Dietitians' practices in dialysis units in Brazil: nutritional assessment and intervention.

INTRODUCTION: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. OBJECTIVE: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. METHODOLOGY: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians' demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. RESULTS: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. CONCLUSION: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially.

A comprehensive review of Pfaffia glomerata botany, ethnopharmacology, phytochemistry, biological activities, and biotechnology.

ETHNOPHARMACOLOGICAL RELEVANCE: Pfaffia glomerata (Spreng.) Pedersen, Amaranthaceae, is found in South America, mainly in Brazil, where it is considered a species of great medicinal interest owing to its popular use as a tonic, aphrodisiac, anti-inflammatory, and analgesic. These properties can be attributed to the presence of the phytosteroid, 20-Hydroxyecdysone (ß-ecdysone), the main compound found in its roots. AIM OF THE REVIEW: This review aims to provide information about the botanical characteristics, ethnomedicinal uses, the phytochemistry, the biological activities, and the biotechnology of P. glomerata, an important species to local communities and groups researching medicinal plants of South America. MATERIALS AND METHODS: The information available on P. glomerata was collected from scientific databases (ScienceDirect, PubMed/MEDLINE, SciELO, and Scopus) until June 7, 2023, using the search terms "Pfaffia glomerata", "Pfaffia glomerata (Spreng.) Pedersen", and "Brazilian ginseng". The review includes studies that evaluated the botanical, ethnopharmacological, and phytochemical aspects, biological properties, nutraceutical uses, and the application of biotechnology for improving the biosynthesis of metabolites of interest. RESULTS: A total of 207 studies were identified, with 81 articles read in full. Seventy-six studies were included for qualitative synthesis. Overall, 40 compounds belonging to different classes are presented in this review, including ecdysteroids, triterpenes, saponins, flavonoids, anthraquinones, tannins, coumarins, alkaloids, and polysaccharides. Among them, flavonoids, anthraquinones, tannins, coumarins, and alkaloids were only putatively identified. ß-Ecdysone, triterpenes, saponins, and polysaccharides are the chemical components most frequently identified and isolated from P. glomerata and possibly responsible for ethnopharmacological use and the biological activities of this species, with important in vitro and in vivo activities, such as anti-inflammatory, antidepressant, aphrodisiac, analgesic, gastroprotective, antioxidant, and prebiotic. CONCLUSIONS: This review summarizes discussions about the P. glomerata species, highlighting its ethnopharmacological, chemical, biotechnological, and nutraceutical importance. New scientific studies on this species are encouraged in the search for new therapeutic molecules with pharmaceutical potential and nutraceutical applications.

Folk medicine, biological activity, and chemical profiles of Brazilian Acanthaceae (Lamiales) - A review.

INTRODUCTION: The botanical family Acanthaceae (order Lamiales) potentially comprises 4900 species in 191 genera with extensive morphological, habit and habitat diversity. The family is widely distributed throughout the world but is especially rich in tropical and subtropical regions. Many of its species have great ornamental importance and are broadly used for medicinal purposes in several countries of Asia and Africa. Brazil is a main center of diversity of the family, where they are distributed across all its biomes, mainly in the herbaceous-shrub stratum. Medicinal investigations about Brazilian species are scarce, the exception being a single native species, Justicia pectoralis Jacq., that is widely used and studied chemically. AIM OF THE REVIEW: This work compiled studies that indicated folk medicinal use, investigated biological activity, or evaluated the chemical composition of Brazilian species of Acanthaceae. MATERIAL AND METHODS: Medicinal uses, investigations of biological activities and chemical data were collected and summarized through bibliographic surveys. Tables were compiled to standardize the information and the appropriate references were gathered for each species. Registration of chemical components used in the treatment of ailments and in preserving health were emphasized with the aim of stimulating future investigations. RESULTS: The breadths of habitats and morphologies of the family are directly related to its chemical diversity, as confirmed here for Brazilian species. Although the investigated species represent less than 9% of the total richness of the family in Brazil, they encompass a great diversity of chemical substances. The data indicated folk medicinal uses for 26 species and biological tests for 23, while 30 species were investigated chemically. Ruellia and Justicia were the most researched genera with 12 and 11 species, representing approximately 14% and 7% of Brazilian species of each genus, respectively. Two species are native to other countries but become naturalized in Brazil. Studies of native species were carried out in different countries around the world, with many reports of medicinal uses and biological tests. Examples of uses include anticancer and antidepressant actions, as well as activities against respiratory problems and other diseases. CONCLUSIONS: This work highlights the chemical and biological diversity of the studied Brazilian species of Acanthaceae, which emphasizes the need to expand studies with native Brazilian species.

