenteritis in birds. In general, avian RVs are understudied; consequently, there is a paucity of information regarding these viruses. Therefore, the characterization of these viral species is highly relevant because more robust information on genetic, epidemiologic, and evolutionary characteristics can clarify the importance of these infections, and inform efficient prevention and control measures. In this study, we describe partial genome characterizations of two avian RV species, RVF and RVG, detected in asymptomatic poultry flocks in Brazil. Complete or partial sequences of at least one of the genomic segments encoding VP1, VP2, VP4, VP6, VP7, NSP1, NSP4, NSP4, or NSP5 of 23 RVF and 3 RVG strains were obtained, and demonstrated that multiple variants of both RVF and RVG circulate among Brazilian poultry. In this study, new and important information regarding the genomic characteristics of RVF and RVG is described. In addition, the circulation of these viruses in the study region and the genetic variability of the strains detected are demonstrated. Thus, the data generated in this work should help in understanding the genetics and ecology of these viruses. Nonetheless, the availability of a greater number of sequences is necessary to advance the understanding of the evolution and zoonotic potential of these viruses.

Dengue induces iNOS expression and nitric oxide synthesis in platelets through IL-1R.

Introduction: Dengue is an arthropod-born disease caused by dengue virus (DENV), that may manifest as a mild illness or severe form, characterized by hemorrhagic fever and shock. Nitric oxide (NO) is a vasodilator signaling molecule and an inhibitor of platelet aggregation known to be increased in platelets from dengue patients. However, the mechanisms underlying NO synthesis by platelets during dengue are not yet elucidated. IL-1ß is a pro-inflammatory cytokine able to induce iNOS expression in leukocytes and present in dengue patients at high levels. Nevertheless, the role of IL-1ß in platelet activation, especially regarding iNOS expression, are not clear. Methods: We prospectively followed a cohort of 28 dengue-infected patients to study NO synthesis in platelets and its relationship with disease outcomes. We used in vitro infection and stimulation models to gain insights on the mechanisms. Results and Discussion: We confirmed that platelets from dengue patients express iNOS and produce higher levels of NO during the acute phase compared to healthy volunteers, returning to normal levels after recovery. Platelet NO production during acute dengue infection was associated with the presence of warning signs, hypoalbuminemia and hemorrhagic manifestations, suggesting a role in dengue pathophysiology. By investigating the mechanisms, we evidenced increased iNOS expression in platelets stimulated with dengue patients´ plasma, indicating induction by circulating inflammatory mediators. We then investigated possible factors able to induce platelet iNOS expression and observed higher levels of IL-1ß in plasma from patients with dengue, which were correlated with NO production by platelets. Since platelets can synthesize and respond to IL-1ß, we investigated whether IL-1ß induces iNOS expression and NO synthesis in platelets. We observed that recombinant human IL-1ß enhanced iNOS expression and dose-dependently increased NO synthesis by platelets. Finally, platelet infection with DENV in vitro induced iNOS expression and NO production, besides the secretion of both IL-1α and IL-1ß. Importantly, treatment with IL-1 receptor antagonist or a combination of anti-IL-1α and anti-IL-1ß antibodies prevented DENV-induced iNOS expression and NO synthesis. Our data show that DENV induces iNOS expression and NO production in platelets through mechanisms depending on IL-1 receptor signaling.

Rotavirus F and G circulating in chickens in Southeastern Brazil.

Rotavirus (RV) infections represent a significant cause of enteritis and diarrhea in avian species and pose a major concern for the poultry industry. However, the prevalence of rotavirus infections among birds is poorly understood. Stool samples were collected from laying and broiler hens from commercial poultry farms in the states of Rio de Janeiro and Espírito Santo, Southwest region of Brazil, for detection of rotavirus species F and G (RVF and RVG, respectively) by reverse transcription polymerase chain reaction. RV was detected in 11.7% (38/325) of samples: 35 samples were positive for RVF and 3 for RVG. RVF was detected in 15 samples from Rio de Janeiro and 23 samples from Espírito Santo. RVG was detected in 3 samples from Espírito Santo. All the positive samples were from asymptomatic broiler chickens. The prevalence of RV infection in these flocks was high, especially considering that the birds had no apparent clinical disease. Silent circulation in the herds signifies the need for a continuous surveillance program to guide measures to control and prevent this viral infection. Continuous monitoring of pathogens is crucial to ensure greater productivity on poultry farms.

