High silent prevalence of human herpesvirus 1 (HSV-1) infection affecting the indigenous reservation of the municipality of Dourados, Central-West Brazil.

BACKGROUND: The indigenous population located in the central region of Brazil, is the second largest in terms of population size in the country. The Indigenous Reserve of Dourados has risk factors that increase the vulnerability of the indigenous population to infectious diseases, especially Human alphaherpesvirus (HSV-1), a neglected disease with high prevalence in priority populations in developing countries. The virus can also cause many more severe diseases, including widespread neonatal infections, herpetic keratitis, and herpes encephalitis, which can be fatal if left untreated. We estimated the prevalence of anti-HSV-1 antibodies and correlated it with the demographic and behavioral characteristics of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). METHODS: Our approach was cross-sectional. From March 2017 to November 2018. Using anti-HSV-1 (Gg1) IgM and anti-HSV-1 (gG1) IgG Euroimmun and the detection and quantification of HSV-1 viral load in plasma samples, through real-time PCR. The maps were constructed using QGIS and the statistical analyses using R Studio software. RESULTS: A total of 1138 individuals (> 18 years old) were enrolled. The prevalence of anti-HSV-1 IgM and IgG were 20% and 97.5%, respectively. The prevalence of anti-HSV-1 antibodies for IgG was higher in both sexes. Anti-HSV-1 IgM antibodies were present in 17.1%, 21.2%, 12.5%, and 22% of the participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. Real-time PCR was used for confirmatory testing; HSV-1 DNA was detected in 25.6% (54/211) of anti-HSV1 IgM-positive samples. Viral loads ranged from 5.99E + 02 to 3.36E + 13. CONCLUSIONS: The seroprevalence of HSV-1 IgM and detection of HSV-1 DNA in the Indigenous population confirmed high silent prevalence. Furthermore, the seroprevalence of HSV-1 in the Indigenous population was higher than that reported in the general adult Brazilian population. Various socioeconomic factors, drug use, and health and sexual behaviors could contribute to the facilitation of HSV-1 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health access barriers and improve the implementation of public health policies aimed at promoting information regarding the prevention, treatment, and control of HSV-1 infection in Brazilian Indigenous populations.

Safety and Pharmacokinetics of a Combined Antioxidant Therapy against Myocardial Reperfusion Injury: A Phase 1 Randomized Clinical Trial in Healthy Humans.

Myocardial reperfusion injury (MRI) accounts for up to 50% of the final size in acute myocardial infarction and other conditions associated with ischemia-reperfusion. Currently, there is still no therapy to prevent MRI, but it is well known that oxidative stress has a key role in its mechanism. We previously reduced MRI in rats through a combined antioxidant therapy (CAT) of ascorbic acid, N-acetylcysteine, and deferoxamine. This study determines the safety and pharmacokinetics of CAT in a Phase I clinical trial. Healthy subjects (n = 18) were randomized 2:1 to CAT or placebo (NaCl 0.9% i.v.). Two different doses/infusion rates of CATs were tested in a single 90-minute intravenous infusion. Blood samples were collected at specific times for 180 minutes to measure plasma drug concentrations (ascorbic acid, N-acetylcysteine, and deferoxamine) and oxidative stress biomarkers. Adverse events were registered during infusion and followed for 30 days. Both CAT1 and CAT2 significantly increased the CAT drug concentrations compared to placebo (P < .05). Most of the pharmacokinetic parameters were similar between CAT1 and CAT2. In total, 6 adverse events were reported, all nonserious and observed in CAT1. The ferric-reducing ability of plasma (an antioxidant biomarker) increased in both CAT groups compared to placebo (P < .001). The CAT is safe in humans and a potential treatment for patients with acute myocardial infarction undergoing reperfusion therapy.

Epidemiological Survey of Human Alphaherpesvirus 2 (HSV-2) Infection in Indigenous People of Dourados Municipality, Central Brazil.

