Trends and challenges in analytical chemistry for multi-analysis of illicit drugs employing wastewater-based epidemiology.

Wastewater-based epidemiology (WBE) for quantification of illicit drug biomarkers (IDBs) in wastewater samples is an effective tool that can provide information about drug consumption. The most commonly quantified IDBs belong to different chemical classes, including cocaine, amphetamine-type stimulants, opioids, and cannabinoids, so the different chemical properties of these molecules pose a challenge in the development of analytical methods for multi-analyte analysis. Recent workflows include the steps of sampling and storage, sample preparation using solid-phase extraction (SPE) or without extraction, and quantification of analytes employing gas or liquid chromatography coupled with mass spectrometry. The greatest difficulty is due to the fact that wastewater samples are complex chemical mixtures containing analytes with different chemical properties, often present at low concentrations. Therefore, in the development of analytical methods, there is the need to simplify and optimize the analytical workflows, reducing associated uncertainties, analysis times, and costs. The present work provides a critical bibliographic survey of studies published from the year 2020 until now, highlighting the challenges and trends of published analytical workflows for the multi-analysis of IDBs in wastewater samples, considering sampling and sample preparation, method validation, and analytical techniques.

Necessidades em Saúde do Trabalhador da Atenção Básica: relato de experiência de articulação entre pesquisadores, gestores e trabalhadores no Município de São Paulo / Health needs of primary care workers: an experience report of articulation between researchers, managers and workers in the city of São Paulo

Resumo A Tradução do Conhecimento (TC) disponibiliza tecnologias que podem ser empregadas na operacionalização da integração entre universidade e sociedade, para a formulação de políticas informadas por evidências, em resposta a necessidades em saúde. A partir da formação de um grupo de trabalho - uma das tecnologias de TC disponíveis - e para compreender as necessidades em saúde dos trabalhadores inseridos na Atenção Básica (AB), este estudo objetivou relatar a experiência de problematização e instrumentalização realizada com pesquisadores, gestores e trabalhadores da AB no município de São Paulo. O referencial do Materialismo Histórico e Dialético conduziu o processo de realização de oficinas emancipatórias com os participantes. Dessa forma, foram levantados problemas enfrentados pelos trabalhadores, e realizados workshops e seminários de instrumentalização, de acordo com as necessidades do grupo de participantes. No processo de compreensão das necessidades em saúde dos trabalhadores da AB, os participantes relacionaram as formas de organização do trabalho aos desgastes dos trabalhadores, o que foi enfatizado pelo grupo. A formação do grupo foi estratégica para alcançar o objetivo, bem como direcionar a pesquisa sobre as respostas às necessidades em saúde dos trabalhadores na área, etapa seguinte da TC.

Abstract Knowledge Translation (KT) provides technologies that can be used to operationalize the collaboration between university and society for evidence-informed policy-making in response to health needs. Based on the formation of a working group (one of the available KT technologies) and to understand the health needs of Primary Health Care (PHC) workers in the city of São Paulo, this study aimed to report the experience of problematization and instrumentalization carried out with researchers, managers and PHC workers of the city of São Paulo. The Historical and Dialectical Materialism oriented the process of emancipatory workshops with the participants. The problems faced by the workers were raised and workshops and seminars were held to provide knowledge according to the needs of the group of participants. In the process of understanding the health needs of PHC workers the participants related the forms of work organization to the workers' wear out, which was emphasized by the group. The formation of the group was strategic to reach the objective and also to direct the research on the answers to the health needs of workers in the area, the next stage of the KT.

Commercial Extruded Plant-Based Diet Lowers Circulating Levels of Trimethylamine N-Oxide (TMAO) Precursors in Healthy Dogs: A Pilot Study.

