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Abstract Background Atherosclerosis risk factors can have different impacts on cardiovascular diseases and on the anatomical distribution of Peripheral Arterial Disease (PAD). Objectives To study the influence of atherosclerosis risk factors on the anatomical distribution of PAD in patients with chronic limb-threatening ischemia (CLTI). Methods We performed an observational, cross-sectional, and analytical study that included 476 hospitalized patients with CLTI due to PAD. We compared the presence of atherosclerosis risk factors (age, gender, diabetes mellitus, smoking, and hypertension) in patients with PAD involving three different anatomic areas (aortoiliac, femoropopliteal, and infrapopliteal). Multivariate analysis was performed to identify associations between atherosclerosis risk factors and PAD distribution. Results The mean age of the 476 patients was 69 years, 249 (52%) were men, and 273 (57%) had diabetes. Seventy-four percent (353) had minor tissue loss. Multivariate analysis identified three risk factors associated with PAD anatomical distribution (gender, smoking, and DM). Women had a 2.7 (CI: 1.75-4.26) times greater chance of having femoropopliteal disease. Smokers had a 3.6-fold (CI: 1.54-8.30) greater risk of aortoiliac disease. Diabetic patients were 1.8 (CI: 1.04-3.19) times more likely to have isolated infrapopliteal occlusive disease. Conclusions The study showed that gender, DM, and smoking impact on the anatomical distribution of PAD in patients with CLTI. Diabetic patients were more likely to have only infrapopliteal disease, women had a greater risk of femoropopliteal PAD, and smokers had a greater risk of aortoiliac occlusive disease.

Resumo Contexto Os fatores de risco para aterosclerose podem ter influência distinta nas doenças cardiovasculares, impactando também no território da doença arterial periférica (DAP). Objetivos Estudar a influência dos diferentes fatores de risco para a aterosclerose na distribuição anatômica da DAP em pacientes com isquemia crítica crônica de membros (ICCM). Métodos Foi realizado um estudo observacional, transversal e analítico, incluindo 476 doentes internados devido à ICCM por DAP. Foram estudados, comparativamente, os pacientes com DAP dos três distintos territórios anatômicos (aortoilíaco, femoropoplíteo e infragenicular) em relação à presença dos fatores de risco para a aterosclerose (idade, gênero, diabetes mellitus, tabagismo e hipertensão arterial). A análise multivariada foi realizada para testar a associação entre os fatores de risco e a distribuição anatômica da DAP. Resultados A média de idade dos pacientes foi de 69 anos, 249 (52%) eram homens, e 273 (57%), diabéticos. Predominaram os pacientes na Categoria 5 da Classificação de Rutherford (353/74%). Na análise multivariada, as mulheres tiveram chance 2,7 (IC: 1,75-4,26) vezes maior de doença do território femoropoplíteo. Os doentes tabagistas tiveram 3,6 (IC: 1,54-8,30) vezes maior risco de doença do território aortoilíaco. Diabéticos apresentaram 1,8 (IC: 1,04-3,19) vezes maior chance de obstrução apenas do território infragenicular. Conclusões O estudo mostrou que gênero, diabetes mellitus e tabagismo influenciam no padrão de distribuição da DAP em pacientes com ICCM. Os doentes diabéticos apresentaram maior chance de doença isolada do território infragenicular, as mulheres tiveram maior risco de DAP do território femoropoplíteo e os tabagistas possuem maior chance comprometimento aortoilíaco.

https://doi.org/10.1590/1677-5449.202300141

Bovine genital leptospirosis: Findings in bulls maintained in Caatinga biome conditions
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Barnabé, Nathanael N.C.

; Soares, Rafael R.

; Nogueira, Denise B.

; Araújo Júnior, João P.

; Malossi, Camila D.

; Costa, Diego F.

; Silva, Maria L.C.R.

; Higino, Severino S.S.

; Azevedo, Sérgio S.

; Alves, Clebert J.

Pesquisa Veterinária Brasileira

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2023, Volume 43 elocation e07376

