Specific behaviors during auditory fear conditioning and postsynaptic expression of AMPA receptors in the basolateral amygdala predict interindividual differences in fear generalization in male rats.

Auditory fear conditioning in rats is a widely used method to study learning, memory, and emotional responding. Despite procedural standardizations and optimizations, there is substantial interindividual variability in fear expression during test, notably in terms of fear expressed toward the testing context alone. To better understand which factors could explain this variation between subjects, we here explored whether behavior during training and expression of AMPA receptors (AMPARs) after long-term memory formation in the amygdala could predict freezing during test. We studied outbred male rats and found strong variation in fear generalization to a different context. Hierarchical clustering of these data identified two distinct groups of subjects that independently correlated with a specific pattern of behaviors expressed during initial training (i.e., rearing and freezing). The extent of fear generalization correlated positively with postsynaptic expression of GluA1-containing AMPA receptors in the basolateral nucleus of the amygdala. Our data thus identify candidate behavioral and molecular predictors of fear generalization that may inform our understanding of some anxiety-related disorders, such as posttraumatic stress disorder (PTSD), that are characterized by overgeneralized fear.

mTORC1 promotes TOP mRNA translation through site-specific phosphorylation of LARP1.

LARP1 is a key repressor of TOP mRNA translation. It binds the m7Gppp cap moiety and the adjacent 5'TOP motif of TOP mRNAs, thus impeding the assembly of the eIF4F complex on these transcripts. mTORC1 controls TOP mRNA translation via LARP1, but the details of the mechanism are unclear. Herein we elucidate the mechanism by which mTORC1 controls LARP1's translation repression activity. We demonstrate that mTORC1 phosphorylates LARP1 in vitro and in vivo, activities that are efficiently inhibited by rapamycin and torin1. We uncover 26 rapamycin-sensitive phospho-serine and -threonine residues on LARP1 that are distributed in 7 clusters. Our data show that phosphorylation of a cluster of residues located proximally to the m7Gppp cap-binding DM15 region is particularly sensitive to rapamycin and regulates both the RNA-binding and the translation inhibitory activities of LARP1. Our results unravel a new model of translation control in which the La module (LaMod) and DM15 region of LARP1, both of which can directly interact with TOP mRNA, are differentially regulated: the LaMod remains constitutively bound to PABP (irrespective of the activation status of mTORC1), while the C-terminal DM15 'pendular hook' engages the TOP mRNA 5'-end to repress translation, but only in conditions of mTORC1 inhibition.

Upper Bound of Neutrino Masses from Combined Cosmological Observations and Particle Physics Experiments.

We investigate the impact of prior models on the upper bound of the sum of neutrino masses, ∑m_{ν}. Using data from the large scale structure of galaxies, cosmic microwave background, type Ia supernovae, and big bang nucleosynthesis, we argue that cosmological neutrino mass and hierarchy determination should be pursued using exact models, since approximations might lead to incorrect and nonphysical bounds. We compare constraints from physically motivated neutrino mass models (i.e., ones respecting oscillation experiments) to those from models using standard cosmological approximations. The former give a consistent upper bound of ∑m_{ν}≲0.26 eV (95% CI) and yield the first approximation-independent upper bound for the lightest neutrino mass species, m_{0}^{ν}<0.086 eV (95% CI). By contrast, one of the approximations, which is inconsistent with the known lower bounds from oscillation experiments, yields an upper bound of ∑m_{ν}≲0.15 eV (95% CI); this differs substantially from the physically motivated upper bound.

Contributions of human cultures to biodiversity and ecosystem conservation.

The expansion of globalized industrial societies is causing global warming, ecosystem degradation, and species and language extinctions worldwide. Mainstream conservation efforts still focus on nature protection strategies to revert this crisis, often overlooking the essential roles of Indigenous Peoples and Local Communities (IP&LC) in protecting biodiversity and ecosystems globally. Here we assess the scientific literature to identify relationships between biodiversity (including ecosystem diversity) and cultural diversity, and investigate how these connections may affect conservation outcomes in tropical lowland South America. Our assessment reveals a network of interactions and feedbacks between biodiversity and diverse IP&LC, suggesting interconnectedness and interdependencies from which multiple benefits to nature and societies emerge. We illustrate our findings with five case studies of successful conservation models, described as consolidated or promising 'social-ecological hope spots', that show how engagement with IP&LC of various cultures may be the best hope for biodiversity and ecosystem conservation, particularly when aligned with science and technology. In light of these five inspiring cases, we argue that conservation science and policies need to recognize that protecting and promoting both biological and cultural diversities can provide additional co-benefits and solutions to maintain ecosystems resilient in the face of global changes.

