Seroprevalence of Treponema pallidum infection in Brazilian indigenous people: a cross-sectional study.

Indigenous communities in Brazil have a complex epidemiological profile, which increases their chances of contracting sexually transmitted diseases. However, limited data is available on Treponema pallidum infections in this population. We investigated the seroprevalence and risk factors associated with T. pallidum infection in an indigenous population of Dourados, Mato Grosso do Sul. Blood samples were collected from September 2017 to March 2020, and the participants were interviewed to obtain comprehensive data on demography and sexual behavior. Serological tests were performed to detect T. pallidum infection. Besides conducting descriptive analysis, we performed Chi-squared tests and determined the bivariate odds ratio. The data were also analyzed using logistic regression. Among the 2190 invited individuals, 1927 (88%) were included in this study. The seroprevalence of T. pallidum infection was 2.91%. The results of a multivariate analysis showed that individuals who were 30-39 years old, with up to 4 years of school education, living in households without piped water, with a history of genital lesions, multiple sexual partners, and having a history of STIs had the highest seroprevalence of T. pallidum. This study showed that behavioral, social, and economic factors play an important role in the transmission of T. pallidum within the indigenous population. Thus, targeted intervention, including imparting education in the native language, mass testing initiatives, and implementing public policies to improve socioeconomic indicators, is needed to reduce the cases of syphilis in this community.

Seroprevalence of Treponema pallidum infection among high-risk populations from Brazil.

Syphilis is a significant public health concern worldwide. According to the 2020 estimates, nearly 7.1 million new cases of syphilis have been reported globally, with over 30 % of these cases reported from American nations, particularly Brazil. Concerns have been raised regarding the susceptibility of specific groups to syphilis due to challenges and vulnerabilities that place these groups at a higher risk of infections or complications in the treatment outcomes. The present study aimed to compare the seroprevalence and the factors associated with syphilis among such high-risk groups. The study was designed as a cross-sectional one and was conducted with pregnant women, people living with HIV (PLHIV), people living with tuberculosis (PLTB), indigenous and healthy populations in Mato Grosso do Sul, Brazil. The study was conducted between June 2019 and August 2022, during which the included patients were subjected to treponemal and non-treponemal serological assays. The study also included a survey conducted through a self-reported questionnaire to collect information regarding the participants' demographics and sexual behaviors. A total of 550 samples were collected, with 110 participants in each of the five groups. The results of the study revealed that the seroprevalence of Treponema pallidum infection in pregnant women, PLHIV, PLTB, indigenous and healthy populations of the study region was 10 % (n = 11/110), 41.81 % (n = 46/110), 17.27 % (n = 19/110), 5.45 % (n = 6/110), and 8.18 % (n = 9/110), respectively. Homosexual orientation (p = 0.04) and a history of sexually transmitted infection (STI) (p = 0.01) were associated with the seroprevalence of T. pallidum infection in PLHIV. However, no such associations were noted in the remaining four groups. The seroprevalence of T. pallidum infection was observed to vary significantly among the different high-risk groups, which highlighted the persistent concern of syphilis, particularly among vulnerable populations. These findings underscore the significance of focused interventions and public health strategies customized to the specific requirements of each of the groups evaluated in the present study to decrease the number of cases of syphilis and thereby prevent future complications in patients with other serious infections.

Assessment of inter- and intraobserver agreement for META score in distinguishing osteoporotic from multiple myeloma vertebral fractures.

PURPOSE: To conduct an independent assessment of inter- and intraobserver agreement for the META score as a tool for differentiating osteoporotic vertebral fractures and multiple myeloma vertebral fractures. METHODS: This is a retrospective observational study. The magnetic resonance imaging analysis was made by two independent spinal surgeons. We designated a Subjective assessment, in which the surgeon should establish a diagnostic classification for each vertebral fracture based on personal experience: secondary to osteoporosis, categorized as a benign vertebral fracture (BVF), or attributed to multiple myeloma, categorized a malign vertebral fracture (MVF). After a 90-day interval, both surgeons repeated the evaluations. For the next step, the observers should establish a diagnosis between BVF and MVF according to the META score system, and both observers repeated the evaluations after a 90-day interval. The intra and interobserver reliability of the Subjective evaluation was studied using the kappa (κ) test. Then, the META evaluations were paralleled using the intraclass correlation coefficient (ICC). RESULTS: A total of 220 patients who had the potential to participate in the study were initially enrolled, but after applying the exclusion criteria, 44 patients were included. Thirty-three patients had BVF, and 12 patients presented MVF. Interobserver agreement for both Subjective evaluations moments (initial and 90-days interval) found a slight agreement for both moments (0.35 and 0.40 respectively). Kappa test for both META evaluations moments (initial and 90-days interval) found a moderate interobserver agreement for both moments (0.54 and 0.48 respectively). It was observed that the ICC calculated for the Initial evaluation using META score was 0.680 and that in the 90-days interval was 0.726, indicating regular to good agreement. Kappa test for intraobserver agreements for the Subjective evaluation presented moderate agreement for both Surgeons. On the other side, Kappa test for intraobserver agreements for the META evaluation presented substantial agreement for both Surgeons. The Intraclass Correlation Coefficient of the META score found presented an almost perfect agreement for both Surgeons. CONCLUSION: Intra and interobserver agreement for both surgeons were unsatisfactory. The lack of consistent reproducibility by the same observer discourages and disfavors the routine use of the META score in clinical decision making, when potentially cases of multiple myeloma may be present.