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT: Leptospirosis is a disease that causes economic and social impact, as it affects wild and domestic animals and humans. There may be peculiarities in the epidemiology of this disease in the Caatinga biome, Brazil, where the environment is adverse and the etiologic agent, Leptospira spp., requires alternative transmission routes. Considering that in bovine leptospirosis the genital carrier is constantly neglected and the lack of reports on the role of bulls in the epidemiology of the bovine genital leptospirosis (BGL) syndrome, mainly in semiarid conditions such as Caatinga biome, this study aimed to investigate bulls maintained in Caatinga biome conditions as genital carriers of leptospires. Urinary tract (urine, bladder, and kidney) and reproductive tract (vas deferens, cauda epididymis, and vesicular gland) samples were collected from 42 slaughtered bulls. Microscopic agglutination test (MAT), polymerase chain reaction (PCR), and microbiological isolation were included as diagnostic methods. Anti-Leptospira spp. antibodies were found in 17 (40.48%) animals, while 26 animals (61.90%) had at least one organ or urine with leptospiral DNA, and 10 animals (23.81%) were positive at bacteriological culture. Sequenced samples targeting the LipL32 gene showed 99% similarity with Leptospira borgpetersenii. Molecular analysis of samples from the vas deferens and cauda epididymis is recommended for the diagnosis of genital leptospirosis in bulls and, if it is impossible to collect these tissues, semen can be used. In conclusion, this study provides important information relating to bulls from the Caatinga biome, Brazil, as carriers of genital leptospirosis. The results indicate that, even under adverse environmental conditions, leptospires may survive and propagate, mainly due to the characteristic of genital carriers for the sexually spreading of adapted Leptospira species without influence by external variables. Thus, prevention and control strategies for bovine leptospirosis need to include actions aimed at the genital carrier.

RESUMO: A leptospirose é uma doença que causa impacto econômico e social, pois afeta animais silvestres, domésticos e humanos. É possível que existam peculiaridades na epidemiologia desta doença no bioma Caatinga, Brasil, onde o ambiente é adverso e o agente etiológico, Leptospira spp., requer vias alternativas de transmissão. Considerando que na leptospirose bovina o portador genital é constantemente negligenciado e a falta de relatos sobre o papel dos touros na epidemiologia da síndrome da leptospirose genital bovina (BGL), principalmente em condições semiáridas como no bioma Caatinga, este estudo teve como objetivo investigar touros mantidos em condições do bioma Caatinga como portadores genitais de leptospiras. Amostras do trato urinário (urina, bexiga e rim) e do trato reprodutivo (ducto deferente, cauda do epidídimo e glândula vesicular) foram coletadas de 42 touros abatidos. Teste de soroaglutinação microscópica (SAM), reação em cadeia da polimerase (PCR) e isolamento microbiológico foram incluídos como métodos de diagnóstico. Anticorpos anti-Leptospira spp. foram encontrados em 17 (40,48%) animais, enquanto 26 animais (61,90%) apresentaram pelo menos um órgão ou urina com DNA leptospírico, e 10 animais (23,81%) foram positivos na cultura bacteriológica. As amostras sequenciadas a partir do gene LipL32 apresentaram 99% de similaridade com Leptospira borgpetersenii. Recomenda-se a análise molecular de amostras de ducto deferente e cauda do epidídimo para o diagnóstico de leptospirose genital em touros e, na impossibilidade da coleta desses tecidos, o sêmen pode ser utilizado. Em conclusão, este estudo fornece informações importantes sobre touros do bioma Caatinga, Brasil, como portadores de leptospirose genital. Os resultados indicam que, mesmo em condições ambientais adversas, as leptospiras podem sobreviver e se propagar, principalmente devido à característica de os portadores genitais disseminarem sexualmente espécies adaptadas de Leptospira sem influência de variáveis externas. Assim, as estratégias de prevenção e controle da leptospirose bovina precisam incluir ações voltadas para o portador genital.

https://doi.org/10.1590/1678-5150-pvb-7376

Fatores associados à contaminação e internação hospitalar por COVID-19 em profissionais de enfermagem: estudo transversal
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Püschel, Vilanice Alves de Araújo

; Fhon, Jack Roberto Silva

; Nogueira, Lilia de Souza

; Poveda, Vanessa de Brito

; Oliveira, Larissa Bertacchini de

; Salvetti, Marina de Góes

; Lemos, Cassiane de Santana

; Bruna, Camila Quartim de Moraes

; Lima, Fernanda Rodrigues

; Silva, Ana Beatriz Pandolfo da

; Carbogim, Fábio da Costa

Revista Latino-Americana de Enfermagem

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2022, Volume 30 elocation e3571

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Objetivo: identificar fatores associados à contaminação e internação hospitalar por COVID-19 em profissionais de enfermagem. Método: estudo transversal, realizado em hospital especializado em cardiologia, com 415 profissionais de enfermagem. Foram avaliadas as variáveis sociodemográficas, comorbidades, condições de trabalho e questões relacionadas ao adoecimento pela COVID-19. Na análise dos dados, utilizaram-se os testes Qui-Quadrado, Fisher, Wilcoxon, Mann-Whitney e Brunner Munzel, a razão de chances para internação hospitalar, além de regressão logística binária. Resultados: a taxa de profissionais de enfermagem acometidos pela COVID-19 foi de 44,3% e os fatores associados à contaminação foram o número de pessoas no mesmo domicílio com COVID-19 (OR 36,18; p<0,001) e o uso de transporte público (OR 2,70; p=0,044). Ter sintomas graves (OR 29,75), pertencer ao grupo de risco (OR 3,00), apresentar taquipneia (OR 6,48), falta de ar (OR 5,83), cansaço (OR 4,64), febre (OR 4,41) e/ou mialgia (OR 3,00) aumentou as chances de internação hospitalar dos profissionais com COVID-19. Conclusão: habitar o mesmo domicílio que outras pessoas com a doença e usar transporte público aumentou o risco de contaminação pelo novo coronavírus. Os fatores associados à internação hospitalar dos profissionais contaminados foram a presença de fatores de risco para doença, a gravidade e o tipo dos sintomas apresentados.

