Population-based seroprevalence of SARS-CoV-2 and the herd immunity threshold in Maranhão

ABSTRACT OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.

Children and adolescents ostomized in a reference hospital: Epidemiological profile / Perfil epidemiológico de crianças e adolescentes estomizados em hospital de referência

Objectives: To assess the epidemiological profile of children and adolescents with intestinal stoma, assisted at the Presidente Dutra University Hospital (HUPD), São Luís (MA). Methods: Observational, descriptive, retrospective, and individuated study. Data were collected from 110 children and adolescents with elimination intestinal stoma, from January 2006 to February 2013. The following variables were analyzed: age, gender, patient origin, and stomata indication, type, and temporal character. After data collection, descriptive analysis was made by Bioestat 5.0 program. Results: Of 110 patients, 78.2% were male and 21.8% female. The average age was 9.4 years old. 55.5% came from the Maranhão state countryside, and 44.5% from the capital, São Luís. Regarding stoma type, colostomies made up 88.2%, and were 11.8% ileostomies, all temporary stoma. The main cause was trauma (42.7%), with firearm abdominal puncture being the most frequent cause (71.5% of the category); followed by congenital anomalies (38.2%), and obstructive (5.4%) and inflammatory (4.5%) causes. Conclusion: Studied children and adolescents were mostly male, from Maranhão state countryside. The main cause was trauma, and colostomy was the most common stoma type.

Objetivos: Avaliar o perfil epidemiológico de crianças e adolescentes portadores de estomas intestinais atendidos no Hospital Universitário Presidente Dutra (HUPD) em São Luís (MA). Métodos: Estudo observacional, descritivo, retrospectivo e individuado em que foram coletados dados de 110 crianças e adolescentes com estomas intestinais de eliminação de janeiro de 2006 a fevereiro de 2013. Analisaram-se as variáveis: idade, sexo, procedência dos pacientes, indicação, tipo e caráter temporal dos estomas. Após coleta dos dados, foi feita análise descritiva pelo programa Bioestat 5.0. Resultados: Dos 110 pacientes, 78,2% eram do sexo masculino e 21,8% do sexo feminino. A idade média foi de 9,4 anos. 55,5% era procedente do interior do Estado do Maranhão e 44,5% da capital, São Luís. Com relação ao tipo: 88,2% eram colostomias e 11,8% ileostomias, todos os estomas temporários. A causa principal foi o trauma (42,7%), sendo a perfuração abdominal por arma de fogo a mais frequente (71,5% da categoria); seguido pelas anomalias congênitas (38,2%), causas obstrutivas (5,4%) e inflamatórias (4,5%). Conclusão: As crianças e adolescentes estudados eram, em sua maioria, do sexo masculino, proveniente do interior do Estado do Maranhão, tendo como principal causa a traumática e a colostomia como o tipo de estoma mais comum.

Evaluation of the use of raw extract of Euphorbia tirucalli L. in the healing process of skin wounds in mice

PURPOSE: To evaluate the effects of crude extract of Euphorbia tirucalli in cutaneous wound healing. METHODS: A total of 20 Swiss mice were randomly divided into two groups, aveloz (GA) and control (CG), and each group was further divided into two subgroups based on the deaths scheduled for the 7th and 14th days after surgery. The animals underwent a resection of cutaneous fragment with 1cm in diameter on the dorsum; the GA was applied in each animal on the subsequent days, 0.1 mL (30 mg/mL) hydroalcoholic extract of Euphorbia tirucalli was applied on the wound, while the same volume of 0.9% saline solution was applied to the GC. It was evaluated the lesion diameter and after programmed death, a surgical specimen was resected for histopathology. RESULTS: In the macroscopic analysis, no statistically significant difference was observed (p = 0.120 and p = 0.186, for the 7th and 14th days of death, respectively). The histological evaluation revealed no statistically significant difference in the variables acute inflammation (p = 0.014) and fibrosis (p = 0.018), when compared the group aveloz with the control group on day 14. CONCLUSION: The crude hydroalcoholic extract of Euphorbia tirucalli L. demonstrated better outcomes in the healing process, acute inflammation and fibrosis on the 14 day postoperatively.

