COVID-19 and Comorbidities: What Has Been Unveiled by Metabolomics?

The COVID-19 pandemic has brought about diverse impacts on the global population. Individuals with comorbidities were more susceptible to the severe symptoms caused by the virus. Within the crisis scenario, metabolomics represents a potential area of science capable of providing relevant information for understanding the metabolic pathways associated with the intricate interaction between the viral disease and previous comorbidities. This work aims to provide a comprehensive description of the scientific production pertaining to metabolomics within the specific context of COVID-19 and comorbidities, while highlighting promising areas for exploration by those interested in the subject. In this review, we highlighted the studies of metabolomics that indicated a variety of metabolites associated with comorbidities and COVID-19. Furthermore, we observed that the understanding of the metabolic processes involved between comorbidities and COVID-19 is limited due to the urgent need to report disease outcomes in individuals with comorbidities. The overlap of two or more comorbidities associated with the severity of COVID-19 hinders the comprehension of the significance of each condition. Most identified studies are observational, with a restricted number of patients, due to challenges in sample collection amidst the emergent situation.

Evaluation of massive education in prison health: a perspective of health care for the person deprived of freedom in Brazil.

Education, with an emphasis on prison health, has acted as a policy inducing changes in work processes, which the Brazilian National Health System (SUS) has used, and which is present in permanent health education, which promotes health care for people deprived of liberty. This article aims to present an analysis of the impacts of the strategy of massive education on prison health in Brazil from the perspective of health professionals and other actors operating in the Brazilian prison system. The data used in the study come from a questionnaire consisting of 37 questions applied nationwide between March and June 2022. Responses were collected from students who completed the course "Health Care for People Deprived of Freedom" of the learning pathway "Prison System", available in the Virtual Learning Environment of the Brazilian Health System (AVASUS). This course was offered nationally, whose adhesion (enrollment) occurred spontaneously, i.e., the course was not a mandatory. The data collected allowed us to analyze the impacts of massive education on prison health. The study also shows that the search for the course is made by several areas of knowledge, with a higher incidence in the health area, but also in other areas, such as humanities, which also work directly with the guarantee of the rights of people deprived of liberty, which are professionals in the areas of social work, psychology, and education. The analysis based on the data suggests that the massive education mediated by technology through the courses of the learning pathway, besides disseminating knowledge-following the action plan of the 2030 Agenda of the United Nations Educational, Scientific and Cultural Organization (UNESCO)-, are an effective tool to promote resilience in response to prison health and care demands of people deprived of liberty.

Molecular detection of vector-borne pathogens in semen from dogs in southeastern Brazil.

Vector-borne pathogens (VBPs) are primarily transmitted by arthropod vectors, but secondary ways of transmission have been described, including via venereal route. Nonetheless, there is still limited research on possible sexual transmission of VBPs in dogs. We molecularly investigated the presence of vector-borne pathogens in semen from dogs living in an area where these agents are endemic. Upon PCR testing, seven out of 22 (31.8%) semen samples tested positive for at least one VBP, whereas simultaneous positivity to two or more pathogens was detected in three (13.6%) dogs. Among pathogens detected in semen, Trypanosoma cruzi (n = 1) and Leishmania infantum (n = 3) were identified to species level by restriction fragment length polymorphism analysis. Attempts to sequence PCR products from other pathogens were unsuccessful, but coupled epidemiological and molecular data suggest the presence of Anaplasma platys (n = 5), Babesia vogeli (n = 1) and Ehrlichia canis (n = 1) in semen from dogs. Further experimental studies would be needed to confirm the sexual transmission hypothesis for these VBPs and also the possible implications of these findings for canine reproduction.

Massive health education through technological mediation: Analyses and impacts on the syphilis epidemic in Brazil.