Immune Response to an Inactivated Vaccine of SARS-CoV-2 (CoronaVac) in an Indigenous Brazilian Population: A Cohort Study.

INTRODUCTION: Although the adaptive immune responses to the CoronaVac vaccine are known, their dynamics in indigenous communities remain unclear. In this study, we assessed the humoral and cellular immune responses to CoronaVac (Sinovac Biotech Life Sciences, 2021 NCT05225285, Beijing, China), in immunized Brazilian indigenous individuals. METHODS: We conducted a prospective cohort study on indigenous Brazilian people between February 2021 and June 2021. Analyses of immune responses were carried out before (T1) and after a vaccination schedule was completed (T2). Demographic data were collected using a questionnaire. RESULTS: We initially included 328 patients; among them, 120 (36.6%) had no SARS-CoV-2 antibodies. Peripheral blood mononuclear cells (PBMCs) were collected from 106 patients during follow-up visits, of which 91 samples were analyzed by immunophenotyping assay to detect SARS-CoV-2-specific memory T-cell response. Post-vaccination, the levels of memory B-cells and Natural Killer T-lymphocytes increased. Bororó village residents, females, and Terena ethnic group members had higher levels of anti-spike IgG antibodies post-vaccination, whereas alcohol and tobacco users had lower concentrations. CONCLUSIONS: To our best knowledge, this was the first comprehensive assessment of antibody and T-cell responses against CoronaVac vaccination in indigenous patients. Our findings showed that antibody response and T-cell immunity against SARS-CoV-2 were present in most patients following the vaccination schedule.

Seroprevalence Of SARS-COV-2 infection in asymptomatic indigenous from the largest Brazilian periurban area.

This study assessed the seroprevalence of SARS-CoV-2 in 496 asymptomatic individuals from Mato Grosso do Sul, located in Dourados, the largest periurban indigenous area in Brazil, from January 25 to February 4, 2021. The volunteers participated before receiving their first dose of the CoronaVac inactivated vaccine. For screening, blood samples were collected and analyzed using SARS-CoV-2 rapid tests and the enzyme-linked immunosorbent assay (ELISA). We observed varying trends in total anti-SARS-CoV-2 antibodies across different variables. Seropositivity among the participants tested was 63.70% (316/496) using the rapid test and 52.82% (262/496) were positive using the ELISA method. The majority of participants identified with the Guarani-Kaiowá ethnic group, with 66.15% (217/328), and other ethnic groups with 58.84% (193/328). The median age of the subjects was 30.5 years, with 79.57% (261/328) being femaleThis research showed the elevated seroprevalence of SARS-CoV-2 antibodies in asymptomatic Brazilians. The findings indicate a high seropositivity rate among the asymptomatic indigenous population of Midwest Brazil. This underscores the overlooked status of these communities and underscores the need for targeted national initiatives that emphasize the protection of vulnerable ethnic groups in the fight against COVID-19.

Desigualdade racial na educação superior: percepções de estudantes universitários / Racial inequality in higher education: perceptions of college students / Desigualdad racial en la educación superior: percepciones de estudiantes universitarios

Partindo da problemática sobre as desigualdades raciais presentes na educação superior no contexto brasileiro, o presente artigo tem como objetivo investigar as percepções de estudantes universitários acerca do tema. Para tanto, propôs--se uma pesquisa de caráter qualitativo com estudantes de cursos de graduação de instituições públicas e privadas de diferentes áreas de conhecimento e regiões do país. Os participantes responderam, além do questionário sociodemográfico, a questões sobre desigualdades raciais no ambiente universitário. Ao abordar a questão racial, os resultados da pesquisa corroboram a literatura, que aponta dificuldades específicas em relação à vivência do racismo no âmbito educa-cional. Desse modo, esta pesquisa contribui para compreensão do fenômeno e levantamento de dados sobre as percepções desse público. (AU)

Starting from the issue of racial inequalities in higher education in the Brazilian context, this article aims to investigate the perceptions of university students on the subject. To achieve this, a qualitative research was proposed with students from undergraduate courses in public and private institutions from different fields of knowledge and regions of the country. In addition to the sociodemographic questionnaire, participants answered questions about racial inequalities in the university environment. Addressing the racial issue, the research results corroborate the literature, indicating specific difficulties related to experiencing racism in the educational sphere. Thus, this research contributes to the understanding of the phenomenon and the collection of data on the perceptions of this audience. (AU)