Elevations in circulating trimethylamine N-oxide (TMAO) and its precursors are observed in humans and dogs with heart failure and are associated with adverse outcomes in people. Dietary intervention that reduces or excludes animal ingredients results in rapid reduction of plasma TMAO and TMAO precursors in people, but the impact of diet in dogs has not been studied. The objective of the current study was to determine the effect of diet on plasma TMAO and 2 of its precursors (choline and betaine) in dogs fed a commercial extruded plant-based diet (PBD) or a commercial extruded traditional diet (TD) containing animal and plant ingredients. Sixteen healthy adult mixed breed dogs from a university colony were enrolled in a randomized, 2-treatment, 2-period crossover weight-maintenance study. Mean (SD) age and body weight of the dogs were 2.9 years (± 1.7) and 14.5 kg (± 4.0), respectively. Eight dogs were female (3 intact, 5 spayed) and 8 dogs were male (4 intact, 4 castrated). Plasma choline, betaine and TMAO were quantified by LC-SID-MRM/MS at baseline, and after 4 weeks on each diet. Choline and betaine were also quantified in the diets. Plasma choline levels were significantly lower (P = 0.002) in dogs consuming a PBD (Mean ± SD, 6.8 µM ± 1.2 µM) compared to a TD (Mean ± SD, 7.8 µM ± 1.6 µM). Plasma betaine levels were also significantly lower (P = 0.03) in dogs consuming a PBD (Mean ± SD, 109.1 µM ± 25.3 µM) compared to a TD (Mean ± SD, 132.4 µM ± 32.5 µM). No difference (P = 0.71) in plasma TMAO was detected in dogs consuming a PBD (Median, IQR, 2.4 µM, 2.1 µM) compared to a TD (Median, IQR, 2.3 µM, 1.1 µM). Betaine content was lower in the PBD than in the TD while choline content was similar in the diets. Our findings indicate consumption of a commercial extruded PBD for 4 weeks reduces circulating levels of the TMAO precursors choline and betaine, but not TMAO, in healthy adult dogs.

Terapia Ocupacional com crianças e jovens em pandemia: análise de processos de trabalho e reflexões para uma prática emancipatória / Occupational Therapy with children and young people during pandemic: analysis of work processes and reflections for an emancipatory practice / Terapia Ocupacional con niños y jóvenes en pandemia: análisis de procesos de trabajo y reflexiones para una práctica emancipativa

Contextualização: A partir de práticas de terapeutas ocupacionais na cidade de São Paulo, durante a pandemia do coronavírus, este artigo apresenta dois processos de trabalhos de terapeutas ocupacionais com crianças e jovens. Síntese dos elementos do estudo: análise dos processos de trabalho das profissionais no âmbito do SUS. Ferramentas específicas fundadas emuma abordagem crítica foram identificadas e descritas: análise do cotidiano com desenvolvimento de recursos adaptativos; análise de elementos da reprodução social; mapeamento, análise, proposição e legitimação de atividades significativas; articulação de recursos materiais para engajamento nestas atividades. Conclusão: Enfatizaram-se as contradições do modo de produção capitalista e das estruturas sociais ao produzir reflexões sobre uma prática situada e contextualizada.(AU) Palavras-chave: Terapia Ocupacional. COVID-19. Infância. Juventude. Saúde Coletiva

Contextualization: Based on the practices of occupational therapists in the city of São Paulo, during the coronavirus pandemic, this article presented two work processes of occupational therapists with children and young people. Synthesis of the study's elements: analysis of the processes of professionals in the work within the scope of SUS. Specific tools based on a critical approach were identified and described: daily analysis and the development of adaptive resources; analysis of elements of social reproduction; mapping, analysis, proposition and legitimization of meaningful activities; articulation of material resources to engage in these activities. Conclusion: The contradictions of the mode of production and social structures were emphasized while producing reflections on a situated and contextualized practice.(AU) Keywords: Occupational Therapy. COVID-19. Childhood youth. Collective Health

Objetivo: A partir de las prácticas de los terapeutas ocupacionales en la ciudad de São Paulo, durante la pandemia del coronavirus, este artículo presentado dos procesos de trabajo de terapeutas ocupacionales con niños y jóvenes. Síntesis de los elementos del estudio: análisis de los procesos de trabajo de los profesionales, en el ámbito del SUS. Se identificaron y describieron herramientas específicas basadas en un enfoque crítico: análisis diario con el desarrollo de recursos adaptativos; análisis de elementos de reproducción social; mapeo, análisis, propuesta y legitimación de actividades significativas; articulación de recursos materiales para participación en estas actividades. ConclusiónLas contradicciones del modo de producción y las estructuras sociales se enfatizaron al producir reflexiones sobre una práctica situada y contextualizada.(AU) Palabras clave: Niñez. Colaboración intersectorial. Terapia ocupacional. Participación comunitaria

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Mild to moderate overweight in dogs: is there an impact on routine hematological and biochemical profiles, echocardiographic parameters and cardiac autonomic modulation?

