Can habits and behaviors predict colonization by community-associated MRSA in patients admitted to a Brazilian hospital?

This study aimed to identify factors associated with colonization by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in adult patients admitted to a Brazilian hospital. This is a cross-sectional study, in which patients underwent a nasal swab and were asked about hygiene behavior, habits, and clinical history. Among the 702 patients, 180 (25.6%) had S. aureus and 21 (2.9%) MRSA. The factors associated with MRSA colonization were attending a gym (OR 4.71; 95% CI; 1.42 - 15.06), smoking habit in the last year (OR 2.37; 95% CI; 0.88 - 6.38), previous hospitalization (OR 2.18; CI 95%; 0.89 - 5.25), and shared personal hygiene items (OR 1.99; 95% CI; 0.71 - 5.55). At the time of admission, colonization by CA-MRSA isolates was higher than that found in the general population. This can be an important public health problem, already endemic in hospitals, whose factors such as those associated with habits (smoking cigarettes) and behaviors (team sports practice and activities in gyms) have been strongly highlighted. These findings may help developing infection control policies, allowing targeting patients on higher-risk populations for MRSA colonization.

Purple Urine Bag Syndrome: A Rare Phenomenon Managed in Primary Care.

Purple urine bag syndrome (PUBS) is a rare manifestation of urinary tract infection (UTI) characterized by bluish-purple discoloration of urine, typically seen in patients with long-term urinary catheters. It occurs due to the bacterial metabolism of dietary tryptophan into indole, which is converted into indoxyl sulfate in the liver and then excreted in the urine, where it reacts with catheter materials under alkaline conditions. Risk factors include chronic constipation, advanced age, female gender, dehydration, and recurrent UTIs. Morganella morganii is one of the bacteria commonly implicated. Although usually benign, PUBS can signal underlying UTIs, especially in asymptomatic patients. The case presented involves an 81-year-old woman with a history of urothelial carcinoma and a monoJ catheter since pelvic exenteration and ureterostomy. She presented with blue-colored urine in the collection bag; she was asymptomatic, but the urinalysis had leukocytes, nitrites and alkaline pH, and the uroculture was positive for M. morganii. Antibiotic therapy resolved the symptoms initially, but recurrence prompted further treatment and optimization of constipation management. PUBS, although rare, poses risks, especially in vulnerable populations. Identification of risk factors and causative agents is crucial for effective treatment, typically involving catheter replacement, antimicrobial therapy, and constipation correction. Prevention focuses on minimizing catheter use, regular replacement, and hygiene optimization. Early recognition and management in primary care settings can prevent complications and reduce patient and caregiver distress. In conclusion, PUBS is a visually evident condition that may serve as an early indication of UTI, particularly in patients with chronic catheterization. Treatment and prevention strategies should be tailored to individual risk factors to prevent the recurrence or persistence of the syndrome. Awareness among healthcare professionals and patients is essential for timely diagnosis and management. The presented case demonstrates the importance of primary care in managing complex conditions and highlights the close patient-physician relationship in such settings.

The WMI Rat of Premature Cognitive Aging Presents Intrinsic Vulnerability to Oxidative Stress in Primary Neurons and Astrocytes Compared to Its Nearly Isogenic WLI Control.

The primary neuronal and astrocyte culture described here is from the stress-hyperreactive Wistar Kyoto (WKY) More Immobile (WMI) rat with premature aging-related memory deficit, and its nearly isogenic control, the Less Immobile (WLI) strain. Primary WMI hippocampal neurons and cortical astrocytes are significantly more sensitive to oxidative stress (OS) generated by administration of H2O2 compared to WLI cells as measured by the trypan blue cell viability assay. Intrinsic genetic vulnerability is also suggested by the decreased gene expression in WMI neurons of catalase (Cat), and in WMI cortical astrocytes of insulin-like growth factor 2 (Igf2), synuclein gamma (Sncg) and glutathione peroxidase 2 (Gpx2) compared to WLI. The expressions of several mitochondrial genes are dramatically increased in response to H2O2 treatment in WLI, but not in WMI cortical astrocytes. We propose that the vulnerability of WMI neurons to OS is due to the genetic differences between the WLI and WMI. Furthermore, the upregulation of mitochondrial genes may be a compensatory response to the generation of free radicals by OS in the WLIs, and this mechanism is disturbed in the WMIs. Thus, this pilot study suggests intrinsic vulnerabilities in the WMI hippocampal neurons and cortical astrocytes, and affirm the efficacy of this bimodal in vitro screening system for finding novel drug targets to prevent oxidative damage in illnesses.