A partir de la cuestión de la desigualdad racial en la educación superior en el contexto brasileño, este artículo tuvo como objetivo investigar las percep-ciones de los estudiantes universitarios sobre el tema. Para ello, se planteó una investigación cualitativa con estudiantes de instituciones públicas y privadas de diferentes áreas del conocimiento y regiones del país. Los participantes respondieron, además del cuestionario sociodemográfico, preguntas sobre desi-gualdades raciales en el ámbito universitario. Al abordar la cuestión racial, los resultados de la investigación corroboran la literatura, que apunta dificultades específicas con relación a la vivencia del racismo en el ámbito educativo. Por lo tanto, esta investigación contribuye a comprender el fenómeno y recopilar datos sobre las percepciones de este público. (AU)

Fully automatic segmentation of brain lacunas resulting from resective surgery using a 3D deep learning model.

The rapid and constant development of deep learning (DL) strategies is pushing forward the quality of object segmentation in images from diverse fields of interest. In particular, these algorithms can be very helpful in delineating brain abnormalities (lesions, tumors, lacunas, etc), enabling the extraction of information such as volume and location, that can inform doctors or feed predictive models. In this study, we describe ResectVol DL, a fully automatic tool developed to segment resective lacunas in brain images of patients with epilepsy. ResectVol DL relies on the nnU-Net framework that leverages the 3D U-Net deep learning architecture. T1-weighted MRI datasets from 120 patients (57 women; 31.5 ± 15.9 years old at surgery) were used to train (n=78) and test (n=48) our tool. Manual segmentations were carried out by five different raters and were considered as ground truth for performance assessment. We compared ResectVol DL with two other fully automatic methods: ResectVol 1.1.2 and DeepResection, using the Dice similarity coefficient (DSC), Pearson's correlation coefficient, and relative difference to manual segmentation. ResectVol DL presented the highest median DSC (0.92 vs. 0.78 and 0.90), the highest correlation coefficient (0.99 vs. 0.63 and 0.94) and the lowest median relative difference (9 vs. 44 and 12 %). Overall, we demonstrate that ResectVol DL accurately segments brain lacunas, which has the potential to assist in the development of predictive models for postoperative cognitive and seizure outcomes.

How Did COVID-19 Impact the Antimicrobial Consumption and Bacterial Resistance Profiles in Brazil?

The indiscriminate use of antibiotics has favored the selective pressure of multidrug resistance among microorganisms. This research evaluated the pattern of antibiotic prescriptions among the Brazilian population between January 2018 and December 2021. Additionally, the study sought to analyze the incidence rates of central line-associated bloodstream infection (CLABSI) and examine the profiles of antibiotic resistance. We assessed the hospital and community antimicrobial consumption from the National Health Surveillance Agency Database and correlated it to microorganisms. The consumption of antimicrobials in the hospital environment increased by 26% in 2021, highlighting polymyxin B, which increased by 204%. In 2021, 244,266 cases of CLABSI were reported, indicating a nosocomial infection rate of 7.9%. The rate of resistance to polymyxin B was higher in Pseudomonas aeruginosa (1400%) and Klebsiella pneumoniae (514%). Azithromycin emerged as the predominant antibiotic utilized within the community setting, accounting for 24% of the overall consumption. Pearson's correlation analysis revealed a significant and positive correlation (r = 0.71) between the elevated usage of azithromycin and the incidence of COVID-19. Our results indicate an increase in antimicrobial consumption during the COVID-19 pandemic and reinforce the fact that the misuse of antimicrobials may lead to an expansion in antimicrobial resistance.

Prevalence of HIV-1 infection and associated characteristics in a Brazilian indigenous population: a cross-sectional study.