With syphilis cases on the rise, Brazil declared an epidemic in 2016. To address the consequent public health crisis, the Ministry of Health laid out a rapid response plan, namely, the "Syphilis No!" Project (SNP), a national instrument to fight the disease which encompasses four dimensions: (a) management and governance, (b) surveillance, (c) comprehensive care, and (d) strengthening of educommunication. In the dimension of education, the SNP developed the learning pathway "Syphilis and other Sexually Transmitted Infections (STIs)" to strengthen and promote Health Education. This pathway features 54 Massive Open Online Courses (MOOCs), delivered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). This paper analyzes the impacts of the learning pathway "Syphilis and other STIs" on the response to the epidemic in Brazil, highlighting the educational process of the learning pathway and its social implications from the perspective of the United Nations' 2030 Agenda and its Sustainable Development Goals. Three distinct databases were used to organize the educational data: the learning pathway "Syphilis and other STIs" from AVASUS, the National Registry of HealthCare Facilities from the Brazilian Ministry of Health (MoH), and the Brazilian Occupation Classification, from the Ministry of Labor. The analysis provides a comprehensive description of the 54 courses of the learning pathway, which has 177,732 enrollments and 93,617 participants from all Brazilian regions, especially the Southeast, which accounts for the highest number of enrollees. Additionally, it is worth noting that students living abroad also enrolled in the courses. Data characterization provided a demographic study focused on the course participants' profession and level of care practiced, revealing that the majority (85%) worked in primary and secondary healthcare. These practitioners are the target audience of the learning pathway and, accordingly, are part of the personnel directly engaged in healthcare services that fight the syphilis epidemic in Brazil.

The relevancy of massive health education in the Brazilian prison system: The course "health care for people deprived of freedom" and its impacts.

Introduction: Brazil has one of the largest prison populations globally, with over 682,000 imprisoned people. Prison health is a public health emergency as it presents increasingly aggravating disease rates, mainly sexually transmitted infections (STI). And this problem already affects both developed and developing nations. Therefore, when thinking about intervention strategies to improve this scenario in Brazil, the course "Health Care for People Deprived of Freedom" (ASPPL), aimed at prison health, was developed. This course was implemented in the Virtual Learning Environment of the Brazilian Health System (AVASUS). Given this context, this study analyzed the aspects associated with massive training through technological mediation and its impacts on prison health. Methods: This cross-sectional study analyzed data from 8,118 ASPPL course participants. The data analyzed were collected from six sources, namely: (i) AVASUS, (ii) National Registry of Health Care Facilities (CNES), (iii) Brazilian Occupational Classification (CBO), (iv) National Prison Department (DEPEN); (v) Brazilian Institute of Geography and Statistics (IBGE); and the (iv) Brazilian Ministry of Health (MoH), through the Outpatient Information System of the Brazilian National Health System (SIA/SUS). A data processing pipeline was conducted using Python 3.8.9. Results: The ASPPL course had 8,118 participants distributed across the five Brazilian regions. The analysis of course evaluation by participants who completed it shows that 5,190 (63.93%) reported a significant level of satisfaction (arithmetic mean = 4.9, median = 5, and standard deviation = 0.35). The analysis revealed that 3,272 participants (40.31%) are health workers operating in distinct levels of care. The prison system epidemiological data shows an increase in syphilis diagnosis in correctional facilities. Conclusions: The course enabled the development of a massive training model for various health professionals at all care levels and regions of Brazil. This is particularly important in a country with a continental size and a large health workforce like Brazil. As a result, social and prison health impacts were observed.

Downregulation of metallothionein 2A reduces migration, invasion and proliferation activities in human squamous cell carcinoma cells.

BACKGROUND: The invasive behaviour of squamous cell carcinoma (SCC), a common malignant tumour of the mouth, is a process mediated by cell proliferation, extracellular matrix proteolysis and other factors. Studies have shown a potential relationship between growth factors, metallothionein 2A (MT2A) and matrix metalloproteinase (MMP) activation in malignant tumours. The aim of this study was to downregulate MT2A in cells (Cal27) derived from human squamous cell carcinoma. METHODS: Cal27 cells with reduced MT2A were subjected to proliferation, migration and invasion assays. Immunofluorescence and western blot confirmed MT2A depletion by siRNA. Growth curve assays assessed cell proliferation. Indirect immunofluorescence analysed the expression of MT2A, MMP-2, MMP-9, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α), tumour necrosis factor alpha (TNF-α) and Ki67. Zymography evaluated the effects of MT2A silencing on MMP-2 and -9 expression. Migration and invasion activities were evaluated using migration and invasion assays. RESULTS: CAL27 cells displayed MT2A, MMP-2, MMP-9, EGF, TGF-α, TNF-α and Ki67. MT2A depletion decreased MMP-9, EGF, TGF-α and Ki67 protein levels, while increasing TNF-α. CONCLUSIONS: MT2A downregulation reduced cell proliferation, migration and invasion activities. Therefore, MT2A has an important role in cell proliferation, migration and invasion in human oral SCC cells.