Death Induced by Survival gene Elimination (DISE) correlates with neurotoxicity in Alzheimer's disease and aging.

Alzheimer's disease (AD) is characterized by progressive neurodegeneration, but the specific events that cause cell death remain poorly understood. Death Induced by Survival gene Elimination (DISE) is a cell death mechanism mediated by short (s) RNAs acting through the RNA-induced silencing complex (RISC). DISE is thus a form of RNA interference, in which G-rich 6mer seed sequences in the sRNAs (position 2-7) target hundreds of C-rich 6mer seed matches in genes essential for cell survival, resulting in the activation of cell death pathways. Here, using Argonaute precipitation and RNAseq (Ago-RP-Seq), we analyze RISC-bound sRNAs to quantify 6mer seed toxicity in several model systems. In mouse AD models and aging brain, in induced pluripotent stem cell-derived neurons from AD patients, and in cells exposed to Aß42 oligomers, RISC-bound sRNAs show a shift to more toxic 6mer seeds compared to controls. In contrast, in brains of "SuperAgers", humans over age 80 who have superior memory performance, RISC-bound sRNAs are shifted to more nontoxic 6mer seeds. Cells depleted of nontoxic sRNAs are sensitized to Aß42-induced cell death, and reintroducing nontoxic RNAs is protective. Altogether, the correlation between DISE and Aß42 toxicity suggests that increasing the levels of nontoxic miRNAs in the brain or blocking the activity of toxic RISC-bound sRNAs could ameliorate neurodegeneration.

Assessing the spatiotemporal occurrence and ecological risk of antifouling biocides in a Brazilian estuary.

Diuron and Irgarol are common antifouling biocides used in paints to prevent the attachment and growth of fouling organisms on ship hulls and other submerged structures. Concerns about their toxicity to non-target aquatic organisms have led to various restrictions on their use in antifouling paints worldwide. Previous studies have shown the widespread presence of these substances in port areas along the Brazilian coast, with a concentration primarily in the southern part of the country. In this study, we conducted six sampling campaigns over the course of 1 year to assess the presence and associated risks of Diuron and Irgarol in water collected from areas under the influence of the Maranhão Port Complex in the Brazilian Northeast. Our results revealed the absence of Irgarol in the study area, irrespective of the sampling season and site. In contrast, the mean concentrations of Diuron varied between 2.0 ng L-1 and 34.1 ng L-1 and were detected at least once at each sampling site. We conducted a risk assessment of Diuron levels in this area using the risk quotient (RQ) method. Our findings indicated that Diuron levels at all sampling sites during at least one campaign yielded an RQ greater than 1, with a maximum of 22.7, classifying the risk as "high" based on the proposed risk classification. This study underscores the continued concern regarding the presence of antifouling biocides in significant ports and marinas in Brazilian ports, despite international bans.

Luz UVC como estratégia de desinfecção do ar e superfícies hospitalares / Luz UV-C como estrategia de desinfección del aire y superficies hospitalarias / UVC light as a strategy for disinfection of hospital air and surfaces

Resumo Objetivo Avaliar a eficácia antimicrobiana de um dispositivo fixo emissor de luz UV-C na desinfecção de diferentes superfícies do ambiente hospitalar e sua eficácia antifúngica na qualidade do ar. Métodos Estudo quase-experimental realizado em uma unidade de internação hospitalar, que utilizou o Bioamostrador de ar Andersen® de seis estágios para análise do ar; e na avaliação das superfícies, utilizaram-se três suspensões de microrganismos (Acinetobacter sp. MDR, Escherichia coli e Klebsiella pneumoniae produtora de KPC) para contaminar o ambiente. Para ambos foram feitas coletas pré (controle) e pós-acionamento da luz UV-C (teste). Resultados Na avaliação do ar houve uma redução importante da contagem de colônias após a luz UV-C e não foram encontrados fungos patogênicos ou toxigênicos em nenhum dos dois momentos. Em relação à desinfecção das superfícies, nenhum crescimento bacteriano foi observado após a intervenção da luz, demonstrando 100% de inativação bacteriana nas condições testadas. Conclusão A utilização da tecnologia com emissão de luz UV-C fixa foi eficaz e pode ser considerada uma intervenção promissora para protocolos de desinfecção de superfícies hospitalares.

