Abstract The study analyzed the consumption of non-standard medication in the health of indigenous peoples, emphasizing the rationality of pharmacotherapy, by conducting a cross-sectional study of secondary data from 2018 and 2019 in the Minas Gerais/Espírito Santo Special Sanitary Indigenous Health Districts. These medicines were classified by Anatomical Therapeutic Chemical Classification. Non-parametric tests were applied to compare the origin of prescription and the form of acquisition, assessing access to medication. Rationality was verified through the consumption profile and the therapeutic option in the list of standardized medicines. A total of 104,928 pharmaceutical presentations were consumed, 66,967 (66%) for the alimentary tract and metabolism, 17,705 (17%) for the nervous system, and 12,961 (12%) for the cardiovascular system. With respect to medicines consumed per region, 171 (90%) out of 190 had a therapeutic option. Prescriptions were more from the SUS. Differences were found in the way the medicines were acquired. The study pointed to significant consumption of non-standard medicines, and there may be failings in therapeutic rationality. In indigenous health, ethnocultural and social issues are challenges to access to medicines with rational use.

Resumo O estudo analisou o consumo de medicamentos não padronizados na saúde indígena, enfatizando a racionalidade da farmacoterapia, por meio de um estudo transversal dos dados secundários, de 2018 e 2019, no Distrito Especial Sanitário de Saúde Indígena Minas Gerais/Espírito Santo. Esses medicamentos foram classificados pela Anatomical Therapeutic Chemical Classification. Para a comparação da origem de prescrição e da forma de aquisição, empregaram-se testes não paramétricos, avaliando o acesso a medicamentos. Verificou-se a racionalidade por meio do perfil de consumo e da opção terapêutica na lista de medicamentos padronizados. Foram consumidas 104.928 apresentações farmacêuticas, 66.967 (66%) eram para o trato alimentar e o metabolismo; 17.705 (17%) para o sistema nervoso; 12.961 (12%) para o sistema cardiovascular. Quanto aos medicamentos mais consumidos por regiões, 171 (90%) dos 190 apresentavam opção terapêutica. As prescrições foram mais provenientes do SUS. Encontraram-se diferenças na forma de aquisição dos medicamentos. O estudo apontou importante consumo de medicamentos não padronizados, podendo existir falhas na racionalidade terapêutica. Na saúde indígena, questões etnoculturais e sociais constituem desafios para o acesso aos medicamentos com uso racional.

RESUMO: Aeromonas sp. são bactérias presentes naturalmente no ecossistema aquático e apresentam potencial patogênico, sendo considerados patógenos emergentes em humanos e animais. Ainda, causam perdas consideráveis em piscicultura e, através da água, podem também contaminar inúmeros alimentos. Diante disso o objetivo do trabalho foi quantificar e analisar o perfil de resistência aos antimicrobianos de bactérias do gênero Aeromonas sp. em peixes. Um total de 72 amostras foram adquiridas, sendo duas variedades de peixes (peixe de couro Pseudoplatystoma fasciatum x Leiarius marmoratus e os peixes redondos Colossoma macropomum x Piaractus mesopotamicus e Colossoma macropomum x Piaractus brachypomus), dois tipos (fresco e congelado) e de três estabelecimentos comerciais (supermercado, feira e peixaria). As 55 culturas isoladas de Aeromonas foram avaliadas quanto ao perfil de resistência aos antimicrobianos pelo método de difusão em disco. Os valores encontrados na quantificação de Aeromonas sp. variaram de 4,22 a 6,00 Log UFC/g, e foram identificadas dez espécies diferentes, sendo A. eucrenophila, A. hydrophila, A. caviae, A. media, A. jandaei, A. veronii bv. sobria, A. trota, A. schubertii, A. veronii bv. veronii e A. shigelloides. Entre os 55 isolados, 64,45% apresentaram resistência a Ampicilina-sulbactam, 75% foram sensíveis à gentamicina e ciprofloxacina. Concluiu-se que 100% das amostras avaliadas estavam contaminadas por Aeromonas sp. podendo apresentar risco à saúde do consumidor visto que estas podem ser agentes etiológicos de Doenças Transmitidas por Alimentos (DTAs). O perfil de resistência aos antimicrobianos comprovou a resistência a ampicilina e apresentou multirresistência a diferentes classes de antimicrobianos, demonstrando um problema relacionado à opção de antimicrobiano para tratamento no caso do desenvolvimento de alguma doença.