Platelets in dengue infection: more than a numbers game.

Dengue virus (DENV) infection is responsible for the development of dengue illness, which can be either asymptomatic, present mild manifestations or evolve to severe dengue. Thrombocytopenia is an important characteristic during DENV infection, being observed both in mild and severe dengue, although the lowest platelet counts are encountered during severe cases. This review gathers information regarding several mechanisms that have been related to alterations in platelet number and function, leading to thrombocytopenia but also platelet-mediated immune and inflammatory response. On this regard, we highlight that the decrease in platelet counts may be due to bone marrow suppression or consumption of platelets at the periphery. We discuss the infection of hematopoietic progenitors and stromal cells as mechanisms involved in bone marrow suppression. Concerning peripheral consumption of platelets, we addressed the direct infection of platelets by DENV, adhesion of platelets to leukocytes and vascular endothelium and platelet clearance mediated by anti-platelet antibodies. We also focused on platelet involvement on the dengue immunity and pathogenesis through translation and secretion of viral and host factors and through platelet-leukocyte aggregates formation. Hence, the present review highlights important findings related to platelet activation and thrombocytopenia during dengue infection, and also exhibits different mechanisms associated with decreased platelet counts.Graphical abstract:Schematic mechanistic representation of platelet-mediated immune responses and thrombocytopenia during dengue infection. (A) DENV-infected platelets secrete cytokines and chemokines and also adhere to activated vascular endothelium. Platelets aggregate with leukocytes, inducing the secretion of NETs and inflammatory mediators by neutrophils and monocytes, respectively. (B) DENV directly infects stromal cells and hematopoietic precursors, including megakaryocytes, which compromises megakaryopoiesis. Both central and peripheric mechanisms contribute to DENV-associated thrombocytopenia.

Platelet-leukocyte interactions in the pathogenesis of viral infections.

Evolving evidence demonstrates that platelets have major roles in viral syndromes through previously unrecognized viral sensing and effector functions. Activated platelets and increased platelet-leukocyte aggregates are observed in clinical and experimental viral infections. The mechanisms and outcomes of platelet-leukocyte interactions depend on the interacting leukocyte as well as on the pathogen and pathological conditions. In this review, we discuss the mechanisms involved in platelet interactions with leukocytes and its functions during viral infections. We focus on the contributions of human platelet-leukocyte interactions to pathophysiological and protective responses during viral infections of major global health relevance, including acquired immunodeficiency syndrome (AIDS), dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), influenza pneumonia, and COVID-19.

Occurrence of Lipoptena mazama and Lipoptena guimaraesi (Diptera: Hippoboscidae) on gray brocket deer (Mazama gouazoubira) in southern Brazil.

The genus Lipoptena includes hematophagous insects of the family Hippoboscidae that parasitize different deer species. The present study aims to identify 19 flies that parasitize deer of the genus Mazama in the State of Paraná, Brazil. We analyzed 18 flies (Lipoptena mazamae) and 1 Lipoptena guimaraesi. This study expands the host list for L. guimaraesi, previously restricted to a single deer species (Ozotoceros bezoarticus).

Survey of Freshly Harvested Oat Grains from Southern Brazil Reveals High Incidence of Type B Trichothecenes and Associated Fusarium Species.

The current study investigated the fungal diversity in freshly harvested oat samples from the two largest production regions in Brazil, Paraná (PR) and Rio Grande do Sul (RS), focusing primarily on the Fusarium genus and the presence of type B trichothecenes. The majority of the isolates belonged to the Fusarium sambucinum species complex, and were identified as F. graminearum sensu stricto (s.s.), F. meridionale, and F. poae. In the RS region, F. poae was the most frequent fungus, while F. graminearum s.s. was the most frequent in the PR region. The F. graminearum s.s. isolates were 15-ADON genotype, while F. meridionale and F. poae were NIV genotype. Mycotoxin analysis revealed that 92% and 100% of the samples from PR and RS were contaminated with type B trichothecenes, respectively. Oat grains from PR were predominantly contaminated with DON, whereas NIV was predominant in oats from RS. Twenty-four percent of the samples were contaminated with DON at levels higher than Brazilian regulations. Co-contamination of DON, its derivatives, and NIV was observed in 84% and 57.7% of the samples from PR and RS, respectively. The results provide new information on Fusarium contamination in Brazilian oats, highlighting the importance of further studies on mycotoxins.