Therapeutic itineraries of quilombola women in northern Minas Gerais, Brazil. / Itinerários terapêuticos de mulheres quilombolas do norte de Minas Gerais, Brasil.

Quilombolas are ethnic-racial groups, of black ancestry, and had their territories consolidated in Brazil in regions with difficult access and far from large centers. The objective of this study is to know the therapeutic itinerary (IT) adopted by quilombola women in traditional communities located in the North of the state of Minas Gerais. This is a qualitative study with the theoretical model using the Arthur Kleinman health care system. The study scenario was 23 quilombola communities in northern Minas Gerais. Forty quilombola women aged between 25 and 89 years were interviewed. Data analysis was performed following the IT. Units of analysis emerged that were grouped into three categories: quilombola women and the meaning of health and care; the professional care system in quilombola communities; and route of care in situations experienced by women. The therapeutic itinerary of the communities is mainly related to the actions of popular medicine. It was also possible to observe that there are weaknesses in relation to health care due to factors such as difficulty of access to institutionalized services.

Os quilombolas são grupos étnico-raciais de ancestralidade negra e tiveram seus territórios consolidados no Brasil em regiões com acesso difícil e distante dos grandes centros. O objetivo desse estudo é conhecer o itinerário terapêutico (IT) adotado por mulheres quilombolas em comunidades tradicionais localizadas no norte do estado de Minas Gerais. Trata-se de um estudo com abordagem qualitativa com o modelo teórico utilizando o sistema de cuidados à saúde de Arthur Kleinman. O estudo se deu em 23 comunidades quilombolas do norte de Minas Gerais. Foram entrevistadas 40 mulheres quilombolas, com idades entre 25 e 89 anos. A análise dos dados foi realizada seguindo os IT. Emergiram unidades de análise que foram agrupadas em três categorias: as mulheres quilombolas e o significado da saúde e do cuidado; o sistema de cuidado profissional nas comunidades quilombolas; e itinerário de cuidados nas situações vivenciadas pelas mulheres. O itinerário terapêutico das comunidades se mostra relacionado principalmente às ações de medicina popular. Foi possível observar ainda que existem fragilidades em relação à atenção à saúde devido a fatores como dificuldade de acesso aos serviços institucionalizados.

Therapeutic itineraries in health care in Quilombola communities. / Itinerários terapêuticos no cuidado em saúde em comunidades quilombolas.

This article aimed to map therapeutic itineraries in health care within rural Quilombola communities in the north of Minas Gerais, Brazil. This is a section of a qualitative research conducted in six visited communities. The data was collected through 18 individual interviews, analyzed using the theoretical-methodological framework of Therapeutic Itineraries, and organized into three empirical themes. The narratives allowed for understanding the paths taken in health care by the Quilombola population, identifying the components of the popular subsystem (natural resources, the use of teas and home remedies), the family subsystem (transmission of knowledge and cultural heritage of care), and the professional subsystem (hospital level, medical care, primary and specialized attention). The difficulties of access are not only due to geographical distances, but also broader aspects of social determination, such as institutional racism, low availability of services, the need for payment for transportation and medical procedures. In this sense, it is necessary to have an approach and interventions from public policies to address ethnic-racial, economic, and access inequalities in health care services.

