RESUMO Esta pesquisa analisou a exposição de mulheres em situação de prostituição no centro de São Paulo à covid-19. Este estudo transversal contou com amostra de conveniência selecionada em maio de 2021. Entrevistou-se 219 mulheres majoritariamente negras, de meia idade, pobres e com comorbidades. Dentre essas mulheres, 61 tiveram sintomas de covid-19, 23 com teste positivo,7 foram internadas e 4 relataram complicações pós-covid-19. Somente 26 (30,2%) haviam sido vacinadas. Além das desigualdades de gênero, raça e classe, essas mulheres são expostas a um maior risco de contraírem covid-19, devido às condições de trabalho e por apresentarem doença grave relacionada à idade e falta de vacinação.

ABSTRACT This study analyzed the exposure of women engaged in prostitution in downtown São Paulo to COVID-19. This cross-sectional study had a convenience sample selected in May 2021. We interviewed 219, mostly black, middle-aged, poor women with comorbidities. Among them, 61 had shown COVID-19 symptoms, 23, tested positive for the disease, seven underwent hospitalization, and four reported post-COVID-19 complications. Only 26 (30.2%) had been vaccinated. In addition to gender, race, and class inequalities, these women suffer both from a higher risk of contracting COVID-19 due to their working conditions and from the subsequent worsening of that disease due to age and lack of vaccination.

RESUMO Esta pesquisa analisou a exposição de mulheres em situação de prostituição no centro de São Paulo à covid-19. Este estudo transversal contou com amostra de conveniência selecionada em maio de 2021. Entrevistou-se 219 mulheres majoritariamente negras, de meia idade, pobres e com comorbidades. Dentre essas mulheres, 61 tiveram sintomas de covid-19, 23 com teste positivo,7 foram internadas e 4 relataram complicações pós-covid-19. Somente 26 (30,2%) haviam sido vacinadas. Além das desigualdades de gênero, raça e classe, essas mulheres são expostas a um maior risco de contraírem covid-19, devido às condições de trabalho e por apresentarem doença grave relacionada à idade e falta de vacinação.

ABSTRACT This study analyzed the exposure of women engaged in prostitution in downtown São Paulo to COVID-19. This cross-sectional study had a convenience sample selected in May 2021. We interviewed 219, mostly black, middle-aged, poor women with comorbidities. Among them, 61 had shown COVID-19 symptoms, 23, tested positive for the disease, seven underwent hospitalization, and four reported post-COVID-19 complications. Only 26 (30.2%) had been vaccinated. In addition to gender, race, and class inequalities, these women suffer both from a higher risk of contracting COVID-19 due to their working conditions and from the subsequent worsening of that disease due to age and lack of vaccination.

Abstract In the current search for renewable energy sources, residual biomass has been highlighted as a potential source of chemical compounds that are currently obtained from petroleum. Among the derivatives obtained from this, 5-hydroxymethylfurfural and furfural are considered key parts in this process as they are key compounds in the fine chemical industry. This work aims at the use of the rice husks and soybean peel for the synthesis of 5-hydroxymethylfurfural and furfural using the ionic liquid [BMIM][Br]. The physical pre-treatment of biomasses was carried out followed by acid hydrolysis. For the synthesis of the furanic compounds, different temperatures and reaction times were used. The products obtained in each step were analyzed by infrared spectrophotometry and by high performance liquid chromatography. The best yields for rice husks was obtained with 4 hours of reaction at 120 °C (34%) and for soy peel with 3 hours of reaction at 120 °C (59%), for furfural production. For 5-hydroxymethylfurfural production the yields were 8.7% and 3.4% for rice and soy husks, respectively. It was found that glucose was the main group related to bio-products obtaining.

Abstract INTRODUCTION: Vaccination against varicella-zoster virus (VZV) has been effective and safe in countries that routinely administer the vaccine. Brazil began universal VZV vaccination in 2013. This study aimed to identify VZV genotypes present in Manaus, Brazil prior to widespread immunization. METHODS: Vesicular lesions or cerebral-spinal-fluid samples were collected from patients diagnosed with VZV, herpes zoster, or meningitis/encephalitis. DNA was extracted, amplified, and sequenced. RESULTS: Half the isolates were clade-5 viruses and the remaining were divided between the European clades 1 and 3. CONCLUSIONS: This study provides insights into the circulating VZV genotypes in Manaus prior to widespread vaccination.