Background: Despite significant progress in the areas of prevention, diagnosis, and treatment, HIV continues to result in a substantial number of fatalities on a global scale each year. Gaining insights from epidemiological data can prove instrumental in the development of health promotion strategies, particularly within vulnerable populations, such as indigenous groups. Consequently, our study aimed to investigate the prevalence of HIV infection within the indigenous population residing in the second-largest region of Brazil. Additionally, we sought to explore the subtypes of HIV-1 and detect any drug-resistance mutations present within this population. Methods: In this cross-sectional study, we aimed to evaluate the prevalence of HIV-1 infection and explore its associated characteristics within the indigenous population residing in the villages of Jaguapiru and Bororó, located in the Dourados area of Mato Grosso do Sul (MS), Brazil. Blood samples were collected for rapid HIV screening, serological tests, nucleic acid amplification, and HIV subtyping. Additionally, the HIV-1 viral load and CD4+ T lymphocyte count of the people living with HIV (PLHIV) were assessed at the time of recruitment and 24 weeks later. Findings: Out of the 2190 invited individuals, 1927 (88%) were included in this study. The average age of the participants was 34.2 (±13.8) years, with a majority of 74% being female. Moreover, 68.44% of the participants identified themselves as belonging to the Guarani-Kaiowa ethnic group. HIV seroprevalence was 0.93% (18/1927), and 73.22% (1411/1927) were unaware of their serological status. The prevalence of HIV-1 was higher in single indigenous people [10/617 (1.62%)], who received government benefits [14/1021 (1.37%)], had less than five years of formal education [11/685 (1.61%)], had sexual intercourse with users of injectable drugs [2/21 (9.52%)], with history of sexually transmitted infections (STIs) [10/62 (16.2%)] and incarceration [3/62 (4.84%)]. Of 18 positive samples, 44.4% (8/18) were successfully amplified, and HIV-1 subtype C was prevalent. Furthermore, we identified HIV-1 drug resistance mutations in four patients, specifically from the classes of Protease Inhibitor, Nucleoside Reverse Transcriptase Inhibitor, and Non-Nucleoside Reverse Transcriptase Inhibitor. Notably, three of these patients exhibited a high viral load even after 24 weeks of undergoing antiretroviral therapy. Out of the 18 PLHIV, 66.66% (12/18) had a viral load below 1000 copies/mL, while 50% (9/18) had a CD4+ T lymphocytes count greater than 350 cells/mL after 24 weeks of treatment. Interpretation: Despite the concerted efforts to control HIV infection, the prevalence observed in the indigenous population under study surpassed that reported in other Brazilian indigenous groups. This disparity highlights the disproportionate impact of the disease on this particular group. The detection of drug-resistance mutations further emphasizes the critical need to expand diagnostic coverage, closely monitor treatment strategies, and maintain ongoing molecular surveillance. These measures are imperative for enhancing HIV management within this vulnerable population. Funding: This study was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (FUNDECT), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Secretaria do Estado de Saúde (SES) of Governo do Estado de Mato Grosso do Sul, and Universidade Federal da Grande Dourados (UFGD).

Multidrug-resistant gram-negative bacteria in patients with COVID-19: An epidemiological and clinical study.

Epidemiological data regarding the incidence of secondary multidrug-resistant (MDR) Gram-negative infection in patients with coronavirus disease (COVID-19) in Brazil are still ambiguous. Thus, a case-control study was designed to determine factors associated with the acquisition of MDR Gram-negative bacteria (GNB) in patients with and without COVID-19 and describe the mortality rates and clinical features associated with unfavorable outcomes. In total, we assessed 280 patients admitted to Brazilian intensive care units from March/2020 to December/2021. During the study, 926 GNB were isolated. Out of those, 504 were MDR-GNB, representing 54.4% of the resistance rate. In addition, out of 871 patients positive for COVID-19, 73 had secondary MDR-GNB infection, which represented 8.38% of documented community-acquired GNB-MDR infections. The factors associated with patients COVID-19-MDR-GNB infections were obesity, heart failure, use of mechanical ventilation, urinary catheter, and previous use of ß-lactams. Several factors associated with mortality were identified among patients with COVID-19 infected with MDR-GNB, including the use of a urinary catheter; renal failure; and the origin of bacterial cultures such as tracheal secretion, exposure to carbapenem antibiotics, and polymyxin. Mortality was significantly higher in patients with COVID-19-MDR-GNB (68.6%) compared to control groups, where COVID-19 was 35.7%, MDR-GNB was 50%, and GNB was 21.4%. Our findings demonstrate that MDR-GNB infection associated with COVID-19 has an expressive impact on increasing the case fatality rate, reinforcing the importance of minimizing the use of invasive devices and prior exposure to antimicrobials to control the bacterial spread in healthcare environments to improve the prognosis among critical patients.

Cardiomiopatia arritmogênica com acometimento biventricular: diagnóstico precoce por alteração de ECG e alta suspeição clínica / Arrhythmogenic cardiomyopathy with biventricular involvement: early diagnosis due to ECG changes and high clinical suspicion