Resumen Objetivo Evaluar la eficacia antimicrobiana de un dispositivo fijo emisor de luz UV-C para la desinfección de diferentes superficies del ambiente hospitalario y su eficacia antifúngica en la calidad del aire. Métodos Estudio cuasi experimental realizado en una unidad de internación hospitalaria, en que se utilizó el biomuestreador de aire Andersen® de seis etapas para el análisis del aire. En el análisis de las superficies, se utilizaron tres suspensiones de microorganismos (Acinetobacter sp. MDR, Escherichia coli y Klebsiella pneumoniae productora de KPC) para contaminar el ambiente. En ambos se tomó una muestra antes (control) y después de accionar la luz UV-C (prueba). Resultados En el análisis del aire hubo una reducción importante del recuento de colonias después de la luz UV-C y no se encontraron hongos patógenos ni toxigénicos en ninguno de los dos momentos. Con relación a la desinfección de las superficies, no se observó ningún crecimiento bacteriano después de la intervención de la luz, lo que demuestra un 100 % de inactivación bacteriana en las condiciones analizadas. Conclusión El uso de la tecnología con emisión de luz UV-C fija fue eficaz y puede ser considerada una intervención prometedora para protocolos de desinfección de superficies hospitalarias.

Abstract Objective To evaluate a fixed UV-C light emitting device for its antimicrobial effectiveness in the disinfection of distinct surfaces and its antifungal effectiveness on air quality in the hospital environment. Methods This quasi-experimental study was conducted in a hospital inpatient unit, in which a six-stage air Biosampler (Andersen®) was used for air analysis. In the evaluation of surfaces, three suspensions of microorganisms (Acinetobacter sp. multidrug-resistant, Escherichia coli, and KPC-producing Klebsiella pneumoniae) were used to contaminate the environment. In both evaluations, pre- (control) and post-activation of UV-C light (test) collections were made. Results In the air evaluation, an important reduction was observed in the colony count after irradiation with UV-C light, and pathogenic or toxigenic fungi were not found in either of the two moments. Regarding the disinfection of surfaces, no bacterial growth was observed after the application of UV-C light, showing 100% bacterial inactivation under the tested conditions. Conclusion The use of fixed UV-C light emission technology was effective and can be considered a promising intervention for hospital surface disinfection protocols.

Tecnologias educacionais direcionadas ao aleitamento materno produzidas na pós-graduação em enfermagem brasileira / Educational technologies directed to breastfeeding produced in brazilian nursing graduate / Tecnologías educativas orientadas a la lactancia materna producidas en programas de posgrado en enfermería brasileños

Objetivo: Conhecer as tecnologias educacionais voltadas à prática do aleitamento materno desenvolvidas por enfermeiros. Método: Revisão Integrativa realizada nas bases de dados da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Biblioteca Digital Brasileira de Teses e Dissertações, em dezembro de 2021. Inicialmente foram identificados 313 trabalhos, após aplicados critérios de inclusão e exclusão foram selecionados 13 estudos para a amostra. Resultados: Verificou-se as seguintes tecnologias: álbum seriado, iconografia 3D, rádio, telefone, literatura de cordel, websites e simuladores realísticos de baixa fidelidade. Os estudos visaram desenvolver, avaliar ou validar tecnologias educacionais voltadas para o aleitamento materno no que diz respeito aos benefícios quando se trata do manejo correto. Conclusão: As tecnologias educacionais têm sido alvo no desenvolvimento de pesquisas em Enfermagem, contribuindo para a promoção do aleitamento materno, beneficiando mães e bebês e dinamizando o processo de cuidar.

Objective: To learn about educational technologies related to breastfeeding practice. Methods: Integrative Review conducted in the Coordination for the Improvement of Higher Education Personnel (CAPES) and Brazilian Digital Library of Theses and Dissertations (BDTD) databases, from December 2019 to December 2021. Initially, 313 studies were identified, and after applying the inclusion and exclusion criteria, 13 studies were selected for the sample. Results: The following technologies were verified: serialized album, 3D iconography, radio, telephone, string literature, websites, and low fidelity realistic simulators. The studies aimed to develop, evaluate, or validate educational technologies focused on breastfeeding with regard to the benefits when it comes to the correct management. Conclusion: Educational technologies have been a target in the development of nursing research, contributing to the promotion of breastfeeding, benefiting mothers and babies and streamlining the care process.