Obesity is considered the most common nutritional disease of dogs. Even though overt obesity is more likely to impair health, even moderately overweight dogs are at greater risk for requiring medication for chronic health problems earlier in life. Although the number of overweight dogs far exceeds the number of obese ones, most of the studies published so far focused on derangements in a mixed overweight/obese population (Body condition score - BCS ≥7/9) rather than in separated groups. This study aimed to evaluate the impact of mild to moderate obesity on routine hematological and biochemical profile and cardiovascular parameters in dogs. Nine healthy lean (BCS =4-5/9) and 24 overweight dogs (BCS = 6-7/9) were enrolled. Complete blood count, serum biochemistry analyses, echocardiographic parameters, and cardiac autonomic function by heart rate variability (HRV) were determined. In our study population, although total protein, globulin and phosphorus concentrations were increased in overweight compared to lean dogs, all complete blood count and biochemical parameters were within reference ranges for both groups. Parameters usually increased in obese dogs, like triglycerides and cholesterol concentrations, were within reference ranges in our overweight population. There were no significant changes in echocardiographic parameters, but HRV had a significant decrease in high frequency (HF) power (P = 0.02), suggesting a depression in parasympathetic activity. Our findings show that mild to moderate overweight dogs do not show the hematological and echocardiographic alterations already reported for mixed overweight/obese populations but might have impaired cardiac autonomic modulation. Although not enough to make conclusions, our data raise the question of whether research studies should place overweight and obese dogs in the same category.

Short-term amino acid, clinicopathologic, and echocardiographic findings in healthy dogs fed a commercial plant-based diet.

Consumer demand for commercially prepared plant-based (PB) dog food is increasing, but studies evaluating the short- or long-term effects of PB diets on canine health are lacking. The objective of this study was to assess the short-term amino acid (AA), clinicopathologic, and echocardiographic findings in 34 client-owned dogs fed a commercial extruded plant-based diet (PBD) in which pea protein was the primary protein source and 4 control dogs fed a commercial extruded traditional diet (TD). Plasma AA and whole blood taurine concentrations were measured in dogs at baseline and after 4 weeks on the PBD or the TD. Hematologic, serum biochemical, and echocardiographic testing were performed at baseline and after 12 weeks on the PBD or the TD. Four dogs in the PBD group did not complete the study. All essential AAs, except methionine, were higher in dogs after 4 weeks on the PBD compared to baseline. Taurine (plasma and whole blood) was also higher after 4 weeks on the PBD compared to baseline. A meaningful difference was detected in whole blood taurine between the PBD group and the control group at 4 weeks (P = .026) with the PBD group being higher. Median hematologic and biochemical results for the PBD group were within normal limits at baseline and at 12 weeks. In the PBD group, left ventricular internal diastolic dimension (LVIDd, P = < .001) and normalized LVIDd (P = .031) were higher 12 weeks post-PBD compared to baseline. There were no meaningful differences in left ventricular internal systolic dimension (LVIDs), normalized LVIDs, or fractional shortening 12 weeks post-PBD. There was no statistical evidence of difference between the 2 groups of dogs for any of the echocardiographic parameters at baseline or at 12 weeks. Essential AA or taurine deficiency was not observed in this cohort of dogs fed a commercial extruded PBD. Additionally, clinically relevant hematologic, serum biochemical and echocardiographic alterations were not detected. Further research is required to determine if long-term static feeding of PB diets can meet and maintain AA and other nutrient targets in dogs.

Motivations and attitudes of Brazilian dairy farmers regarding the use of automated behaviour recording and analysis systems.