INTRODUÇÃO: A cardiopatia arritmogênica (CA) definida como um distúrbio arritmogênico do músculo cardíaco não explicado por doença isquêmica, hipertensiva ou valvar pode se apresentar clinicamente com arritmias atriais e ventriculares, distúrbios do sistema de condução e/ ou insuficiência cardíaca. Entre as demais etiologias, a CA do ventrículo direito (CAVD) é a mais bem caracterizada, quando o envolvimento acomete predominantemente essa cavidade, evoluindo com substituição fibrogordurosa do miocárdio e taquicardia ventricular com morfologia de bloqueio de ramo esquerdo. RELATO DE CASO: Paciente masculino, 45 anos, encaminhado para avaliação cardiológica devido alteração do ECG em avaliação pré-operatória. Relatou apenas cansaço aos esforços extra-habituais desde a infância. O ECG evidenciava inversão da onda T de V1 a V4 bem como fragmentação do QRS em D1 e aVL. Holter de 24 h demonstrou presença de 1054 extrassístoles ventriculares monomórficas isoladas. Ecocardiograma (Eco) apresentou dilatação mínima do VD, aumento da trabeculação na região apical e disfunção sistólica leve (FAC 29%). A ressonância magnética cardíaca (RMC) evidenciou dilatação ventricular e disfunção sistólica do VD à custa de hipocinesia da porção apical e discinesia do segmento basal da parede lateral e da via de saída, bem como realce tardio no segmento basal da parede inferior, além de áreas de infiltrado gorduroso no septo interventricular e no segmento apical da parede lateral do ventrículo esquerdo. Sequenciamento de nova geração demonstrou variante patogênica no gene PKP2, corroborando o diagnóstico de CA com acometimento biventricular. COMENTÁRIOS E CONCLUSÃO: No presente relato, o ECG de base alterado foi fundamental para suspeita diagnóstica, bem como a propedêutica direcionada. Paciente apresentava 3 critérios maiores (alterações morfofuncionais compatíveis ao Eco/RMC, inversão de T V1-V3 em ECG na ausência de bloqueio de ramo direito, teste genético positivo para alelo patogênico) e 1 critério menor (> 500 extrassístoles ventriculares em Holter de 24 h), caracterizando o diagnóstico definitivo de CA.Visto que esta patologia é causa importante de morte súbita em indivíduos jovens, reforçamos a necessidade de alta suspeição clínica e valorização dos achados eletrocardiográficos.

Transition to a sustainable food supply chain during disruptions: A study on the Brazilian food companies in the Covid-19 era.

The COVID-19 pandemic has brought negative impacts to global supply chains, in particular to the agricultural sector. Although these companies have been developing programs to mitigate the impacts caused by COVID-19, researchers have been worried about a possible weakening of the adoption of sustainable initiatives due to a focus on dealing with the consequences of the pandemic. Grounded on the Resource Orchestration Theory, the goal of this study was to assess the effects of the COVID-19 outbreak on sustainable (environmental, social, and economic) performance in the context of agri-food supply chains. To do so, a questionnaire survey was used to collect data from 349 different medium and large agri-food companies in Brazil. Data were analyzed using Structural Equation Modeling-Partial Least Squares technique. This study has found out that, under the impacts arising from COVID-19 pandemic (1) supply management and transportation and logistics management had a positive impact on food supply chains' sustainable performance; (2) the effects of relationship management and supply chain wide impact management were found to be negative on sustainable performance; and (3) the effects of demand and production management on sustainable performance were not considered significant. We propose a framework that clearly represents the relationship between the disrupted supply chain areas and sustainable performance through the development of orchestration capabilities. By knowing which kinds of impacts produce the most significant effects on sustainable performance, policy makers and managers will be able to make decisions and take actions to avoid negative effects and to improve firms' sustainable performance.

Radiation-Induced Undifferentiated Pleomorphic Sarcoma after Breast Conserving Therapy: Case Report / Sarcoma Pleomórfico de Mama Radioinduzido Pós-Tratamento Conservador de Câncer de Mama Inicial: Relato de Caso / Sarcoma Pleomórfico de Mama Radioinducido tras Tratamiento Conservador de Cáncer de Mama Inicial: Informe de Caso

Introduction: Breast sarcoma is a rare form of malignancy that arises from connective tissue, comprising less than 5% of all sarcomas. Undifferentiated pleomorphic sarcoma (UPS) of the breast is a rare and aggressive subtype of radiation-induced sarcoma that can occur in treated breast cancer patients. The diagnosis is challenging and often missed due to the low incidence, long latency period, unspecific imaging finding, and difficulties in clinical and histological detection. Case report: A 56-year-old woman was diagnosed with early-stage triple-negative breast cancer in 2013 and underwent breast-conserving therapy (BCT). After five years follow-up, she developed mastalgia and breast induration, and after mammography and ultrasound without suspicious lesions, a magnetic resonance imaging (MRI) was performed and showed a highly suggestive malignancy mass measuring 8.0 cm and invading the chest wall. The core biopsy revealed a spindle cells malignant tumor, negative for pan cytokeratin and most of immuno-histochemical markers, suggesting sarcoma, but requiring investigation of surgical specimen to exclude metaplastic carcinoma. She underwent Halsted radical mastectomy, full-thickness left anterior chest wall resection contemplating segments of the 4th and 5th ribs and reconstruction with synthetic mesh. The surgical specimen evidenced a UPS with clear margins. The patient had good postoperative recovery and remains in follow-up with the mastology team. Conclusion: This report shows that radiation-induced sarcomas of the breast can be difficult to diagnose, and how later treatment can demand a major surgery with higher morbidity. Prognosis may improve if detected early