Este artigo teve como objetivo mapear os itinerários terapêuticos no cuidado em saúde em comunidades quilombolas rurais no norte de Minas Gerais, Brasil. Trata-se de um recorte de uma pesquisa qualitativa realizada em seis comunidades visitadas. Os dados foram produzidos por meio de 18 entrevistas individuais, analisados pelo referencial teórico-metodológico dos itinerários terapêuticos e organizados em três temas empíricos. As narrativas permitiram a compreensão dos percursos trilhados no cuidado em saúde pela população quilombola, a identificação dos componentes do subsistema popular (recursos naturais, o uso de chás e remédios caseiros), do subsistema familiar (transmissão de conhecimentos e herança cultural de cuidados), e do subsistema profissional (nível hospitalar, cuidados médicos, atenção primária e especializada). As dificuldades de acesso não decorrem apenas das distâncias geográficas, envolvem aspectos mais amplos da determinação social, como o racismo institucional, a baixa oferta de serviços, a necessidade de pagamento para deslocamentos e procedimentos médicos. Nesse sentido, fazem-se necessárias uma abordagem e intervenções das políticas públicas frente às desigualdades étnico-raciais, econômicas e de acesso aos serviços de cuidado em saúde.

Àgô Sankofa: an overview of the progression of sickle cell disease in Brazil in the past two decades. / Àgô Sankofa: um olhar sobre a trajetória da doença falciforme no Brasil nos últimos 20 anos.

Sickle cell disease (SCD) is an emblematic case of historical health neglect in Brazil and reflects how institutional racism produces health inequalities. This article engaged in a historical journey of this disease, showing the delayed implementation of health policies for people with sickle cell disease, often concealed in Public Power's (in)actions and omissions. The lack of commitment to implement the recommendations of the Brazilian Ministry of Health, such as neonatal screening, and the difficulty in incorporating technologies for health care result from this modus operandi. The advances and setbacks in programmatic actions and the constant pressure on several governmental entities have characterized the reported saga in the last twenty years. The present text discusses the policies for people with SCD, appropriating the Sankofa symbol, meaning that building the present is only possible by remembering past mistakes. Thus, we recognize this trajectory and this historical moment in which there is a concrete possibility of moving forward and achieving the longed-for comprehensive care for people with SCD. There is an invitation to glance at a new perspective, one in which hope is the trigger for the movements needed to guarantee the rights of people with SCD.

A doença falciforme (DF) é um caso emblemático de negligência histórica em saúde no Brasil e reflete como o racismo institucional produz iniquidades em saúde. Este artigo fez um percurso histórico até os dias atuais e mostra atraso na implementação de políticas de saúde voltadas para as pessoas com DF, tantas vezes encoberto em (in)ações e omissões do poder público. O descompromisso para a efetivação das recomendações do Ministério da Saúde, a exemplo da triagem neonatal, e a dificuldade de incorporar as tecnologias para a assistência à saúde resultam desse modus nada operandi. Os avanços e retrocessos nas ações programáticas, bem como a pressão constante sobre os diversos entes governamentais, caracterizaram a saga dos últimos 20 anos. O texto disserta sobre as políticas voltadas para as pessoas com DF, apropriando-se da simbologia Sankofa, já que só é possível construir o presente pelo aprendizado dos erros do passado. Assim, reconhecemos essa trajetória e esse momento histórico em que há possibilidade concreta de avançar e concretizar o tão almejado cuidado integral para pessoas com DF. Concluiu-se que há um convite para um novo olhar, em que esperançar seja o disparador das movimentações necessárias para a garantia do direito para as pessoas com DF.

Antimicrobial photodynamic therapy with Brazilian green propolis controls intradermal infection induced by methicillin-resistant Staphylococcus aureus and modulates the inflammatory response in a murine model.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of skin and soft tissue infections worldwide. This microorganism has a wide range of antibiotics resistance, a fact that has made the treatment of infections caused by MRSA difficult. In this sense, antimicrobial photodynamic therapy (aPDT) with natural products has emerged as a good alternative in combating infections caused by antibiotic-resistant microorganisms. The objective of the present study was to evaluate the effects of aPDT with Brazilian green propolis against intradermal MRSA infection in a murine model. Initially, 24 Balb/c mice were infected intradermally in the ears with 1.5 × 108 colony-forming units of MRSA 43300. After infection, they were separated into 4 groups (6 animals per group) and treated with the vehicle, only Brazilian green propolis, only blue LED light or with the aPDT protocol (Brazilian green propolis + blue LED light). It was observed in this study that aPDT with Brazilian green propolis reduced the bacterial load at the site of infection. Furthermore, it was able to inhibit weight loss resulting from the infection, as well as modulate the inflammatory response through greater recruitment of polymorphonuclear cells/neutrophils to the infected tissue. Finally, aPDT induced an increase in the cytokines IL-17A and IL-12p70 in the draining retromaxillary lymph node. Thus, aPDT with Brazilian green propolis proved to be effective against intradermal MRSA infection in mice, reducing bacterial load and modulating the immune response in the animals. However, more studies are needed to assess whether such effects are repeated in humans.

