Spatial dynamics of the COVID-19 pandemic in Brazil.

The objective of this study was to analyse the dynamics of spatial dispersion of the coronavirus disease 2019 (COVID-19) in Brazil by correlating them to socioeconomic indicators. This is an ecological study of COVID-19 cases and deaths between 26 February and 31 July 2020. All Brazilian counties were used as units of analysis. The incidence, mortality, Bayesian incidence and mortality rates, global and local Moran indices were calculated. A geographic weighted regression analysis was conducted to assess the relationship between incidence and mortality due to COVID-19 and socioeconomic indicators (independent variables). There were confirmed 2 662 485 cases of COVID-19 reported in Brazil from February to July 2020 with higher rates of incidence in the north and northeast. The Moran global index of incidence rate (0.50, P = 0.01) and mortality (0.45 with P = 0.01) indicate a positive spatial autocorrelation with high standards in the north, northeast and in the largest urban centres between cities in the southeast region. In the same period, there were 92 475 deaths from COVID-19, with higher mortality rates in the northern states of Brazil, mainly Amazonas, Pará and Amapá. The results show that there is a geospatial correlation of COVID-19 in large urban centres and regions with the lowest human development index in the country. In the geographic weighted regression, it was possible to identify that the percentage of people living in residences with density higher than 2 per dormitory, the municipality human development index (MHDI) and the social vulnerability index were the indicators that most contributed to explaining incidence, social development index and the municipality human development index contributed the most to the mortality model. We hope that the findings will contribute to reorienting public health responses to combat COVID-19 in Brazil, the new epicentre of the disease in South America, as well as in other countries that have similar epidemiological and health characteristics to those in Brazil.

Influence of the use of medicinal plants in medication adherence in elderly people.

OBJECTIVE: The objective of this study was to investigate the relationship between the use of medicinal plants and medication adherence in elderly people. METHODS: Observational, cross-sectional study of elderly residents in Cuité-PB, Northeastern Brazil, through a household survey. A stratified proportional and systematic random sample of 240 elders was interviewed in their homes and the use of pharmaceutical medicines and of medicinal plants was assessed by direct examination. The association of medication adherence with socio-demographic, clinical, medication and use of medicinal plants was analysed with multiple logistic regression. RESULTS: The results showed that medication non-adherence increases with use of herbal medicines (adjusted odds ratio 2.022, 95% CI 1.059-3.862, p = 0.03), as well as with the number of different medicinal plants used (adjusted odds ratio 1.937, 95% CI 1.265-2.965, p = 0.002). CONCLUSION/INTERPRETATION: This study provides first-hand evidence that the use of herbal medicines is associated with poor medication adherence. Given the high frequency of the use of herbal medicines, further research into the mechanisms of this association is justified.

Morphological and molecular characterization of Cladosporium cladosporioides species complex causing pecan tree leaf spot.

The objective of this study was to characterize species of the Cladosporium cladosporioides complex isolated from pecan trees (Carya illinoinensis) with symptoms of leaf spot, based on morphological and molecular approaches. Morphological attributes were assessed using monosporic cultures on potato dextrose agar medium, which were examined for mycelial growth, sporulation, color, and conidia and ramoconidia size. Molecular characterization comprised isolation of DNA and subsequent amplification of the translation elongation factor 1α (TEF-1α) region. Three species of the C. cladosporioides complex were identified: C. cladosporioides, Cladosporium pseudocladosporioides, and Cladosporium subuliforme. Sporulation was the most important characteristic differentiating species of this genus. However, morphological features must be considered together with molecular analysis, as certain characters are indistinguishable between species. TEF-1αcan be effectively used to identify and group isolates belonging to the C. cladosporioides complex. The present study provides an important example of a methodology to ascertain similarity between isolates of this complex causing leaf spot in pecan trees, which should facilitate future pathogenicity studies.

Discriminant analysis of patients' reasons for choosing or refusing treatments for partial edentulism.

