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Abstract Untreated HIV infection leads to severe immunodeficiency and can be associated with an accelerated aging process and a higher prevalence of frailty. Systemic changes are known to cause greater oral manifestations and decreased orofacial function. However, there is no investigation on Temporomandibular Disorders (TMD) in this population. This study aims to assess the prevalence of TMD in individuals living with HIV/AIDS. This cross-sectional study included HIV patients, with undetectable plasma viral load, under follow-up in the infectious disease's outpatient clinic at the Federal University of Bahia hospital. We recorded socio-demographic data, Fried's frailty criteria, Research Diagnostic Criteria for Temporomandibular Disorder, and Beck's Depression Inventory (BDI) through the application of structured questionnaires and extra-oral examination findings. Data analysis was conducted on SPSS-v18. The sample consisted of 198 patients. The prevalence of TMD was (33.8 %), most affecting females (46.6 %). Difficulty in opening the mouth and parafunctional habits were the main symptoms of the disease, as well as functional limitations. The mean of the BDI score was higher in TMD group than in those without TMD (11.01 ± 8.61 vs. 7.60 ± 7.52 valor de p = 0.004). Logistic regression showed an association between sex (OR=2.305, 95 % CI 1.243‒4.275) and depression (OR = 1.045, 95 % CI 1.005‒1.087) and TMD in HIV patients. The present study observed the prevalence of symptoms associated with TMD as difficulty opening the mouth, muscle fatigue, and joint noises in patients with chronic HIV and associated with depression. Highlights the importance of a broader view of the health of individuals living with HIV. function However (TMD population HIVAIDS AIDS HIV/AIDS crosssectional cross sectional load followup follow up diseases disease s hospital sociodemographic socio demographic data Frieds Fried criteria Disorder Becks Beck (BDI extraoral extra findings SPSSv18. SPSSv18 SPSSv SPSS v18. v18 v SPSS-v18 19 33.8 338 33 8 (33. %, , %) 46.6 466 46 6 (46. %. . limitations 11.01 1101 11 01 (11.0 861 61 8.6 vs 760 7 60 7.6 752 52 7.5 0.004. 0004 0.004 0 004 0.004) OR=2.305, OR2305 OR 2 305 (OR=2.305 9 1.243‒4.275 12434275 1 243 4 275 1045 045 1.045 1.005‒1.087 10051087 005 087 fatigue SPSSv1 v1 SPSS-v1 33. 3 (33 46. (46 11.0 110 (11. 86 8. 76 7. 75 5 000 0.00 00 OR=2.305 OR230 30 (OR=2.30 1.243‒4.27 1243427 24 27 104 04 1.04 1.005‒1.08 1005108 08 SPSS-v (3 (4 11. (11 0.0 OR=2.30 OR23 (OR=2.3 1.243‒4.2 124342 10 1.0 1.005‒1.0 100510 ( (1 0. OR=2.3 OR2 (OR=2. 1.243‒4. 12434 1. 1.005‒1. 10051 OR=2. (OR=2 1.243‒4 1243 1.005‒1 1005 OR=2 (OR= 1.243‒ 124 1.005‒ 100 OR= 1.243 12 1.005 1.24 1.00 1.2

https://doi.org/10.1016/j.bjid.2024.103769

Autochtonal case of chronic, unifocal, pulmonary paracoccidioidomycosis with methotrexate use, in Salvador ‒ Brazil chronic unifocal use
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Franco, Priscila de Abreu

; Araújo Neto, Cesar Augusto de

; Silva, Sonia Regina Leite da

; Coelho Filho, João Carlos

; Brites, Carlos

; Pereira-Silva, Jorge Luiz

Brazilian Journal of Infectious Diseases

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2024, Volume 28 N. 3 elocation 103768