Abstract Objective: to identify factors associated with infection and hospitalization due to COVID-19 in nursing professionals. Method: a cross-sectional study carried out with 415 nursing professionals in a hospital specialized in cardiology. The sociodemographic variables, comorbidities, working conditions and issues related to illness due to COVID-19 were evaluated. Chi-Square, Fisher’s, Wilcoxon, Mann-Whitney and Brunner Munzel tests were used in data analysis, as well as Odds Ratio for hospitalization, in addition to binary logistic regression. Results: the rate of nursing professionals affected by COVID-19 was 44.3% and the factors associated with infection were the number of people living in the same household infected by COVID-19 (OR 36.18; p<0.001) and use of public transportation (OR 2.70; p=0.044). Having severe symptoms (OR 29.75), belonging to the risk group (OR 3.00), having tachypnea (OR 6.48), shortness of breath (OR 5.83), tiredness (OR 4.64), fever (OR 4.41) and/or myalgia (OR 3.00) increased the chances of hospitalization in professionals with COVID-19. Conclusion: living in the same household as other people with the disease and using public transportation increased the risk of infection by the new coronavirus. The factors associated with the hospitalization of contaminated professionals were presence of risk factors for the disease, severity and type of the symptoms presented.

Resumen Objetivo: identificar los factores asociados al contagio y la hospitalización por COVID-19 en los profesionales de enfermería. Método: estudio transversal, realizado en un hospital especializado en cardiología, con 415 profesionales de enfermería. Se evaluaron las variables sociodemográficas, comorbilidades, condiciones de trabajo y preguntas relacionadas con la enfermedad por COVID-19. En el análisis de los datos, se utilizaron las pruebas de Chi-Cuadrado, Fisher, Wilcoxon, Mann-Whitney y Brunner Munzel, la razón de chance para la hospitalización, además de la regresión logística binaria. Resultados: la tasa de profesionales de enfermería afectados por el COVID-19 fue del 44,3% y los factores asociados al contagio fueron el número de personas en una misma vivienda con COVID-19 (OR 36,18; p<0,001) y el uso de transporte público (OR 2,70; p=0,044). Presentar síntomas graves (OR 29,75), pertenecer al grupo de riesgo (OR 3,00), tener taquipnea (OR 6,48), dificultad para respirar (OR 5,83), cansancio (OR 4,64), fiebre (OR 4,41) y/o mialgia (OR 3,00) aumentó las chances de hospitalización de los profesionales con COVID-19. Conclusión: vivir en el mismo domicilio que otras personas que tienen la enfermedad y utilizar el transporte público aumentó el riesgo de contagio por el nuevo coronavirus. Los factores asociados a la hospitalización de los profesionales contagiados fueron la presencia de factores de riesgo para enfermarse, la gravedad y el tipo de síntomas presentados.

https://doi.org/10.1590/1518-8345.5593.3571

Glycerin supplementation strategies for three or seven days affects oxidative stress, follicle dynamics and ovulatory response in Morada Nova sheep
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Andrade, Mariza Araújo Morais de Moura

; Alves, Juliana Paula Martins

; Galvão, Iolly Tábata Oliveira Marques

; Cavalcanti, Camila Muniz

; Silva, Maria Raquel Lopes

; Conde, Alfredo José Herrera

; Bezerra, Alessandra Façanha

; Fernandes, César Carneiro Linhares

; Teixeira, Dárcio Italo Alves

; Rondina, Davide

Animal Reproduction

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2022, Volume 19 N. 2 elocation e20200025