In this Research Communication we investigate the motivations of Brazilian dairy farmers to adopt automated behaviour recording and analysis systems (ABRS) and their attitudes towards the alerts that are issued. Thirty-eight farmers participated in the study distributed into two groups, ABRS users (USERS, n = 16) and non-users (NON-USERS, n = 22). In the USERS group 16 farmers accepted being interviewed, answering a semi-structured interview conducted by telephone, and the answers were transcribed and codified. In the NON-USERS group, 22 farmers answered an online questionnaire. Descriptive analysis was applied to coded answers. Most farmers were young individuals under 40 years of age, with undergraduate or graduate degrees and having recently started their productive activities, after a family succession process. Herd size varied with an overall average of approximately 100 cows. Oestrus detection and cow's health monitoring were the main reasons given to invest in this technology, and cost was the most important factor that prevented farmers from purchasing ABRS. All farmers in USERS affirmed that they observed the target cows after receiving a health or an oestrus alert. Farmers believed that they were able to intervene in the evolution of the animals' health status, as the alerts gave a window of three to four days before the onset of clinical signs of diseases, anticipating the start of the treatment.The alerts issued by the monitoring systems helped farmers to reduce the number of cows to be observed and to identify pre-clinically sick and oestrous animals more easily. Difficulties in illness detection and lack of definite protocols impaired the decision making process and early treatment, albeit farmers believed ABRS improved the farm's routine and reproductive rates.

Gas6 drives Zika virus-induced neurological complications in humans and congenital syndrome in immunocompetent mice.

Zika virus (ZIKV) has the ability to cross placental and brain barriers, causing congenital malformations in neonates and neurological disorders in adults. However, the pathogenic mechanisms of ZIKV-induced neurological complications in adults and congenital malformations are still not fully understood. Gas6 is a soluble TAM receptor ligand able to promote flavivirus internalization and downregulation of immune responses. Here we demonstrate that there is a correlation between ZIKV neurological complications with higher Gas6 levels and the downregulation of genes associated with anti-viral response, as type I IFN due to Socs1 upregulation. Also, Gas6 gamma-carboxylation is essential for ZIKV invasion and replication in monocytes, the main source of this protein, which was inhibited by warfarin. Conversely, Gas6 facilitates ZIKV replication in adult immunocompetent mice and enabled susceptibility to transplacental infection. Our data indicate that ZIKV promotes the upregulation of its ligand Gas6, which contributes to viral infectivity and drives the development of severe adverse outcomes during ZIKV infection.

Respiratory Viral Shedding in Healthcare Workers Reinfected with SARS-CoV-2, Brazil, 2020.

We documented 4 cases of severe acute respiratory syndrome coronavirus 2 reinfection by non-variant of concern strains among healthcare workers in Campinas, Brazil. We isolated infectious particles from nasopharyngeal secretions during both infection episodes. Improved and continued protection measures are necessary to mitigate the risk for reinfection among healthcare workers.

Reliability of panoramic radiography in predicting proximity of third molars to the mandibular canal: A comparison using cone-beam computed tomography.

PURPOSE: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. MATERIALS AND METHODS: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. RESULTS: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal (P<0.05). CONCLUSION: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

Malária símia: detecção de plasmodium em fezes de primatas não humanos / Simian malaria: detection of plasmodium in feces of non-human primates