Dengue virus 3 genotype I shows natural changes in heparan sulphate binding sites, cell interactions, and neurovirulence in a mouse model.

Dengue virus (DENV) is the most prevalent pathogen of the Flaviviridae family. Due to the considerable increase in DENV incidence and spread, symptoms such as CNS involvement have increased. Heparan sulphate (HS) was the first molecule identified as an adhesion factor for DENV in mammalian cells. Viral phenotypes with different HS interactions are associated with various clinical symptoms, including neurological alterations. Here, using in silico analyses, in vitro studies, and the in vivo mouse model, we characterized two natural circulating DENV3 genotype I (GI) lineage 1 (L1) in Brazil-DENV3 MG-20 (from Minas Gerais) and DENV3 PV_BR (from Rondônia) that present divergent neurovirulent profiles and sensitivity to sulphated molecules. We identified substitutions at the viral envelope (E) in positions 62 and 123 as likely responsible for the differences in neurovirulence. The E62K and E123Q substitutions in DENV3 MG-20 and DENV3 PV_BR, respectively, greatly influenced in silico electrostatic density and heparin docking results. In vivo, mice inoculated with DENV3 MG-20 died, but not those infected with DENV3 PV_BR. The clinical symptoms, such as paralysis of the lower limbs and meningoencephalitis, and histopathology, also differed between the inoculated groups. In vitro heparin and heparinases assays further demonstrated the biological impact of these substitutions. Other characteristics that have been previously associated with alterations in cell tropism and neurovirulence, such as changes in the size of lysis plaques and differences in cytopathic effects in glioblastoma cells, were also observed.

Occurrence of Lipoptena mazama and Lipoptena guimaraesi (Diptera: Hippoboscidae) on gray brocket deer (Mazama gouazoubira) in southern Brazil / Ocorrência de Lipoptena mazama e Lipoptena guimaraesi (Diptera: Hippoboscidae) em veado-catingueiro (Mazama gouazoubira) no sul do Brasil

Abstract The genus Lipoptena includes hematophagous insects of the family Hippoboscidae that parasitize different deer species. The present study aims to identify 19 flies that parasitize deer of the genus Mazama in the State of Paraná, Brazil. We analyzed 18 flies (Lipoptena mazamae) and 1 Lipoptena guimaraesi. This study expands the host list for L. guimaraesi, previously restricted to a single deer species (Ozotoceros bezoarticus).

Resumo O gênero Lipoptena engloba insetos hematófagos da família Hippoboscidae que parasitam diferentes espécies de cervídeos. O presente estudo tem por objetivo relatar a identificação de 19 moscas encontradas parasitando cervídeos do gênero Mazama, no Estado do Paraná, Brasil. Dentre os espécimes analisados, 18 pertenciam à espécie Lipoptena mazamae e um à espécie Lipoptena guimaraesi. O presente artigo expande a lista de hospedeiros de L. guimaraesi, antes restrita a uma única espécie de cervídeo (Ozotoceros bezoarticus).

Lipopolysaccharide triggers different transcriptional signatures in taurine and indicine cattle macrophages: Reactive oxygen species and potential outcomes to the development of immune response to infections.