The aim of the study was to explore partially edentulous patients' reasons for choosing or refusing prosthodontic treatment with removable partial dentures (RPD), fixed partial dentures (FPD) and implant partial dentures (IPD). Clinical and oral health-related quality of life measures were collected from 165 partially edentulous patients undergoing treatment. Patients' preferences were recorded and reasons for choosing or refusing treatments were measured with 32 questions using a five-point Likert scale. Descriptive statistics, chi-square and multiple logistic regression were used to compare patients' preferences according to clinical variables. Discriminant analysis was used to examine the impact of each reason for a patient's decision to choose or refuse treatment options. Results showed that older patients (P < 0.001) and with greater oral-related quality of life impacts (P < 0.05) were more likely to choose RPD. IPD were preferred by patients with higher education levels (P < 0.01). Discriminant functions revealed that the desire to have a fixed or removable denture had great impact on preferences. Removal of tooth structure was the main reason for refusing FPD and financial cost had a great impact on refusing IPD. Overall agreement between observed patients' decisions and those predicted by the discriminant function was >90% for all treatments. Reasons vary greatly among patients, and the role of individual perception of potential reasons for treatment selection was the most important determinants of patients' decisions. The main reasons for choosing or refusing treatments focused in this study can be used to guide shared decision-making, providing treatments that better match patients' expectations and desires.

In vitro antimicrobial susceptibility of staphylococci isolated from canine pyoderma in Rio de Janeiro, Brazil.

The study aimed to determine the etiology and antimicrobial resistance of staphylococci isolated from canine pyoderma. Samples were obtained from dogs with pyoderma and isolates were identified by biochemical reactions and tested for susceptibility to 15 antimicrobials. Thirty nine staphylococci isolates were obtained, and S. pseudintermedius was the most frequent (47.4%). All isolates showed resistance to at least one drug and 77.1% were multiresistant. The most effective drug was oxacillin. The study reports the alarming antimicrobial resistance of Staphylococcus isolated from canine pyoderma samples.

Mucoid degeneration of the anterior cruciate ligament: magnetic resonance imaging findings of an underdiagnosed entity.

Although imaging and clinical criteria are already established for the diagnosis of mucoid degeneration of the anterior cruciate ligament (ACL), many radiologists remain unaware of their existence. Once regarded as a rare occurrence, it has been recently suggested that its incidence is in fact very much higher than previously thought, and that it is probably underdiagnosed or misdiagnosed as partial ruptures of the ACL or as cystic ganglia. In this review, the authors revisit the literature concerning this subject and present their personal experience with it, stressing the paramount importance of magnetic resonance imaging and correlation with clinical data for a correct diagnosis.

Genetic disorders in normally androgenized infertile men and the use of intracytoplasmic sperm injection as a way of treatment.

OBJECTIVE: To determine the incidence of chromosomal abnormalities in normally androgenized infertile men with no other recognized causes of infertility or who had ever been submitted to other unsuccessful methods of treatment. DESIGN: Collaborative retrospective study of clinical experience collected by an endocrinologist and a geneticist over a 5-year period. SETTING: Outpatients at an endocrinology clinic. PATIENT(S): Infertile male patients with azoospermia (n = 23), oligozoospermia (n = 66), and normozoospermia (n = 14) presenting normal (n = 85) or subnormal (n = 18) testicular volume. INTERVENTION(S): All patients were submitted to cytogenetic analysis. MAIN OUTCOME MEASURE(S): Two patients were referred to intracytoplasmic sperm injection (ICSI), and in one case, a successful gemellar pregnancy ended up uneventful. Children's genetic testing were not performed according to parents' request. RESULT(S): Abnormal karyotypes were found in 11 (10.6%) patients. Chromosomal abnormalities were found in 17.3% of the 23 azoospermic patients, in 10.6% of the 66 oligozoospermic patients, and in none of the 14 normozoospermic patients. These disorders were found only in patients with normal testicular volumes and no more than 10 x 10(6) spermatozoa per mL. CONCLUSION(S): A high incidence of chromosomal abnormalities was found in a selected group of normally androgenized infertile male patients. The elevated rate of fertilization achieved in one patient indicates that ICSI is, at the moment, the only choice for treatment of male infertility because of chromosomal abnormalities.

Quality control in the different stages of producing red blood cell concentrate from dogs / Controle de qualidade nas diferentes etapas de produção do concentrado de hemácias em cães

The objective of this study was to perform a quality control assessment of red blood cells after standardization of the blood production stages. For this purpose, separation of the blood components to obtain red blood cells, the storage of the blood packets and an evaluation of blood quality were performed. The mean (± SD) volume, globular volume, hemoglobin and hemolysis percentage of the red blood cell concentrate were 299.77±30.08mL, 60.87±2.60%, 20.57±0.93g/DL and 0.09±0.07%, respectively. The means (± SD) of the volume, globular volume, total hemoglobin percentage of hemolysis and hemoglobin per unit of packed red blood cells after the storage period (8.83±6.73 days) were 57.55±3.01%, 20.30±0.89 0, 20±0.12%, and 60.90±7.65. The red blood cell packets were within the parameters of quality control established by Health Ministry legislation in humans and allow us to conclude that the standardization of blood production stages involves the selection of donors until the end of storage and is necessary to produce quality red blood cells. Quality control aims to find possible flaws in the procedures to be repaired, increasing transfusion safety.(AU)