Abstract: En | Text: En | PDF: En

Abstract Summary We report an autochthonous case of mild unifocal chronic pulmonary paracoccidioidomycosis in a 48-year-old previously healthy woman with no history of possible environmental exposures in endemic rural areas, supposedly resulting from reactivation of a latent pulmonary focus secondary to the use of methotrexate for the control of Chikungunya arthropathy. Laboratory investigation ruled out other immunosuppression. Her only symptoms were a dry cough and chest pain. Diagnosis confirmed by needle lung biopsy. There were no abnormalities on physical examination nor evidence of central nervous system involvement. MRI of the total abdomen showed no involvement of other organs. Computed chest tomography showed a favorable evolution under the use of itraconazole (200 mg/day). Different tomographic presentations findings are highlighted when performed before and after treatment. Conclusions PCM should be considered even in a woman without a history of consistent environmental exposure and in a non-endemic geographic area. 48yearold yearold 48 year old areas arthropathy immunosuppression pain biopsy organs 200 (20 mg/day. mgday mg/day . mg day mg/day) treatment nonendemic non area 4 20 (2 2 (

https://doi.org/10.1016/j.bjid.2024.103768

Description of the new HIV-1 intersubtype B/C circulating recombinant form (CRF146_BC) detected in Brazil HIV1 HIV 1 HIV- BC B C CRF146_BC CRF146BC CRFBC CRF146 CRF (CRF146_BC CRF14 CRF1
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Oliveira, Rodrigo Cunha

; Martin, Darren

; de Souza, Juliana Sacramento Mota

; Alcântara, Luiz Carlos Júnior

; Guimarães, Monick Lindenmeyer

; Brites, Carlos

; Monteiro-Cunha, Joana Paixão

Memórias do Instituto Oswaldo Cruz

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2024, Volume 119 elocation e230214

Abstract: En | Text: En | PDF: En

BACKGROUND The human immunodeficiency virus 1 (HIV-1) infections in Brazil are predominantly caused by two subtypes, B and C. OBJECTIVES Here we present the characterisation of a novel HIV-1 recombinant form, indicating a new Brazilian CRF_BC, named CRF146_BC. METHODS RDP, JphMM and Simplot recombination tools were used to evaluate the mosaic pattern. FINDINGS In this work, we identified three HIV-1 nucleotide sequences previously classified as unique recombinant forms (URFs), plus one new partial genome sharing the same BC recombination pattern. The mosaic genome is almost entirely represented by the subtype C sequence, with a small subtype B recombination region in the pol gene, at the Integrase level. The phylogenetic analyses strongly indicate a common origin between the strains, which were isolated in Rio Grande do Sul, Rio de Janeiro and Bahia states. MAIN CONCLUSIONS Thus, the new HIV-1 CRF146_BC is circulating in three different Brazilian regions: South, Southeast and Northeast. HIV1 HIV (HIV-1 subtypes HIV- form CRFBC CRF CRF_BC CRF146BC CRF146 RDP pattern work URFs, URFs , (URFs) sequence gene level strains Sul states Thus regions South Northeast (HIV- CRF14 (URFs (HIV CRF1

https://doi.org/10.1590/0074-02760230214

Weight gain in patients starting Dolutegravir-based ART according to baseline CD4 count after 48 weeks of follow up Dolutegravirbased Dolutegravir based CD 4
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Cardoso Neto, Érico C.