Abstract: En | Text: En | PDF: En

Abstract This study examined the effect of glycerin supply strategies in different short-term protocols on follicular dynamics and ovulatory rate in Morada Nova sheep. Eighteen Morada Nova ewes with body condition > 2.9 had their estrus and follicular waves synchronized using three injections of prostaglandin analogue at seven-day intervals. All animals received the same diet during 21 days, which consisted of a total mixed ration (TMR) based on chopped elephant grass and concentrate twice daily. In thecontrol group (n=9), ewes were fed the TMR diet. In the other four groups, ewes received 150 mL of glycerol daily, supplied as an oral drench or mixed in the TMR during three or seven days prior to the application of thethird PGF2 alfa analogue. These groups were named as follows: Drench3d (n=10), Drench7d (n=8), TMR3d (n=9) and TMR7d (n=9). Follicle dynamics were monitored by ultrasonography, and plasma glucose and glutathione peroxidase levels were measured at the third prostaglandin administration. Six days after the final PGF2 alfa analogue dose, ovulatory rate was measured by laparoscopy. Glucose was higher (P< 0.001) in the glycerin-treated groups than in control group (83.7 ± 1.7 vs. 68.4 ± 4.5 mg. dL-1; P < 0.001). Ewes in the TMR3d, Drench7d and TMR7d groups had a greater (P < 0.001) number of large follicles (≥ 3 < 5 mm), and the presence of follicles larger than 5 mm was observed. In the same groups, at the third PGF2 alfa analogue dose, a greater (P < 0.001) number of growing follicles (> 3 mm) and a larger size of the largest follicle (P < 0.001) were also recorded. Ovulation rate was 30% higher in the groups that received glycerin for seven days (1.6 ± 0.1 53 vs. 1.1 ± 0.1; P < 0.05), and they also exhibited a 38% reduction in glutathione peroxidase. Thus,the use of glycerin in Morada Nova sheep as a source of energy in short-term supplementation for increase ovulation rate is an efficient strategy when provided for seven days, either orally or in the feed.

https://doi.org/10.1590/1984-3143-ar2020-0025

Household outbreak of sporotrichosis: towards the One Health approach
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Andrade, Elisa Helena Paz

; Bastos, Camila Valgas

; Silva, Afonso Vieira da

; Moreira, Simone Magela

; Costa, Taiza Gonçalves de Araújo

; Salvato, Lauranne Alves

; Colombo, Salene Angelini

; Oliveira, Camila Stefanie Fonseca de

; Soares, Danielle Ferreira de Magalhães

; Keller, Kelly Moura

; Azevedo, Maria Isabel de

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0021-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Although sporotrichosis requires a broad approach for control, few reports have described the relationship between the index case and secondary contacts. In the present work, we report an outbreak involving a woman, a dog, and two cats from the same household environment, including the clinical and epidemiological aspects and outcomes, and discuss the importance of a One Health approach to face this neglected disease. The joint efforts of professionals such as veterinarians and physicians are essential for early diagnosis and surveillance, which contributes to the rapid identification and control of zoonotic sporotrichosis outbreaks.

https://doi.org/10.1590/0037-8682-0021-2022

Repercussões da infodemia associada ao COVID-19 na saúde mental do idoso no Brasil
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Bezerra Cavalcante, Ricardo

; da Costa Carbogim, Fabio

; Fávero Bulgarelli, Alexandre

; Mello dos Santos, Camila

; Queiroz Ribeiro, Andréia

; Carvalho Pinto, Ione

; Machado Zacharias, Fabiana Costa

; Aparecida Fabriz, Luciana

; Moura de Oliveira, Deíse

; Toledo de Mendonça, Erica

; Ricardo Moreira, Tiago

; Miranda Machado, Richardson

; Ribeiro Bitencourt, Graziele

; Alfradique de Souza, Priscilla

; Fereira Santana, Rosimere

; Cabreira Panitz Cruz, Gylce Eloisa

; Rezende Freitas, Eduarda

; Salmazo da Silva, Henrique

; Viana Cruz, Fabiana

; Silva Fhon, Jack Roberto

; Shizuê Kitamura, Elisa

; Gonçalves Leite, Isabel Cristina

; Rodrigues Braz, Patricia

; Consolação dos Santos, Regina

; Prado Rocha, Flávia

; Aparecida Silva, Eveline

; Barreiros Tavares, Thais

; Duarte Martins, Jerusa Gonçalves

; Alves de Araújo Püschel, Vilanice

Revista Cubana de Información en Ciencias de la Salud

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2022, Volume 33 elocation e1871