O objetivo deste estudo foi realizar o controle de qualidade do concentrado de hemácias após a padronização das etapas de produção do sangue. Para isso, realizou-se separação de hemocomponentes para obtenção de concentrado de hemácias, armazenamento das bolsas de sangue e avaliação da qualidade delas. Os valores médios (± DP) do volume, do volume globular, da hemoglobina e do percentual de hemólise do concentrado de hemácias foram: 299,77±30,08mL, 60,87±2,60%, 20,57±0,93g/DL e 0,09±0,07%, respectivamente. Os valores médios (± DP) do volume globular, da hemoglobina total percentual de hemólise e da hemoglobina por unidade de concentrado de hemácias após o período de armazenamento (8,83±6,73 dias) foram: 57,55±3,01%, 20,30±0,89 0,20±0,12%, 60,90±7,65. As bolsas de concentrado de hemácias ficaram dentro dos parâmetros de controle de qualidade estabelecidos pela legislação do Ministério da Saúde em humanos e possibilitaram concluir que a padronização das etapas de produção do sangue envolve desde a seleção de doadores até o final do armazenamento e é necessária para produzir concentrado de hemácias com qualidade. O controle de qualidade visa encontrar possíveis falhas nos procedimentos para que estas possam ser reparadas, aumentando, assim, a segurança transfusional.(AU)

Levels of oxidative stress markers: correlation with hepatic function and worm burden patients with schistosomiasis.

Schistosomiasis is caused by Schistosoma mansoni and is a public health problem in Brazil. The typical granulomatous lesion is associated with the increase in the oxidative damage by generation of free radicals. The aim of this work was to correlate some oxidative stress markers with the worm burden on carriers of schistosomiasis (n = 30) in the acute phase in comparison to healthy subjects (n = 30). The pro-oxidant parameter used was the colorimetric quantification of reactive substances to thiobarbituric acid, while the antioxidant markers used were blood content of reduced glutathione and determination of the activity of catalase. The worm burden was assessed by Kato-Katz method. The results pointed out that initially there was no difference in the catalase activity. However, there was a positive correlation between the increase in parasitic load and intensity of lipid peroxidation, and decrease in the content of reduced glutathione. Additionally, only the aspartate aminotransferase levels presented to be high, while there was a decrease in bilirubin level. Therefore, a possible association between the establishment of the oxidative stress in tissue and the parasitic load of Schistosoma mansoni is suggested.

Imunidade celular em caninos neonatos - do nascimento ao 45° dia de idade / Cellular immunity in canine newborns - from birth to the 45th day of life

O objetivo do presente trabalho foi acompanhar o desenvolvimento imunológico dos neonatos caninos, a fim de avaliar a imunidade celular pela análise dos leucócitos e linfócitos totais e das subpopulações de linfócitos T (CD4+ e CD8+) pela técnica de citometria de fluxo. Foram utilizados 30 cães neonatos de ambos os sexos, sem raça definida, aos três, 10, 17, 24, 31, 38 e 45 dias de idade. A contagem de leucócitos totais aos 45 dias (11.639±3.574) foi significativamente maior que no terceiro dia de idade (8.740±1.812) (P<0,05); não houve diferença entre a contagem total de linfócitos aos 45 dias em relação ao terceiro dia de idade. Quanto às subpopulações de LT CD4+ e LT CD8+, os percentuais de LT CD4+, aos três dias de idade (24,9±16,8 por cento), foram inferiores quando comparados à média entre o 10°, o 24° e o 31°dia (35,5 por cento), e os de CD8+, ao terceiro dia, menores em relação às médias do 10° e do 31° dia de idade. Pode-se concluir que as subpopulações de LT CD4+ e CD8+ sofrem oscilações durante o desenvolvimento pós-natal, sendo estas crescentes em relação aos níveis obtidos aos três dias de idade. A relação CD4+:CD8+ mostrou superioridade para o primeiro tipo celular, sendo que a maior relação entre CD4+ e CD8+ ocorreu no terceiro dia de idade. Com base nos resultados obtidos neste estudo, notaram-se as diferenças semanais nas populações linfocitárias, o que demonstra a dinâmica dessas células durante o período neonatal...