Impact of agr dysfunction on virulence profiles and infections associated with a novel methicillin-resistant Staphylococcus aureus (MRSA) variant of the lineage ST1-SCCmec IV.

BACKGROUND: A novel variant of the ST1-SCCmecIV methicillin-resistant Staphylococcus aureus (MRSA) lineage, mostly associated with nosocomial bloodstream infections (BSI), has emerged in Rio de Janeiro. Bacterial biofilm has been considered a major virulence factor in central venous catheter-associated BSI. The mechanisms involved in biofilm formation/accumulation are multifactorial and complex. Studies have suggested that biofilm production was affected in vitro and vivo for agr-null mutants of S. aureus. RESULTS: The impact of naturally occurring inhibition of agr signaling on virulence profiles and infections associated with the ST1 variant was investigated. agr dysfunction was detected in a significant percentage (13%) of the isolates with concomitant increase in biofilm accumulation in vitro and in vivo, and enhanced ability to adhere to and invade airway cells. The biofilm formed by these ST1 isolates was ica-independent and proteinaceous in nature. In fact, the improved colonization properties were paralleled by an increased expression of the biofilm-associated genes fnbA, spa and sasG. The transcription of sarA, a positive regulator of agr, was two-times reduced for the agr-dysfunctional MRSA. Remarkably, the agr inhibition was genetically stable. Indeed, agr-dysfunctional isolates succeed to colonize and cause both acute and chronic infections in hospitalized patients, and also to effectively accumulate biofilm in a mouse subcutaneous catheter implant model. CONCLUSION: The ability of agr-dysfunctional isolates to cause infections in humans and to form biofilm in the animal model suggests that therapeutic approaches based on agr-inactivation strategies are unlikely to be effective in controlling human-device infections caused by ST1 isolates. The increased biofilm accumulation associated with the acquisition of multiple antimicrobial resistant traits might have influenced (at least in part) the expansion of this USA400 related clone in our hospitals.

Effect of Wendler glottoplasty on voice and quality of life of transgender women.

OBJECTIVE: To investigate the effect of Wendler glottoplasty on voice feminization, voice quality and voice-related quality of life. METHODS: Prospective interventional cohort of transgender women submitted to Wendler glottoplasty. Acoustic analysis of the voice included assessment of fundamental frequency, maximum phonation time formant frequencies (F1 and F2), frequency range, jitter and shimmer. Voice quality was blindly assessed through GRBAS scale. Voice-related quality of life was measured using the Trans Woman Voice Questionnaire and the self-perceived femininity of the voice. RESULTS: A total of 7 patients were included. The mean age was 35.4 years, and the mean postoperative follow-up time was 13.7 months. There was a mean increase of 47.9 ±â€¯46.6 Hz (p = 0.023) in sustained/e/F0 and a mean increase of 24.6 ±â€¯27.5 Hz (p = 0.029) in speaking F0 after glottoplasty. There was no statistical significance in the pre- and postoperative comparison of maximum phonation time, formant frequencies, frequency range, jitter, shimmer, and grade, roughness, breathiness, asthenia, and strain scale. Trans Woman Voice Questionnaire decreased following surgery from 98.3 ±â€¯9.2 to 54.1 ±â€¯25.0 (p = 0.007) and mean self-perceived femininity of the voice increased from 2.8 ±â€¯1.8 to 7.7 ±â€¯2.4 (p = 0.008). One patient (14%) presented a postoperative granuloma and there was 1 (14%) premature suture dehiscence. CONCLUSION: Glottoplasty is safe and effective for feminizing the voice of transgender women. There was an increase in fundamental frequency, without aggravating other acoustic parameters or voice quality. Voice-related quality of life improved after surgery.

Mitochondrial and Redox Changes in Periodontitis and Type 2 Diabetes Human Blood Mononuclear Cells.