Objetivo: Conocer las tecnologías educativas orientadas a la práctica de la lactancia materna. Métodos: revisión integradora realizada en las bases de datos Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES) y la Biblioteca Digital Brasileña de Tesis y Disertaciones (BDTD), desde diciembre de 2019 hasta diciembre de 2021. Inicialmente se identificaron 313 estudios, luego de aplicar los criterios de inclusión y exclusión, se seleccionaron 13 estudios para la muestra. Resultados: se verificaron las siguientes tecnologías: álbum en serie, iconografía 3D, radio, teléfono, literatura de cuerdas, sitios web y simuladores realistas de baja fidelidad. Los estudios tuvieron como objetivo desarrollar, evaluar o validar tecnologías educativas orientadas a la lactancia materna en cuanto a beneficios en cuanto a un correcto manejo se refiere. Conclusión: Las tecnologías educativas han sido un objetivo en el desarrollo de la investigación en enfermería, contribuyendo a la promoción de la lactancia materna, beneficiando a madres y bebés y agilizando el proceso de atención.

RdJ detection tests to identify a unique MRSA clone of ST105-SCCmecII lineage and its variants disseminated in the metropolitan region of Rio de Janeiro.

Hospital bloodstream infection (BSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of morbidity and mortality and is frequently related to invasive procedures and medically complex patients. An important feature of MRSA is the clonal structure of its population. Specific MRSA clones may differ in their pathogenic, epidemiological, and antimicrobial resistance profiles. Whole-genome sequencing is currently the most robust and discriminatory technique for tracking hypervirulent/well-adapted MRSA clones. However, it remains an expensive and time-consuming technique that requires specialized personnel. In this work, we describe a pangenome protocol, based on binary matrix (1,0) of open reading frames (ORFs), that can be used to quickly find diagnostic, apomorphic sequence mutations that can serve as biomarkers. We use this technique to create a diagnostic screen for MRSA isolates circulating in the Rio de Janeiro metropolitan area, the RdJ clone, which is prevalent in BSI. The method described here has 100% specificity and sensitivity, eliminating the need to use genomic sequencing for clonal identification. The protocol used is relatively simple and all the steps, formulas and commands used are described in this work, such that this strategy can also be used to identify other MRSA clones and even clones from other bacterial species.

Therapeutic Potential of Punica granatum and Isolated Compounds: Evidence-Based Advances to Treat Bacterial Infections.

Punica granatum Linn has been known for its nutritional and medicinal value since ancient times and is used in the treatment of various pathologies owing to its antibacterial properties. This review reports the results of the most recent studies on the antibacterial effects of P. granatum and its isolated compounds on bacteria of clinical interest. A search in the PubMed, Scopus, Science Direct, and Science Citation Index Expanded (Web of Science) databases was performed, which included articles that evaluated the antibacterial activity of P. granatum extracts and excluded articles that analyzed other microorganisms or nonpathogenic bacteria, as well as theses, dissertations, duplicate articles, and those not fully available. The literature suggests that P. granatum extracts can act on bacteria, such as methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), Streptococcus mutans, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. In addition, fruit peel was the most commonly used pharmacogen and methanol, ethanol, and water were the most common solvents for the extraction of bioactive compounds. The antibacterial potential of the methanolic extract of pomegranate peel could be attributed to the presence of active compounds, such as 5-hydroxymethylfurfural, punicic acid, gallic acid, and punicalagin. Thus, there is evidence that these plant extracts, having high polyphenol content, can disrupt the bacterial plasma membrane and inhibit the action of proteins related to antimicrobial resistance. P. granatum shows antibacterial activity against Gram-positive and Gram-negative bacteria, with great potential against multidrug-resistant strains. Further research is needed to clarify the mechanism of action related to this biological activity and investigate the isolated substances that may be responsible for the antibacterial effects.