ABSTRACT: The bacteria Aeromonassp. are naturally reported in aquatic ecosystems and possess pathogenic potential, being considered as emerging pathogens in humans and animals. They also cause considerable losses in fish farming and, through water, can contaminate numerous foods. This study quantified and analyzed the antimicrobial resistance profile of Aeromonassp. in fish. A total of 72 samples of two fish varieties (leather fish, Pseudoplatystomafasciatumx Leiariusmarmoratusand round fish, Colossomamacropomumx Piaractusmesopotamicusand Colossomamacropomumx Piaractusbrachypomus) were purchased from two types of sources (fresh and frozen) and three commercial establishments (supermarket, market, and fishmonger). The 55 isolated Aeromonascultures were evaluated for their antimicrobial resistance profile by the disc diffusion method. Upon quantification, the count of Aeromonassp. ranged from 4.22 to 6.00 Log CFU/g; ten different species, including A. eucrenophila, A. hydrophila, A. caviae, A. media, A. jandaei, A. veroniibv. sobria, A. trota, A. schubertii, A. veroniibv. veronii, and A. shigelloides, were identified. Among the 55 isolates, 64.45% showed resistance to Ampicillin-sulbactam, and 75% were sensitive to gentamicin and ciprofloxacin. It was concluded that 100% of the evaluated samples were contaminated by Aeromonassp., which may present a risk to consumer health since bacteria can be etiological agents of Foodborne Diseases. The antimicrobial resistance profile showed resistance to ampicillin and multi-resistance to different classes of antimicrobials, demonstrating problems with choosing an antimicrobial for treatment of any disease.

Abstract The study analyzed the consumption of non-standard medication in the health of indigenous peoples, emphasizing the rationality of pharmacotherapy, by conducting a cross-sectional study of secondary data from 2018 and 2019 in the Minas Gerais/Espírito Santo Special Sanitary Indigenous Health Districts. These medicines were classified by Anatomical Therapeutic Chemical Classification. Non-parametric tests were applied to compare the origin of prescription and the form of acquisition, assessing access to medication. Rationality was verified through the consumption profile and the therapeutic option in the list of standardized medicines. A total of 104,928 pharmaceutical presentations were consumed, 66,967 (66%) for the alimentary tract and metabolism, 17,705 (17%) for the nervous system, and 12,961 (12%) for the cardiovascular system. With respect to medicines consumed per region, 171 (90%) out of 190 had a therapeutic option. Prescriptions were more from the SUS. Differences were found in the way the medicines were acquired. The study pointed to significant consumption of non-standard medicines, and there may be failings in therapeutic rationality. In indigenous health, ethnocultural and social issues are challenges to access to medicines with rational use.

Resumo O estudo analisou o consumo de medicamentos não padronizados na saúde indígena, enfatizando a racionalidade da farmacoterapia, por meio de um estudo transversal dos dados secundários, de 2018 e 2019, no Distrito Especial Sanitário de Saúde Indígena Minas Gerais/Espírito Santo. Esses medicamentos foram classificados pela Anatomical Therapeutic Chemical Classification. Para a comparação da origem de prescrição e da forma de aquisição, empregaram-se testes não paramétricos, avaliando o acesso a medicamentos. Verificou-se a racionalidade por meio do perfil de consumo e da opção terapêutica na lista de medicamentos padronizados. Foram consumidas 104.928 apresentações farmacêuticas, 66.967 (66%) eram para o trato alimentar e o metabolismo; 17.705 (17%) para o sistema nervoso; 12.961 (12%) para o sistema cardiovascular. Quanto aos medicamentos mais consumidos por regiões, 171 (90%) dos 190 apresentavam opção terapêutica. As prescrições foram mais provenientes do SUS. Encontraram-se diferenças na forma de aquisição dos medicamentos. O estudo apontou importante consumo de medicamentos não padronizados, podendo existir falhas na racionalidade terapêutica. Na saúde indígena, questões etnoculturais e sociais constituem desafios para o acesso aos medicamentos com uso racional.