Macrophages are classified upon activation as classical activated M1 and M2 anti-inflammatory regulatory populations. This macrophage polarization is well characterized in humans and mice, but M1/M2 profile in cattle has been far less explored. Bos primigenius taurus (taurine) and Bos primigenius indicus (indicine) cattle display contrasting levels of resistance to infection and parasitic diseases such as C57BL/6J and Balb/c murine experimental models of parasite infection outcomes based on genetic background. Thus, we investigated the differential gene expression profile of unstimulated and LPS stimulated monocyte-derived macrophages (MDMs) from Holstein (taurine) and Gir (indicine) breeds using RNA sequencing methodology. For unstimulated MDMs, the contrast between Holstein and Gir breeds identified 163 Differentially Expressed Genes (DEGs) highlighting the higher expression of C-C chemokine receptor type five (CCR5) and BOLA-DQ genes in Gir animals. LPS-stimulated MDMs from Gir and Holstein animals displayed 1,257 DEGs enriched for cell adhesion and inflammatory responses. Gir MDMs cells displayed a higher expression of M1 related genes like Nitric Oxide Synthase 2 (NOS2), Toll like receptor 4 (TLR4), Nuclear factor NF-kappa-B 2 (NFKB2) in addition to higher levels of transcripts for proinflammatory cytokines, chemokines, complement factors and the acute phase protein Serum Amyloid A (SAA). We also showed that gene expression of inflammatory M1 population markers, complement and SAA genes was higher in Gir in buffy coat peripheral cells in addition to nitric oxide concentration in MDMs supernatant and animal serum. Co-expression analyses revealed that Holstein and Gir animals showed different transcriptional signatures in the MDMs response to LPS that impact on cell cycle regulation, leukocyte migration and extracellular matrix organization biological processes. Overall, the results suggest that Gir animals show a natural propensity to generate a more pronounced M1 inflammatory response than Holstein, which might account for a faster immune response favouring resistance to many infection diseases.

Innate immune receptors in platelets and platelet-leukocyte interactions.

Platelets are chief cells in hemostasis. Apart from their hemostatic roles, platelets are major inflammatory effector cells that can influence both innate and adaptive immune responses. Activated platelets have thromboinflammatory functions linking hemostatic and immune responses in several physiological and pathological conditions. Among many ways in which platelets exert these functions, platelet expression of pattern recognition receptors (PRRs), including TLR, Nod-like receptor, and C-type lectin receptor families, plays major roles in sensing and responding to pathogen-associated or damage-associated molecular patterns (PAMPs and DAMPs, respectively). In this review, an increasing body of evidence is compiled showing the participation of platelet innate immune receptors, including PRRs, in infectious diseases, sterile inflammation, and cancer. How platelet recognition of endogenous DAMPs participates in sterile inflammatory diseases and thrombosis is discussed. In addition, platelet recognition of both PAMPs and DAMPs initiates platelet-mediated inflammation and vascular thrombosis in infectious diseases, including viral, bacterial, and parasite infections. The study also focuses on the involvement of innate immune receptors in platelet activation during cancer, and their contribution to tumor microenvironment development and metastasis. Finally, how innate immune receptors participate in platelet communication with leukocytes, modulating leukocyte-mediated inflammation and immune functions, is highlighted. These cell communication processes, including platelet-induced release of neutrophil extracellular traps, platelet Ag presentation to T-cells and platelet modulation of monocyte cytokine secretion are discussed in the context of infectious and sterile diseases of major concern in human health, including cardiovascular diseases, dengue, HIV infection, sepsis, and cancer.

Burden and quality of life in caregivers of patients with amputated diabetic foot.

Informal caregivers of chronically ill patients often report burden and poor quality of life. This study aimed to evaluate the impact of caring on caregivers of amputated patients with type 2 diabetes and diabetic foot. A cross-sectional study included a convenience sample of 110 caregivers who answered: the Burden Assessment Scale, the Depression Anxiety Stress Scales, the Social Support Satisfaction Scale, the Family Assessment Device, and the Short Form Health Survey. Multiple linear hierarchical regressions were performed to identify the variables that contributed to the burden and the physical and mental quality of life. Differences in burden as well as physical and mental quality of life were found, according to several caregivers' sociodemographic characteristics. Lower social support, more distress, and caregiver's perception of the impact of caring on the family dynamics contributed to burden. Lower distress and not having a chronic illness besides diabetes explained the physical quality of life whereas exercise and lower distress explained mental quality of life. To promote quality of life in caregivers and reduce the burden associated with caregiving, interventions should focus on social support, distress, and the practice of exercise.

Human polyomaviruses 10 and 11 in faecal samples from Brazilian children.