Periodontitis (PDT) and type 2 diabetes (T2D) have demonstrated a bidirectional relationship and imbalanced oxidative stress linked to mitochondrial dysfunction. Therefore, we investigated mitochondrial and redox (de)regulation in peripheral blood mononuclear cells (PBMCs) in comorbid T2D-PDT, compared to PDT, T2D patients, and control individuals. PBMCs were analyzed for mitochondrial respiration, reactive oxygen species, antioxidant proteins, and expression of Nrf2-target genes. PDT and T2D-PDT patients exhibited altered periodontal clinical markers, while T2D and T2D-PDT patients displayed increased blood HbA1c. Decreased oxygen consumption and ATP production were observed in the PDT patient's PBMCs. PDT and T2D-PDT PBMCs also evidenced increased H2O2 levels and reduced catalase levels (also detected in T2D patients), whereas a compromised glutathione cycle was observed in T2D-PDT patients. PBMCs from both T2D or T2D-PDT patients showed increased Nrf2 protein levels, enhanced GCL activity and GCL-catalytic subunit protein levels, and maintained GCLc, GST, and HO-1 mRNA levels. In contrast, the expressions of Nrf2-target genes were significantly diminished in the PDT patient's PBMCs. Decreased SOD1 and GST mRNA levels were also observed in CD3+CD8+-lymphocytes derived from PDT and T2D-PDT patients. In conclusion, PBMCs from T2D-PDT patients showed major redox changes, while mononuclear cells from PDT patients showed mitochondrial deregulation and reduced expression of Nrf2-target genes.

G6PDH as a key immunometabolic and redox trigger in arthropods.

The enzyme glucose-6-phosphate dehydrogenase (G6PDH) plays crucial roles in glucose homeostasis and the pentose phosphate pathway (PPP), being also involved in redox metabolism. The PPP is an important metabolic pathway that produces ribose and nicotinamide adenine dinucleotide phosphate (NADPH), which are essential for several physiologic and biochemical processes, such as the synthesis of fatty acids and nucleic acids. As a rate-limiting step in PPP, G6PDH is a highly conserved enzyme and its deficiency can lead to severe consequences for the organism, in particular for cell growth. Insufficient G6PDH activity can lead to cell growth arrest, impaired embryonic development, as well as a reduction in insulin sensitivity, inflammation, diabetes, and hypertension. While research on G6PDH and PPP has historically focused on mammalian models, particularly human disorders, recent studies have shed light on the regulation of this enzyme in arthropods, where new functions were discovered. This review will discuss the role of arthropod G6PDH in regulating redox homeostasis and immunometabolism and explore potential avenues for further research on this enzyme in various metabolic adaptations.

Incidence of hospital acquired pressure injury in critically ill patients with COVID-19 in prone position admitted to the intensive care unit.

Critical patients have conditions that may favor the occurrence of hospital-acquired pressure injury (HAPI). The objective of this study was to identify the incidence and factors associated with the occurrence of HAPI in patients with coronavirus disease 2019 admitted to the intensive care unit (ICU) who used the prone position. Retrospective cohort study carried out in an ICU of a tertiary university hospital. Two hundred four patients with positive real-time polymerase chain reactions were evaluated, of which 84 were placed in the prone position. All patients were sedated and submitted to invasive mechanical ventilation. Of the prone patients, 52 (62%) developed some type of HAPI during hospitalization. The main place of occurrence of HAPI was the sacral region, followed by the gluteus and thorax. Of the patients who developed HAPI, 26 (50%) had this event in places possibly associated with the prone position. The factors associated with the occurrence of HAPI in patients prone to coronavirus disease 2019 were the Braden Scale and the length of stay in the ICU. The incidence of HAPI in prone patients was extremely high (62%), which denotes the need to implement protocols in order to prevent the occurrence of these events.

Intentional creation of carbon-rich dark earth soils in the Amazon.

Fertile soil known as Amazonian dark earth is central to the debate over the size and ecological impact of ancient human populations in the Amazon. Dark earth is typically associated with human occupation, but it is uncertain whether it was created intentionally. Dark earth may also be a substantial carbon sink, but its spatial extent and carbon inventory are unknown. We demonstrate spatial and compositional similarities between ancient and modern dark earth and document modern Indigenous practices that enrich soil, which we use to propose a model for the formation of ancient dark earth. This comparison suggests that ancient Amazonians managed soil to improve fertility and increase crop productivity. These practices also sequestered and stored carbon in the soil for centuries, and we show that some ancient sites contain as much carbon as the above-ground rainforest biomass. Our results demonstrate the intentional creation of dark earth and highlight the value of Indigenous knowledge for sustainable rainforest management.