Abstract: The objective of this study was to evaluate the quality of milk and cheese and sensory analysis of cheese from goats that received a diet with different levels of sorghum silage in the diet. Twenty Anglonubian dairy goats were used, with an average age of 2 years, average live weight of 43.7 kg, distributed in a completely randomized design, with five replications. Moisture (P=0.001), total solids (P=0.001), fat (p=0.001), TDE (P=0.006) and protein (P=0.003) of goat cheese showed a significant difference due to the inclusion of silage from goat cheese. sorghum in the diet. The sensory attributes soft appearance (P<.0001), look (P<.0001), salty taste (P<.0001) and smooth texture (P=0.0430) showed a significant difference depending on the level of sorghum silage added to the diet. of goats. In the PC analysis, it is observed that three main components were needed to represent the variation of 64.84% of the data. PC 1 determined 29% of the data variation and was represented by the attributes with the highest averages: attractive aroma (5.87) and global acceptability (7.74). The inclusion of up to 45% of sorghum silage in the diet of goats increased milk and cheese fat, which favored high scores for the attributes of softness and global acceptance.

ABSTRACT. The present study aims to conduct a review on the potential use of insect meal as an alternative protein source in poultry feed, particularly to serve the rearing of free-range chickens. Insects are already part of the diet of birds in their natural habitat, and the availability of low-cost alternative foods with low environmental impact is essential for the development of the activity. The review comprehended studies that used meals consisting of silkworm (Bombyx mori) chrysalis, earthworm (Eisenia foetida), housefly (Musca domestica), black soldier fly (Hermetia illucens) and mealworm beetle (Tenebrio molitor) to replace plant-based protein sources. In general, insect meals have a high content of crude protein and ether extract, as well as an essential amino acid profile suitable for poultry feeding. The addition of insect meal in poultry feed normally shows good results as to growth performance and egg production, without causing a negative effect on carcass characteristics, meat sensory quality and egg quality, presenting itself as an alternative protein source with good prospects for replacing plant-based sources in poultry feed.

Abstract Introduction Although extracorporeal photopheresis (ECP) is a promising second-line therapy in the treatment of chronic graft-versus-host disease (cGVHD), its use is limited by its high cost. This study aims to describe the clinical evolution of patients who underwent ECP therapy for cGVHD and to perform an economic analysis of the therapy Methods This was a case series between 2016 and 2020 describing the clinical response to ECP and a micro-cost analysis of the therapy using time-driven activity-based costing. Results Six patients underwent ECP for corticosteroid-dependent cGVHD The cost per ECP session is 14,960.90 Brazilian reais (BRL), which primarily consists of the ECP kit with an activator (82.78%), followed by the hospital's physical structure (14.66%), human resources (2.48%) and exams/inputs (0.08%). The number of sessions performed ranged from 2 to 42. The total cost of the therapy per patient ranged from BRL 30,000 to 500,000. Conclusion The response of the patient with cGVHD to treatment with ECP was variable. These micro-costing results can be used to develop remuneration and cost control strategies in hematopoietic stem cell transplantation programs, as well as in further economic studies.

Abstract Background Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents. Objective to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS. Methods The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli. Results Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components. Conclusion Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.