Introdução: O sarcoma de mama é uma forma rara de câncer que surge do tecido conjuntivo, compreendendo menos de 5% de todos os sarcomas. O sarcoma pleomórfico indiferenciado (SPI) da mama é um subtipo raro e agressivo de sarcoma induzido por radiação que pode surgir em pacientes pós-tratamento conservador de câncer de mama. O diagnóstico é desafiador e, muitas vezes, tardio, em virtude da baixa incidência, longo período de latência, achados de imagem inespecíficos e dificuldades na detecção clínica e histológica. Relato do caso: Paciente do sexo feminino, 56 anos, foi diagnosticada com câncer de mama triplo-negativo estadiamento inicial em 2013 e submetida a tratamento conservador de câncer de mama. Após cinco anos de seguimento, evoluiu com mastalgia e endurecimento mamário e, após mamografia e ultrassonografia sem lesões suspeitas, foi realizada ressonância magnética que evidenciou massa altamente sugestiva de malignidade medindo 8,0 cm com invasão da parede torácica. O resultado da core biopsy revelou um tumor maligno de células fusiformes, negativo para pancitoqueratina e para a maioria dos marcadores imuno-histoquímicos, sugerindo sarcoma, mas exigindo estudo de peça cirúrgica para excluir carcinoma metaplásico. A paciente foi submetida à mastectomia radical de Halsted, ressecção da parede torácica anterior esquerda contemplando segmentos das 4ª e 5ª costelas e reconstrução com tela sintética. O laudo histopatológico da peça cirúrgica evidenciou SPI com margens livres. Evoluiu com boa recuperação pós-operatória, permanecendo em acompanhamento com a equipe de mastologia. Conclusão: O relato de caso ilustra como os sarcomas de mama induzidos por radiação podem ser de difícil diagnóstico e como o tratamento postergado pode exigir uma cirurgia de grande porte com maior morbidade. Estar ciente dessa condição pode melhorar o prognóstico do paciente

Introducción: El sarcoma de mama es una forma rara de cáncer que surge del tejido conectivo y comprende menos del 5% de todos los sarcomas. El sarcoma pleomórfico indiferenciado (SPI) de la mama es un subtipo raro y agresivo de sarcoma inducido por radiación que puede surgir en pacientes después de un tratamiento conservador del cáncer de mama. El diagnóstico es un desafío y, a menudo, se retrasa debido a la baja incidencia, el largo período de latencia, los hallazgos de imagen inespecíficos y las dificultades en la detección clínica e histológica. Informe del caso: Una paciente de 56 años fue diagnosticada de cáncer de mama triple negativo en estadio inicial en 2013 y se sometió a un tratamiento conservador para el cáncer de mama. A los cinco años de seguimiento desarrolló mastalgia y endurecimiento mamario, y tras mamografía y ecografía sin lesiones sospechosas, se realizó una resonancia magnética, que mostró una masa altamente sugestiva de malignidad de 8,0 cm. con invasión de la pared torácica. El estudio anatomopatológico de la lesión mostró un tumor de células fusiformes maligno, negativo para pancitoqueratina y para la mayoría de los marcadores inmuno-histoquímicos, lo que sugería sarcoma, pero requirió un estudio de la pieza quirúrgica para descartar un carcinoma metaplásico. La paciente fue intervenida de mastectomía radical de Halsted, resección de la pared torácica anterior izquierda cubriendo segmentos de las 4ª y 5ª costillas y reconstrucción con malla sintética. El informe histopatológico de la pieza quirúrgica mostró UPS, con márgenes libres. Evolucionó con buena recuperación postoperatoria, permaneciendo en seguimiento con el equipo de mastología. Conclusión: El relato de caso ilustra cómo los sarcomas de mama inducidos por radiación pueden ser difíciles de diagnosticar y cómo el tratamiento tardío puede requerir una cirugía mayor con mayor morbilidad. Ser consciente de esta condición puede mejorar el pronóstico del paciente.Palabras clave: sarcoma; neoplasias de la mama; neoplasias inducidas por radiación; neoplasias primarias secundarias; informes de casos

Atividade de extratos de plantas e óleos essenciais sobre o vírus Sars-Cov-2: análise bibliométrica / Activity of plant extracts and essential oils on the Sars-Cov-2 virus: bibliometric analysis