Clinical-epidemiological characteristics of pregnant women with HIV/syphilis coinfection: an integrative review / Características clínico-epidemiológicas de gestantes com coinfecção HIV/sífilis: revisão integrativa / Características clínico-epidemiológicas de gestantes con coinfección VIH/sífilis: revisión integrativa

Background and Objectives: HIV/syphilis coinfection is an important problem to be considered during pregnancy due to the various negative outcomes such as abortion, stillbirth, prematurity and congenital infections. The study is justified by the need to identify scientific evidence of clinical-epidemiological characteristics and vulnerabilities related to infections, factors that influence the prevalence, and if there are related health problems. The objective was to synthesize scientific evidence about sociodemographic characteristics and clinical manifestations of associated cases of syphilis and HIV. Content: this is an integrative literature review, searching the PubMed, MEDLINE, CINAHL, LILACS, BDENF and MedCarib databases, using the descriptors "HIV", "Syphilis", "Epidemiology", "Coinfection" and "Pregnant woman", combined by Boolean operators "AND" and "OR", guided by the question: what is the scientific evidence related to the clinical-epidemiological characteristics of pregnant women co-infected with HIV/syphilis? It was held from June to September 2022, including articles published in the last eight years. Nine primary articles published between 2015 and 2020 were selected. The association of infections was present in pregnant women of young adult age, non-white race/color, married, low level of education, housewives, residents of urban areas and belonging to more economically disadvantaged social classes. Conclusion: the study highlighted the importance of improving prenatal care, with the aim of reducing the risks of vertical transmission of these diseases, especially with the implementation of public policies aimed at the clinical management of co-infected pregnant women, the allocation of resources and the development of specific intervention protocols.(AU)

Justificativa e Objetivos: A coinfecção HIV/sífilis é um problema importante a ser considerado durante a gravidez devido aos diversos desfechos negativos como aborto, natimorto, prematuridade e infecções congênitas. O estudo justifica-se pela necessidade de identificar evidências científicas de características clínico-epidemiológicas e vulnerabilidades relacionadas às infecções, fatores que influenciam a prevalência e se há problemas de saúde relacionados. O objetivo foi sintetizar evidências científicas sobre características sociodemográficas e manifestações clínicas de casos associados de sífilis e HIV. Conteúdo: trata-se de uma revisão integrativa da literatura, com busca nas bases de dados PubMed, MEDLINE, CINAHL, LILACS, BDENF e MedCarib, utilizando os descritores "HIV", "Syphilis", "Epidemiology", "Coinfection" e "Pregnant woman", combinados por Operadores booleanos "AND" e "OR", norteados pela questão: quais as evidências científicas relacionadas às características clínico-epidemiológicas de gestantes coinfectadas com HIV/sífilis? Foi realizado de junho a setembro de 2022, incluindo artigos publicados nos últimos oito anos. Foram selecionados nove artigos primários publicados entre 2015 e 2020. A associação das infecções esteve presente em gestantes em idade adulta jovem, raça/cor não branca, casadas, baixa escolaridade, donas de casa, residentes em zona urbana e pertencentes a classes sociais mais desfavorecidas economicamente. Conclusão: o estudo destacou a importância da melhoria da assistência pré-natal, com o objetivo de reduzir os riscos de transmissão vertical dessas doenças, especialmente com a implementação de políticas públicas voltadas ao manejo clínico das gestantes coinfectadas, à alocação de recursos e o desenvolvimento de protocolos de intervenção específicos.(AU)

Antecedentes y objetivos: La coinfección VIH/sífilis es un problema importante a considerar durante el embarazo debido a los diversos resultados negativos como aborto, muerte fetal, prematuridad e infecciones congénitas. El estudio se justifica por la necesidad de identificar evidencia científica de características clínico-epidemiológicas y vulnerabilidades relacionadas con las infecciones, factores que influyen en la prevalencia y si existen problemas de salud relacionados. El objetivo fue sintetizar evidencia científica sobre las características sociodemográficas y manifestaciones clínicas de los casos asociados de sífilis y VIH. Contenido: se trata de una revisión integradora de la literatura, buscando en las bases de datos PubMed, MEDLINE, CINAHL, LILACS, BDENF y MedCarib, utilizando los descriptores "VIH", "Sífilis", "Epidemiología", "Coinfección" y "Mujer embarazada", combinados por Operadores booleanos "Y" y "O", guiados por la pregunta: ¿cuál es la evidencia científica relacionada con las características clínico- -epidemiológicas de las gestantes coinfectadas con VIH/sífilis? Se realizó de junio a septiembre de 2022, incluyendo artículos publicados en los últimos ocho años. Se seleccionaron nueve artículos primarios publicados entre 2015 y 2020. La asociación de infecciones estuvo presente en mujeres embarazadas de edad adulta joven, de raza/color no blanca, casadas, de bajo nivel educativo, amas de casa, residentes de áreas urbanas y pertenecientes a clases sociales más desfavorecidas económicamente. Conclusión: el estudio destacó la importancia de mejorar la atención prenatal, con el objetivo de reducir los riesgos de transmisión vertical de estas enfermedades, especialmente con la implementación de políticas públicas orientadas al manejo clínico de las gestantes coinfectadas, la asignación de recursos y el desarrollo de protocolos de intervención específicos.(AU)