The human polyomaviruses (HPyVs) 10 and 11 have been detected in faecal material and are tentatively associated with diarrhoeal disease. However, to date, there are insufficient data to confirm or rule out this association, or even to provide basic information about these viruses, such as how they are distributed in the population, the persistence sites and their pathogenesis. In this study, we analysed stool specimens from Brazilian children with and without acute diarrhoea to investigate the excretion of HPyV10 and HPyV11 as well as their possible associations with diarrhoea. A total of 460 stool specimens were obtained from children with acute diarrhoea of unknown aetiology, and 106 stool specimens were obtained from healthy asymptomatic children under 10 years old. Samples were collected during the periods of 1999-2006, 2010-2012 and 2016-2017, and found previously to be negative for other enteric viruses and bacteria. The specimens were screened for HPyV10 and HPyV11 DNA by the polymerase chain reaction (PCR). Randomly selected positive samples were sequenced to confirm the presence of HPyV10 and HPyV11. The sequenced strains showed a percent of nucleotide identity of 93.4-99.6% and 85.5-98.9% with the reference HPyV10 and HPyV11 strains, respectively, confirming the PCR results. HPyV10 and HPyV11 were detected in 7.2% and 4.7% of the stool specimens from children with and without diarrhoea, respectively. The prevalence of both viruses was the same among children with diarrhoea and healthy children. There was also no difference between boys and girls or the degree of disease (severe, moderate or mild) among groups. Phylogenetic analysis showed that all of the genotypes described so far for HPyV10 and HPyV11 circulate in Rio de Janeiro. Our results do not support an association between HPyV10 and HPyV11 in stool samples and paediatric gastroenteritis. Nevertheless, the excretion of HPyV10 and HPyV11 in faeces indicates that faecal-oral transmission is possible.

[Intersectoral approach to obesity prevention and control: the Brazilian experience from 2014 to 2018Enfoque intersectorial para la prevención y el control de la obesidad: la experiencia de Brasil en el período 2014-2018]. / Abordagem intersetorial para prevenção e controle da obesidade: a experiência brasileira de 2014 a 2018.

The present article aims to describe and discuss the actions implemented from 2014 to 2018 at the federal level in the context of the Intersectoral Strategy to Prevent and Control Obesity issued by the Brazilian federal government. The goal of the Intersectoral Strategy is to prevent and control obesity based on six action plans: 1) availability and access to adequate and healthy foods; 2) education, communication, and information; 3) promotion of healthy lifestyles in specific environments/territories; 4) food and nutrition surveillance; 5) comprehensive care for individuals presenting obesity in the health care network; and 6) regulation and control of the quality and harmlessness of food. To gather information, semi-structured questionnaires were submitted to representatives from the ministries of Education, Health, Planning, Citizenship, and Agrarian Development. The actions implemented in the period were described in terms of the six action plans. Positive results were achieved through the shared management model adopted, even though many challenges still remain. The agenda for action proposed in the Intersectoral Strategy is attuned to the Brazilian context, and intersectoral management was still in place until the writing of the present article.

El objetivo del presente artículo es describir las actividades realizadas a nivel federal en el período 2014-2018 dentro del marco de la estrategia intersectorial de prevención y control de la Obesidad, publicada por el Gobierno Federal de Brasil, y hacer algunos comentarios pertinentes. La estrategia tiene por objetivo prevenir y controlar la obesidad y se ha organizado en seis grandes ejes de acción: 1) disponibilidad de alimentos adecuados y saludables y acceso a los mismos; 2) educación, comunicación e información; 3) promoción de estilos de vida saludables en entornos y territorios específicos; 4) vigilancia alimentaria y nutricional; 5) atención integral a la salud de las personas con sobrepeso y obesidad en la red asistencial, y 6) regulación y control de la calidad y la inocuidad de los alimentos. Para recopilar información se enviaron cuestionarios semiestructurados a representantes de los Ministerios de Educación, Salud, Planificación, Ciudadanía y Desarrollo Agrario. Las actividades realizadas se presentan según los ejes de acción de la estrategia. Se lograron resultados positivos a partir del modelo de coordinación adoptado, con gestión compartida, aunque fue preciso superar varios desafíos. El programa de trabajo sobre los ejes de acción propuestos en la estrategia está en consonancia con el contexto brasileño y el modelo intersectorial de gestión permaneció vigente hasta el momento de preparación de este artículo.

Predictors of the Number of Installs in Psychiatry Smartphone Apps: Systematic Search on App Stores and Content Analysis.