The influence of exotic and native plants on illnesses with physical and spiritual causes in the semiarid region of Piauí, Northeast of Brazil.

BACKGROUND: Local medical systems (LMS) include native and exotic plants used for the treatment of diseases of physical and spiritual nature. The incorporation of exotic plants into these systems has been the subject of many studies. In this context, an analysis was conducted on the influence of the origin of plants on diseases of physical and spiritual nature in order to evaluate the therapeutic versatility of native and exotic species in these therapeutic targets, to investigate whether exotic plants mainly fill gaps not met by native plants (diversification hypothesis), and identify which species are prioritized in the redundant targets in these two therapeutic groups in the rural community of Morrinhos, Monsenhor Hipólito, Piauí. METHODS: Data collection took place in 2 stages. First, free lists and semi-structured interviews with local residents (n = 134) were conducted to survey plants used for therapeutic purposes and the associated illnesses. Then, another phase of interviews was carried out to evaluate the prioritization between native and exotic plants in redundant therapeutic targets. To test the diversification hypothesis (DH) in each group of illnesses, data were analyzed using generalized linear models (Poisson and Binomial GLMs); versatility was measured by the number of therapeutic indications and compared between resources using the Mann-Whitney test, and prioritization in each group was verified by comparing the proportions of native and exotic plants with the χ2 test. RESULTS: One hundred and thirty-two species of plants were surveyed, being 71 exotic and 61 native, with indications for physical and spiritual illnesses. The results revealed that the diversification hypothesis did not explain the inclusion of exotic plants in the local medical system to treat physical or spiritual illnesses and that the therapeutic versatility of exotic and native resources in the two groups was also similar (p > 0.05). However, exotic plants were prioritized in illnesses with physical causes and native plants in illnesses with spiritual causes. CONCLUSIONS: The local medical system presents similar and distinct patterns in the therapeutic targets, depending on the perspective evaluated. Therefore, it is necessary to investigate the patterns of use of medicinal plants in different sociocultural contexts in order to broaden the debate about the role of plant origin in the selection of treatments for illnesses with different causes.

Amazonian useful plants described in the book "Le Pays des Amazones" (1885) of the Brazilian propagandist Baron de Santa-Anna Nery: a historical and ethnobotanical perspective.

BACKGROUND: Frederico José de Santa-Anna Nery (1848-1901) was a Brazilian Baron who referred to himself as a "volunteer propagandist" for Brazil in Europe, serving as an immigration agent to publicize the living conditions in the Amazon region, advocating for its development and modernization at the end of the nineteenth century. Santa-Anna Nery's most famous book is "Le Pays des Amazones" (The Lands of the Amazons), first published in 1885, which the author dedicated a chapter to introduce and report on the Amazonian useful plant species and its relationship with humans. The aim of this work is to understand the historical context and ethnobotanical value of the plant species in the Brazilian Amazon at the end of the nineteenth century through an analysis of the book "Le Pays des Amazones" (1885) by Baron de Santa-Anna Nery, as well as to bring to light the historical importance of this very influential propagandist, who has been forgotten nowadays. METHODS: The original book "Le Pays des Amazones" (1885), as well as the original 3rd edition and its translated version into Portuguese, was carefully analyzed and all information about plants was systematized, with botanical names being updated. Finally, using the scientific name of medicinal plants alone or in combination with their traditional use, a search was carried out in databases in order to indicate current pharmacological studies that provide evidence about the described traditional uses. RESULTS: A total of 156 plant species were identified in the book, although 132 species had their scientific names updated. These species belong to 45 different families, with Fabaceae and Arecaceae the most represented, and 109 plants are Brazilian native. Considering only the 36 medicinal plants, the main medicinal indications reported were astringent, purgative/laxative, stimulant and tonic, vermifuge, febrifuge, sudorific, emetic, diuretic and antidysenteric. Regarding other useful plants (non-medicinal), 97 species were cited for food, constructions and buildings, spices and condiments, ornaments and objects, carpentry, textile fibers, gums, oils, balms and essences, pigments and tanning, hunting and fishing. CONCLUSIONS: When the book "Le Pays des Amazones" is analyzed from a timeless perspective, with a particular focus on historical ethnobotany, it is possible to observe the economic, social, and political importance of many useful plants for the Amazon at the end of the nineteenth century and how the relationship between local people, indigenous communities, and immigrants was established with plant biodiversity.