Sexually transmitted Human alphaherpesvirus 2 (HSV-2) causes genital ulcers, especially among sexually active adolescents and adults. We estimated the exact prevalence of anti-HSV-2 antibodies and correlated it with the demographic and behavioral aspects of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). In total, 1360 individuals (>18 years old) were administered serologic tests. The prevalence of anti-HSV-2 IgM was 12.9%, that of anti-HSV-2 IgG was 57.2%, and 8.5% cases tested positive for both HSV-2 IgM and IgG. The prevalence of anti-HSV-2 antibodies was higher in females (59.5%) compared to males (49%), with an OR of 0.64 (0.49-0.83). Anti-HSV-2 antibodies were found in 14.2%, 12.3%, 15.4%, and 14.5% of participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. In summary, the seroprevalence of HSV-2 in the Indigenous population was five times higher than that reported in the general adult Brazilian population. Educational level, income level, smoking, condom use, incarceration, illicit drug abuse, the sharing of used needles and syringes without adequate disinfection, homosexual relationships, prostitution, the sexual practices among drug users, and avoidance of contraceptive methods could contribute to the facilitation of HSV-2 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health-access barriers and improve the implementation of public health policies aimed at promoting information regarding and preventing, treating, and controlling HSV-2 infection in Brazilian Indigenous populations.

Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020.

OBJECTIVE: To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS: A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS: Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4-17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6-20.6) and state (16.2%; 95%CI 14.4-18.2) public school systems compared to the private school system (11.7; 95%CI 10.0-13.7), among black and brown students (18.4%; 95%CI 16.8-20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9-20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION: Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.

Trypanosoma cruzi strains in the Calomys callosus: parasitemia and reaction of intracellular forms with stage-specific antibodies in the acute and chronic phase of infection and after immunosuppression.

An experimental model for chronic Chagas disease was developed to investigate whether reactivation is influenced by the genetic origin of Trypanosoma cruzi isolates. In addition, we examined whether the distribution of T. cruzi stage-specific epitopes, as defined by monoclonal antibodies (Mab), raised against mammalian-stage parasite forms, exhibited comparable distribution patterns in Calomys callosus myocardium during the acute phase and after reactivation of the infection. Animals were infected with parasites of the G (T. cruzi I), Y (T.cruzi II) or CL strains (T. cruzi VI). Heart sections were labelled with the Mabs 2C2, 1D9, 2B7, 3B9 and 4B9, which react with carbohydrate epitopes on Ssp-4, a major amastigote surface glycoprotein. Mab 1D9 and 2B7 showed polymorphic distributions over amastigotes among animals infected with the G, Y or CL strains. Mab 3B2, which recognises a non-carbohydrate epitope in flagellated forms, showed an active state of parasite dissemination in the myocardium of C. callosus that were infected with Y or CL strains and then immunosuppressed after 6 or 12 months. C. callosus infected with the G strain (T. cruzi I) displayed absence of amastigote nests in the heart after immunosuppression. Our results permit us to suggest that parasites of the G strain may be more sensitive to the immune response, since we could not find either evidence of parasitemia or amastigote nests. Conversely, parasites from the Y and CL strains appeared able to escape the immune response, as evidenced by an inflammatory infiltrate and disseminated infection after immunosuppression.

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020-2021.

OBJECTIVE: To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS: This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS: In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9-11.8%) to 25.0% (95%CI: 21.7-28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION: The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

Perceived stress in workers of Emergency Care Units in Palmas, Tocantins.

BACKGROUND: Emergency Care Units are environments susceptible to occupational stress that can lead its staff members to illness. OBJECTIVE: The objective of this study was to identify the levels of perceived stress in professionals who work in Emergency Care Units in the municipality of Palmas, state of Tocantins. METHODS: This was a cross-sectional study conducted with 165 health care professionals working in Emergency Care Units. A structured questionnaire containing sociodemographic and economic aspects and the Perceived Stress Scale (EPS-10) were used. RESULTS: The levels of perceived stress were identified in the 3 groups evaluated, and were more frequent among professionals with higher education, with an average of 17.8. There was a predominance of women (64.9%), 84.2% of the participants were public servants, 52.7% worked for longer than 12 hours, and 59.3% had an average income between R$ 790,00 and R$ 5.000,00. CONCLUSION: Professionals who work in the Emergency Care Units are under stress conditions. Health preventive and promotion measures should be developed and promoted to minimize this reality.