The aim of this study was to evaluate the immune development of newborn canines, evaluating the cellular immunity by analysis of leukocyte and lymphocyte totals and sub-population of T lymphocytes (CD4+ and CD8+) by the flow cytometry technique. Thirty neonatal mongrel dogs of both sexes were used, at 3, 10, 17, 24, 31, 38 and 45 days of age. The total leukocyte count to 45 days (11639±3574/µL) was significantly greater than on the third day of age (8740±1812) (p<0.05); There were no differences between the total count of lymphocytes at 45 days in relation to the third day of age. As for the subpopulations of CD4+ and CD8+, CD4+ cell percentages, at three days of age (24.9±16.8) they were inferior when compared to the average between the 10th, 24th and 31st day (35.5), and CD8+ cells, on the third day, were lower compared with averages from the 10th and 31st day of age. It can be concluded that the subpopulations of CD4+ and CD8+ cells undergo oscillations during development, with growing postnatal levels obtained at three days old. The CD4:CD8 ratio showed superiority to the first cell type, and the largest relationship between CD4+ and CD8+ occurred on the third day of age. Based on the results obtained in this study, the differences noted in lymphocyte populations weekly showed the dynamics of these cells during the neonatal period...

Production of multivalent fluorescent antisera for identification of organisms in the Mycobacterium avium-Mycobacterium intracellulare complex.

Antisera to ten strains of mycobacteria in the Mycobacterium avium-Mycobacterium intracellulare group were obtained by injecting rabbits with ultraviolet light-killed cells. The antisera were conjugated with fluorescein isothiocyanate and used in the direct fluorescent antibody test. Individual antisera reacted specifically with the mycobacterial serotype used to produce them. The antisera were then combined in two multivalent pools. Each multivalent pool reacted specifically with its corresponding antigens. The multivalent antisera were thus found to provide a rapid identification method for the mycobacteria studied.

Interstitial deletion of (17)(p11.2). A microdeletion syndrome. Another example.

Another example of del (17)(p11.2) in a 3-year-old boy with psychomotor retardation, broad face, midface hypoplasia, prognathism, and behavioural anomalies was diagnosed clinically and confirmed by prometaphase analysis. It seems that this new microdeletion syndrome may not be so rare.

In vitro antimicrobial susceptibility of staphylococci isolated from canine pyoderma in Rio de Janeiro, Brazil / Susceptibilidade in vitro a antimicrobianos de staphylococci isolados de cães com piodermatite no estado do Rio de Janeiro, Brasil

The study aimed to determine the etiology and antimicrobial resistance of staphylococci isolated from canine pyoderma. Samples were obtained from dogs with pyoderma and isolates were identified by biochemical reactions and tested for susceptibility to 15 antimicrobials. Thirty nine staphylococci isolates were obtained, and S. pseudintermedius was the most frequent (47.4 percent). All isolates showed resistance to at least one drug and 77.1 percent were multiresistant. The most effective drug was oxacillin. The study reports the alarming antimicrobial resistance of Staphylococcus isolated from canine pyoderma samples.

O estudo se propõe a avaliar a etiologia e a susceptibilidade de estafilococos isolados de cães com dermatite. Os isolados foram identificados por provas bioquímicas e testados quanto a sua susceptibilidade a 15 antimicrobianos. Trinta e nove isolados de Staphylococci foram obtidos, e S. pseudintermedius foi mais freqüente (47,4 por cento). Todos isolados apresentaram resistência a pelo menos uma droga e 77,1 por cento foram multirresistentes. A oxacilina foi a droga mais eficaz. O estudo demonstra níveis alarmantes de resistência antimicrobiana nos Staphylococcus de pioderma canino.

Ring 13 in an adult male with a 13:13 translocation mother.

A male with a ring 13 chromosome [r(13)(p11q34)], mild mental retardation, short stature, oligoasthenospermia, and few dysmorphisms is reported. His mother who had a poor reproductive history is carrier of a t(13q13q), featuring a dicentric NOR-negative element. The clinical significance of the r(13) and the mother's unusual karyotype are discussed.

Combined cytogenetic techniques and non-fluorescent Y. Cytologic evidences of dic(Yp)(q11) in a previously interpreted 46,X,Yq-.

mos 45,X/46,X,Y with no bright fluorescence was studied in 4 patients presenting variable phenotypes, from Turner's syndrome, with or without virilization, to ambiguous external genitalia, with combined cytogenetic techniques. G-11 staining demonstrated, in all cases, that the abnormal Y was a dic(Yp). Considerations about the possibility that some of the 46,X,Yq-males attending infertility clinics may be examples of dic(Yp) are made.