Methods of induction and augmentation of labor in a freestanding birth center: a cross-sectional study.

OBJECTIVE: To describe and analyze the use of methods of induction and augmentation of labor in a freestanding birth center (FBC). METHOD: Cross-sectional study carried out at a FBC located in São Paulo (SP), with all women booked from 2011 to 2021 (n = 3,397). RESULTS: The majority of women (61.3%) did not receive any method. The methods were used alone or in combination (traditional Chinese medicine, massage, castor oil, stimulating tea, amniotomy, and oxytocin). Traditional Chinese medicine (acupuncture, acupressure, and moxa) was the most used method (14.7%) and oxytocin was the least frequent (5.1%). The longer the water breaking time, the greater the number of methods used (p < 0.001). Amniotomy was associated with maternal transfers (p < 0.001). CONCLUSION: Induction and augmentation of labor were strictly adopted. The use of natural or non-pharmacological methods prevailed. Robust clinical studies are needed to prove the effectiveness of non-pharmacological methods of stimulation of childbirth, in addition to strategies for their implementation in other childbirth care services, to really prove the effectiveness of non-pharmacological methods in the parturition process, that is, in labor and birth.

The perception of fungi among Karajá indigenous children and adolescents from Brazil.

BACKGROUND: Environmental perception involves the interpretation and interaction of individuals with their surroundings, influenced by cultural, social, and individual factors. Analyzing the environmental perception of children and adolescents contributes to fostering awareness and ethical behavior toward the environment. Indigenous communities, such as the Karajá from Brazil, possess significant environmental knowledge due to their connection with nature, providing distinctive insights into biodiversity and natural interconnections. In this study, the perception of fungi among Karajá indigenous children and adolescents was investigated. METHODS: The study involved 229 elementary school students from the Macaúba, Fontoura and Santa Isabel do Morro communities, located on Bananal Island, Brazil. Students were encouraged to draw what they knew about fungi and answer where they learned about fungi and what name they give to these organisms. The drawings were analyzed considering seven categories. RESULTS: The term most used to refer to fungi was hedoro(u) (56%), followed by fungus (21%) and mushroom (11%). Most students said they had learned about fungi in nature (38%) and at school (36%). The most represented organisms were in fact fungi (93%), mainly being portrayed in nature (94%). Most participants did not attribute any ecological function to fungi (83%), although 16% of them recognized fungi as decomposers and 1% as phytopathogenic agents. Negative aspects, particularly food contamination, were more frequently represented (13%) than positive aspects (4%). The drawings identified two morphological types: mushrooms (87%) and mold (13%). Among these mushrooms, 68% possibly represent the Amanita muscaria species. CONCLUSIONS: Although the children and adolescents showed that they noticed the fungi around them, the group's concept and understanding were limited to the figure of the mushroom and the negative aspects related to food contamination. Strong association of the fungi with the A. muscaria is noteworthy, since it does not occur in the environment in which the participants live, suggesting that external stimuli, such as TV or the internet, can influence their perception more than the nature they are exposed to.

An update review on monoterpene indole alkaloids and biological activities of Tabernaemontana species occurring in Brazil.