; Martins Netto, Eduardo

; Brites, Carlos

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 5 elocation 102807

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Excessive weight gain is a current concern among People Living with HIV (PLHIV) starting ART. Objectives: To evaluate the weight gain after 48-weeks of ART in naive patients, according with baseline CD4 count. Methods: PLHIV starting 3TC + TDF + DTG with at least 48-weeks of follow up in two AIDS referral centers were stratified by baseline CD4 count (lower or higher than 200 cells/mm3). Data on CD4 count, HIV viral load, weight/Body Mass Index (BMI), lipids and glucose levels were collected at baseline, 24 and 48 weeks of treatment. For analysis purpose, patients were categorized according to their BMI progression. Results: A total of 270 patients were included in the study. Mean CD4 count were 78.3 ± 61.7 and 536.7 ± 273 cells/mm3 for low and high CD4 count groups, respectively (p < 0.001). Baseline BMI was significantly lower in low CD4 group (21.7 vs. 23.6 Kg/m2, p < 0.001). Patients in low CD4 group gained more weight than those in high CD4 group (11.2 ± 8.5 kg vs. 2.2 ± 4.2 Kg, p = 0.004). Overall weight gain was higher in women, regardless group (13.1 ± 7.9 Kg vs. 1.4 ± 3.6 Kg for women and men, respectively, p < 0.001). The proportion of overweight/obesity significantly increased in low CD4 group. Viral suppression rate was high for both groups. At week 48 the overall proportion of overweight/obesity was like that reported for the Brazilian population. Conclusions: Weight gain in the present study indicates a “return to health” phenomenon. Excessive weight gain was more frequent in women. Background (PLHIV Objectives 48weeks CD Methods TC 20 cells/mm3. cellsmm3 cellsmm . cells mm3 mm cells/mm3) load weightBody Body BMI, , (BMI) 2 4 treatment purpose progression Results 27 783 78 3 78. 617 61 7 61. 5367 536 536. cells/mm groups 0.001. 0001 0.001 0 001 0.001) 21.7 217 21 (21. vs 236 23 6 23. Kgm2 Kgm m2 m Kg/m2 11.2 112 11 (11. 85 8 5 8. 22 2. 42 4. 0.004. 0004 0.004 004 0.004) 13.1 131 13 1 (13. 79 9 7. 14 1. 36 3. men overweightobesity overweight obesity population Conclusions return health phenomenon (BMI 53 000 0.00 00 21. (21 Kg/m 11. (11 13. (13 0.0 (2 (1 0. (

https://doi.org/10.1016/j.bjid.2023.102807

Seroprevalence and indexes of IgG antibodies for SARS-CoV-2 infection among People Living With HIV, tuberculosis patients and healthcare workers, in Salvador, Brazil SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- HIV workers Salvador SARS-CoV
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Santana, Daniele Souza de

; Netto, Eduardo Martins

; Vaz, Sara Nunes

; Dantas, Paulo Henrique

; Brites, Carlos

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 5 elocation 102811

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: COVID-19 can trigger different clinical presentations in distinct population groups, some of which are considered at higher risk of SARS-CoV-2 infection. Little is known about the susceptibility of certain populations to the infection. Objectives: We aimed to determine the prevalence of COVID-19 among People Living With HIV/AIDS (PLWH) attending a tertiary public hospital in Salvador, Brazil, patients with active pulmonary tuberculosis and Hospital's Healthcare Workers (HCW), and to compare their SARS-CoV-2 antibody levels. Methods: In this observational study we included 2294 participants from June 9, 2020 to August 10, 2021. IgG SARS-CoV-2 antibodies from all participants (275 PLWH, 42 with active tuberculosis and 1977 healthcare workers) were measured. Prevalence of COVID-19 and antibodies indexes were compared across groups. Results: We detected a higher prevalence of COVID-19 in patients with active tuberculosis (42.9%) than in PLWH (22.5%) or HCW (11.7%). Previously vaccinated participants with a COVID-19 history had median higher IgG antibody indexes (8.2; IQR: 5.5–10) than those vaccinated who did not have COVID-19 until the time of this study (4.1; IQR: 1.6–6.2, p < 0.001). Conclusion: Prevalence of previous SARS-CoV-2 infection was higher among tuberculosis patients than that found in HCW and PLWH, but antibodies levels were similar across groups. Introduction COVID19 COVID 19 COVID-1 groups SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Objectives HIVAIDS HIV AIDS (PLWH Salvador Brazil Hospitals Hospital s HCW, , (HCW) Methods 229 9 202 10 2021 275 (27 4 197 workers measured Results 42.9% 429 (42.9% 22.5% 225 22 5 (22.5% 11.7%. 117 11.7% . 11 7 (11.7%) 8.2 82 8 (8.2 IQR 5.5–10 5510 4.1 41 1 (4.1 1662 6 1.6–6.2 0.001. 0001 0.001 0 001 0.001) Conclusion COVID1 COVID- SARS-CoV (HCW 20 27 (2 42.9 (42.9 22.5 (22.5 11.7 (11.7% 8. (8. 5.5–1 551 4. (4. 166 1.6–6. 000 0.00 00 ( 42. (42. 22. (22. 11. (11.7 (8 5.5– 55 (4 16 1.6–6 0.0 (42 (22 (11. 5.5 1.6– 0. (11 5. 1.6 (1 1.