Estratégias utilizadas por enfermeiros da atenção primária na prevenção do câncer de colo do útero: revisão integrativa / Strategies used by primary care nurses in the prevention of cervical cancer: integrative review

Objetivo: identificar, na literatura científica, as estratégias utilizadas por enfermeiros da Atenção Primária para a prevenção do câncer de colo do útero. Métodos: revisão integrativa nas bases de dados EMBASE, LILACS (BVS), SCOPUS e Web of Science, entre março e abril de 2023. Após a busca, seguiu-se com leitura na íntegra dos artigos selecionados e extração dos dados para análise. A amostra final foi constituída por 5 estudos. Resultados: as principais estratégias utilizadas foram intervenções educativas, com predominância de palestras e posterior convite ou coleta de material para a realização do exame preventivo. Também foram utilizadas rodas de conversa (círculo de cultura), orientações por contato telefônico e oferta de ficha clínica auto preenchível na consulta de enfermagem. Conclusões: os estudos possibilitaram identificar estratégias positivas na prevenção do câncer de colo do útero, podendo direcionar enfermeiros a investir cada vez mais em metodologias voltadas a uma maior autonomia das mulheres

Objective: to identify, in the scientific literature, the strategies used by primary care nurses to prevent cervical cancer. Methods: An integrative review of the EMBASE, LILACS (BVS), SCOPUS, and Web of Science databases between March and April 2023. After the search, the selected articles were read in full, and the data were extracted for analysis. The final sample consisted of 5 studies. Results: the main strategies used were educational interventions, with a predominance of lectures and subsequent invitations or collection of material to carry out the preventive exam. Conversation circles (culture circles), telephone guidance, and the provision of a self-completed clinical form during the nursing consultation were also used. Conclusions: the studies made it possible to identify positive strategies for preventing cervical cancer, which could direct nurses to increasingly invest in methodologies aimed at increasing women's autonomy

Diclofenac, ibuprofen, and paracetamol biodegradation: overconsumed non-steroidal anti-inflammatories drugs at COVID-19 pandemic.

The consumption of non-steroidal anti-inflammatory drugs (NSAIDs) have increased significantly in the last years (2020-2022), especially for patients in COVID-19 treatment. NSAIDs such as diclofenac, ibuprofen, and paracetamol are often available without restrictions, being employed without medical supervision for basic symptoms of inflammatory processes. Furthermore, these compounds are increasingly present in nature constituting complex mixtures discarded at domestic and hospital sewage/wastewater. Therefore, this review emphasizes the biodegradation of diclofenac, ibuprofen, and paracetamol by pure cultures or consortia of fungi and bacteria at in vitro, in situ, and ex situ processes. Considering the influence of different factors (inoculum dose, pH, temperature, co-factors, reaction time, and microbial isolation medium) relevant for the identification of highly efficient alternatives for pharmaceuticals decontamination, since biologically active micropollutants became a worldwide issue that should be carefully addressed. In addition, we present a quantitative bibliometric survey, which reinforces that the consumption of these drugs and consequently their impact on the environment goes beyond the epidemiological control of COVID-19.

Breast cancer survival and the health system in Brazil: an analysis of public and private healthcare.

Background: The incidence of breast cancer is increasing globally; however, survival outcomes vary and are lower in developing countries. Methods: We analyzed the 5- and 10-year survival rates for breast cancer according to the type of healthcare insurance (public vs. private) in a referral center for cancer care in the Brazilian southeast region. This hospital-based cohort study included 517 women diagnosed with invasive breast cancer between 2003 and 2005. The Kaplan-Meier method was used to estimate the probability of survival, and the Cox proportional hazards regression model was used to assess prognostic factors. Results: The 5- and 10-year breast cancer survival rates were as follows: private healthcare service survival rate of 80.6% (95% CI 75.0-85.0) and 71.5% (95% CI 65.4-77.1), respectively, and public healthcare service survival rate of 68.5% (95% CI 62.5-73.8) and 58.5% (95% CI 52.1-64.4), respectively. The main factors associated with the worst prognosis were lymph node involvement in both healthcare services and tumor size >2 cm only in public health services. The use of hormone therapy (private) and radiotherapy (public) was associated with the best survival rates. Conclusions: The survival discrepancies found between health services can be explained mainly by the difference in the stage of the disease at the time of diagnosis, indicating inequalities in access to the early detection of breast cancer.

