RESUMO
Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.
Assuntos
Infecção por Zika virus/transmissão , Infecção por Zika virus/virologia , Zika virus/isolamento & purificação , América/epidemiologia , Número Básico de Reprodução , Brasil/epidemiologia , Variação Genética , Genoma Viral/genética , Humanos , Microcefalia/epidemiologia , Microcefalia/virologia , Epidemiologia Molecular , Filogeografia , Análise Espaço-Temporal , Zika virus/genética , Infecção por Zika virus/epidemiologiaRESUMO
Low-level laser therapy (LLLT) could be an alternative for the treatment of swelling and pain after orthognathic surgery, but there is a paucity of data in the literature on the effects of its use. This study verified the efficacy of an LLLT protocol to reduce swelling and pain after orthognathic surgery. Ten healthy patients who underwent a bilateral sagittal split with Le Fort I osteotomy were randomly selected for this study. The LLLT protocol consisted of intraoral and extraoral application to one side of the face after surgery (irradiated side); application to the other side was simulated (non-irradiated side). The irradiated and non-irradiated sides were compared regarding the swelling coefficient and were assessed for pain using a visual analogue scale. There were no significant differences between the irradiated and non-irradiated sides regarding swelling and pain in the immediate postoperative assessment. Swelling decreased significantly on the irradiated side in the postoperative assessments on days 3, 7, 15, and 30. Self-reported pain was less intense on the irradiated side at the 24-h (1.2 vs. 3.4) and 3-day (0.6 vs. 2.1) assessments, but at 7 days after surgery neither side showed pain. This LLLT protocol can improve the tissue response and reduce the pain and swelling resulting from orthognathic surgery.
Assuntos
Edema/prevenção & controle , Terapia com Luz de Baixa Intensidade , Procedimentos Cirúrgicos Ortognáticos , Dor Pós-Operatória/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Adolescente , Adulto , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Lasers Semicondutores , Pessoa de Meia-Idade , Ortodontia Corretiva , Osteotomia de Le Fort , Osteotomia Sagital do Ramo Mandibular , Manejo da Dor , Medição da Dor , Resultado do TratamentoAssuntos
Anormalidades Congênitas/virologia , Feto/anormalidades , Leite Humano/virologia , Doenças do Sistema Nervoso/virologia , Zika virus/isolamento & purificação , Adulto , Líquidos Corporais/virologia , Brasil , Anormalidades Congênitas/diagnóstico por imagem , Feminino , Feto/diagnóstico por imagem , Feto/virologia , Genótipo , Humanos , Recém-Nascido , Mães , Doenças do Sistema Nervoso/diagnóstico por imagem , Filogenia , Gravidez , RNA Viral/análise , RNA Viral/urina , Ultrassonografia , Zika virus/genéticaRESUMO
We assessed the susceptibility of Escherichia coli strains causing communityacquired urinary tract infection (UTI) in a large urban center in Brazil, comparing two different populations (patients with health insurance vs. uninsured). 581 nonduplicate strains of E. coli were isolated. The prevalence of antimicrobial resistance was greater than 20% for ampicillin (51%), trimethoprim-sulfamethoxazole (43%), tetracycline (41%) and chloramphenicol (22%). Overall, 12% of the E. coli isolates were resistant to ciprofloxacin. Resistance prevalences to most antimicrobials were similar in the two study populations. Our data provide much needed information on the prevalence of antimicrobial resistance among E. coli causing communityacquired UTI in Brazil. Antimicrobial resistance among strains of E. coli causing community-acquired UTIs was relatively high, particularly resistance to ciprofloxacin.