Effect of methylene blue on hemodynamic response in the early phase of septic shock: A case series.

RATIONALE: Methylene blue (MB) has been used to increase blood pressure in septic shock, acting on the activity of guanylate cyclase and nitric oxide synthase. PATIENCE CONCERNS: The aim of this study is to demonstrate the benefit of MB in early phase of septic shock.Diagnoses: We report 6 cases of patients with septic shock with up to 72 hours of evolution. INTERVENTIONS: We used MB after fluid replacement, use of norepinephrine and vasopressin. Patients received a loading dose of MB and maintenance for 48 hours. OUTCOMES: All patients presented a reduction in the dose of vasopressors and lactate levels soon after the administration of the loading dose of MB, an effect that was maintained with the maintenance dose for 48 hours. Interleukin 6 and interleukin 8 were elevated at the beginning of the septic condition, with a progressive and marked reduction after the beginning of MB infusion, demonstrating a role of MB in reducing the inflammatory activity. LESSONS: This case series suggests that MB used early in the treatment of septic shock may be useful in reducing vasopressor dose and lactate levels. Further studies are still required to further validate these findings.

Comparison of coach-athlete perceptions on internal and external training loads in trained cyclists.

ABSTRACTThe aim was to compare the rating of perceived exertion (RPE), duration and session-RPE (S-RPE) prescribed by the coaches to those perceived by the cyclists in training sessions. The classification of RPE, duration and S-RPE of 14 male road cycling and mountain biking athletes were compared with the planned values of five coaches. The results revealed no differences for average RPE (P = 0.586), duration (P = 0.717) and S-RPE (P = 0.738) between coaches and cyclists. When comparing the three categories of effort, the results of the intensity of training sessions designed to be easy were perceived as significantly harder by cyclists compared to coaches (3.0 [2.0] vs. 2.0 [0.0] a.u.; P = 0.013). In addition, the correlations between coaches and cyclists on RPE (r = 0.73), duration (r = 0.95) and S-RPE (r = 0.87) were large, almost perfect and very large (P < 0.0001) respectively. In conclusion, our results indicate a mismatch between coaches (prescription) and cyclists (perception) of easy RPE training sessions, where the cyclists perceived the session harder. However, the S-RPE can be used to prescribe and quantifying the internal training load of trained cyclists.

Deficiency of Acetyl-CoA Carboxylase Impairs Digestion, Lipid Synthesis, and Reproduction in the Kissing Bug Rhodnius prolixus.

Rhodnius prolixus is a hematophagous insect, vector of Chagas disease. After feeding, as blood is slowly digested, amino acids are used as substrates to fuel lipid synthesis, and adult females accumulate lipids in the fat body and produce eggs. In order to evaluate the importance of de novo fatty acid synthesis for this insect metabolism, we generated acetyl-CoA carboxylase (ACC) deficient insects. The knockdown (AccKD) females had delayed blood digestion and a shorter lifespan. Their fat bodies showed reduced de novo lipogenesis activity, did not accumulate triacylglycerol during the days after blood meal, and had smaller lipid droplets. At 10 days after feeding, there was a general decrease in the amounts of neutral lipids and phospholipids in the fat body. In the hemolymph, no difference was observed in lipid composition at 5 days after blood meal, but at day ten, there was an increase in hydrocarbon content and a decrease in phospholipids. Total protein concentration and amino acid composition were not affected. The AccKD females laid 60% fewer eggs than the control ones, and only 7% hatched (89% for control), although their total protein and triacylglycerol contents were not different. Scanning electron microscopy of the egg surface showed that chorion (eggshell) from the eggs laid by the AccKD insects had an altered ultrastructural pattern when compared to control ones. These results show that ACC has a central role in R. prolixus nutrient homeostasis, and its appropriate activity is important to digestion, lipid synthesis and storage, and reproductive success.

Prosodic Differences in the Voices of Transgender and Cisgender Women: Self-Perception of Voice - An Auditory and Acoustic Analysis.