Educommunication as a strategy to face Syphilis: an analysis of the open educational resources available at AVASUS / Educomunicação como estratégia de enfrentamento à Sífilis: uma análise dos recursos educacionais abertos disponíveis no AVASUS

Introduction: Syphilis is a problem for the Brazilian Public Health. Therefore, the Brazilian Ministry of Health has been promoting actions to fight this disease; among them, the "No Syphilis Project" stands out, and develops open educational resources (OER), among several activities. Objective: To analyze the open educational resources available in the SUS (the Brazilian Unified Health System) Virtual Learning Environment, focused on syphilis. Methods: This qualitative study, based on epistemology in the field of phenomenology, is a content analysis operated with the meanings constructed to parts of a set of texts and the objects of its analysis were the teaching plans of 19 educational resources available at AVASUS, which dealt with the theme "Syphilis". The analysis was organized into two unitss: The main purpose of the educational resource and Thematic focus of the educational resource. Results: The overlapping of clinical aspects of the disease to the detriment of socio-environmental aspects and the prevalence of informational objectives can be observed, with the exception of one resource that presented an objective that sought a more active action by the course participant. In the analysis unit 1 it was possible to identify the prevalence of objectives such as 'presenting' or 'conveying' content/information related to the disease. In the analysis unit 2 it was possible to identify the "classic" biomedical cycle of approaching a disease, focusing on diagnosis. Conclusion: The study contributed to the identification of gaps from the thematic and methodological point of view that can guide the planning for the construction of new educational resources.

Introdução: A sífilis é um problema de saúde pública do Brasil, que via seu Ministério da Saúde vem promovendo ações de enfrentamento da doença, entre as quais se destaca o "Projeto Sífilis Não", que desenvolve, entre diversas atividades, recursos educacionais abertos. Objetivo: Analisar os recursos educacionais abertos, disponíveis no ambiente virtual de aprendizagem do Sistema Único de Saúde (AVASUS), circunscritos na temática da sífilis. Métodos: Este estudo qualitativo, com base espistemológica no campo da fenomenologia, constitui-se em uma análise de conteúdo que operou com os significados contruídos com base em um conjunto de textos e teve como objetos de análise os planos de ensino de 19 recursos educacionais disponíveis no AVASUS e que versavam sobre o tema "sífilis". A análise foi organizada em duas unidades: objetivo principal do recurso educacional; e foco femático do recurso educacional. Resultados: Pode-se observar a sobreposição de aspectos clínicos da doença aos aspectos socioambientais e a prevalência de objetivos informacionais ­ com exceção de um recurso, cujo objetivo buscava uma ação mais ativa por parte do cursista. Na unidade de análise 1, foi possível identificar a prevalência de objetivos como "apresentar" ou "dar a conhecer" conteúdos/informação relacionados à doença. Na unidade de análise 2, foi possível verificar o ciclo biomédico "clássico" de abordagem de uma doença, com foco no diagnóstico. Conclusão: O estudo contribuiu para a identificação de lacunas dos pontos de vista temático e metodológico, que pode orientar o planejamento para a construção de novos recursos educacionais.

Syphilis on the big screen: an audiovisual representation of the health-disease process / Sífilis e cinema: a representação do processo saúde-doença no audiovisual