Introdução. A malária é uma doença infecciosa vetorial sendo atualmente considerada uma das maiores protozooses do mundo, mantendo-se endêmica principalmente na África, na região Amazônica da América do Sul e no Sudeste Asiático. Essa doença é causada por protozoários do gênero Plasmodium, sendo que cinco espécies são capazes de infectar humanos: P. vivax, P. falciparum, P. malariae, P. ovale e o mais recente, P. knowlesi, que é considerado como um parasito zoonótico. Há fatos que demonstram que esses parasitas que hoje infectam humanos, descendem de Plasmodium símios, e as infecções de símios continuam ocorrendo até os dias atuais. No Brasil os principais agentes de malária símia são Plasmodium brasilianum e Plasmodium simium (similar com P. malariae e P. vivax, respectivamente), sendo que esses dois parasitos estão envolvidos em situações zoonóticas no bioma Mata Atlântica, sendo o seu vetor o Anopheles cruzii. Tendo em vista esse cenário epidemiológico da malária residual, foi verificada a importância de realizar uma revisão sobre os principais estudos baseados e detecção de Plasmodium em fezes de primatas não humanos. Objetivo. Realizar uma revisão bibliográfica e atualização das principais técnicas existentes de detecção de Plasmodium em fezes de primatas não humanos descritas na literatura; bem como conhecer e realizar as técnicas de extração de DNA de fezes de primatas não humanos e técnicas de PCR em tempo real e PCR convencional para rastreamento de DNA de primatas não humanos e de plasmódios. Materiais e Métodos. Foi realizado levantamento bibliográfico nas bases de dados da SciELO, Lilacs, PubMed, MedLine e na Biblioteca Virtual em Saúde (BVS), de artigos e livros que descrevam a utilização de técnicas de detecção de Plasmodium em fezes de primatas não humanos, utilizando um total de 46 artigos publicados entre os anos de 1951 a 2021. Resultados. No delineamento da revisão foram selecionados 46 artigos que apresentassem menção explicita sobre as técnicas de detecção de Plasmodium, fezes e/ou menção explicita sobre malária e/ou malária símia. Na prática laboratorial, foram realizadas extrações de DNA e realizadas reações de PCR em Tempo real (TaqMan 18S rRNA) e PCR para amplificação de fragmento de cyt b de gênero Plasmodium em trinta e cinco amostras fecais de Alouatta guariba clamitans do Parque Estadual da Cantareira, município de São Paulo (Projeto FAPESP 2014/10.919-4, coordenado pela Dra. Ana Maria R. de C. Duarte). Discussão/Conclusão. Após a realização da revisão e das práticas laboratoriais, foi possível conhecer a abrangência do uso da técnica não invasiva e diagnostico de plasmódios em fezes de primatas não humanos no mundo, em especial na África e Sudeste Asiático, e também levantar as principais vantagens e desvantagens da utilização de fezes para detecção de Plasmodium. Diante disso, conclui-se que a utilização das técnicas PCR utilizando DNA oriundo das fezes podem trazer relevantes benefícios nos estudos de malária símia e humana em situações zoonóticas, bem como auxiliar nas atividades de Vigilância e Controle.

Fundamentação do processo de trabalho da terapia ocupacional em saúde coletiva: uma abordagem materialista histórico-dialética / Working process foundations of occupational therapy practice in health: a dialectical historical materialistic approach