Resumo Antecedentes A esclerose múltipla (EM) é uma doença inflamatória desmielinizante. Estudos com potenciais evocados auditivos têm demonstrado déficits de condução e processamento neural em adultos com EM, mas pouco se sabe sobre as respostas electrofisiológicas em crianças e adolescentes. Objetivo avaliar a via auditiva central por meio dos potenciais evocados auditivos de tronco encefálico (PEATE) e dos potenciais evocados auditivos de longa latência (PEALL) em crianças e adolescentes com EM. Métodos Foram avaliados17 indivíduos com EM, de ambos os sexos, com idades entre 9 e 18 anos, e 17 voluntários saudáveis, pareados por sexo e idade. Todos os indivíduos tinham audição normal sem alterações de orelha média. Os indivíduos foram avaliados por meio do PEATE com estímulo clique e do PEALL com paradigma de oddball e estímulo tone-burst. Resultados Foram observadas alteração em 60% das avaliações dos indivíduos com EM. No PEATE, 58,82% dos pacientes com EM apresentaram alteração, com aumento da latência da onda V, e interpicos III-V e I-V aumentados em comparação aos voluntários saudáveis. No PEALL, 52,94% dos pacientes com EM apresentaram alteração. Embora diferenças estatísticas foram observadas apenas na amplitude P2-N2, os pacientes com EM apresentaram latências prolongadas e amplitudes menores em comparação aos voluntários saudáveis para todos os componentes. Conclusão Crianças e adolescentes com EM apresentaram alteração das respostas do PEATE, com atraso de condução neural entre o núcleo coclear e o lemnisco lateral. Além disso, os resultados alterados do PEALL sugeriram uma diminuição na velocidade de processamento neural e de discriminação sensorial da audição.

BACKGROUND The parasite Giardia duodenalis infects a wide range of vertebrate hosts, including domestic and wild animals as well as humans. Giardia is genotyped into eight assemblages (A-H). Zoonotic assemblages A and B have already been identified in humans and wild and domestic animals (non-human primates and cats) from Brazilian Amazon and in the world. Due to its zoonotic/zooanthroponotic nature, surveillance initiatives and the definition of Giardia assemblages are important in order to characterise the epidemiological scenario and to implement further control measures. OBJECTIVES Determine assemblages of G. duodenalis in sloths from the Brazilian Amazon Region. METHODS Faecal parasitological examination of sloths from Amazonas State. Polymerase chain reaction (PCR) targeting the beta giardin (BG), and genes from multilocus sequence typing (MLST) scheme, amplicon sequencing and phylogenetic analysis. FINDINGS Here, we identified, by microscopy, Giardia in two northern sloths (Bradypus tridactylus). These two samples were submitted to molecular assays and it was revealed that both were infected by G. duodenalis assemblage A. Phylogenetic analysis showed that they belong to assemblage A within sequences from humans and wild and domestic animals. CONCLUSION Therefore, besides showing, by the first time, the current presence of this parasite in sloths, our findings reveals that this wild animal species would be part of the zoonotic/zooanthroponotic scenario of this parasite in the Brazilian Amazon.

SUMMARY OBJECTIVE: The polycystic ovary syndrome is the most common endocrine disorder, characterized by the dysregulation of ovarian angiogenesis. This alteration can be related to changes in the activities of the vascular endothelial growth factor (VEGF) gene. Single-nucleotide polymorphisms have been observed in the promoter, intronic, and untranslated regions of the VEGF gene, and several studies have suggested that these polymorphisms may be associated with the risk of polycystic ovary syndrome. This study aimed to investigate the association between rs2010963 and rs833061 polymorphisms and haplotypes of VEGF in the etiology of polycystic ovary syndrome. METHODS: A total of 210 women, 102 diagnosed with polycystic ovary syndrome and 108 controls, participated in this study. The genotyping of the samples was performed by PCR-RFLP and real-time PCR for rs2010963 and rs833061 polymorphisms, respectively. The statistical analyses were performed by the chi-square test and logistic regression model. RESULTS: The clinical characteristics of the patients showed that 75.8% of the patients did not become pregnant, 36.3% had a family history of polycystic ovary syndrome, 58.6% were obese, and about 60% had clinical characteristics of hyperandrogenism. There were no associations between the distribution of rs2010963 (OR 1.24; 95%CI 0.60–2.57; p=0.56) and rs833061 (OR 0.78; 95%CI 0.32–1.92; p=0.59) in patients and controls. CONCLUSIONS: The patients with polycystic ovary syndrome have similar rates of VEGF polymorphisms rs2010963 and rs833061 on the general population.