INTRODUCTION: The voice is an important parameter for identifying the speaker's gender. Transgender people seek to adapt their bodies to gender identity, and transgender women have greater difficulties in achieving vocal acceptance. In this context, the evaluation of the various parameters of the voice of transgender and cisgender women is essential to make it possible to propose appropriate intervention measures. OBJECTIVES: To identify the differences in vocal characteristics of transgender and cisgender women. METHODS: An sectional study was conducted. The sample comprised 20 transgender women and 20 cisgender women who underwent evaluation of acoustic parameters, emotional prosody, self-perception, and perception of gender by lay listeners. RESULTS: The vocal characteristics of transgender and cisgender women differ in terms of the following parameters: f0, glottal noise excitation (GNE), vocal intensity, speech range profile (SRP), the first three formants of the vowel /a/, and in terms of emotional prosody, including duration and melodic contour. Higher values ​​were mostly found in the cisgender population, except for noise level and vocal intensity. In addition, in most cases lay listeners identified the voices of transgender women as belonging to the male gender. There was a negative correlation between vocal dissatisfaction and f0 among transgender women. CONCLUSIONS: Even though they perform vocal adjustments, the voices of transgender women are different from cisgender women in terms of acoustic parameters, vocal extension, and emotional prosody including duration and melodic contour. These differences have repercussions on the perception of gender by listeners.

Ophthalmological findings in patients suspected with COVID-19 at a tertiary hospital in Pernambuco, Brazil.

PURPOSE: This study evaluated the frequency of the most common ophthalmological, neurological, and systemic findings in symptomatic patients seen at a COVID-19 screening service at Hospital das Clínicas - Universidade Federal de Pernambuco. METHODS: A total of 104 patients under clinical suspicion of SARS-CoV-2 infection underwent medical evaluation through an ophthalmological and systemic symptoms survey. All participants selected for the study underwent COVID-19 RT-PCR testing. RESULTS: The mean age was 38.8 years, with 44.23% between 31 and 40 years old, 68.27% female, and 31.73% male. The most common symptoms in patients with a positive RT-PCR test were cough (69.23%), fever (42.3%), hyposmia (38.46%), myalgia (38.46%), and ageusia (30.77%). In the positive group, 34.61% presented with ophthalmological symptoms: burning (19.23%), eye pain (11.54%), foreign body sensation (7.7%), hyperemia (7.7%), and tearing (3.84%). CONCLUSIONS: Systemic clinical features were characteristic of upper respiratory infection, but neurological findings of hyposmia and anosmia proved to be important markers for suspicion of SARS-CoV-2 infection. Ophthalmic symptoms in patients with COVID-19 were similar to those observed in other viral conditions and may precede systemic conditions. A high rate of self-medication was observed for general symptoms compared with ophthalmological conditions.

Effect of methylene blue on hemodynamic and metabolic response in septic shock patients.

INTRODUCTION: Septic shock is a lethal disease responsible for a large proportion of deaths in the Intensive Care Unit (ICU), even with therapy centered on fluid resuscitation, use of vasopressors and empirical antibiotic therapy applied within the first hour of diagnosis. Considering the multifactorial pathophysiology of septic shock and the mechanism of action of vasopressors, some patients may not respond adequately, which can lead to the maintenance of vasodilatation, hypotension and increased morbidity, and mortality. This protocol aims to verify whether the use of methylene blue in septic patients with an early diagnosis can contribute to an earlier resolution of a shock compared to standard treatment. METHODS AND ANALYSIS: This is a study protocol for a single-center randomized clinical trial design in an ICU of a tertiary university hospital. In this study, we intend to include 64 patients aged between 18 and 80 years with a diagnosis of septic shock, of any etiology, with up to 72 hours of evolution after volume restoration, using norepinephrine at a dose ≥0.2 µg/kg/min and vasopressin at a dose of 0.04 IU/min. After the initial approach, we will randomize patients into two groups, standard care, and standard care plus methylene blue. The sample size was calculated in order to show 30% differences in septic shock resolution between groups. The Research Ethics Committee approved the study, and all patients included will sign an informed consent form (Clinical registration: RBR-96584w4).

Hypercoagulability Due to COVID-19 Leading to Impending Phlegmasia Cerulea Dolens and Sub-Massive Bilateral Pulmonary Embolism.

This is a case report of a 47-year-old male with a history of hypertension and pre-diabetes who presented to the emergency department with dyspnea, progressive unilateral leg swelling and pain. The patient tested positive for coronavirus disease 2019 (COVID-19) infection about a week earlier. The patient was found to have an extensive clot burden of his lower extremity veins, both deep and superficial, which extended to his inferior vena cava (IVC). Based on the patient's clinical exam and ultrasound findings, the patient was diagnosed with impending phlegmasia cerulea dolens. Due to his renal failure, the patient was taken for a ventilation/perfusion (V/Q) scan which found widespread V/Q mismatch highly suggestive of pulmonary embolism. Interventional radiology took the patient for lower extremity venogram, catheter-directed alteplase administration, and IVC filter placement. The patient was admitted to the intensive care unit (ICU) for further management and had a stable recovery.