Introduction: In addition to its entertainment role, cinema has a strong relationship with history and a significant social appeal, as it provides the possibility of discussing the matters of society in a dynamic way. Important historical facts such as wars, technological development and pandemics have become recurrent themes on the screens, since they impact various social groups. By the same token, the theme of sexually transmitted infections has been extensively explored in motion pictures, portraying the origins of diseases, their impact on the social environment, and how the health-disease process unfolds. Objective: This study aimed to perform a critical analysis of audiovisual works that bring syphilis in its plot, in order to identify and discuss the evolution of the health-disease process throughout history, as well as its representation in the cinematic perspective. Methods: A descriptive analysis of audiovisual works was carried out along with a bibliographic search. Results: The corpus of the study consisted of four films, the feature films: "La Pelle", by Liliana Cavani; "Miss Evers' Boys", by Joseph Sargent; "Heleno: O Príncipe Maldito", by José Henrique Fonseca; and "Dr. Ehrlich's Magic Bullet", by William Dieterle. In all four works, we have different perspectives of the same health problem, but in different scenarios. Conclusion: Reflecting about these scenarios, as well as the real world, helps us to understand and search for what each of the represented groups' needs in order to face the disease more objectively and effectively.

Introdução: Para além do seu papel no entretenimento, o cinema possui uma forte relação com a história e um apelo social considerável, tendo em vista a possibilidade de discutir, de modo mais dinâmico, aquilo que é assunto na sociedade. Diante disto, fatos históricos importantes, como guerras, desenvolvimento tecnológico e pandemias, passaram a ser temas recorrentes nas telas, uma vez que impactam em cadeia vários grupos sociais. Nessa perspectiva, a temática das IST tem sido bastante explorada no contexto cinematográfico, retratando as origens das doenças, seu impacto no meio social e a forma como decorre todo o processo saúde-doença. Objetivo: O presente estudo buscou realizar uma análise crítica de obras cinematográficas que trouxessem a sífilis em seu enredo com o intuito de identificar e discutir a evolução do processo saúde-doença ao longo da história, bem como de sua representação na perspectiva cinematográfica. Métodos: Trata-se de uma análise descritiva de obras audiovisuais, aliada a uma pesquisa bibliográfica. Resultados: O corpus da pesquisa constitui-se em quatro filmes, os longas-metragens: "La Pelle", de Liliana Cavani; "Miss Evers' Boys", de Joseph Sargent; "Heleno: O Príncipe Maldito", de José Henrique Fonseca, e "Dr. Ehrlich's Magic Bullet", de William Dieterle. Considera-se que nas obras existam perspectivas distintas sobre um mesmo problema de saúde, em uma mesma época, porém representado em cenários diferentes. Conclusão: Refletir sobre esses cenários, assim como no mundo real, ajuda-nos a entender e buscar o que cada uma dessas sociedades representadas necessita para o enfrentamento da doença de forma mais objetiva e resolutiva

Inhibitory Copulation Effect of Vibrational Rival Female Signals of Three Stink Bug Species as a Tool for Mating Disruption.

Stink bugs are major pests in diverse crops around the world. Pest management strategies based on insect behavioral manipulation could help to develop biorational management strategies of stink bugs. Insect mating disruption using vibratory signals is an approach with high potential for pest management. The objective of this work was to investigate the effect of conspecific female rival signals on the mating behavior and copulation of three stink bug species to establish their potential for mating disruption. Previously recorded female rival signals were played back to bean plants where pairs of the Neotropical brown stink bug, Euschistus heros, and two green stink bugs, Chinavia ubica and Chinavia impicticornis were placed. Vibratory communication and mating behavior were recorded for each pair throughout the experimental time (20 min). Female rival signals show a disrupting effect on the reproductive behavior of three conspecific investigated stink bug species. This effect was more clearly expressed in E. heros and C. ubica than in C. impicticornis. The likelihood of copulating in pairs placed on control plants, without rival signals, increased 29.41 times in E. heros, 4.6 times in C. ubica and 1.71 times in C. impicticornis. However, in the last case, the effect of female rivalry signals in copulation was not significant. The effect of mating disruption of female rival signals of the three stink bug species may originate from the observed reduction in specific vibratory communication signals emitted, which influences the duet formation and further development of different phases of mating behavior. Our results suggest that female rival signals have potential for application in manipulation and disruption of mating behavior of stink bugs. Further work needs to focus on the effects of female rival signals used in long duration experiments and also their interactions with chemical communication of stink bugs.

Final Endodontic Irrigation with 2% Peracetic Acid: Antimicrobial Activity and Cytotoxicity.