Consensus Recommendations of the Multiple Sclerosis Study Group and the Portuguese Neuroradiological Society for the Use of Magnetic Resonance Imaging in Multiple Sclerosis in Clinical Practice: Part 2.

INTRODUCTION: Magnetic resonance imaging is recognized as the most important diagnostic test in the diagnosis of multiple sclerosis, differential diagnosis and evaluation of progression/therapeutic response. However, to make optimal use of magnetic resonance imaging in multiple sclerosis, the use of a standard, reproducible and comparable imaging protocol is of uttermost importance. In this context, the Portuguese Society of Neuroradiology and the Group of Studies of Multiple Sclerosis, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. This document represents the second part of the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice. MATERIAL AND METHODS: The Portuguese Society of Neuroradiology and the Group of Studies of Multiple Sclerosis, after discussing the topic in national meetings and after a working group meeting held in Figueira da Foz, May 2017, appointed a committee of experts that have developed several standard protocols on the use of magnetic resonance imaging on multiple sclerosis by consensus. The document obtained was based on the best scientific evidence and expert opinion. Portuguese multiple sclerosis consultants and departments of neuroradiology scrutinized and reviewed the consensus paper; comments and suggestions were considered. Standardized strategies of magnetic resonance imaging referral in clinical practice for diagnosis and follow-up of multiple sclerosis were published in the first part of this paper. RESULTS: We provide magnetic resonance imaging acquisition protocols regarding multiple sclerosis diagnostic and monitoring and the information to be included in the report for application across Portuguese healthcare institutions. CONCLUSION: We hope that these first Portuguese magnetic resonance imaging guidelines will contribute to optimize multiple sclerosis management and improve patient care in Portugal.

Introdução: A ressonância magnética é considerada o exame complementar mais importante para o diagnóstico de esclerose múltipla, seus diagnósticos diferenciais e avaliação da sua progressão/resposta terapêutica. No entanto, para um uso ótimo desta ferramenta na esclerose múltipla, é essencial a aplicação de um protocolo de imagem padronizado, reprodutível e comparável. Neste contexto, o Grupo de Estudos de Esclerose Múltipla e a Sociedade Portuguesa de Neurorradiologia, após discussão conjunta, designaram um comité de peritos para a criação de recomendações adaptadas à realidade nacional sobre a utilização da ressonância magnética na esclerose múltipla. Este documento corresponde à segunda parte das primeiras recomendações de consenso portuguesas sobre a utilização da ressonância magnética na esclerose múltipla na prática clínica. Material e Métodos: O Grupo de Estudos de Esclerose Múltipla e a Sociedade Portuguesa de Neurorradiologia após discussão do tema em reuniões de âmbito nacional e de uma reunião do grupo de trabalho que teve lugar na Figueira da Foz em maio de 2017, designaram um comité de peritos que elaboraram por método de consenso protocolos padronizados sobre o uso da ressonância magnética na esclerose múltipla. O documento teve como base a melhor evidência científica e a opinião dos peritos. Posteriormente, o documento foi enviado para escrutínio à maioria dos responsáveis de consulta de esclerose múltipla e dos departamentos de neurorradiologia; tendo sido considerados os seus comentários e sugestões. As estratégias padronizadas de referenciação imagiológica na prática clínica para o diagnóstico e seguimento da esclerose múltipla foram publicadas na primeira parte deste artigo. Resultados: Neste artigo são propostos os protocolos de aquisição de ressonância magnética adequados para o diagnóstico e monitorização da esclerose múltipla, bem como a informação a constar do relatório imagiológico, tendo em vista a sua aplicação nas várias instituições de saúde portuguesas. Conclusão: Os autores esperam que estas primeiras orientações portuguesas sobre a utilização da ressonância magnética na esclerose múltipla na prática clínica contribuam para otimizar a gestão desta patologia e melhorar o tratamento destes doentes em Portugal.

Host cell actin remodeling in response to Trypanosoma cruzi: trypomastigote versus amastigote entry.