BACKGROUND: Mental health is integral to our salubrity, but mental disorders are very debilitating and common. Therefore, it is critical to provide accessible, timely, and inexpensive mental care. This can be done through mobile health (mHealth), namely, mobile medical apps, which are gaining popularity among clinicians and patients. mHealth is a fast-paced field, and there is significant variation in the number of installs among psychiatry apps. However, the factors that influence psychiatry app installs have yet to be studied. OBJECTIVE: This study aimed to identify predictors of the number of app installs in psychiatry. METHODS: A literature review identified which factors influence app installs. Psychiatry apps available in the Google Play Store were reviewed, and publicly available data were collected. A multivariate ordinal logistic regression analysis was performed to evaluate the effect of said factors on the number of installs. RESULTS: Our search identified 128 psychiatry apps: 2.3% (3/128) had never been installed, approximately half (53.1%, 68/128) had less than 500 installs, and only 0.8% (1/128) had over 10,000,000 installs. A multivariate logistic regression analysis identified that apps with a lower price (P<.001), a higher rating (P<.001), optional in-app purchases (P<.001), and age restriction (P=.04) had a higher number of installs. The involvement of a psychiatrist or other health care professional (HCP) had no statistically significant influence on the number of installs. Only data from the Google Play Store and the developers' websites were available for analysis, and the depth of involvement of HCPs was impossible to document. CONCLUSIONS: Psychiatry apps with a lower price, optional in-app purchases, age restriction, and a higher rating are expected to have a higher number of installs. Unlike other medical fields, in this study, the explicit participation of psychiatrists in app development was not a significant predictor of the number of installs. Research is needed to identify other factors that may influence the number of installs, as that can help mHealth app development.

Avaliação da medida central da pressão e rigidez arterial em participantes de caminhada de longa distância / Assessment of central Blood pressure and arterial stiffness in practicing long-distance walking race

Fundamento: A Caminhada Ecológica que ocorre anualmente no Brasil, é um evento único por sua distância (310 Km) e dinâmica de realização (média de 62 km/dia por 5 dias, com ritmo médio de 7,6 km/h). Embora os efeitos benéficos de exercícios de intensidade moderada sejam bem conhecidos, os efeitos do exercício intenso e de longa duração ainda requerem estudo. Objetivo: Avaliar os efeitos da modalidade mista caminhada/corrida em vários parâmetros de pressão arterial (PA) 30 dias antes (A0) do evento, e ao final dos dias 2 (A2), 3 (A3) e 4 (A4) da caminhada. Métodos: Foram medidas PA sistólica e diastólica central (cPAS e cPAD, respectivamente), PA sistólica e diastólica periférica (pPAS e pPAD, respectivamente), pressão de pulso central (cPP), pressão de pulso periférica (pPP), pressão de pulso amplificada (aPP), augmentation index ajustado (AIx75%) e velocidade da onda de pulso (VOP) com Mobil-O-Graph ® (IEM, Stolberg, Alemanha) em 25 atletas do sexo masculino (idade média, 45,3 ± 9,1 anos). Foi considerado significativo valor de p < 0,05. Resultados: Houve redução de cPAS de A0 para A2 (109,5 para 118,1 mmHg) e de A0 para A3 (109,5 para 102,5 mmHg); redução de pPP de A0 para A2 (49,2 para 38,2 mmHg) e de A0 para A4 (49,2 para 41,2 mmHg); redução de aPP de A0 para A1 (15,6 para 9,5 mmHg), de A0 para A2 (15,6 para 8,0 mmHg) e de A0 para A3 (15,6 para 11,2 mmHg). VOP correlacionou-se com idade. Conclusões: A PA caiu nos primeiros dias da caminhada de longa distância, retornando a níveis próximos aos basais no final, e a VOP correlacionou-se fortemente com idade. Esse tipo de exercício promove efeitos na PA e na VOP similares aos vistos em esportes de longa duração e alta intensidade. Tais mudanças em indivíduos saudáveis e treinados não parecem aumentar os riscos cardiovasculares. Este foi o primeiro estudo a avaliar os efeitos desse tipo de exercício no sistema cardiovascular