OBJECTIVE: The aim of present study was to assess the cytotoxicity and antimicrobial efficacy of 2% peracetic acid (PAA) compared with 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX). MATERIAL AND METHODS: For the cytotoxicity test, 100 µl of the tested solutions were added in 12 wells with ECV 304 endothelial cells in each group: NaOCl, CHX, and PAA, in addition to the control group. Each solution was evaluated after 24 hours of contact in four dilutions: 0.2, 0.1, 0.05 and 0.025 through mitochondrial function using MTT colorimetric assay. In the antimicrobial evaluation, 40 dentin blocks 5 mm in length and 0.2 g in weight were incubated with 400 µl of Enterococcus faecalis suspension for 21 days at 37°C. The contaminated samples were divided into three experimental groups within 5 minutes of contact: NaOCl group, CHX group, PAA group, as well as the positive control group. The specimens received treatment and were transferred to a tube with saline for serial dilution of the solution and seeding for isolation and colony forming unit (CFU) count. STATISTICAL ANALYSIS: The results obtained were expressed as mean (A570 nm) ± standard deviation (SD) and in a multiple linear regression model and multiple comparisons conducted. RESULTS: The antimicrobial evaluation revealed that the NaOCl and CHX groups showed a statistically significant difference compared with the control group (p < 0.001), while the PAA reduced only the CFU growth. It can be concluded that, among the agents tested, PAA expressed greater cell viability, followed by CHX and NaOCl. However, it did not show greater antimicrobial activity in vitro in the mature biofilm of Enterococcus faecalis.

Gestational diabetes mellitus and obesity are related to persistent hyperglycemia in the postpartum period / Diabetes mellitus gestacional e obesidade estão relacionados à hiperglicemia persistente no período pós-parto

Abstract Objective To evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6-12 weeks postpartum). Methods This is a longitudinal cohort study with women who have had gestational diabetes and/or macrosomic children between March 1st, 2016 and March 1st, 2017. Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi- Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%. Results One hundred and twenty-two women were included. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes. Thirteen percent of the participants developed persistent hyperglycemia. A univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of hyperglycemia in the postpartum period. Conclusion Maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy are associated with hyperglycemia during the postpartum period.

Resumo Objetivo Avaliar características sociodemográficas e obstétricas de mulheres com diabetes gestacional que mantêm hiperglicemia no período pós-parto (6-12 semanas pós-parto). Métodos Este é um estudo longitudinal de coorte com mulheres com diagnóstico de diabetes gestacional e/ou macrossomia fetal entre 1° de março de 2016 a 1° de março de 2017. As mulheres coletaram glicemia de jejum, teste de tolerância a glicose e hemoglobina glicada entre 6 a 12 semanas pós-parto. Os dados foram coletados de prontuários médicos e durante entrevista na primeira consulta de revisão pós-parto. Uma análise estatística foi realizada através do cálculo de frequências, porcentagens, teste do qui-quadrado, teste exato de Fisher, teste de Mann-Whitney e regressão multivariada de Poisson. A significância estatística adotada foi de 5%. Resultados Cento e vinte e duas mulheres foram incluídas. A maioria delas tinha menos de 35 anos de idade (70,5%), eram brancas, multíparas, e não tinham história de diabetes gestacional. Treze por cento das participantes desenvolveu hiperglicemia persistente. A análise univariada mostrou que os fatores relacionados com a persistência de hiperglicemia no período pós-natal foram: idade materna acima de 35 anos, sobrepeso, obesidade grau 1 e ganho de peso abaixo de 5 quilos. A análisemultivariada incluiu o diagnóstico no primeiro trimestre como fator de risco para hiperglicemia persistente. Conclusão Mulheres acima de 35 anos, obesidade, sobrepeso e diagnóstico de diabetes gestacional no primeiro trimestre estão relacionados com hiperglicemia persistente no período pós-parto.

Gestational Diabetes Mellitus and Obesity are Related to Persistent Hyperglycemia in the Postpartum Period.

OBJECTIVE: To evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6-12 weeks postpartum). METHODS: This is a longitudinal cohort study with women who have had gestational diabetes and/or macrosomic children between March 1st, 2016 and March 1st, 2017. Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi-Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%. RESULTS: One hundred and twenty-two women were included. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes. Thirteen percent of the participants developed persistent hyperglycemia. A univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of hyperglycemia in the postpartum period. CONCLUSION: Maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy are associated with hyperglycemia during the postpartum period.