Resumo Este artigo apresenta parte de uma investigação sobre o processo de apropriação da língua portuguesa escrita por crianças surdas, sinalizantes de Língua Brasileira de Sinais (Libras), e busca descrever os seus dizeres e analisar as produções induzidas durante a pesquisa. Trata-se de pesquisa qualitativa, descritiva e de cunho exploratório. Participaram seis colaboradores que cursavam a Educação Infantil e os anos iniciais do Ensino Fundamental em uma escola de surdos. Foram utilizadas entrevistas e atividades realizadas a partir da contação de uma história em Libras. Nessas atividades, as crianças escreveram palavras, textos, completaram histórias, criaram personagens e fizeram desenhos. As entrevistas, realizadas em Libras, foram gravadas em vídeo, traduzidas e textualizadas na língua portuguesa escrita. Na análise dos dados, constatou-se que não há distinção inicial entre o processo de apropriação da língua portuguesa das crianças surdas em relação àquelas que são ouvintes, conforme relatado na literatura; entretanto, há diferenciação em relação ao momento em que as crianças ouvintes começam a relacionar o som com a grafia, caracterizando o “ponto de virada” para o entendimento do mecanismo da escrita. Problematiza-se o que pode ser tomado como o “ponto de virada” para as crianças surdas na apreensão do funcionamento da escrita. Verificou-se que elas utilizam pistas visuais e fazem conjecturas para a escrita, que podem estar relacionadas à consciência visual. Esse “ponto de virada” pode ser favorecido por um letramento bilíngue que envolva elementos como escrita de sinais, escrita diferida e escrita bilíngue, a partir de bases diferentes daquelas utilizadas com as crianças ouvintes.

Abstract This article presents part of an investigation into the process of appropriation of the written Portuguese language by deaf children, signers of Brazilian Sign Language (Língua Brasileira de Sinais [Libras]). It seeks to describe their sayings and analyze the induced productions during the research. Six collaborators participated who attended Kindergarten and early elementary school years in a deaf school. This is qualitative, descriptive and exploratory research. Interviews and activities based on telling a story in Libras were used. In these activities, the children wrote words and texts, completed stories, developed characters, and drew pictures. The interviews, conducted in Libras, were videotaped, translated and textualized in written Portuguese. Data analysis found no initial distinction between the Portuguese language appropriation process of deaf children and those who are hearing, as reported in the literature. However, there is a difference when hearing children relate sound to spelling, characterizing the “turning point” for understanding the writing mechanism. We question what can be taken as the “turning point” for deaf children in the apprehension of writing functioning. It has been found that they use visual clues and make conjectures for writing, which may be related to visual awareness. This “turning point” can be favored by a bilingual literacy that involves signwriting, deferred writing and bilingual writing from different bases than those used with hearing children.

Abstract We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.

Abstract This study characterized the morphological aspects of marine collagen - spongin (SPG) extract from marine sponges, as well as, evaluating its in vitro and in vivo biological performance. Aplysina fulva marine sponge was used for the SPG extraction. It was investigated the physicochemical and morphological properties of SPG by using scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction and compared to PMMA and bovine collagen. Additionally, the SPG cytotoxicity and its influence on cell proliferation, through in vitro tests. Moreover, the in vivo biological response was investigated using an experimental model of tibial bone defect. The results demonstrated that SPG presented an irregular granular aspect, with a composition of OH, C=O, NH, CN and an amorphous profile. Also, in vitro viability results for the L929 and MC3T3 cell lines cultured with SPG extracts demonstrated normal growth in comparison to controls, except for MC3T3 viability at day 3. For in vivo analysis, using tibial bone defects in rats, SPG treated animals presented an increased rate of material resorption and higher granulation and bone formation deposition in the region of the defect, mainly after 45 days. As a conclusion, SPG was successfully extracted. The in vitro and in vivo studies pointed out that SPG samples produced an increase in L929 and MC3T3 viability and improved the performance in tibial bone defects. It can be concluded that SPG can be used as a bone graft for bone regeneration.