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO: O fenômeno denominado infodemia refere-se ao aumento do volume informacional sobre um tema em específico, que se multiplica rapidamente em um curto período de tempo, e tem-se destacado frente ao contexto da crise sanitária desencadeada pela pandemia de COVID-19. O excesso de informações pode suscitar sentimentos de medo, ansiedade, estresse e outras condições de sofrimento mental. O estudo tem como objetivo descrever o perfil de exposição a informações sobre COVID-19 e suas repercussões na saúde mental de idosos brasileiros. Trata-se de um estudo transversal realizado com 1924 idosos brasileiros. Coletaram-se dados por meio de web-based survey enviada aos idosos por redes sociais e e-mail, no período de julho a outubro de 2020. Os resultados da análise descritiva dos dados demonstram que a maioria dos idosos apresentou idade entre 60 e 69 anos (69,02%), é do sexo feminino (71,26%), casados (53,79%) e de cor branca (75,57%). Cerca de 21,67% (n = 417) concluíram a graduação, 19,75% (380) concluíram especialização e 16,63% (320) concluíram mestrado ou doutorado. Foram reportados como fontes frequentes de exposição às notícias ou informações sobre a COVID-19, a televisão 862 (44,80%) e as redes sociais 651 (33,84%). Os participantes assinalaram que a televisão (46,47%; n = 872), as redes sociais (30,81%; n = 575) e o rádio (14,48%; 251) os afetavam psicológica e/ou fisicamente. Receber notícias falsas sobre a COVID-19 pela televisão (n = 482; 19,8%) e pelas redes sociais (n = 415; 21,5%) repercutiu, principalmente, estresse e medo. As informações disseminadas contribuem para conscientização, mas, também, afetam física e/ou psicologicamente muitos idosos, principalmente gerando medo e estresse.

ABSTRACT The phenomenon called infodemia refers to the increase in the volume of information on a specific topic, which multiplies rapidly in a short period of time, and has stood out in the context of the health crisis triggered by the COVID-19 pandemic. Too much information can trigger feelings of fear, anxiety, stress, and other conditions of mental distress. The study aims to describe the profile of exposure to information about COVID-19 and its repercussions on the mental health of elderly Brazilians. This is a cross-sectional study carried out with 1924 elderly Brazilians. Data were collected through a web-based survey sent to the elderly via social networks and email, from July to October 2020. The results of the descriptive analysis of the data show that most of the elderly were aged between 60 and 69 years (69.02%), female (71.26%), married (53.79%) and white (75.57%). About 21.67% (n = 417) concluded their graduation, 19.75% (380) concluded their specialization and 16.63% (320) concluded their master's or doctoral degrees. Television 862 (44.80%) and social networks 651 (33.84%) were reported as frequent sources of exposure to news or information about COVID-19. Participants indicated that television (46.47%; n = 872), social networks (30.81%; n = 575) and radio (14.48%; 251) affected them psychologically and/or physically. Receiving fake news about COVID-19 on television (n = 482; 19.8%) and on social media (n = 415; 21.5%) mainly resulted in stress and fear. The disseminated information contributes to awareness, but also affects physically and/or psychologically many elderly people, mainly generating fear and stress.

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Oxidative stress biomarkers in treatment-responsive and treatment-resistant schizophrenia patients
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Buosi, Patrick

; Borghi, Fábio Aparecido

; Lopes, Angélica Marta

; Facincani, Isabela da Silva

; Fernandes-Ferreira, Rafael

; Oliveira-Brancati, Camila Ive Ferreira

; do Carmo, Tayanne Silva

; Souza, Dorotéia Rossi Silva

; da Silva, Danilo Grünig Humberto

; de Almeida, Eduardo Alves

; de Araújo Filho, Gerardo Maria

Trends in Psychiatry and Psychotherapy

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dec 2021, Volume 43 N. 4 Pages 278 - 285

Abstract: En | Text: En | PDF: En

Abstract Introduction Schizophrenia is a complex psychiatric disorder that affects approximately twenty million people worldwide. Various factors have been associated with the physiopathology of this disease such as oxidative stress, which is an imbalance between pro-oxidant and antioxidant molecules. Objective This study evaluated the association between biomarkers of oxidative stress and response to pharmacological treatment among patients with schizophrenia in the context of their clinical information, demographic data, and lifestyle. Methods A total of 89 subjects were included, 26 of whom were treatment-responsive schizophrenia patients (Group 1), 27 treatment-resistant schizophrenia patients (Group 2), and 36 healthy controls (Group 3). All of the subjects completed a questionnaire to provide clinical and demographic data, and all provided peripheral blood samples. The oxidative stress markers analyzed using spectrophotometry were catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), total glutathione (GSH-t), malondialdehyde (MDA), and Trolox-equivalent antioxidant capacity (TEAC; p < 0.05). Results When all schizophrenia patients (G1 + G2) were compared to the control group, SOD levels were found to be lower among schizophrenia patients (p < 0.0001), while MDA and CAT levels were higher (p < 0.0001 and p = 0.0191, respectively). GPx, GSH-t, and TEAC levels were similar in all three groups (p > 0.05). Conclusion Lower SOD levels and higher MDA and CAT levels indicate oxidative damage in schizophrenia patients, regardless of their response to pharmacological treatment. Smoking is associated with oxidative stress, in addition, a family history of the disease was also found to be correlated with cases of schizophrenia, which reflects the relevance of genetics in disease development.