ETHNOPHARMACOLOGICAL RELEVANCE: The Tabernaemontana genus belongs to the Apocynaceae family of which 30 species are found in Brazil. Some Tabernaemontana species are used by Brazilian indigenous people and other communities, or are listed in the Yanomami Pharmacopeia. Ethnopharmacological data include use(s) for muscle problems, depressed sternum, back pain, abscess, indigestion, eye irritation, earache, itching, vaginal discharge, as an aid for older people who are slow and forgetful, mosquito and snake bites, infection by the human botfly larvae, calmative, and fever. Obviously, many of these uses are attributed to the alkaloids found in Tabernaemontana species. AIM OF THE REVIEW: The aim is to gather information on Tabernaemontana species occurring in Brazil, as sources of monoterpene indole alkaloids (MIAs). In addition, we aim to collect reported experimental demonstrations of their biological activity, which may provide the foundation for further studies, including phytochemistry, the development of medicinal agents, and validation of phytopreparations. MATERIAL AND METHODS: The Brazilian Flora 2020 database was used as source for Tabernamontana species occurring in Brazil. The literature review on these species was collected from Web of Science, Scopus, PubMed, and Scifinder. The keywords included names and synonyms of Tabernaemontana species found in Brazil, which were validated by the Word Flora Online Plant List. RESULTS: A literature survey covering the time frame from 1960 until June 2023 resulted in 121 MIAs, including 48 not yet reported in the last review published in 2016. Some alkaloid extracts, fractions, and isolated alkaloids present evidenced biological activity, such as anticancer, anti-inflammatory, antinociceptive, antimicrobial, antiparasitic, antiviral, and against snake venoms, among others. Notably, ethnopharmacological based information has been the basis of some reports on Tabernaemontana species. CONCLUSIONS: Our literature survey shows that Tabernaemontana species present bioactive MIAs, such as voacamine and affinisine, demonstrating significant cytotoxicity activity against several tumoral cell lines. Those compounds can be considered promising candidates in the search for new anticancer drugs. However, the Amazonian plant biome is increasingly damaged, which may lead to the extinction of biological diversity. This threat may also affect Tabernaemontana species, which have scarcely been investigated regarding the potential of their phytochemicals for the development of new drugs.

Causal agents of Stemphylium-induced foliar diseases of tomatoes and other Solanaceae hosts in Brazil.

AIM: An extensive survey was done to clarify the prevalent Stemphylium species on Solanaceae plants across Brazil, and their host ranges. METHODS AND RESULTS: Eighty nine (89) Stemphylium isolates were obtained from naturally infected tomatoes as well as S. paniculatum, potato, eggplant, scarlet eggplant (Solanum aethiopicum var. gilo), Physalis angulata, and Capsicum species. Phylogenetic analyses encompassing the ITS-5.8S rDNA and glyceraldehyde-3-phosphate dehydrogenase genomic regions placed the isolates into two distinct groupings with either Stemphylium lycopersici or S. solani. Isolates of S. lycopersici (n = 81) were obtained infecting tomato, potato, eggplant, S. paniculatum, and P. angulata. Isolates of S. solani (n = 8) were detected in natural association with scarlet eggplant and tomato. Two isolates of S. lycopersici displayed a wide experimental host range in greenhouse bioassays, infecting accessions of 12 out of 18 species. Ocimum basilicum (Lamiaceae) was the only experimental host outside the Solanaceae family.

Metal and metalloid maternal transfer in a newborn West Indian manatee (Trichechus manatus) two years after the northeastern oil spill disaster of 2019 in Brazil.

A large-scale oil spill along the northeastern Brazilian coast in 2019-2020 severely impacted primary manatee habitats in Brazil. This study aimed to assess metal and metalloid contamination in a dead manatee calf found following this oil spill. Several elements were detected, including chromium, iron, nickel, lead, and vanadium, which are crude oil components, and thallium, a component of dispersants used to degrade and dissipate crude oil. The presence of these contaminants in the manatee calf is indicative of maternal exposure, metabolism, and newborn transference via placenta and lactation. This is the first report of mother-calf metal transfer in manatees, highlighting the species' vulnerability and potential long-term population dynamics effects, and the first report for several metals and metalloids in these animals, laying the foundation for future research efforts. These findings highlight the urgent need for continued environmental monitoring, ecotoxicological assessments, and conservation initiatives.

Evolution of adolescents' dietary patterns in Northeast Brazil from 2008 to 2018.