Introdução: O objeto deste estudo é a fundamentação do processo de trabalho em terapia ocupacional (TO), construída a partir da saúde coletiva latino-americana, filiada ao Materialismo Histórico-Dialético (MHD). A partir de Karl Marx e György Lukács, adotou-se particularmente a inflexão de Ricardo Bruno Mendes-Gonçalves para a saúde. A dimensão ontológica da teoria marxiana permite analisar as atividades humanas como processos de trabalho orientados por um fim, decompondo-os em seus elementos, relacionados entre si dialeticamente. Assim, torna-se possível uma análise pormenorizada de cada prática social, valendo-se das categorias que fundamentam a teoria referida. Objetivos: Compreender e sistematizar o processo de trabalho em TO no setor saúde, de acordo com o referencial da saúde coletiva latino-americana, fundada no MHD, além de sistematizar processo de construção coletiva de conhecimento sobre as práticas, como ferramenta de fortalecimento de trabalhadores em TO. Método: Pesquisa-ação emancipatória, com os eixos: a participação radical de todos os envolvidos, que significa compreender os participantes como pesquisadores internos em relação horizontal com os externos; a construção dialética de conhecimento, em diálogo entre realidade e teoria, experiência individual e determinações coletivas dos fenômenos analisados; e a transformação social, no sentido da superação do capitalismo. Foram realizadas dez oficinas emancipatórias, com dez terapeutas ocupacionais e análise da produção coletiva durante o percurso. Incorporou-se a categoria mediações como elemento metodológico de análise da totalidade social, com base em José Paulo Netto, Reinaldo Pontes e István Mészáros. Resultados: A pesquisa indica a atividade humana como objeto do processo de trabalho em TO, definida nos termos da categoria trabalho no referencial do MHD, que determina seu caráter dinâmico e complexo na mediação que realiza no cotidiano dos sujeitos. A contribuição singular da profissão para o trabalho emancipatório coletivo foi identificada como análise emancipatória das atividades humanas, através dos elementos dos processos de trabalho que as compõem e sua dialética. Identificou-se o produto final do trabalho em TO como a participação radical dos sujeitos acompanhados, reconhecidos como membros de uma classe social e ontologicamente coletivos, em sua singularidade, bem como considerando os impactos de suas relações sociais. Como ferramentas da prática, foram identificados quatro elementos metodológicos: a análise emancipatória da atividade humana, a proposição emancipatória de atividades, a operacionalização da participação radical e a intervenção sobre o tecido social. Compreendeu-se o cotidiano como o meio em que o processo de trabalho se estabelece, complexo da reprodução social, que é política e histórica. Conclusões: O diálogo entre a saúde coletiva latino-americana e a TO social reconhece a chamada questão social como parte do objeto de ambas, o que denota uma radicalidade em comum: a da assunção do papel emancipatório do trabalho coletivo. Defende-se que a especificidade da prática em TO no setor saúde está relacionada à análise emancipatória da complexidade de operacionalização da práxis social e seus impactos na determinação social da saúde. Análise e intervenção, ambas fundadas na dialética entre atividade humana e cotidiano, concretizado na participação radical dos sujeitos envolvidos, potencializam a composição da práxis revolucionária coletiva que, no horizonte da utopia concreta, gerará os meios para produzir uma nova sociedade.

Introduction: The ontological dimension of marxist theory allows the analysis of human activities as working processes oriented by an intention, by decomposing them into its elements that relate to each other dialectically. This thesis studied the foundations of occupational therapy (OT) working process, based on Latin-American collective health affiliated with Dialectical Historical Materialism (DHM). Based on Karl Marx and György Lukács, it was adopted Ricardo Bruno Mendes-Gonçalves inflections for health field of practices. It is proposed that detailed analysis of every social practice is possible, based on the categories of the referred theory. Objectives: To understand and systematize the working process in OT in the health field, based on the Latin American collective health framework, founded on the DHM, and to systematize the methodological process of collective construction of knowledge about OT practices, as a tool for strengthening workers. Method: Emancipatory action research, comprising as main elements: the radical participation of all those involved, which means understanding the participants as internal researchers in a horizontal relationship with the external researchers; the dialectical development of knowledge, in a dialogue between reality and theory, individual experience and collective determinations of the analyzed phenomena; and social transformation, meaning the seek for overcoming capitalism. Ten emancipatory workshops were held, with ten occupational therapists with permanent analysis of collective production along the way. The theoretical category mediations was incorporated as a methodological element for the analysis of social totality, based on José Paulo Netto, Reinaldo Pontes and István Mészáros. Results: Human activity was identified as the object of the working process in OT, defined by the category work in the DHM theory, which determines its dynamic and complex characteristics in the mediation it performs in the everyday lives of individuals. The emancipatory analysis of human activities, based on the elements of the working processes that compose them and their dialectics were considered the singular contribution of OT to collective emancipatory praxis. The final product of OT practice was identified as the radical participation of the individuals, recognized as members of a social class and ontologically collective individuals, either in their singularity as well as by the impacts of their social relations. As tools of practice, four methodological elements were identified: the emancipatory analysis of human activity, the emancipatory proposition of activities, the operationalization of radical participation and the intervention in the social fabric. Everyday life was understood as the means in which the working process is established, a complex of social reproduction, which is political and historical. Conclusions: The dialogue between Latin American collective health and Brazilian social OT recognizes the social issues as part of the object of both, which points to a common radicality in the assumption of the emancipatory role of collective work. OT practice in the health field is related to the emancipatory analysis of the complexity of operationalizing social praxis and its impacts on the social determination of health. Analysis and intervention, both founded on the dialectics between human activity and everyday life, materialized in the radical participation of individuals, enhance the composition of the collective revolutionary praxis that, in the horizon of concrete utopia, will generate the means to produce a new society.