https://doi.org/10.47626/2237-6089-2020-0078

Métodos para avaliação da efetividade de vacinas para COVID-19 com ênfase em abordagens quase-experimentais
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Pescarini, Julia Moreira

; Teixeira, Camila Silveira Silva

; Cruz, Enny Paixão

; Ortelan, Naia

; Pinto, Priscila Fernanda Porto Scaff

; Ferreira, Andrêa Jacqueline Fortes

; Alves, Flavia Jôse Oliveira

; Pinto Junior, Elzo Pereira

; Falcão, Ila Rocha

; Rocha, Aline dos Santos

; Silva, Nivea Bispo da

; Ortiz, Renzo Flores

; Saavedra, Ramon da Costa

; Oliveira, Vinicius de Araújo

; Ribeiro-Silva, Rita de Cássia

; Ichihara, Maria Yury Travassos

; Boaventura, Viviane

; Barral Netto, Manoel

; Kerr, Ligia Regina Franco Sansigolo

; Werneck, Guilherme Loureiro

; Barreto, Mauricio L.

Ciência & Saúde Coletiva

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nov 2021, Volume 26 N. 11 Pages 5599 - 5614

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.

Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.

https://doi.org/10.1590/1413-812320212611.18622021 1 downloads

Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato

; Ferreira, Gilda Aparecida

; Gomides Reis, Ana Paula Monteiro

; Reis Neto, Edgard Torres

; Abreu, Mirhelen Mendes

; Albuquerque, Cleandro Pires

; Araújo, Nafice Costa

; Bacchiega, Ana Beatriz

; Bianchi, Dante Valdetaro

; Bica, Blanca

; Bonfa, Eloisa Duarte

; Borba, Eduardo Ferreira

; Brito, Danielle Christinne Soares Egypto

; Duarte, Ângela Luzia Branco Pinto

; Santo, Rafaela Cavalheiro Espírito

; Fernandes, Paula Reale

; Guimarães, Mariana Peixoto

; Gomes, Kirla Wagner Poti

; Kakehasi, Adriana Maria

; Klumb, Evandro Mendes

; Lanna, Cristina Costa Duarte

; Marques, Claudia Diniz Lopes

; Monticielo, Odirlei André

; Mota, Licia Maria Henrique

; Munhoz, Gabriela Araújo

; Paiva, Eduardo Santos

; Pereira, Helena Lucia Alves

; Provenza, José Roberto

; Ribeiro, Sandra Lucia Euzébio

; Rocha Junior, Laurindo Ferreira

; Sampaio, Camila Santana Justo Cintra

; Sampaio, Vanderson Souza

; Sato, Emília Inoue

; Skare, Thelma

; de Souza, Viviane Angelina

; Valim, Valeria

; Lacerda, Marcus Vinícius Guimarães

; Xavier, Ricardo Machado

; Pinheiro, Marcelo Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 60

Abstract: En | Text: En | PDF: En

Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).

https://doi.org/10.1186/s42358-021-00217-0 22 downloads

10.

Molecular detection of Leishmania infantum in donkeys and mules under semiarid conditions in Brazil
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Limeira, Clécio Henrique

; Oliveira, Murilo Duarte de

; Araújo Júnior, João Pessoa

; Malossi, Camila Dantas

; Ullmann, Leila Sabrina

; Silva, Maria Luana Cristiny Rodrigues

; Azevedo, Sérgio Santos de

; Alves, Clebert José

Revista Brasileira de Parasitologia Veterinária

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2021, Volume 30 N. 4 elocation e015021

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A leishmaniose visceral é uma zoonose parasitária que afeta principalmente populações mais pobres e vulneráveis, e os cães domésticos são considerados as principais fontes de infecção para o vetor e, portanto, para os humanos. Porém diversos estudos têm pesquisado o papel de outros hospedeiros vertebrados no ciclo da doença. Neste contexto, objetivou-se realizar um levantamento da infecção por Leishmania infantum em asininos e muares, vivendo em região semiárida do Brasil. Foi utilizado sangue total de 72 equídeos (65 asininos e 7 muares) para a realização de diagnóstico molecular por meio da técnica de Reação em Cadeia de Polimerase em Tempo Real (qPCR). Um total de 25% das amostras (18/72) resultaram positivas na qPCR, porém não houve diferença significativa entre as espécies (asininos e muares), sexo (macho e fêmea) e situação de abandono dos animais (sim ou não). Asininos e muares, vivendo em condições semiáridas, apresentam alta frequência de infecção por L. infantum, sendo válido atribuir importância a essas espécies no ciclo epidemiológico da leishmaniose visceral, seja como um reservatório em potencial, seja apenas como uma fonte alimentar abundante para os vetores.