Trypanosoma cruzi is the protozoan parasite that causes Chagas' disease, a highly prevalent vector-borne disease in Latin America. Chagas' disease is a major public health problem in endemic regions with an estimated 18 million people are infected with T. cruzi and another 100 million at risk (http://www.who.int/ctd/chagas/disease.htm). During its life cycle, T. cruzi alternates between triatomine insect vectors and mammalian hosts. While feeding on host's blood, infected triatomines release in their feces highly motile and infective metacyclic trypomastigotes that may initiate infection. Metacyclic trypomastigotes promptly invade host cells (including gastric mucosa) and once free in the cytoplasm, differentiate into amastigotes that replicate by binary fission. Just before disruption of the parasite-laden cell, amastigotes differentiate back into trypomastigotes which are then released into the tissue spaces and access the circulation. Circulating trypomastigotes that disseminate the infection in the mammalian host may be taken up by feeding triatomines and may also transform, extracellularly, into amastigote-like forms. Unlike their intracellular counterparts, these amastigote-like forms, henceforth called amastigotes, are capable of infecting host cells. Studies in which the mechanisms of amastigote invasion of host cells have been compared to metacyclic trypomastigote entry have revealed interesting differences regarding the involvement of the target cell actin microfilament system.

Assistência do enfermeiro no aleitamento materno: uma revisão de literatura / Nurse assistance in breastfeeding: a literature review / Asistencia de enfermería en la lactancia materna: revisión bibliográfica

Introdução: O leite materno e uma importante fonte de nutrição o mesmo possui as substâncias adequadas para suprir todas as necessidades do bebê. Além de nutritivo, o leite materno protege contra infecções, evita a desnutrição, reduz a morbidade por diarreia, infecções respiratórias, previne episódios de otite média, asma dentre outros. O aleitamento materno exclusivo deve ser preconizado até os 6 meses de vida, sendo recomenda a continuação da amamentação pelo menos até o segundo aniversário da criança. Neste contexto, a assistência do enfermeiro é de fundamental importância pois o mesmo possui as habilidades necessárias para dar suporte nessa fase tão importante. Objetivos: os objetivos deste estudo foram demonstrar as principais características do Leite Materno, os benefícios da amamentação e demonstrar o papel do enfermeiro neste contexto. Método: Esta pesquisa foi desenvolvida a partir de uma revisão integrativa da literatura. Resultados; os dados obtidos a partir desta revisão demonstraram que a assistência do enfermeiro no contexto do aleitamento materno se dá principalmente através da consulta de enfermagem, onde o mesmo presta os cuidados necessários para minimizar os possíveis prejuízos para o binômio mãe e filho, por meio de orientações e desenvolvimento de ações que visam promover e incentivar o aleitamento. Conclusão: conclui-se que o enfermeiro é um profissional impar dentro da atenção prestada, sua atua extremamente indispensável em todas as etapas envolvidas no aleitamento materno.

Introduction: Breast milk is an important source of nutrition and has the appropriate substances to meet all the baby's needs. In addition to being nutritious, breast milk protects against infections, prevents malnutrition, reduces morbidity due to diarrhea, respiratory infections, and prevents episodes of otitis media and asthma, among others. Exclusive breastfeeding should be recommended until the child is six months old, and continued breastfeeding is recommended until at least the child's second birthday. In this context, the nurse's assistance is of fundamental importance, since he/she has the necessary skills to provide support in this very important phase. Objectives: The objectives of this study were to demonstrate the main characteristics of breast milk, the benefits of breastfeeding, and to show the nurse's role in this context. Method: This research was developed from an integrative literature review. Results: The data obtained from this review showed that the nurse's assistance in the context of breastfeeding occurs mainly through the nursing consultation, where the nurse provides the necessary care to minimize possible damage to the mother and child, through guidance and development of actions aimed at promoting and encouraging breastfeeding. Conclusion: it is concluded that the nurse is a unique professional in the care provided, and his/her actions are extremely indispensable in all the stages involved in breastfeeding.