OBJETIVO: Avaliar características sociodemográficas e obstétricas de mulheres com diabetes gestacional que mantêm hiperglicemia no período pós-parto (6­12 semanas pós-parto). MéTODOS: Este é um estudo longitudinal de coorte com mulheres com diagnóstico de diabetes gestacional e/ou macrossomia fetal entre 1° de março de 2016 a 1° de março de 2017. As mulheres coletaram glicemia de jejum, teste de tolerância a glicose e hemoglobina glicada entre 6 a 12 semanas pós-parto. Os dados foram coletados de prontuários médicos e durante entrevista na primeira consulta de revisão pós-parto. Uma análise estatística foi realizada através do cálculo de frequências, porcentagens, teste do qui-quadrado, teste exato de Fisher, teste de Mann-Whitney e regressão multivariada de Poisson. A significância estatística adotada foi de 5%. RESULTADOS: Cento e vinte e duas mulheres foram incluídas. A maioria delas tinha menos de 35 anos de idade (70,5%), eram brancas, multíparas, e não tinham história de diabetes gestacional. Treze por cento das participantes desenvolveu hiperglicemia persistente. A análise univariada mostrou que os fatores relacionados com a persistência de hiperglicemia no período pós-natal foram: idade materna acima de 35 anos, sobrepeso, obesidade grau 1 e ganho de peso abaixo de 5 quilos. A análise multivariada incluiu o diagnóstico no primeiro trimestre como fator de risco para hiperglicemia persistente. CONCLUSãO: Mulheres acima de 35 anos, obesidade, sobrepeso e diagnóstico de diabetes gestacional no primeiro trimestre estão relacionados com hiperglicemia persistente no período pós-parto.

Prevalence of oxacillin-susceptible methicillin-resistant Staphylococcus aureus nasal carriage and their clonal diversity among patients attending public health-care facilities.

Context: Nosocomial infections arise from many microorganisms, including Staphylococcus aureus. Aims: The aim of this study is to determine the molecular epidemiology of circulating methicillin-resistant S. aureus (MRSA) clones among patients attending community and health-care facilities in Nova Friburgo, RJ, Brazil. Methods: A total of 1002 nasal swab samples were collected from May 2010 to September 2015. S. aureus isolates were identified through phenotypic tests, submitted to antimicrobial susceptibility tests and genotypic analysis to detect mecA, panton-valentine leucocidin (PVL) genes, SCCmec, SPA and multilocus sequencing typing (MLST) typing. Results: We identified 294 (29.3%) isolates as S. aureus and 91 (9.1%) as MRSA. A total of 17 isolates did not present a correlation between phenotypic and genotypic resistance profiles. Among MRSA isolates, 17 (18.7%) carried PVL genes. A total of 20 different SPA types were determined, being grouped by MLST into eight different sequence types. ST5/t002 was the most prevalent genotype found among these isolates. Conclusions: There is a gradual colonisation shift happening in the infection pattern by S. aureus in Brazil. The Brazilian Epidemic Clone (ST239-SCCmec IIIa-PVL-) seems to be substituted by isolates from different clonal complexes, such as ST5, ST8 and ST30. The non-correlation between phenotypic/genotypic resistance profile observed in some isolates suggests the presence of other methicillin resistance mechanisms different from mecA presence or a difference in the nucleotide sequence, which prevents the primers to identify the specific region during polymerase chain reaction reactions. MRSA identification should be based on phenotypic and genotypic testing to ensure the various types of resistance mechanisms.

Impact of vaccination on the incidence of varicella hospitalizations in a state in Southeast Brazil.

