In January and February 2019, a malacological survey was conducted in the area surrounding the residence of a 12-year-old child that had contracted cerebral angiostrongyliasis in the municipality of Macapá, capital of the Amapá State, northern Brazil. The serological examination was positive for Angiostrongylus cantonensis infection, the principal etiological agent of this parasitosis. A sample of 54 molluscs was artificially and individually digested for parasitological analysis, containing 38 specimens of Achatina fulica, nine specimens of Bulimulus tenuissimus and seven specimens of Sarasinula linguaeformis. A. fulica was the most abundant mollusc, and the only species infected with A. cantonensis, as well as presenting co-infections with other nematodes. This is the first report of cerebral angiostrongyliasis in the Amazon Region, and the first record of A. fulica infected with A. cantonensis in Amapá. These findings highlight the potential risks of human angiostrongyliasis, and the need to implement public health measures to control the spread of the disease.

BACKGROUND The main clinical forms of paracoccidioidomycosis (PCM) are the acute/subacute form (AF) and the chronic form (CF), and they both display considerable clinical variability. The immune responses of PCM patients, during and after treatment, remain neglected, mainly in the case of CF patients, due to the high prevalence of pulmonary sequelae. OBJECTIVE To evaluate the distribution of whole blood T cell subsets, serum cytokines, and biomarkers of pulmonary fibrosis in PCM patients, according to the clinical form and at different time points, during the antifungal therapy. METHODS Eighty-seven PCM patients, from an endemic area in Brazil, were categorised into groups, according to the clinical form (AF or CF) and the moment of treatment. The peripheral blood T lymphocyte subsets of these patients were analysed using fluorescence-activated cell sorting. The serum levels of cytokines, basic fibroblast growth factor and surfactant protein-D (SP-D) were also analysed. FINDINGS In the CF patients, an expansion of the peripheral blood TCD4+ cells was observed during the treatment, and this persisted even after two years of antifungal treatment. In addition, these patients showed high serum levels of SP-D. CONCLUSION Our findings highlight the immunological changes CF patients undergo, during and after treatment, possibly due to the hypoxia triggered by pulmonary fibrosis and emphysema.

Resumo Objetivo O objetivo deste estudo foi obter extratos por diferentes métodos de extração de Casearia sylvestris, incluindo a obtenção de óleo essencial, a fim de comparar suas atividades antimicrobianas em relação aos enxaguatórios bucais convencionais com clorexidina contra bactérias orais. Material e método Para esta avaliação, extratos das folhas foram obtidos por diferentes métodos de extração (infusão, decocção, maceração e percolação) utilizando diferentes sistemas de solventes: 100% de água, 100%, de etanol, metanol 100%, água: etanol 3: 7; água: etanol 7: 3; água: metanol 7: 3 e água: metanol 3: 7. O óleo essencial, que corresponde a uma fração volátil, foi obtido por hidrodestilação usando o aparelho de Clevenger modificado. O método de microdiluição em caldo foi usado para determinar os valores de concentração inibitória mínima (MIC) e a concentração bactericida mínima (MBC) para os seguintes microrganismos: Streptococcus mutans ATCC 25175, ATCC 49456 S. mitis, S. sanguinis ATCC 10556, S. salivarius ATCC 25975, Lactobacillus casei ATCC 11578 e Enterococcus faecalis ATCC4082. Gluconato de clorexidina foi usada como um controle positivo. Resultado Todos os extratos avaliados no protocolo utilizado apresentaram valores de MIC superior a 400 ug/mL e alguns mostraram atividade bactericida. A atividade antimicrobiana do óleo essencial foi maior do que a atividade dos extratos, e a melhor concentração inibitória mínima e valores de concentração bactericida mínima foram obtidos contra L. casei (MIC de 0,023 ug/mL e MBC de 0,046 ug/mL) e S. mutans (MIC de 25 ug/mL e MBC de 50 ug /mL), respectivamente. Conclusão O óleo essencial de Casearia sylvestris tem atividade antimicrobiana significativa contra microrganismos orais.

Abstract Aim The aim of this study was to obtain Casearia sylvestris leave extracts by different extractive methods, including the obtention of essential oil, in order to compare their antimicrobial activities to conventional mouthwash chlorhexidine against oral bacteria. Material and method For this evaluation, extracts from the leaves were obtained by different methods of extraction (infusion, decoction, maceration and percolation) using different solvent systems: water 100%, ethanol 100%, methanol 100%, water: ethanol 3:7; water: ethanol 7:3; water: methanol 7:3 and water: methanol 3:7. The essential oil, which corresponds to a volatile fraction, was obtained by hydrodistillation using Clevenger modified apparatus. The microdilution broth method was used to determine the values of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for the following microorganisms: Streptococcus mutans ATCC 25175, S. mitis ATCC 49456, S. sanguinis ATCC 10556, S. salivarius ATCC 25975, Lactobacillus casei ATCC 11578 and Enterococcus faecalis ATCC4082. Chlorhexidine gluconate was used as a positive control. Result All extracts evaluated in the used protocol displayed MIC values higher than 400 µg/mL and few showed bactericidal activity. The antimicrobial activity of essential oil was higher than the activity of the extracts, and the best minimum inhibitory concentration and minimum bactericidal concentration values were obtained against L. casei (MIC of 0.023 µg/mL and MBC of 0.046 µg/mL) and S. mutans (MIC of 25 µg/mL and MBC of 50 µg/mL), respectively. Conclusion The essential oil of Casearia sylvestris has significant antimicrobial activity against oral microorganisms.

For centuries, specific instruments or regular toothbrushes have routinely been used to remove tongue biofilm and improve breath odor. Toothbrushes with a tongue scraper on the back of their head have recently been introduced to the market. The present study compared the effectiveness of a manual toothbrush with this new design, i.e., possessing a tongue scraper, and a commercial tongue scraper in improving breath odor and reducing the aerobic and anaerobic microbiota of tongue surface. The evaluations occurred at 4 moments, when the participants (n=30) had their halitosis quantified with a halimeter and scored according to a 4-point scoring system corresponding to different levels of intensity. Saliva was collected for counts of aerobic and anaerobic microorganisms. Data were analyzed statistically by Friedman's test (p<0.05). When differences were detected, the Wilcoxon test adjusted for Bonferroni correction was used for multiple comparisons (group to group). The results confirmed the importance of mechanical cleaning of the tongue, since this procedure provided an improvement in halitosis and reduction of aerobe and anaerobe counts. Regarding the evaluated methods, the toothbrush's tongue scraper and conventional tongue scraper had a similar performance in terms of breath improvement and reduction of tongue microbiota, and may be indicated as effective methods for tongue cleaning.