Introducción: La leche materna es una importante fuente de nutrición y posee las sustancias adecuadas para satisfacer todas las necesidades del bebé. Además de ser nutritiva, la leche materna protege frente a infecciones, previene la desnutrición, reduce la morbilidad por diarrea, infecciones respiratorias, previene episodios de otitis media y asma entre otros. La lactancia materna exclusiva debe recomendarse hasta los seis meses de edad, y la lactancia materna continuada al menos hasta que el niño cumpla dos años. En este contexto, la asistencia de la enfermera es de fundamental importancia, ya que tiene las habilidades necesarias para proporcionar apoyo en esta fase tan importante. Objetivos: Los objetivos de este estudio fueron demostrar las principales características de la leche materna, los beneficios de la lactancia materna y mostrar el papel de las enfermeras en este contexto. Método: Esta investigación se desarrolló a partir de una revisión bibliográfica integradora. Resultados: los datos obtenidos a partir de esta revisión demuestran que la asistencia del enfermero en el contexto de la lactancia materna se hace principalmente a través de la consulta de enfermería, donde presta los cuidados necesarios para minimizar los posibles perjuicios para el binomio madre e hijo, mediante orientaciones y desarrollo de acciones que buscan promover e incentivar la lactancia. Conclusión: se concluye que la enfermera es una profesional imparcial en los cuidados prestados, y su actuación es sumamente imprescindible en todas las etapas que conlleva la lactancia materna.

Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020 / Soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares no município de São Paulo, 2020

ABSTRACT OBJECTIVE To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4-17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6-20.6) and state (16.2%; 95%CI 14.4-18.2) public school systems compared to the private school system (11.7; 95%CI 10.0-13.7), among black and brown students (18.4%; 95%CI 16.8-20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9-20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.

RESUMO OBJETIVO Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4-17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6-20,6) e estadual (16,2%; IC95% 14,4-18,2) em relação à rede privada (11,7; IC95% 10,0-13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8-20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9-20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal.

Distribution of Trypanosoma cruzi stage-specific epitopes in cardiac muscle of Calomys callosus, BALB/c mice, and cultured cells infected with different infective forms.

To examine whether distinct parasite infective forms or the mammalian host could affect the distribution of Trypanosoma cruzi stage-specific epitopes defined by monoclonal antibodies (Mabs) raised against mammalian-stage parasite forms, immunofluorescence studies followed the intracellular life cycle of the parasite in the cardiac muscle of Calomys callosus and BALB/c mice in the acute phase of the disease and in LLC-MK(2) cultured cells. Animals and cells were infected either with tissue-culture derived trypomastigotes (TCT) or bloodstream trypomastigotes (BT) from the Y strain of T. cruzi. Samples were examined under confocal fluorescence microscopy after labeling with Mabs 2C2, 1D9, 2B7, 3G8, 3B9, and 4B9 that react with carbohydrate epitopes on Ssp-4, a major amastigote surface glycoprotein; Mab 4B5 that identifies a noncarbohydrate epitope on all intracellular parasites stages, and Mab 3B2 that also recognizes a noncarbohydrate epitope expressed only in flagellated forms. Samples were double labeled with DAPI to visualize parasites' kinetoplasts and nuclei. Most of the Mabs used in this work displayed a surface labeling pattern on amastigotes present in Calomys and mice hearts, and in LLC-MK(2) cultured cells infected with BT or TCT. Mab 2B7, however, displayed a marked polymorphic distribution in antigen expression between both mammalian hosts, independent on the infective form. Beyond the polymorphic distribution of amastigote surface epitopes, Calomys, and mice heart sections presented several inflammatory cells around amastigotes and trypomastigotes nests.

Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers.

OBJECTIVES: To assess nutritional iron status and anemia prevalence in children less than 5 years old at public daycare centers in the city of Recife, PE, Brazil. METHODS: A cross-sectional study, with a systematic random sampling of 162 children aged 6 to 59 months. Nutritional iron status was assessed in terms of body iron reserves (serum ferritin), transferrinemia (serum iron, total iron binding capacity, and transferrin saturation %), erythropoiesis (free erythrocyte protoporphyrin) and hemoglobin production (hemoglobin). RESULTS: The prevalence of anemia (hemoglobin < 11.0 g/dL) was 55.6% (95%CI 47.3-63.5), evidence was found of depleted iron stocks (serum ferritin < 12.0 ng/mL) in 30.8% (95%CI 22.9-39.3), low transferrinemia levels (transferrin saturation % < 16) in 60.1% (95%CI 51.7-68.0) and deficient erythropoiesis (free erythrocyte protoporphyrin > 40 micromol/mol heme) in 69.6% (95%CI 61.0-77.1) of the children. Iron parameters were not correlated with sex (p > 0.05). However, children < 24 months exhibited lower hemoglobin concentrations (p < 0.00) and higher levels of free erythrocyte protoporphyrin (p < 0.000) and total iron binding capacity (p < 0.001) when compared with children > 24 months. The significant correlation observed between reserves, transferrinemia and erythropoiesis is a finding that is compatible with the expected lifecycle of iron in the body. CONCLUSIONS: Iron deficiency and anemia appear to be an important public health problem among children less than 5 years old at public daycare centers in Recife. Therefore, effective actions aimed at the prevention and control of this deficiency are strongly recommended in this ecological context.