Chondrolaryngoplasty in transgender women: Prospective analysis of voice and aesthetic satisfaction.

Introduction: Chondrolaryngoplasty or "tracheal shaving" is cosmetic surgery to reduce the laryngeal prominence in transgender women. Complications may include damage to the vocal folds and epiglottic destabilization or aesthetic dissatisfaction. Objective: To assess and compare acoustic and perceptual voice outcomes and aesthetic satisfaction of transgender women submitted to chondrolaryngoplasty. Methods: Prospective interventional cohort of transgender women submitted to chondrolaryngoplasty between March 2018 and October 2019. Voice analysis included simple-blind application of the GRBAS Hirano scale by speech therapist and measurement of the fundamental frequency, in the preoperative and 1-month postoperative periods. The visual analog scale was used to analyze the aesthetic satisfaction, before and 6-months after chondrolaryngoplasty. Results: Fifteen patients participated, with a mean age of 31.7 ± 8.3 years (range 22-51 years). The mean postoperative follow-up period was 15.3 ± 6.1 months (range 6-25 months). There was a significant improvement in the visual analog scale for aesthetic satisfaction, with a preoperative mean = 0.7 ± 1.0 and a postoperative mean = 9.3 ± 1.1 (95% CI for difference = 7.3 to 9.6; p < 0.001). All patients presented a positive variation. The preoperative mean fundamental frequency was 171.3 ± 41.2 Hz and the postoperative, 177.1 ± 39.5 Hz, with no statistical significance (95% CI for difference = -30.1 to 41.7; p = 0.74). There was no statistically significant difference in the pre- and postoperative comparison of each component of the GRBAS scale. One (7%) patient presented a hyperpigmented scar and 2 (13%) reported hoarseness during the first postoperative week. There were no major complications such as disinsertion of the epiglottis or vocal folds. Conclusion: Chondrolaryngoplasty led to significant aesthetic satisfaction in transgender women. The surgery caused no noticeable vocal change in pitch or perception.

Modified Glutamatergic Postsynapse in Neurodegenerative Disorders.

The postsynaptic density (PSD) is a complex subcellular domain important for postsynaptic signaling, function, and plasticity. The PSD is present at excitatory synapses and specialized to allow for precise neuron-to-neuron transmission of information. The PSD is localized immediately underneath the postsynaptic membrane forming a major protein network that regulates postsynaptic signaling and synaptic plasticity. Glutamatergic synaptic dysfunction affecting PSD morphology and signaling events have been described in many neurodegenerative disorders, either sporadic or familial forms. Thus, in this review we describe the main protein players forming the PSD and their activity, as well as relevant modifications in key components of the postsynaptic architecture occurring in Huntington's, Parkinson's and Alzheimer's diseases.

Trend analysis of clinical aspects of congenital syphilis in Brazil, 2009-2018.

INTRODUCTION: Congenital syphilis is caused by the vertical transmission of bacteria, Treponema pallidum, from nontreated or inappropriately treated pregnant to the fetus. OBJECTIVE: To evaluate the clinical aspects of Congenital syphilis in Brazil, between 2009-2018. METHOD: It is an analytical cross-sectional study whose data were collected from the Department of Chronical Conditions and Sexually Transmitted Infections of Brazilian Health Ministry. Clinical variables were analyzed using the software Joinpoint Regression, which makes a segmented linear regression. RESULTS: In the study period, 156,969 cases of Congenital syphilis and 1642 deaths by this disease were reported. The trend analysis indicates growing in diagnosis of maternal syphilis during prenatal care, appropriate treatment of pregnant, realization of prenatal care, maternal partner treatment, diagnosis of syphilis in children under seven days, and diagnosis of recent syphilis. CONCLUSIONS: Although the trend analysis presents relative improvement in Congenital syphilis panorama in Brazil, the disease still related to high numbers of evitable perinatal morbidity and mortality. Therefore, the prenatal assistance with quality is fundamental to have a possible change in this field in the country.