Abstract Visceral leishmaniasis is a parasitic zoonosis that mainly affects poorest and most vulnerable populations, and domestic dogs are considered to be the main source of infection to the vector and therefore humans. However, several studies have investigated the role of other vertebrate hosts in the disease cycle. In this context, the aim of the present study was to conduct a survey of Leishmania infantum infection in donkeys and mules living in a semiarid region of Brazil. Whole blood sampled from 72 equids (65 donkeys and 7 mules) was used to perform molecular diagnosis using the real-time polymerase chain reaction (qPCR) technique. A total of 25% of the samples (18/72) were positive through qPCR, but there were no significant differences between the species (donkeys or mules), sex (male or female) and abandonment situation of the animals (yes or no). Donkeys and mules living under semiarid conditions have high frequency of L. infantum infection. It is therefore worth assigning importance to these species in the epidemiological cycle of visceral leishmaniasis, either as potential reservoirs or just as an abundant food source for vectors.

https://doi.org/10.1590/s1984-29612021095 3 downloads

11.

ASSESSMENT OF EATING BEHAVIOR AND FOOD NEOPHOBIA IN CHILDREN AND ADOLESCENTS FROM UBERABA-MG
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Silva, Taísa Alves

; Jordani, Maísa Tirintan

; Guimarães, Isabela Garcia da Cunha

; Alves, Luciene

; Braga, Camila Bitu Moreno

; Luz, Sylvana de Araujo Barros

Revista Paulista de Pediatria

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2021, Volume 39 elocation e2019368

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Investigar e comparar o comportamento e a neofobia alimentares de crianças e adolescentes de diferentes faixas etárias, índice de massa corporal/idade e sexo. Métodos: Tratou-se de um estudo transversal, com amostra por conveniência, envolvendo 150 crianças e adolescentes com faixa etária entre 3 e 13 anos, de ambos os sexos, atendidas em um ambulatório pediátrico de um hospital escola em Uberaba, MG. Para avaliar o comportamento alimentar, utilizaram-se as subescalas do Child Eating Behaviour Questionnaire (CEBQ) e para a neofobia alimentar o Child Food Neophobia Scale (CFNS). Resultados: Verificaram-se pontuações mais altas nas subescalas “resposta à comida” (p=0,015), “prazer em comer” (p=0,002) e “sobreingestão emocional” (p=0,009) em crianças e adolescentes com idades maiores. As crianças com idades menores obtiveram pontuações mais altas nas subescalas como “resposta à saciedade” (p=0,004) e “ingestão lenta” (p=0,001). Observou-se uma tendência à maior pontuação quanto à “resposta à comida” (p=0,005) e à “sobreingestão emocional” (p=0,013) nos participantes com obesidade grave. Não houve diferenças quanto à escala de neofobia alimentar. De modo geral, a neofobia alimentar correlacionou-se positivamente com o desinteresse pela comida e negativamente com o interesse pela comida. Conclusões: O estudo indicou diferenças significantes em alguns domínios do comportamento alimentar entre as crianças e os adolescentes da amostra, porém não houve diferenças em relação à neofobia alimentar. Nesse sentido, esses resultados podem contribuir para o aprimoramento de intervenções futuras referentes ao comportamento e à neofobia alimentares infantis.

ABSTRACT Objective: To investigate and compare the eating behavior and food neophobia of children and adolescents from different age groups, body mass index per age, and sex. Methods: This was a cross-sectional study, with a convenience sample, involving 150 children and adolescents aged 3 to 13 years, of both sexes, treated at a pediatric outpatient clinic of a teaching hospital in the municipality of Uberaba-MG, Brazil. Subscales of the Child Eating Behavior Questionnaire (CEBQ) were used to evaluate eating behavior, and the Child Food Neophobia Scale (CFNS) was used to evaluate food neophobia. Results: Higher scores were found in the subscales “food responsiveness” (p=0.015), “enjoyment of food” (p=0.002), and “emotional overeating” (p=0.009) among older children and adolescents. Younger children had higher scores in the subscales “satiety responsiveness” (p=0.004) and “slowness in eating” (p=0.001). There was a tendency toward higher scores for “food responsiveness” (p=0.005) and “emotional overeating” (p=0.013) in participants with severe obesity. There were no differences in the scale of food neophobia. Overall, food neophobia positively correlated with lack of interest in food and negatively correlated with interest in food. Conclusions: The study showed significant differences in some domains of eating behavior among children and adolescents of the sample; however, no differences were found regarding food neophobia. These results may contribute to the improvement of future interventions related to infant eating behavior and food neophobia.

https://doi.org/10.1590/1984-0462/2021/39/2019368 1256 downloads

12.