Copper-Contaminated Substrate Biosorption by Penicillium sp. Isolated from Kefir Grains.

In this bioremediation study, the fungus Penicillium sp. isolated from kefir grains was evaluated for its resistance to copper in the culture medium. Penicillium sp. was cultivated in liquid medium prepared using 2% malt-agar at pH 7.0. Biomass of the fungus was significantly reduced, but only when 800 mg·L-1 of Cu(NO3)2 copper nitrate was used. The effect on radial growth of the fungus in experiments combining different pH values and the inorganic contaminant showed an inhibition of 73% at pH 4.0, 75% at pH 7.0 and 77% at pH 9.0 in liquid medium. Thus, even though the growth of Penicillium sp. could be inhibited with relatively high doses of copper nitrate, images obtained with scanning electron microscopy showed the preservation of fungal cell integrity. Therefore, it can be concluded that Penicillium sp. isolated from kefir grains can survive while performing bioremediation to minimize the negative effects of copper on the environment through biosorption.

Immunomodulatory Activity of Probiotics in Models of Bacterial Infections.

As resistance to conventional antibiotics among bacteria continues to increase, researchers are increasingly focusing on alternative strategies for preventing and treating bacterial infections, one of which is microbiota modulation. The objective of this review is to analyze the scientific literature on the immunomodulatory effects of probiotics in bacterial infections. This is an integrative review of the literature based on systematic steps, with searches performed in the databases Medline, PubMed, Scopus, Embase, and ScienceDirect. The most prevalent bacterial genera used to evaluate infectious processes were Salmonella, Escherichia, Klebsiella, and Streptococcus. Lactobacillus was the most commonly used probiotic genus, with Lactobacillus delbrueckii subsp. bulgaricus is the most frequently used species. In most studies, prophylactic treatment with concentrations of probiotics equal to or greater than 8 log CFU/mL was chosen. However, there was considerable heterogeneity in terms of effective treatment duration, indicating that the results cannot be generalized across all studies. This review found that probiotics interact with the immune system through different mechanisms and have a positive effect on preventing different types of bacterial infections.

Trichoderma asperellum Extract Isolated from Brazil Nuts (Bertholletia excelsa BONPL): In Vivo and In Silico Studies on Melanogenesis in Zebrafish.

Endophytic fungi are those that present part of their life cycle in healthy tissues of different plant hosts in symbiosis without causing harm. At the same time, fungus-plant symbiosis makes it possible for microorganisms to synthesize their own bioactive secondary metabolites while in the stationary stage. To accomplish this, the endophytic fungus Trichoderma asperellum was isolated from Bertholletia excelsa (Brazil nut) almonds. The fungus was cultivated and extracted with ethyl acetate, obtaining AM07Ac. Then, using HPTLC (High-performance thin-layer chromatography) and nuclear magnetic resonance (1H NMR), ß-amyrin, kaempferol, and brucine were identified as major compounds. Further in vivo assays in zebrafish demonstrated the activity of AM07Ac on melanogenesis by producing a concentration-response inhibitory effect, which, through an in silico study, proved to be related to the noted major compounds known to inhibit tyrosinase activity. The inhibition of tyrosinase prevents melanin accumulation in skin. Therefore, these results imply the importance of investigating microorganisms and their pharmacological activities, in particular the endophytic fungus Trichoderma asperellum as a generator of active metabolites for melanogenesis modulation.

Vernonia polyanthes Less. (Asteraceae Bercht. & Presl), a Natural Source of Bioactive Compounds with Antibiotic Effect against Multidrug-Resistant Staphylococcus aureus.