Registros arqueológicos relatam que o uso das plantas medicinais acontece desde a pré-história, com apontamentos de que o homem ao se alimentar de raízes e ervas, instintivamente, utilizava as plantas como medicamentos e, diante da pandemia de COVID-19, deve-se levar em consideração que a busca pelo tratamento de uma doença, sem a menor perspectiva de controle, passe por todos os meandros da medicina incluindo a medicina alternativa, por meio das plantas medicinais. O objetivo deste trabalho foi descrever os artigos científicos publicados sobre extratos de plantas e óleos essenciais que possuem atuação sobre o vírus SARS-CoV-2 no período de 2020 a 2022. Tratou-se de estudo exploratório, descritivo e retrospectivo, realizado, por meio de revisão bibliográfica. O total de artigos recuperados foi de 424 sobre extratos de plantas e 15 sobre óleos essenciais que, após a exclusão de artigos, selecionou-se 34 (8%) de extratos de plantas e dois (13%) de óleos essenciais, com os quais se desenvolveram as análises. Quanto às características formais da produção científica, concluiu-se que no ano de 2020 não foram encontrados artigos sobre os temas. Os autores chineses, indianos e japoneses tiveram a mesma totalidade de publicações, mas os indianos e japoneses apresentaram artigos mais atualizados. As instituições públicas foram as que mais publicaram sobre os temas e a China foi o país com maior número de publicações. Nas análises de rede de correlação por coautoria e por coocorrência dos termos, concluiu-se que as coautorias dos dois temas não apresentaram diferenças nas correlações entre os autores e os termos MeSH que tiveram maior força de relacionamento foram SARS-CoV-2, Plant Extracts, COVID-19, Humans, Antiviral Agents e Volatile Oils. Sobre os conteúdos abordados concluiu-se que as plantas medicinais, seus extratos e os óleos essenciais possuem potencial eficácia sobre a inibição do vírus SARS-CoV-2, com exceção do óleo essencial de eucalipto que possui efeito contrário no que diz respeito à infectividade do vírus.

Archaeological records show that the use of medicinal plants has been going on since prehistoric times, with indications that when man ate roots and herbs, he instinctively used plants as medicines and, in the face of the COVID-19 pandemic, it must be taken into account that the search for the treatment of a disease, without the slightest prospect of control, goes through all the intricacies of medicine including alternative medicine, through medicinal plants. The aim of this study is to describe the scientific articles published on plant extracts and essential oils that act on the SARS-CoV-2 virus between 2020 and 2022. This is an exploratory, descriptive and retrospective study, carried out by means of a bibliographic review. The total number of articles retrieved was 424 on plant extracts and 15 on essential oils. After excluding the articles, 34 (8%) on plant extracts and two (13%) on essential oils were selected for analysis. As for the formal characteristics of scientific production, it was concluded that no articles on the topics were found in 2020. Chinese, Indian and Japanese authors had the same total number of publications, but the Indians and Japanese had more up-to-date articles. Public institutions published the most on the topics and China was the country with the highest number of publications. The analyses of the correlation network by co-authorship and by co-occurrence of terms showed that the co-authorships of the two topics did not differ in the correlations between the authors and the MeSH terms with the strongest relationships were SARS-CoV-2, Plant Extracts, COVID-19, Humans, Antiviral Agents and Volatile Oils. It was concluded that medicinal plants, their extracts and essential oils are potentially effective in inhibiting the SARS-CoV-2 virus, with the exception of eucalyptus essential oil, which has the opposite effect in terms of virus infectivity.

The first year of the COVID-19 pandemic in an indigenous population in Brazil: an epidemiological study.

This cross-sectional observational study that describes the epidemiological data of the first year of the COVID-19 pandemic in the Mato Grosso do Sul State, aimed to demonstrate the differences between indigenous and non-indigenous populations, characterize confirmed cases of COVID-19 according to risk factors related to ethnicity, comorbidities and their evolution and to verify the challenges in facing the disease in Brazil. SIVEP-Gripe and E-SUS-VE, a nationwide surveillance database in Brazil, from March 2020 to March 2021 in Mato Grosso do Sul state, were used to compare survivors and non-survivors from indigenous and non-indigenous populations and the epidemiological incidence curves of these populations. A total of 176,478, including 5,299 indigenous people, were confirmed. Among the indigenous population, 52.5% (confidence interval [CI] 51.2-53.9) were women, 38% (CI 36.7-39.4) were 20-39 years old, 56.7% were diagnosed by rapid antibody tests, 12.3% (CI 95%:11.5-13.2) had at least one comorbidity, and 5.3% (CI 95%:4.7-5.9) were hospitalized. In the non-indigenous patients, 56.8% were confirmed using RT-PCR, 4.4% (CI 95%:4.3-4.5) had at least one comorbidity, and 8.0% (CI 95%:7.9-8.2) were hospitalized. The majority of non-survivors were ≥60 years old (65.1% indigenous vs. 74.1% non-indigenous). The mortality in indigenous people was more than three times higher (11% vs. 2.9%). Indigenous people had a lower proportion of RT-PCR diagnoses; deaths were more frequent in younger patients and were less likely to be admitted to hospital. Mass vaccination may have controlled the incidence and mortality associated with COVID-19 in this population during the period of increased viral circulation.

Detection of Treponema pallidum in whole blood samples of patients with syphilis by the polymerase chain reaction.