BACKGROUND Giardia duodenalis is a protozoan parasite that infects humans and other mammals and causes giardiasis worldwide. Giardia is genotyped into eight assemblages (A-H), with assemblages A and B considered zoonotic. OBJECTIVES The aim of this study was to determine the assemblages of G. duodenalis from individuals living in rural and urban areas of the Amazonas State. METHODS 103 human faecal specimens microscopically positive for the presence of Giardia obtained from four municipalities in Amazonas and four animal faecal specimens were genotyped based on the sequences of two genes, triosephosphate isomerase (TPI) and β-giardin (BG). FINDINGS In humans, assemblage A was the most represented with the identification of sub-assemblages AI, AII and AIII based on BG and sub-assemblages AI and AII based on TPI. Similarly, there is a diversity of sub-assemblage B considering BG (B and BIII) and TPI (B, BIII and BIV). In addition, we characterised homogeneous and heterogeneous genotypes comprising assemblages/sub-assemblages A and B in individuals from urban and rural areas. Here, for the first time, it was genotyped Giardia that infects animals from the Brazilian Amazon region. We identified sub-assemblage AI in one Ateles paniscus and two Felis catus and sub-assemblage BIV in one Lagothrix cana. MAIN CONCLUSIONS Therefore, humans and animals from the urban and rural Amazon share Giardia genotypes belonging to assemblages A and B, which are found in cosmopolitan regions around the world.

RESUMO: Fisális, Physalis peruviana L., é uma cultura em expansão no Brasil, dessa forma a identificação de espécies fitófagas que causam danos nesta cultura é importante para desenvolver controle preventivo e estratégias para o Manejo Integrado de Pragas. Neste estudo, relatamos a ocorrência de Lema bilineata Germar (Coleoptera: Chrysomelidae) no cultivo de P. peruviana e descrevemos os danos causados por suas larvas e adultos. Observou-se que o número de indivíduos de L. bilineata, tanto larvas como adultos, influenciaram significativamente o consumo total de folhas de P. peruviana. Além disso, relatamos pela primeira vez a presença de três inimigos naturais, incluindo um fungo, uma mosca e uma formiga, associados a esta praga no Brasil que poderiam ser utilizados como agentes de controle biológico.

ABSTRACT: Increased production of the Cape gooseberry (Physalis peruviana L.) in Brazil has given rise to interest in identifying the phytophagous species that might damage this crop to inform preventive control and integrated pest management strategies. In this study, we report the occurrence and describe the damage that larvae and adults of Lema bilineata Germar (Coleoptera: Chrysomelidae) cause in P. peruviana. The number of L. bilineata individuals, both larvae and adults, significantly affected the total consumption of P. peruviana leaves. We also report, for the first time, three natural enemies, including a fungus, a fly, and an ant, which are associated with this pest in Brazil and may play a role in biological control strategies.

Abstract The coronavirus disease (COVID-19) has been prioritized in relation to other illnesses considered critical, such as cancer, cardiovascular diseases/stroke, diabetes, and autoimmune diseases. The management of patients with these diseases involves dental care to reduce systemic complications caused by odontogenic infections, and/or to treat oral manifestations of systemic comorbidities. In this regard, the dental care of these individuals must be guaranteed during the pandemic. Although a high risk of exposure to and catching of COVID-19 is expected to befall dental professionals, biosafety guidelines reduce the likelihood of infection. Thus, the current scenario poses challenges, and offers decision-making approaches and tools that facilitate the management of individuals with oral manifestations of chronic and/or critical diseases, using hospital-based services. This article presents an overview for hospital service providers who are at the forefront of COVID-19 care, including a secure protocol, and clinical guidelines based on the experience of the Hospital das Clínicas in Belo Horizonte, a public referral service, supported by the Brazilian National Health System.