Da psicodinâmica à psicopatologia do trabalho no Brasil: (in)definições e possibilidades / De la psicodinámica a la psicopatología del trabajo em Brasil: (in)definiciónes y posibilidades / From psychodynamics to psychopathology of work in Brazil: (in)definitions and possibilities

RESUMO. O presente artigo analisou o estado da arte da psicopatologia do trabalho no Brasil, como objeto de pesquisa e como disciplina, a partir de revisão bibliográfica sistemática integrativa. Foi realizado levantamento em bases de dados virtuais utilizando os descritores 'psicopatologia do trabalho' e 'psicopatologia' (AND) 'trabalho'. Foram incluídos artigos disponibilizados integralmente em português publicados em revistas com revisão cega de pares contendo os descritores no título, resumo, palavras-chave e/ou corpo do texto. O conjunto final dos textos analisados se constituiu de 28 artigos publicados entre 1992 e 2019 majoritariamente em periódicos da psicologia com psicodinâmica do trabalho como referencial teórico e/ou metodológico. Foram ainda identificadas três tendências no uso do termo 'psicopatologia do trabalho' nos artigos: 1) psicopatologia do trabalho como objeto de estudo; 2) como disciplina; e 3) para debater as compreensões das relações entre trabalho e patologias e suas implicações na prática. Enquanto objeto de estudo, as relações entre trabalho e doença mental são negligenciadas. Como disciplina, identificaram-se imprecisões que flexibilizam ou ignoram os limites entre psicopatologia e psicodinâmica do trabalho. Ambas as tendências da literatura podem estar relacionadas com a desconsideração de fatores históricos na determinação da construção dos campos de estudo.

RESUMEN. El presente artículo analizó el estado del arte de la Psicopatología del Trabajo en Brasil, como objeto de investigación y como disciplina, a partir de revisión bibliográfica sistemática integrativa. Se realizó un levantamiento en bases de datos virtuales utilizando los descriptores 'psicopatología del trabajo' y 'psicopatología' (AND) 'trabajo'. Se incluyeron artículos disponibles integralmente en portugués publicados en revistas con revisión ciega de pares conteniendo los descriptores en el título, resumen, palabras clave y/o cuerpo del texto. El conjunto final de textos analizados se constituyó de 28 artículos publicados entre 1992 y 2019 mayoritariamente en periódicos de Psicología con Psicodinámica del Trabajo como referencial teórico y/o metodológico. Se identificaron tres tendencias en el uso del término 'psicopatología del trabajo' en los artículos: 1) psicopatología del trabajo como objeto de estudio; 2) como disciplina; y 3) para debatir las comprensiones de las relaciones entre trabajo y patologías y sus implicaciones en la práctica. En cuanto objeto de estudio, las relaciones entre el trabajo y la enfermedad mental son poco estudiadas. Como disciplina, se identificaron imprecisiones que flexibilizan o ignoran los límites entre Psicopatología y Psicodinámica del Trabajo. Ambas tendencias de la literatura pueden estar relacionadas con la desconsideración de factores históricos en la determinación de la construcción de los campos de estudio.