INTRODUCTION: This study aimed to analyze cases of complicated varicella and the impact of varicella vaccination in Minas Gerais, Brazil. METHODS: This was a time series study of a territorial basis using data on varicella cases from 2010 to 2016, which was provided by the State Health Department of Minas Gerais on . Descriptive statistics were used for the analysis, and the generalized linear regression model proposed by Prais-Winsten was used for the time tendency, adopting a significance level of 5% and the integrated autoregressive modeling of moving averages. RESULTS: There were 1,635 cases of varicella; out of which cellulitis (44%) was the predominant complication. The home-acquired cases were 38.9% and 464 cases (40.6%) were not previously vaccinated. There was a significant decrease in the incidence coefficient when comparing the pre- and post- immunization periods, from 1.95 cases/100,000 inhabitants in 2010 to 0.24 cases/100.000 inhabitants in 2016 (p<0.05). There was a higher incidence of cases recorded among males, with higher prevalence in the age group of 1-4 years (54.7%). Lethality was higher between 5-9 years of age (44%). Mortality was higher in the age group of 0-4 years and among females (2.58/100,000 inhabitants/year). The overall trend of the incidence coefficient was a decreasing one, with an annual percentage variation. CONCLUSIONS: The number of complicated varicella cases notified decreased, coincidentally, in the post-immunization period. However, the immunization coverage period was restricted for the assessment of the correlation between immunization coverage and incidence.

Dermatological manifestations in patients with human T-cell lymphotropic virus at a reference service in Amazon.

INTRODUCTION: Individuals infected with the human T-cell lymphotropic virus type 1 (HTLV-1) commonly present skin lesions, which may be a warning sign for the diagnosis of infection. This study describes the most prevalent skin manifestations in HTLV carriers attended at the clinic of Núcleo de Medicina Tropical (NMT) of the Universidade Federal do Pará (UFPA) in Belém, Pará, Brazil. METHODS: This is a study of a series of cases of patients infected with human T-cell lymphotropic virus types 1 and 2 (HTLV-1/2) treated at NMT UFPA between 1999 and 2016. A descriptive analysis of data was applied. RESULTS: Among 788 surveyed medical records in the service, 15.10% (n = 119) were referred to the dermatology clinic. From the series of cases that presented with skin lesions, 66.39% were female and 33.61% were male, and the average age of this group was 48 years. There was a predominance of patients with noninfectious inflammatory manifestations (64.2%), followed by infectious ones (24.6%), and 1.58% with lymphoproliferative diseases. As for the group of lesions, 45.26% of the erythematous-squamous type were observed, followed by dyschromia (24.21%), and eczematous (14.74%). One patient with a diagnosis of adult T-cell leukemia/lymphoma, another with parapsoriasis, and four with infective dermatitis are highlighted. CONCLUSION: Skin disorders in the HLTV positive patient are important causes of referral to the dermatologist with etiological and skin lesions groups diversity. In the series of cases studied, lymphoproliferatives diseases and infective dermatitis associated with HTLV-1 were presented as a challenge for the diagnosis and clinical management of these patients.

Impact of vaccination on the incidence of varicella hospitalizations in a state in Southeast Brazil

Abstract INTRODUCTION: This study aimed to analyze cases of complicated varicella and the impact of varicella vaccination in Minas Gerais, Brazil. METHODS: This was a time series study of a territorial basis using data on varicella cases from 2010 to 2016, which was provided by the State Health Department of Minas Gerais on . Descriptive statistics were used for the analysis, and the generalized linear regression model proposed by Prais-Winsten was used for the time tendency, adopting a significance level of 5% and the integrated autoregressive modeling of moving averages. RESULTS: There were 1,635 cases of varicella; out of which cellulitis (44%) was the predominant complication. The home-acquired cases were 38.9% and 464 cases (40.6%) were not previously vaccinated. There was a significant decrease in the incidence coefficient when comparing the pre- and post- immunization periods, from 1.95 cases/100,000 inhabitants in 2010 to 0.24 cases/100.000 inhabitants in 2016 (p<0.05). There was a higher incidence of cases recorded among males, with higher prevalence in the age group of 1-4 years (54.7%). Lethality was higher between 5-9 years of age (44%). Mortality was higher in the age group of 0-4 years and among females (2.58/100,000 inhabitants/year). The overall trend of the incidence coefficient was a decreasing one, with an annual percentage variation. CONCLUSIONS: The number of complicated varicella cases notified decreased, coincidentally, in the post-immunization period. However, the immunization coverage period was restricted for the assessment of the correlation between immunization coverage and incidence.