RESUMO OBJETIVO: Examinar os dados de normatização do WHODAS 2.0-BO para idosos brasileiros (World Health Disability Assessment Schedule – Brazilian version for older people) e sua distribuição de acordo com sexo, idade, percepção subjetiva de saúde, desempenho em teste de mobilidade e presença de doenças crônicas e depressão. MÉTODOS: Estudo transversal, com 350 participantes com 60 anos ou mais, homens e mulheres, atendidos em um centro de referência secundário para consultas médicas ou de reabilitação. Os idosos foram avaliados por meio de um questionário semiestruturado, contendo dados sociodemográficos e clínicos, o WHODAS 2.0-BO e a escala de depressão geriátrica (EDG), e submetidos a um teste mobilidade, o Timed Up and Go. Os dados foram analisados por sua distribuição em percentis na população e por análise de variância. RESULTADOS: Duzentos e sessenta e seis (76%) participantes eram mulheres, a idade média foi de 71,8 (DP = 6,7) anos. O escore médio do WHODAS 2.0-BO foi de 4,3 (DP = 5,2) pontos, sendo o maior valor encontrado 33 pontos. O tempo para o Timed up and Go foi de 10,0 (DP = 3,2) segundos. Cerca de 30% dos idosos não relataram nenhuma dificuldade nas tarefas avaliadas pelo WHODAS 2.0-BO e metade da amostra alcançou até dois pontos. CONCLUSÕES: Observou-se um escore de 12 pontos no percentil 90 em uma escala de zero a 40, o que sugere incapacidade grave. O escore do WHODAS 2.0-BO aumentou com o avançar da idade, bem como na presença de comorbidades, de percepção subjetiva de saúde ruim, de depressão, de hipertensão arterial, de dificuldade para enxergar e escutar e de alteração da mobilidade.

ABSTRACT OBJECTIVE: To examine the normative data of WHODAS 2.0-BO for older Brazilians (World Health Disability Assessment Schedule – Brazilian version for older people) and its distribution according to sex, age, health, subjective health perception, performance in a mobility test and presence of chronic diseases and depression. METHODS: Cross-sectional study, with 350 participants with 60 years of age or older, men and women, patients of a geriatric specialized center for medical consultations or rehabilitation. The older adults were evaluated using a semi-structured questionnaire containing demographic and clinical data (WHODAS 2.0-BO) and the geriatric depression scale (GDS), having been subsequently subjected to a mobility test (Timed Up and Go). The data were analyzed via their distribution in percentiles of the population and via analysis of variance. RESULTS: Two-hundred and sixty-six (76%) participants were women, and the average age was 71.8 (DP = 6.7) years old. The average score in WHODAS 2.0-BO was 4.3 (DP = 5.2) points, the highest value found having corresponded to 33 points. The average time for the Timed Up and Go test was 10.0 (SD = 3.2) seconds. About 30% of the older adults did not report any difficulties in the tasks evaluated by WHODAS 2.0-BO and half of the sample scored up to two points. CONCLUSIONS: A score corresponding to 12 points in the 90 percentile on a scale from zero to 40 was observed, which suggests severe disability. The score in WHODAS 2.0-BO increased with the advance in age, as well as in the presence of comorbidities, negative health perception, depression, high blood pressure, visual and hearing impairment and mobility impairment.

RESUMO OBJETIVO: Examinar os dados de normatização do WHODAS 2.0-BO para idosos brasileiros (World Health Disability Assessment Schedule – Brazilian version for older people) e sua distribuição de acordo com sexo, idade, percepção subjetiva de saúde, desempenho em teste de mobilidade e presença de doenças crônicas e depressão. MÉTODOS: Estudo transversal, com 350 participantes com 60 anos ou mais, homens e mulheres, atendidos em um centro de referência secundário para consultas médicas ou de reabilitação. Os idosos foram avaliados por meio de um questionário semiestruturado, contendo dados sociodemográficos e clínicos, o WHODAS 2.0-BO e a escala de depressão geriátrica (EDG), e submetidos a um teste mobilidade, o Timed Up and Go. Os dados foram analisados por sua distribuição em percentis na população e por análise de variância. RESULTADOS: Duzentos e sessenta e seis (76%) participantes eram mulheres, a idade média foi de 71,8 (DP = 6,7) anos. O escore médio do WHODAS 2.0-BO foi de 4,3 (DP = 5,2) pontos, sendo o maior valor encontrado 33 pontos. O tempo para o Timed up and Go foi de 10,0 (DP = 3,2) segundos. Cerca de 30% dos idosos não relataram nenhuma dificuldade nas tarefas avaliadas pelo WHODAS 2.0-BO e metade da amostra alcançou até dois pontos. CONCLUSÕES: Observou-se um escore de 12 pontos no percentil 90 em uma escala de zero a 40, o que sugere incapacidade grave. O escore do WHODAS 2.0-BO aumentou com o avançar da idade, bem como na presença de comorbidades, de percepção subjetiva de saúde ruim, de depressão, de hipertensão arterial, de dificuldade para enxergar e escutar e de alteração da mobilidade.