ABSTRACT. This article analyzed the state of the art of psychopathology of work in Brazil, as an object of study and as a subject, by performing an integrative systematic literature review. A search was conducted in virtual databases using the descriptors 'psychopathology of work' and 'psychopathology' (AND) 'work'. We included articles available in full in Portuguese, published in blind peer-reviewed journals containing the descriptors in the title, abstract, keywords and/or body of the text. The final set of texts consisted of 28 articles published between 1992 and 2019, mostly in psychology journals using psychodynamics of work as theoretical and/or methodological reference. Three trends were also identified in the use of the term 'psychopathology of work' in the articles: 1) psychopathology of work as an object of study; 2) as a subject; and 3) to discuss the understandings of the relationships between work and pathologies and their practical implications. As an object of study, the relationship between work and mental illness is neglected. As a subject, inaccuracies that flexibilize or ignore the limits between psychopathology of work and psychodynamics of work were identified. Both trends in the literature may be related to the lack of reflections that consider the Brazilian context to understand the relations between work and pathology.

Sensilla and secretory glands in the antennae of a primitive ant: Dinoponera lucida (Formicidae: Ponerinae).

Morphology of the antennae of the female workers of the ponerine ant Dinoponera lucida was examined by light and scanning electron microscopy. In several antennomers, we found secretory gland cells of class I and III. Class III gland cells release their secretion through single pores in the antennal surface, whereas class I secretory cells are seen as tall epidermal cells close to the cuticle. Both gland types have weak reaction for total proteins and neutral polysaccharides. Six distinct sensilla types were observed: trichodea, chaetica, campaniform, basiconica, placodea, and coeloconica. The possible sensory functions of these sensilla and the gland functions are discussed.

Effects of risk factors in the likelihood of breast cancer subtypes in Brazilian women / Efeitos de fatores de risco na probabilidade de subtipos do câncer de mama em mulheres brasileiras

INTRODUCTION: Breast cancer is a heterogenous disease with multiple causes and it lacks more investigation related to its risk factors. OBJECTIVE: To evaluate the likelihood of breast cancer subtypes according to the positivity to estrogen and progesterone receptors (ER+ and PR+ respectively), with or without the expression HER2, related to the following risk factors: age, parity, diabetes mellitus, arterial hypertension, occurrence of familiar cancer case and body mass index (BMI). METHODS: The sample with 79 individuals was divided into three subtypes 1 (ER+/PR-), 2 (ER+/PR+) and 3 (RE+/RP+/HER+) and then analyzed by quantitative methods using Ordinal Generalized Linear Models (OGLM) for estimating the marginal effects of risk factors for the studied subtypes, and modeling the heteroscedasticity in terms of error. RESULTS: It were observed the following statistically significant positive effects: (1) age for the tumoral subtype 1 (ER+/PR-) and (2) parity for the subtype 2 (ER+/PR+); while the significant negative effects were: (1) age for subtype 3 (ER+/PR+/HER2+); (2) parity for both 1 (ER+/PR-) and 3 (ER+/PR+/HER2+) subtypes; and arterial hypertension for subtype 1 (ER+/PR-). There were no statistically significant effects for BMI, Diabetes mellitus and occurrence of familiar cancer variables on the studied tumoral subtypes. CONCLUSION: The risk factos age and parity demonstrated varied effects for the breast cancer subtypes according the expression of estrogen, progesterone and HER2 receptors.

INTRODUÇÃO: O câncer de mama é uma doença heterogênea, multifatorial e que necessita de mais estudos relacionados aos fatores de riscos. OBJETIVO: Analisar a probabilidade dos subtipos tumorais do câncer de mama receptores de estrogênio (RE) ou progesterona (RP) positivos, com ou sem expressão de HER2, em relação aos fatores de risco: idade, parto, diabetes mellitus, hipertensão arterial, ocorrência de câncer de mama familiar e índice de massa corporal (IMC). MÉTODOS: A análise da amostra de 79 pacientes dividida nos subtipos 1 (RE+/RP-), 2 (RE+/RP+) e 3 (RE+/RP+/HER+), foi feita por meio de métodos quantitativos usando o Modelo Linear Generalizado Ordinal (MLGO) para estimar os efeitos marginais dos fatores de risco para os subtipos estudados, e ao mesmo tempo modelando a heterocedasticidade do termo de erro. RESULTADOS: Nos resultados foram observados os seguintes efeitos positivos estatisticamente significantes: (1) da idade para o subtipo tumoral 1 (RE+/RP-) e (2) do número de partos para o subtipo 2 (RE+/RP+); enquanto os efeitos negativos significativos foram os seguintes: (1) da idade para o subtipo 3 (RE+/RP+/HER2+); (2) do número de partos para o sutipos 1 (RE+/RP) e 3 (RE+/RP+/HER2+); e da hipertensão arterial para o o subtipo 1 (RE+/RP-). Não foram observados efeitos estatisticamente significativos das variáveis IMC, Diabetes mellitus e ocorrência de câncer de mama familiar sobre os subtipos tumorais estudados. CONCLUSÃO: Os fatores de risco idade e número de partos têm efeitos variados para os subtipos do câncer de mama segundo a expressão de receptores para estrogênio, progesterona e HER2.