OBJECTIVE: To evaluate the evolution of the dietary patterns of adolescents in the northeast region of Brazil. METHODS: Secondary analysis of data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Surveys), collected by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2008-2009 and 2017-2018. A total of 3,095 adolescents were evaluated in 2008-2009 and 3,015 in 2017-2018. Food consumption was assessed using two dietary records in 2008-2009 and two 24-hour recalls in 2017-2018, applied on non-consecutive days. Based on these data, principal components factor analysis (PCFA) was performed, followed by orthogonal rotation of the varimax type, to derive dietary patterns, stratified by sex. The results were described as means or percentage frequencies, with their respective 95% confidence intervals. RESULTS: Three main dietary patterns were identified among adolescents from the northeast region of Brazil. Among boys, in 2008-2009, the patterns were called snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and mixed, in this order of representativeness of the group's eating habits. Among female adolescents, in 2008-2009, the patterns were snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and processed meats. CONCLUSION: The dietary patterns identified in 2008-2009 and 2017-2018 were similar in both genders; however, the snacks pattern, which explained most of the data variability in 2008-2009, was replaced by the traditional Brazilian.

Yams (Dioscorea spp.) in shellmounds and swiddens: ancient history in Babitonga Bay, Santa Catarina State, southern Brazil.

BACKGROUND: In Babitonga Bay, southern Brazil, records of yam consumption exist among shellmound builders from at least 4000 years ago. Shellmounds (sambaquis) are anthropogenic structures in the form of mounds with layers of shells associated with other faunal remains, as well as with charcoal, artefacts and burial. Larger sambaquis are considered to be funerary monuments. The indigenous Jê and Guarani people also lived in the region before the European invasion and cultivated yams. Currently, exotic and domesticated yams are cultivated in the region by farmers. Our aim is to describe the long-term history between the people and Dioscorea in the Babitonga Bay region based on its consumption and occurrence in shellmounds and swiddens. METHODS: Surveys of Dioscorea spp. and host were carried out in the vegetation of shellmounds and in the surrounding area using visual detection through intensive searches in transects using the walking method. The survey of Dioscorea species used and cultivated in the precolonial, colonial and current periods was carried out based on the literature. In the present study, only Dioscorea trifida cultivations were recorded. RESULTS: Dioscorea cayennensis, Dioscorea chondrocarpa, Dioscorea dodecaneura, Dioscorea laxiflora, Dioscorea olfersiana, and Dioscorea scabra, all recorded in associated vegetation of shellmounds, in different combinations of the species. In swiddens, D. trifida is most common, followed by Dioscorea alata and, to a lesser extent, Dioscorea bulbifera and D. cayennensis. Records of food use prevail, but they are used as medicinal plants. Yams are integrated on anthropogenic soils of shellmounds and in swiddens in monoculture systems or in intercropping with Zea mays or Colocasia esculenta. The presence of exotic food trees and D. cayennensis in some shellmounds indicates the influence of colonizers on the composition of the vegetation. In sambaquis, there are overlapping processes of construction of cultural niches by different human groups at different times. CONCLUSIONS: The sambaquis and the associated vegetation and swiddens form part of a domesticated landscape. The native species of Dioscorea recorded in shellmounds and surrounding vegetation do not depend on human action to perpetuate themselves in the environment. However, this does not rule out human influence in the past, but it does not indicate horticulture among the Sambaquianos. Greater investment in genetic, archaeobotanical and ethnobotanical research can contribute to a better understanding of the relationship between people and yams over thousands of years.

Redefining the treponemal history through pre-Columbian genomes from Brazil.

The origins of treponemal diseases have long remained unknown, especially considering the sudden onset of the first syphilis epidemic in the late 15th century in Europe and its hypothesized arrival from the Americas with Columbus' expeditions1,2. Recently, ancient DNA evidence has revealed various treponemal infections circulating in early modern Europe and colonial-era Mexico3-6. However, there has been to our knowledge no genomic evidence of treponematosis recovered from either the Americas or the Old World that can be reliably dated to the time before the first trans-Atlantic contacts. Here, we present treponemal genomes from nearly 2,000-year-old human remains from Brazil. We reconstruct four ancient genomes of a prehistoric treponemal pathogen, most closely related to the bejel-causing agent Treponema pallidum endemicum. Contradicting the modern day geographical niche of bejel in the arid regions of the world, the results call into question the previous palaeopathological characterization of treponeme subspecies and showcase their adaptive potential. A high-coverage genome is used to improve molecular clock date estimations, placing the divergence of modern T. pallidum subspecies firmly in pre-Columbian times. Overall, our study demonstrates the opportunities within archaeogenetics to uncover key events in pathogen evolution and emergence, paving the way to new hypotheses on the origin and spread of treponematoses.