Background: An ecological hiking occurs yearly in Brazil. It is a unique event because of its distance (310 km) and dynamics (mean of 62 km/day for 5 days with mean pace of 7.6 km/h). Although beneficial effects of moderate-intensity exercises are well-known, the effects of intense and long-duration exercise still require study. Objective: To evaluate the effects of mixed walking/running race on various blood pressure (BP) parameters 30 days before (A0), on the 2 nd (A2), 3 rd (A3), and 4 th (A4) days after completing the day's stage. Methods: Central systolic (cSBP) and diastolic BP (cDBP), peripheral systolic (pSBP) and diastolic BP (pDBP), central pulse pressure (cPP), peripheral pulse pressure (pPP), amplified pulse pressure (aPP), corrected augmentation index (AIx75%) and pulse wave velocity (PWV) were measured using an oscillometric Mobil-O-Graph ® (IEM, Stolberg, Germany) in 25 male athletes (mean age of 45.3 ± 9.1 years). A p value < 0.05 was considered a statistically-significant difference. Results: cSBP decreased from A0 to A2 (109.5 to 118.1 mmHg) and from A0 to A3 (109.5 to 102.5 mmHg); pPP decrease from A0 to A2 (49.2 to 38.2 mmHg) and from A0 to A4 (49.2 to 41.2 mmHg); aPP decrease from A0 to A1 (15.6 to 9.5 mmHg), from A0 to A2 (15.6 to 8.0 mmHg) and from A0 to A3 (15.6 to 11.2 mmHg). PWV correlated with age. Conclusions: Blood pressure dropped on the first days of the race and returned to close to baseline values at the end. PWV correlates strongly with age. This type of exercise promotes effects on BP and PWV similar to those seen in long-duration, high-intensity sports. These changes in trained healthy individuals do not seem to increase cardiovascular risks. This was the first study to assess the effects of this type of exercise on the cardiovascular system

BREAST NECROSIS IN A CHRONIC USER OF WARFARIN / Necrose mamária em usuária crônica de varfarina

Warfarin-induced skin necrosis is a rare event that generally happens within the first days of warfarin use and is due to the initial, and transitory, prothrombotic state caused by unbalanced pro and anticoagulant factors. We describe the first case of breast necrosis in a 50-year-old woman, who uses warfarin chronically, and had its anticoagulant effect enhanced by the concomitant use of diclofenac.

A necrose cutânea induzida por varfarina é um evento raro, que geralmente ocorre nos primeiros dias de uso dessa medicação, sendo atribuída ao provável efeito inicial pró-trombótico causado pelo desbalanço transitório entre fatores pró e anticoagulantes. É descrito o primeiro caso de necrose mamária em uma mulher de 50 anos usuária crônica de varfarina, a qual teve seu efeito anticoagulante potencializado pelo uso concomitante de diclofenaco sódico.

Biofilms of Candida spp. from the ocular conjunctiva of horses with reduced azole susceptibility: a complicating factor for the treatment of keratomycosis?

OBJECTIVES: This study aimed to assess the biofilm-forming ability of Candida spp. from the ocular conjunctiva of horses and to investigate the antifungal susceptibility of these biofilms. PROCEDURES: Initially, the biofilm-forming ability of 15 strains was assessed by crystal violet staining, which reveals the fungal biomass adhered to the polystyrene plates, and scanning electron microscopy. Then, the minimum inhibitory concentrations (MICs) of amphotericin B, fluconazole, itraconazole, and caspofungin were initially determined against strains in planktonic form. Afterward, antifungal susceptibility of mature biofilms was evaluated by exposing them to 10 × MIC and 50 × MIC of the tested drugs, followed by the assessment of their metabolic activity, using the oxidoreduction indicator XTT. Results were analyzed through ANOVA and Tukey's post-test, and P-values below 5% led to significant conclusions. RESULTS: Eight strains produced biofilms and were classified as strong (1/15), moderate (3/15) and weak (4/15) producers, according to the amount of crystal violet retained by the adhered fungal biomass. Biofilm metabolic activity of one C. tropicalis did not decrease after exposure to the tested antifungals, while biofilm metabolic activity of five strains was reduced by amphotericin B, but not the other drugs. One C. parapsilosis sensu stricto and one C. glabrata showed significant reduction in biofilm metabolic activity after exposure to fluconazole, itraconazole, and caspofungin, but not amphotericin B. CONCLUSIONS: The results demonstrate that Candida from the ocular conjunctiva of horses can pose as a risk to animal health as they are capable of forming biofilms, which are commonly involved in fungal keratitis.