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020-2021

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9-11.8%) to 25.0% (95%CI: 21.7-28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

Peritrophic membrane protein in the larval stingless bee Melipona quadrifasciata anthidioides: immunolocalization of secretory sites.

The origin of the peritrophic membrane (PM) in bees is still a matter of debate. It is either of type I (synthesized by the entire midgut epithelium) or of type II (released from the anterior midgut end). The present study identified secretory sites of peritrophin-55 kDa, a PM protein in larvae of Melipona quadrifasciata anthidioides. Peritrophin-55 was isolated from PMs and was used for the production of a polyclonal antibody. Our study demonstrates the presence of peritrophin-55 in vesicles and on microvilli of digestive cells and in the PM. It suggests that the PM is of type-I, being specific for the larval phase of this stingless bee.

Carcinoma basocelular da pálpebra inferior com invasão do canalículo lacrimal e reconstrução com retalho de transposição e enxertia de mucosa oral / Basal cell carcinoma of the lower eyelid affecting the lacrimal canaliculus and reconstruction with transposition flap and oral mucosa graft

A pálpebra inferior é uma das regiões mais acometidas pelo carcinoma basocelular (CBC). Apresentamos uma opção de retalho da pele do canto interno com enxerto de mucosa oral para reconstrução palpebral após exérese de CBC acometendo aproximadamente 60% da pálpebra inferior e com comprometimento completo pelo tumor do canalículo lacrimal inferior. A utilização do retalho de transposição de pele do canto interno e enxertia de mucosa oral é segura. Apresentamos uma técnica reproduzível e com boa evolução no pós-operatório. O posicionamento e a movimentação palpebral foram restabelecidos, permitindo a drenagem da lágrima pelo canalículo superior com correção da epífora.

The lower eyelid is one of the sites most affected by basal cell carcinoma (BCC). We present an option of inner corner skin flap with oral mucosa graft for eyelid reconstruction after BCC excision. This tumor affects approximately 60% of the lower eyelid and shows complete lower lacrimal canaliculus involvement. The use of internal corner skin transposition flap and oral mucosa graft is safe. The technique is reproducible and with good postoperative evolution. Positioning and eyelid movement were restored, allowing tear drainage through the upper canaliculus with complete correction of the tears' overflow (epiphora).

Retalho em ilha tunelizado na reconstrução de defeito na sobrancelha / Tunneled island flap for reconstruction of eyebrow defect

Cirurgias na face configuram-se, muitas vezes, em desafios para o cirurgião em virtude da complexa anatomia, importância estética e funcional. Intervenções na subunidade cosmética que compreende as sobrancelhas podem ser particularmente difíceis. O objetivo deste trabalho é demonstrar o uso do retalho em ilha nesta região. Foi realizada exérese de nevo melanocítico, com bom resultado final e ausência de complicações pós-operatórias. Esta técnica é comumente utilizada para reconstrução facial, porém existem poucos casos descritos em que foi utilizada para reconstrução de sobrancelhas

Facial surgeries are often challenging for surgeons due to their complex anatomy, aesthetic and functional importance. Interventions in the cosmetic subunit that comprises the eyebrows can be particularly difficult. This case report aims to demonstrate the use of island flap in this region. We performed the excision of melanocytic nevus, with a good outcome and absence of postoperative complications. This technique is commonly used for facial reconstruction; however, the literature describes only a few cases using this method for eyebrow reconstruction.