Takotsubo syndrome induced by brachytherapy in a patient with endocervical adenocarcinoma.

BACKGROUND: Takotsubo syndrome (TTS), also known as stress cardiomyopathy, apical ballooning syndrome and broken heart syndrome, is characterized by acute-onset chest pain, electrocardiographic (ECG) abnormalities and reversible left ventricular (LV) disfunction in the absence of a culprit obstructive lesion in the coronary arteries; therefore, myocardial infarction is the most important differential diagnosis. Usually induced by emotional/physical stress, its treatment consists in hemodynamic support until complete and spontaneous recovery occurs, which is generally achieved within a few days to weeks. Cervical malignancies are an important public health issue in low/middle-income countries and, in the setting of locally advanced disease, concurrent chemoradiation followed by brachytherapy is considered the standard treatment, harboring curative potential. CASE REPORT: We report a case of a 38-year-old woman who underwent concurrent chemoradiotherapy and developed cardiopulmonary arrest in ventricular fibrillation during a brachytherapy session. Complementary tests disclosed altered ECG and cardiac biomarkers, no evidence of coronary artery obstruction, as well as LV disfunction consistent with TTS on echocardiogram and cardiac MRI. After few days of supportive therapy, complete recovery of heart function was observed. CONCLUSIONS: Especially for cancer patients, who usually experience intense emotional/physical stress intrinsically associated with their diagnosis and aggressive treatments, considering TTS as a differential diagnosis is warranted. Intracavitary brachytherapy procedure may represent a trigger for TTS.

Aliskiren Reduces the Adrenal Zona Glomerulosa Apoptosis and Autophagy in Wistar Rats with 2K1C Hypertension.

Hypertension is a disease classified as primary or secondary, manifested not only by elevation of blood pressure but also involved in structural and functional changes of target organs. Renal artery stenosis is a leading factor of secondary hypertension, and its progress is associated with overactivation of the renin-angiotensin-aldosterone system (RAAS). Aliskiren is a renin inhibiting drug that suppresses RAAS and culminates in decreased renin release, plasma angiotensin II concentration, and inhibition of aldosterone secretion. In this sense, the aim of the present study was to analyze the structural and ultrastructural morphophysiology of the adrenal glomerular zone, after treatment with aliskiren in Wistar rats with 2K1C hypertension. Parameters as structure and ultrastructure of the adrenal glomerular zone, cellular apoptosis, nuclear cell proliferation, and AT1 receptor expression were analyzed by immunostaining and electron microscopy. Our results showed that the hypertensive animals treated with aliskiren presented a reestablishment of AT1 receptor expression and decrease in apoptosis and autophagy. In addition, treatment with aliskiren improves the cell aspects in the adrenal glomerular zone, evidenced by ultrastructural analysis through preserved nuclei and well-developed mitochondria. Therefore, our evidence suggests that aliskiren has a beneficial effect on the adrenal glomerular zone remodeling in animals with renovascular hypertension.

Oropouche Virus Infects, Persists and Induces IFN Response in Human Peripheral Blood Mononuclear Cells as Identified by RNA PrimeFlow™ and qRT-PCR Assays.