Pharmacological evaluation of a traditional Brazilian medicinal plant, Monteverdia ilicifolia. Part I - Preclinical safety study.

ETHNOPHARMACOLOGICAL RELEVANCE: Monteverdia ilicifolia (Maytenus ilicifolia, Celastraceae), known as "espinheira-santa", has been widely used in Brazil to manage mainly gastrointestinal diseases. This species has been listed in the Brazilian Pharmacopeia and in the National List of Essential Medicines (RENAME). Considering that clinical studies about M. ilicifolia are rare, our group has been performing a broader project designed to evaluate the efficacy of M. ilicifolia capsules in a clinical trial, for this reason, approaches to provide safety to those patients are relevant. AIM OF THE STUDY: We aimed to investigate the potential pharmacokinetic interaction and hepatotoxicity and intestinal toxicity of an aqueous extract of M. ilicifolia and its main phytocompounds, catequin, epicatequin, and quercetin. METHODS AND MATERIALS: Slices of liver and intestine of Wistar rats were incubated with different concentrations of M. ilicifolia extract or isolated compounds (catechin, epicatechin and quercetin). Commercial kits were used to evaluate enzyme activities of CYP2D6 and CYP3A4 isoforms, as well as cell viability (MTT) assay and intracellular enzymes leakage, specifically lactate dehydrogenase (LDH), alkaline phosphatase (AP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) were studied. RESULTS: Incubation with M. ilicifolia extract, catechin, epicatechin and quercetin did not affect significantly any evaluated parameter in intestines. The intracellular enzymes leakages, CYP2D6, LDH and AST, were increased with M. ilicifolia extract and quercetin in liver slices. CONCLUSIONS: Our in vitro findings highlighted, for the first time, the potential hepatotoxicity induced by an aqueous extract of M. ilicifolia, consequently this species and its products should be avoided in liver diseases, supporting that studies of safety must be performed including in the context of traditional medicinal plants.

Relatório Técnico Imunização 2022

O presente documento denota o Relatório Técnico de Gestão de Imunização do Brasil, referente ao ano de 2022 – Relatório Anual Brasil 2022, no contexto da Estratégia de Cooperação do País 2022-2027 (ECP/2022-2027), promovida pelo escritório da OPAS/OMS no Brasil, e Ministério da Saúde do Brasil, como uma oportunidade de reforçar os compromissos e as alianças a fim de enfrentar os grandes desafios existentes no campo da saúde pública, especificamente na imunização e, com isso contribuir com os objetivos de recuperação das coberturas vacinais, ao longo do curso de vida. A Coordenação de Imunização da OPAS/OMS no Brasil executou ações dos componentes do Programa Nacional de Imunizações (PNI) em cooperação com o Brasil nas cinco prioridades estratégicas e áreas de foco definidas na ECP/2022-2027: 1) proteger e promover a saúde da população, centrada nas pessoas, famílias e comunidades, especialmente aquelas em situação de vulnerabilidade; 2) recuperar, melhorar e tornar mais forte os serviços de saúde e os programas prioritários impactados pela pandemia da covid-19; 3) contribuir para o desenvolvimento de um Sistema Único de Saúde (SUS) mais resiliente, equitativo e eficaz, de acordo com as necessidades de saúde da população; 4) impulsionar a pesquisa, a inovação e a geração de conhecimentos científicos e tecnológicos em saúde, incluindo aqueles voltados à pesquisa, ao desenvolvimento e à produção de medicamentos, fitoterápicos e produtos tradicionais em saúde, vacinas, biotecnológicos e tecnologias em saúde e 5) reforçar a prevenção, a preparação, a resposta oportuna e a recuperação nas emergências e nos desastres. Neste documento, será apresentada uma análise retrospectiva da situação epidemiológica das doenças preveníveis por vacinação, das estratégias de vacinação, dos riscos e impactos para 2023, bem como dos Eventos Supostamente Atribuíveis à Vacinação ou Imunização (ESAVI). Ainda, será exibido no documento a participação da OPAS/OMS Brasil na elaboração das propostas de melhorias e avanços para o PNI do Brasil e contribuições com os gestores do SUS e outros parceiros que atuam ativamente nesse propósito.