Vernonia polyanthes is a medicinal plant used to treat many disorders, including infectious diseases. This study investigated the chemical constituents and the antibacterial activity of V. polyanthes leaf rinse extract (Vp-LRE). The chemical characterization of Vp-LRE was established using ultra-high performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UHPLC/Q-TOF-MS), and glaucolide A was identified through 1H and 13C nuclear magnetic resonance (NMR) and mass fragmentation. The cytotoxicity was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT). The antibacterial activity was assessed by minimal inhibitory concentration and minimal bactericidal concentration. Interactions between ligands and beta-lactamase were evaluated via molecular docking. UHPLC/Q-TOF-MS detected acacetin, apigenin, chrysoeriol, isorhamnetin, isorhamnetin isomer, kaempferide, 3',4'-dimethoxyluteolin, 3,7-dimethoxy-5,3',4'-trihydroxyflavone, piptocarphin A and glaucolide A. Vp-LRE (30 µg/mL) and glaucolide A (10 and 20 µg/mL) were cytotoxic against RAW 264.7 cells. Glaucolide A was not active, but Vp-LRE inhibited the Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Escherichia coli, Salmonella Choleraesuis and Typhimurium, with a bacteriostatic effect. The compounds (glaucolide A, 3',4'-dimethoxyluteolin, acacetin and apigenin) were able to interact with beta-lactamase, mainly through hydrogen bonding, with free energy between -6.2 to -7.5 kcal/mol. These results indicate that V. polyanthes is a potential natural source of phytochemicals with a significant antibiotic effect against MRSA strains.

Anti-Melanogenic Potential of Natural and Synthetic Substances: Application in Zebrafish Model.

Melanogenesis is a biosynthetic pathway for the formation of the pigment melanin in human skin. A key enzyme in the process of pigmentation through melanin is tyrosinase, which catalyzes the first and only limiting step in melanogenesis. Since the discovery of its methanogenic properties, tyrosinase has been the focus of research related to the anti-melanogenesis. In addition to developing more effective and commercially safe inhibitors, more studies are required to better understand the mechanisms involved in the skin depigmentation process. However, in vivo assays are necessary to develop and validate new drugs or molecules for this purpose, and to accomplish this, zebrafish has been identified as a model organism for in vivo application. In addition, such model would allow tracking and studying the depigmenting activity of many bioactive compounds, important to genetics, medicinal chemistry and even the cosmetic industry. Studies have shown the similarity between human and zebrafish genomes, encouraging their use as a model to understand the mechanism of action of a tested compound. Interestingly, zebrafish skin shares many similarities with human skin, suggesting that this model organism is suitable for studying melanogenesis inhibitors. Accordingly, several bioactive compounds reported herein for this model are compared in terms of their molecular structure and possible mode of action in zebrafish embryos. In particular, this article described the main metabolites of Trichoderma fungi, in addition to substances from natural and synthetic sources.

Intervenções para uso do preservativo por adolescentes em situação de rua: protocolo de revisão sistemática / Interventions for condom use by homeless adolescents: a systematic review protocol

OBJETIVO: Avaliar a eficácia de intervenções em saúde para o uso do preservativo entre adolescentes em situação de rua. MÉTODO: Revisão sistemática de ensaios clínicos randomizados e não randomizados, estudos controlados antes e depois, coortes e caso-controle que apresentem intervenções que contribuem para o uso de preservativo em adolescentes em situação de rua, sem restrição de idioma. As buscas serão realizadas em bases de dados e seguirão os Guidelines Cochranee o checklist PRISMA. RESULTADOS: Espera-se identificar estudos que apontem intervenções relacionadas ao uso do preservativo e redução das IST/HIV/Aids, entre adolescentes em situação de rua, visando contribuir para promoção da saúde e das políticas públicas brasileiras. CONCLUSÃO: Este estudo encontra-se em andamento e o protocolo está aprovado na PROSPERO sob o número CRD42021266572.

OBJECTIVE: To evaluate the effectiveness of health interventions for condom useamong homeless adolescents. METHOD: A systematic review of randomized and non-randomized clinical trials, before-and-after controlled studies, cohort, and case-control studies will be conducted on interventions that contribute to the use of condoms by homeless adolescents without language restrictions. The searches will be carried out in data bases and follow the Cochrane Guidelines and the PRISMA checklist. RESULTS: We expect to identify studies that point to interventions related to the use of condoms and the reduction of STI/HIV/AIDS among homeless adolescents, aiming to contribute to the promotion of health and Brazilian public policies. CONCLUSION: This study is in progress, and the protocol is registered at PROSPERO under the code CRD42021266572.