Oropouche orthobunyavirus (OROV) is an emerging arbovirus with a high potential of dissemination in America. Little is known about the role of peripheral blood mononuclear cells (PBMC) response during OROV infection in humans. Thus, to evaluate human leukocytes susceptibility, permissiveness and immune response during OROV infection, we applied RNA hybridization, qRT-PCR and cell-based assays to quantify viral antigens, genome, antigenome and gene expression in different cells. First, we observed OROV replication in human leukocytes lineages as THP-1 monocytes, Jeko-1 B cells and Jurkat T cells. Interestingly, cell viability and viral particle detection are maintained in these cells, even after successive passages. PBMCs from healthy donors were susceptible but the infection was not productive, since neither antigenome nor infectious particle was found in the supernatant of infected PBMCs. In fact, only viral antigens and small quantities of OROV genome were detected at 24 hpi in lymphocytes, monocytes and CD11c+ cells. Finally, activation of the Interferon (IFN) response was essential to restrict OROV replication in human PBMCs. Increased expression of type I/III IFNs, ISGs and inflammatory cytokines was detected in the first 24 hpi and viral replication was re-established after blocking IFNAR or treating cells with glucocorticoid. Thus, in short, our results show OROV is able to infect and remain in low titers in human T cells, monocytes, DCs and B cells as a consequence of an effective IFN response after infection, indicating the possibility of leukocytes serving as a trojan horse in specific microenvironments during immunosuppression.

Workers' occupational health surveillance systems in low- and middle-income countries: a scoping review protocol.

OBJECTIVE: The aim of this scoping review is to describe the characteristics of occupational surveillance systems available in low- and middle-income countries. INTRODUCTION: Well-established workers' health surveillance systems provide important data to guide public health decision-making. A previous review on occupational health surveillance systems in developed countries found that insufficient collection of information and resources affects the work of policymakers and researchers. Identifying the characteristics of existing systems in low- and middle-income countries can assist in decision-making in these countries. INCLUSION CRITERIA: This review will consider studies on occupational health surveillance systems used in both public and private health services in low- and middle-income countries, which describe, implement, analyze, or evaluate surveillance systems on workers' health and working conditions. METHODS: Primary studies, government documents, and other records focusing on information systems of occupational and work-related diseases, occupational accidents, or injuries, published in English, Portuguese, Spanish, or Italian will be retrieved from seven databases, including LILACS, Scopus, PubMed, CINAHL, and Embase, among others. Various sources of gray literature, such as low- and middle-income countries' government websites, will also be searched. After title and abstract screening, relevant articles will be analyzed in full. Data extracted will be presented in tables and narrative form to provide comprehensive information.

Modulation of cardiac renin-angiotensin system, redox status and inflammatory profile by different volumes of aerobic exercise training in obese rats.

Overactivation of the classical arm of the renin-angiotensin (Ang) system (RAS) occurs during inflammation, oxidative stress and obesity-induced cardiomyopathy. The activation of the protective arm of RAS may act to counterbalance the deleterious effects of the classical RAS. Although aerobic exercise training (AET) shifts the balance of the RAS towards the protective arm, little is known about the molecular adaptations to different volumes of AET. The aim of this study was to evaluate the impact of AET volume on the modulation of RAS, as well as on cardiac biomarkers of oxidative stress and inflammation, in a diet-induced obesity model. Male Wistar rats were fed either control (CON) or high fat (HF) diet for 32 weeks. At week 20, HF group was subdivided into sedentary, low (LEV, 150 min/week) or high (HEV, 300 min/week) exercise volume. After 12 weeks of exercise, body mass gain, systolic blood pressure and heart rate were evaluated, as well as RAS, oxidative stress and inflammation in the heart. Body mass gain, systolic blood pressure and heart rate were higher in HF group when compared with SC group. Both trained groups restored systolic blood pressure and heart rate, but only HEV reduced body mass gain. Regarding the cardiac RAS, the HF group exhibited favoring of the classical arm and both trained groups shifted the balance towards the counterregulatory protective arm. The HF group had higher B1R expression and lower B2R expression than the control group, and B2R expression was reverted in both trained groups. The HF group also presented oxidative stress. The LEV and HEV groups improved the cardiac redox status by reducing Nox 2 and nitrotyrosine expression, but only the LEV group was able to increase the antioxidant defense by increasing Nrf2 signaling. While the HF group presented higher TNF-α, IL-6 and NFκB expression, and lower IL-10 expression, than the SC group, both training protocols improved the inflammatory profile. Although both trained groups improved the deleterious changes related to obesity cardiomyopathy, it is clear that the molecular mechanisms differ between them. Our results suggest that different exercise volumes might reach different molecular targets, and this could be a relevant factor when using exercise to manage obesity.