ABSTRACT OBJECTIVE: To examine the normative data of WHODAS 2.0-BO for older Brazilians (World Health Disability Assessment Schedule – Brazilian version for older people) and its distribution according to sex, age, health, subjective health perception, performance in a mobility test and presence of chronic diseases and depression. METHODS: Cross-sectional study, with 350 participants with 60 years of age or older, men and women, patients of a geriatric specialized center for medical consultations or rehabilitation. The older adults were evaluated using a semi-structured questionnaire containing demographic and clinical data (WHODAS 2.0-BO) and the geriatric depression scale (GDS), having been subsequently subjected to a mobility test (Timed Up and Go). The data were analyzed via their distribution in percentiles of the population and via analysis of variance. RESULTS: Two-hundred and sixty-six (76%) participants were women, and the average age was 71.8 (DP = 6.7) years old. The average score in WHODAS 2.0-BO was 4.3 (DP = 5.2) points, the highest value found having corresponded to 33 points. The average time for the Timed Up and Go test was 10.0 (SD = 3.2) seconds. About 30% of the older adults did not report any difficulties in the tasks evaluated by WHODAS 2.0-BO and half of the sample scored up to two points. CONCLUSIONS: A score corresponding to 12 points in the 90 percentile on a scale from zero to 40 was observed, which suggests severe disability. The score in WHODAS 2.0-BO increased with the advance in age, as well as in the presence of comorbidities, negative health perception, depression, high blood pressure, visual and hearing impairment and mobility impairment.

RESUMO No presente trabalho buscou-se avaliar o grau de tolerância à salinidade e os mecanismos fisiológicos de mudas de seis espécies lenhosas nativas da caatinga, sob um gradiente de salinidade do solo, em casa de vegetação. Utilizou-se um delineamento em bloco ao acaso, em parcelas subdivididas, com cinco repetições, sendo as parcelas formadas pelas seis espécies e as subparcelas pelos níveis de salinidade do solo (1,2; 2,7; 4,7; 6,7; e 8,4 dS m-1). Os resultados demonstram que as espécies da Caatinga exibem uma elevada capacidade de adaptação em solos de salinidade baixa e moderada. Entretanto, considerando-se os graus de redução na produção de matéria seca total, no maior nível de salinidade, observou-se que apenas a espécie M. urundeuva mostrou-se tolerante à salinidade; H. impetiginosus e E. velutina se comportaram como moderadamente tolerantes. No presente estudo, também não foi possível estabelecer uma relação clara entre as trocas gasosas e o acúmulo de solutos orgânicos nas folhas com os graus de tolerância ao sal. Por outro lado, uma forte relação foi observada entre a razão Na+/K+ e o grau de tolerância das espécies em estudo, com as espécies mais tolerantes apresentando menos variação e valores mais baixos com o aumento da salinidade do solo. Estas espécies, contudo, mostraram uma baixa capacidade de retenção de Na+ nos caules, que pode ser um fator limitante na sua utilização em projetos de revegetação em áreas degradadas por salinização secundária.

ABSTRACT The aim of this study was to evaluate the salt tolerance and physiological responses of six woody native species of the Caatinga ecosystem, on a soil salinity gradient in a greenhouse. The experimental design was of randomized blocks in a split-plot scheme; six plant species native of the Caatinga in the plots, and five levels of soil salinity in the sub-plots (1.2, 2.7, 4.7, 6.7 and 8.4 dS m-1), with five replications. The results demonstrate that species of the Caatinga ecosystem display a high capacity for adaptation in soils of low and moderate salinity. However, considering the reduction in total dry matter production at the highest salinity level, it was seen that only the species M. urundeuva was tolerant to salinity, and H. impetiginosus and E. velutina behaved as moderately tolerant. In the present study, it was also not possible to establish a clear relationship between the leaf gas exchange or the accumulation of organic solutes in the leaves with the degrees of salt tolerance. On the other hand, a strong relationship was seen between the Na+/K+ ratio and the degree of tolerance of the species under study, with the more tolerant species displaying less variation and lower values with the increases in soil salinity. These species, however, showed a low capacity for retaining Na+ in the stems, which may be a limiting factor on their use in revegetation projects of those areas degraded by secondary salinization.