An analysis of the spatiotemporal distribution of American cutaneous leishmaniasis in counties located along road and railway corridors in the State of Maranhao, Brazil

Introduction The incidence of American cutaneous leishmaniasis (ACL) is increasing in Latin America, especially in Brazil, where 256,587 cases were confirmed in the last decade. Methods This study used a Bayesian model to examine the spatial and temporal distribution of ACL cases between 2000 and 2009 in 61 counties of State of Maranhão located along the three main road and railway corridors. Results During the study period, 13,818 cases of ACL were recorded. There was a significant decrease in the incidence of ACL in the ten study years. The recorded incidence rate ranged from 7.36 to 241.45 per 100,000 inhabitants. The relative risk increased in 77% of the counties, decreased in 18% and was maintained in only five counties. Conclusions Although there was a decreased incidence of the disease, ACL was present in all of the examined municipalities, thus maintaining the risk of contracting this illness. .

Schinus terebinthifolius raddi (anacardiaceae) no processo de cicatrização de gastrorrafias em ratos / Schinus terebinthifolius raddi (anacardiaceae) in the healing process of gastrorraphy in rats

RACIONAL: A gastrorrafia isolada ou associada ao uso de adesivos biológicos constituiu ao longo da história da cirurgia a forma usual de promover a cicatrização nas lesões gástricas e o uso de fitoterápicos tem sido cada vez mais empregado. OBJETIVO: Avaliar a cicatrização de ferida provocada no estômago de ratos com uso do extrato hidroalcoólico de Schinus terebinthifolius Raddi. MÉTODOS: Foram utilizados 60 ratos, adultos, machos, distribuídos em dois grupos: grupo aroeira e grupo controle, os quais foram subdivididos em três subgrupos de cinco animais conforme o momento das mortes dos animais (7, 14 e 21 dias). Todos os animais foram submetidos ao mesmo procedimento cirúrgico (lesão e rafia do estômago) diferindo apenas que os animais do grupo aroeira receberam dose diária de 100 mg/kg do extrato hidroalcoólico via gavagem enquanto o grupo controle recebeu solução salina isotônica. Os parâmetros avaliados foram: alterações macroscópicas e microscópicas, teste de resistência à insuflação de ar atmosférico e teste pela força de tração. RESULTADOS: Todos os animais demonstraram boa cicatrização da parede abdominal e das gastrorrafias, sem infecção e deiscência. Ambos os grupos apresentaram aderências à superfície das gastrorrafias com órgãos vizinhos. O teste de resistência por insuflação de ar atmosférico e força de tração mostraram maiores médias de pressão no 7º dia e de força de ruptura nos períodos estudados para o grupo aroeira. A intensidade da inflamação crônica revelou diferença estatisticamente significante nas variáveis proliferação fobrobrástica e colagenização. CONCLUSÃO: O uso do extrato hidroalcoólico de Schinus terebinthifolius Raddi acelerou a cicatrização do estômago de ratos.

BACKGROUND: Gastrorraphy, isolated or associated with the use of biological adhesives, was throughout the history of surgery the usual way to promote healing in gastric lesions and the use of herbal medicine has been increasingly more employed. AIM: To evaluate the wound healing in the stomach of rats with the use of the hydroalcoholic extract of Schinus terebinthifolius Raddi (aroeira). METHODS: Sixty rats, adult males, were divided into two groups: aroeira group and control group. Each one was subdivided into four subgroups of 15 animals (test groups). Each subdivided subgroup was also subdivided into three subgroups of five rats (deaths periods of 7, 14 and 21 days). All animals underwent the same surgical procedure (injury and stomach suture); animals in the aroeira group received daily dose of 100 mg/kg of hydroalcoholic extract via gavage while the control group received isotonic saline solution. Parameters evaluated were: macroscopic and microscopic changes, test for resistance to insufflation of atmospheric air and test for tensile strength. RESULTS: All animals had good healing of the abdominal wall and gastrorraphies without infection and dehiscence. Both groups had adhesions to the gastrorraphies surfaces with neighboring organs. The resistance test by insufflation of atmospheric air and tensile strength showed higher average of pressure on the 7th day and breaking strength in the time periods for the aroeira group. The intensity of chronic inflammation revealed statistically significant differences in the variables fibroblast proliferation and collagen. CONCLUSION: The use of hydroalcoholic extract of Schinus terebinthifolius Raddi accelerated the stomach healing in rats.