Métodos para avaliação da efetividade de vacinas para COVID-19 com ênfase em abordagens quase-experimentais
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Pescarini, Julia Moreira

; Teixeira, Camila Silveira Silva

; Cruz, Enny Paixão

; Ortelan, Naia

; Pinto, Priscila Fernanda Porto Scaff

; Ferreira, Andrêa Jacqueline Fortes

; Alves, Flavia Jôse Oliveira

; Pinto Junior, Elzo Pereira

; Falcão, Ila Rocha

; Rocha, Aline dos Santos

; Silva, Nivea Bispo da

; Ortiz, Renzo Flores

; Saavedra, Ramon da Costa

; Oliveira, Vinicius de Araújo

; Ribeiro-Silva, Rita de Cássia

; Ichihara, Maria Yury Travassos

; Boaventura, Viviane

; Barral Netto, Manoel

; Kerr, Ligia Regina Franco Sansigolo

; Werneck, Guilherme Loureiro

; Barreto, Mauricio L.

Ciência & Saúde Coletiva

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2021, Volume 26 N. 11 Pages 5599 - 5614

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-812320212611.18622021

13.

Genomic and phylogenetic characterisation of an imported case of SARS-CoV-2 in Amazonas State, Brazil
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Nascimento, Valdinete Alves do

; Corado, André de Lima Guerra

; Nascimento, Fernanda Oliveira do

; Costa, Ágatha Kelly Araújo da

; Duarte, Debora Camila Gomes

; Luz, Sérgio Luiz Bessa

; Gonçalves, Luciana Mara Fé

; Jesus, Michele Silva de

; Costa, Cristiano Fernandes da

; Delatorre, Edson

; Naveca, Felipe Gomes

Memórias do Instituto Oswaldo Cruz

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2020, Volume 115 elocation e200310

Abstract: En | Text: En | PDF: En

A new coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] is currently causing a life-threatening pandemic. In this study, we report the complete genome sequencing and genetic characterisation of a SARS-CoV-2 detected in Manaus, Amazonas, Brazil, and the protocol we designed to generate high-quality SARS-CoV-2 full genome data. The isolate was obtained from an asymptomatic carrier returning from Madrid, Spain. Nucleotide sequence analysis showed a total of nine mutations in comparison with the original human case in Wuhan, China, and support this case as belonging to the recently proposed lineage A.2. Phylogeographic analysis further confirmed the likely European origin of this case. To our knowledge, this is the first SARS-CoV-2 genome obtained from the North Brazilian Region. We believe that the information generated in this study may contribute to the ongoing efforts toward the SARS-CoV-2 emergence.

https://doi.org/10.1590/0074-02760200310 2354 downloads

14.

Leptospira interrogans infection in tegu lizard (Tupinambis merianae), Brazil
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Fernandes, Juciê Jales

; Pinheiro, Tiago Junior

; Costa, Diego Figueiredo

; Araújo Júnior, João Pessoa

; Malossi, Camila Dantas

; Ullmann, Leila Sabrina

; Silva, Maria Luana Cristiny Rodrigues

; Azevedo, Sérgio Santos

; Alves, Clebert José

; Higino, Severino Silvano dos Santos

Ciência Rural

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2020, Volume 50 N. 12 elocation e20200424

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: Foram utilizados 12 lagartos Teiús (Tupinambis merianae) do Nordeste do Brasil. Encontramos nove animais positivos (75%) para Leptospira sp. na PCR e seis (50%) soropositivos. O sequenciamento de DNA de Leptospira sp. revelou 99% de semelhança com L. interrogans. Os resultados indicam que esta espécie pode desempenhar um papel importante na transmissão da leptospirose humana.

ABSTRACT: We used 12 tegu lizards (Tupinambis merianae) from northeastern Brazil, and we reported nine (75%) Leptospira sp. PCR-positive animals and six (50%) seropositive. Leptospira sp. DNA sequencing revealed 99% similarity with L. interrogans. Our findings indicated that this species may play a role in the transmission of human leptospirosis.

https://doi.org/10.1590/0103-8478cr20200424 463 downloads

15.

Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease
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Alves, Silvia Marinho Martins

; Alvarado-Arnês, Lúcia Elena

; Cavalcanti, Maria da Glória Aureliano de Melo

; Carrazzone, Cristina de Fátima Velloso

; Pacheco, Antônio Guilherme Fonseca

; Sarteschi, Camila

; Moraes, Milton Ozorio

; Oliveira Junior, Wilson Alves de

; Medeiros, Carolina de Araújo

; Pessoa, Fernanda Gallinaro

; Mady, Charles

; Lannes-Vieira, Joseli

; Ramires, Felix José Alvarez

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20190488

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy. METHODS: We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates: age, sex, and trypanocidal treatment. RESULTS: A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04). CONCLUSIONS: Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF.

https://doi.org/10.1590/0037-8682-0488-2019 738 downloads

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