RESUMO O objetivo deste estudo foi caracterizar um serviço de fisioterapia municipal, avaliar e identificar o perfil dos pacientes em lista de espera e propor estratégias de microrregulação do acesso ao atendimento fisioterapêutico em nível secundário para melhoria da resolutividade do sistema. Trata-se de um estudo transversal realizado com a equipe de fisioterapia de atenção secundária e 70 pacientes em lista de espera. A equipe foi entrevistada e os pacientes foram avaliados e encaminhados para os diferentes pontos de atenção segundo suas necessidades. As informações obtidas com as entrevistas dos profissionais e triagem dos pacientes foi utilizada para propor melhorias e maior resolutividade ao serviço. Observou-se que a equipe de fisioterapia de atenção secundária tem alta demanda de atendimento. A origem dos encaminhamentos foi primeiramente de ortopedistas/traumatologistas (88%) e diagnóstico clínico de osteoartrose (36%). Após a avaliação, verificou-se que 72% dos pacientes não necessitavam da complexidade de um atendimento fisioterapêutico secundário. Os problemas encontrados foram relacionados à baixa resolutividade na atenção primária, à ausência de coordenação entre as equipes de fisioterapia, à falta de comunicação com os demais profissionais, e aos critérios de triagem e atendimento em nível secundário de atenção. A falta de compreensão sobre a organização da rede de serviços repercutiu em uma longa lista de espera para atendimento fisioterapêutico secundário. A partir da identificação dos principais problemas, as estratégias indicadas foram a triagem pela equipe de atenção primária e por profissionais médicos de atenção especializada e a instauração de uma coordenadoria para melhora do diálogo entre os pontos de atenção em fisioterapia.

ABSTRACT We characterized a physiotherapy service of the city. The profile of patients on the waiting list was assessed and identified to propose strategies for micro-regulation on the access to secondary-level physiotherapy to improve the resolution rate of the system. This is a cross-sectional study carried out with the physiotherapy team of the secondary care and 70 patients on the waiting list. The team was interviewed and patients were assessed and forwarded to the different care points according to their needs. The information obtained from the interviews of professionals and triage of patients was used to propose improvements and greater resolution. The secondary care physiotherapy team has a high demand. The origin of the referrals was first from Orthopedists/Traumatologists (88%), and clinical diagnosis of Osteoarthritis (36%). After the evaluation, 72% of patients did not need the complexity of a secondary physiotherapy service. The problems found were related to low resolution on primary health care, lack of coordination for physiotherapy teams, lack of dialogue with other professionals, and screening and care criteria in the secondary level of care. The lack of understanding of the network organization of services reflected in a long waiting list for secondary physiotherapy. From the identification of the main problems, strategies indicated were the screening by the primary care staff and medical professionals of the specialized care; and coordinator for improving dialogue between the care points of physiotherapy.

RESUMEN El objetivo de este estudio fue caracterizar un servicio de fisioterapia municipal, evaluar e identificar el perfil de los pacientes en lista de espera y proponer estrategias de microregulación del acceso al atendimiento fisioterapéutico en nivel secundario para mejorar la capacidad de resolución del sistema. Se trata de un estudio transversal realizado con el equipo de fisioterapia de atención secundaria y 70 pacientes en lista de espera. El equipo fue entrevistado y los pacientes fueron evaluados y encaminados para los diferentes puntos de atención de acuerdo con sus necesidades. Las informaciones obtenidas con las entrevistas de los profesionales y triaje de los pacientes fueron utilizadas para proponer mejorías y una mayor capacidad de resolución al servicio. Se observó que el equipo de fisioterapia de atención secundaria tiene alta demanda. El origen de los encaminamientos fue primeramente de ortopedistas/traumatólogos (88%) y diagnóstico clínico de osteoartrosis (36%). Después de la evaluación, se verificó que el 72% de los pacientes no necesitaban de la complejidad de un atendimiento fisioterapéutico secundario. Los problemas encontrados fueron relacionados a la baja capacidad de resolución en la atención primaria, a la ausencia de coordinación entre los equipos de fisioterapia, a la falta de comunicación con los otros profesionales y a los criterios de triaje y atendimiento a nivel secundario de atención. La falta de comprensión acerca de la organización de la red de servicios repercutió en una larga lista de espera para atendimiento fisioterapéutico secundario. A partir de la identificación de los principales problemas, las estrategias indicadas fueron el triaje por el equipo de atención primaria y por profesionales médicos de atención especializada y la instauración de una coordinadoría para la mejora del diálogo entre los puntos de atención en fisioterapia.

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.

INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

O objetivo deste trabalho foi investigar a diversidade, a estrutura genética e o tamanho efetivo, retido em um banco de germoplasma, de duas populações de Myracrodruon urundeuva Fr. All. (aroeira), procedentes de Aramina-SP e Selvíria-MS. As populações foram avaliadas a partir da amostragem de 25 progênies de polinização aberta de cada população. De cada progênie, 17 a 20 indivíduos foram amostrados e genotipados para oito locos microssatélites. Os maiores valores para o número total de alelos (At), número médio de alelos por loco (A), número efetivo de alelos (Ae), heterozigosidade observada (H0) e esperada (He) foram detectados na população Selvíria (At = 105, A = 13,13, Ae = 3,98, H0 = 0,669 e He = 0,749), enquanto Aramina teve At = 94, A = 13,75, Ae = 3,10, H 0 = 0,535 e He = 0,678. A diferenciação nas frequências alélicas das duas populações, com relação ao pólen cruzado (0,159) e do óvulo (0,235), indica que cerca de 84% e 77%, respectivamente, da diversidade genética está dentro das populações. O coeficiente médio de coancestria foi maior (Selvíria Θ = 0,165, Aramina Θ = 0,169) e o tamanho efetivo médio das progênies (Selvíria Ne(v) = 3,04, Aramina Ne(v) = 2,69) foi menor do que o esperado em progênies de populações panmíticas (Θ = 0,125, Ne(v) = 4). O tamanho efetivo total retido no banco ex situ foi estimado em 67,5 na população Selvíria e 71,1 na população Aramina, valores menores do que o requerido (Ne = 150) para a conservação de populações em curto prazo. Entretanto, as duas populações apresentaram alta diversidade genética, o que as qualifica para serem utilizadas em programas de conservação e melhoramento genético da espécie, desde que seja aumentado o tamanho efetivo populacional conservado ex situ.

The objective of this study was to investigate genetic diversity, genetic structure and effective size retained in a germplasm bank formed by two populations of Myracrodruon urundeuva Fr. All. (aroeira) from Aramina-SP and Selvíria-MS. The populations were evaluated from the sample of 25 open-pollinated progenies of each population. From each progeny, 17 to 20 individuals were sampled and genotyped for eight microsatellite loci. The greatest values for the total number of alleles (At), average number of alleles per locus (Ae), effective number of alleles per locus (A), observed heterozygosity (H0) and expected heterozygosity (He) were detected in Selvíria population (At=105, A=13.13, Ae =3.98, H0) =0.669 and He =0.749) in comparison to Aramina (At =94, A =13.75, Ae =3.10, H0=0.535 and He =0.678). The differentiation in allele frequencies between the two populations for the outcross-pollen (0.159) and ovules (0.235), indicate that about 84% and 77% of genetic diversity was within populations. The average coancestry coefficient was higher (Selvíria Θ =0.165, Aramina Θ =0.169) and the average effective population size within progenies (Selvíria Ne(v) =3.04, Aramina Ne(v) =2.69) was lower than expected in progenies of panmitic populations (Θ=0.125, Ne(v) =4). The total effective population size retained in the ex situ bank was estimated in 67.5 in Selvíria population and 71.1 in Aramina population, which values lower than the required (Ne =150) for short terms population conservation. However, the two populations showed high genetic diversity, which qualifies them for use in conservation and breeding programs of the species, provided the ex situ conserved population effective size is increased.

O mecanismo de resistência bacteriana ao mercúrio mais comum é baseada na redução do Hg(II) a Hg0, através da atividade da enzima mercúrio redutase (MerA). O uso do fragmento de 431 pb amplificado de uma região conservada do gene merA, que codifica a enzima MerA,foi utilizado como marcador molecular deste mecanismo, permitindo a identificação de bactérias resistentes ao mercúrio.

The most common bacterial mercury resistance mechanism is based on the reduction of Hg(II) to Hg0, which is dependent of the mercuric reductase enzyme (MerA) activity. The use of a 431 bp fragment of a conservative region of the mercuric reductase (merA) gene was applied as a molecular marker of this mechanism, allowing the identification of mercury resistant bacterial strains.

Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.

Dois casos de lactentes atendidos na Fundação de Medicina Tropical do Amazonas, com síndrome febril exantemática aguda, extravasamento capilar e manifestações hemorrágicas de pequena magnitude, caracterizando quadro de febre hemorrágica do dengue. O diagnóstico etiológico foi confirmado pelo MAC-ELISA e pelo ELISA de inibição para IgG, realizados nos lactentes e nas respectivas mães.

Two cases of infants assisted at the Tropical Medicine Foundation of Amazonas with febrile exanthematic syndrome and mild hemorrhagic manifestations, defining a picture of dengue hemorrhagic fever. The etiologic diagnose was confirmed by the MAC-ELISA and the Inhibition - ELISA, performed in both infants and respective mothers.