Syphilis is caused by the bacterium Treponema pallidum. The diagnosis is based on clinical data and serological analysis; however, the sensitivity and specificity of such tests may vary depending on the type of test and stage of the infection. In order to overcome this premise, this study utilized the polymerase chain reaction (PCR) for the detection of T. pallidum DNA in whole blood samples of patients with syphilis. The blood samples from patients with or without symptoms of syphilis, but with positive results in enzyme-linked immunosorbent assay (ELISA), were included in this study. A venereal disease research laboratory (VDRL) test was performed for all collected sera samples. For PCR, the T. pallidum DNA was extracted from the collected blood samples and a specific primer set was designed to amplify 131 nucleotides of polA (Tp0105). The specificity of the primers was evaluated with the DNA of 17 different pathogens. From a total of 314 blood samples reactive in ELISA, 58.2% (183/314) of the samples were reactive in the VDRL test. In the PCR, 54% (168/314) of the ELISA-reactive samples were positive. In both tests (VDRL and PCR) 104 samples were positive. Of 104 positive samples for both tests, 71 were at the latent stage. Based on these results, it can be concluded that PCR with the designed set of primers can be utilized as a diagnostic method for T. pallidum detection in blood samples of patients with syphilis, especially those with latent infection. In addition, it can be utilized as a supplement for serological methods to improve the diagnosis of syphilis.

Contactless doping characterization of [Formula: see text] using acceptor Cd probes.

Finding suitable p-type dopants, as well as reliable doping and characterization methods for the emerging wide bandgap semiconductor [Formula: see text]-[Formula: see text] could strongly influence and contribute to the development of the next generation of power electronics. In this work, we combine easily accessible ion implantation, diffusion and nuclear transmutation methods to properly incorporate the Cd dopant into the [Formula: see text]-[Formula: see text] lattice, being subsequently characterized at the atomic scale with the Perturbed Angular Correlation (PAC) technique and Density Functional Theory (DFT) simulations. The acceptor character of Cd in [Formula: see text]-[Formula: see text] is demonstrated, with Cd sitting in the octahedral Ga site having a negative charge state, showing no evidence of polaron deformations nor extra point defects nearby. The possibility to determine the charge state of Cd will allow assessing the doping type, in particular proving p-type character, without the need for ohmic contacts. Furthermore, a possible approach for contactless charge mobility studies is demonstrated, revealing thermally activated free electrons for temperatures above [Formula: see text] 648 K with an activation energy of 0.54(1) and local electron transport dominated by a tunneling process between defect levels and the Cd probes at lower temperatures.

Tp0684, Tp0750, and Tp0792 Recombinant Proteins as Antigens for the Serodiagnosis of Syphilis.

The incidence of syphilis has increased alarmingly over the years. Its diagnosis continues to be a challenge, leading to the search for new alternative and effective methods. The objective of this study was to select and evaluate three Treponema pallidum recombinant proteins for potential use in syphilis serodiagnosis. Bioinformatics analysis was performed with three T. pallidum antigens (Tp0684, Tp0750, and Tp0792) to assess their physical, antigenic, and structural characteristics. The antigens were chemically synthesized, recombinant plasmids were expressed in Escherichia coli BL21 Star™ (DE3), and the recombinant proteins were purified by nickel affinity chromatography. The antigenicity of the recombinant proteins was evaluated by western blotting and enzyme-linked immunosorbent assay (ELISA), using the sera from patients with primary and latent syphilis. In silico analysis indicated the antigenic potential once the exposed B cell epitopes were detected in the evaluated proteins. Sera from patients with primary and latent syphilis specifically recognized rTp0684, rTp0750, and rTp0792 recombinant antigens. Moreover, the rTp0684-ELISA receiver operating characteristic (ROC) analysis showed an area under the ROC curve of 0.99, indicating high diagnostic efficacy with 97.62% specificity and 95% sensitivity. In conclusion, rTp0684 showed better potential as an antigen for the development of syphilis serodiagnosis. Thus, bioinformatic analysis can be an important tool to guide the selection of antigens for serological diagnosis. Supplementary Information: The online version contains supplementary material available at 10.1007/s12088-022-01017-w.

From the environment to the hospital: How plants can help to fight bacteria biofilm.

The emergence of resistance to antibiotics has become a global challenge as far as the control and treatment of nosocomial infections are concerned. Compared to the planktonic state, biofilms generally confer more resistance to antibiotics and may become a potential source of infection. Researchers are thus focused on developing novel drugs not as vulnerable as the current ones to bacterial resistance mechanisms and also able to target bacteria in biofilms. Natural products, especially those derived from plant sources, have substantiated significant medicinal activity with unique properties, making them perfect candidates for these much-needed therapeutics. Despite being a vast resource of antimicrobial molecules, limitations, including the low concentration of the extracted active compound and bioavailability, challenge the clinical application of medicinal plants to combat these infections. Nanotechnology through green synthesis is one of the strategies to explore the medicinal potential of plants. Research has established the promising outcome of this method in antibiofilm activity, in addition to improved drug delivery, targeting, and pharmacokinetic profiles. This review summarized the current knowledge on the potentialities of plant products as antibiotic adjuvants to restore the therapeutic activity of drugs. We also discussed biotechnological advances in medicinal plants to fight and eradicate biofilm-forming microorganisms.