https://doi.org/10.1016/j.bjid.2023.102811

Validation of the RAND 36-Item Health Survey questionnaire in Brazil
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LINS-KUSTERER, Liliane

; AGUIAR, Inácio

; SANTOS-LINS, Larissa Souza

; LINS-ROCHA, Matheus

; AGUIAR, Carolina Villa Nova

; MENEZES, Marta Silva

; SAMPAIO, Aline Santos

; QUARANTINI, Lucas C

; COTRIM, Helma P

; BRITES, Carlos

Arquivos de Gastroenterologia

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jun 2022, Volume 59 N. 2 Pages 193 - 197

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

RESUMO Contexto: A qualidade de vida relacionada à saúde é frequentemente usada como uma medida de resultado que melhora a qualidade da atenção à saúde. O SF-36 e o RAND-36 foram derivados do Medical Outcomes Study. Objetivo O presente estudo teve como objetivo validar o RAND-36 no Brasil, em indivíduos saudáveis e pacientes com doença hepática. Métodos: A análise fatorial confirmatória (AFC) foi realizada usando o software JASP. Os parâmetros do elemento foram estimados usando o método Robust Diagonally Weighted Least Squares (RDWLS). O índice de ajuste comparativo (CFI), o índice de adequação (GFI), o índice de Tucker-Lewis (TLI) e o erro quadrático médio de aproximação (RMSEA) foram avaliados. A consistência interna foi medida pelo índice de confiabilidade composta. A validade convergente foi realizada entre os domínios do RAND-36 e o Índice de Capacidade para o Trabalho (ICT). Resultados : Este estudo de validação incluiu 763 indivíduos, 400 (52,4%) com doença hepática crônica. As doenças hepáticas mais prevalentes foram hepatite C (13,9%), doença alcoólica do fígado (11,8%) e esteatose (12,1%). O modelo de medida testado com a AFC obteve os seguintes indicadores de ajuste: X2 (gl): 599,65 (498); CFI: 0,998; GFI: 0,998; TLI: 0,998; RMSEA: 0,016 (90%CI: 0,011-0,021). A validade convergente do RAND-36 e do ICT total variou de média a grande correlação. Conclusão: O RAND-36 é eficaz para medir a percepção da qualidade de vida relacionada à saúde em indivíduos com e sem doença hepática crônica. Os resultados do nosso estudo apoiam as afirmações dos desenvolvedores sobre a confiabilidade do RAND-36 versão 1 como uma medida de qualidade de vida relacionada à saúde. A evidência para a validade do construto do RAND-36 foi substancial.

ABSTRACT Background: Health-related quality of life is frequently used as an outcome measure that improves the quality of care. The SF-36 and RAND-36 were derived from the Medical Outcomes Study. Objective The present study aimed to validate the RAND-36 in Brazil, in healthy individuals and patients with liver disease. Methods: Confirmatory factor analysis (CFA) was conducted by using JASP Software. The parameters of the items were estimated using the Robust Diagonally Weighted Least Squares (RDWLS) approach. Comparative fit index (CFI), Goodness-of-fit index (GFI), Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA) were evaluated. Internal consistency was measured using the Composite reliability index. Convergent validity between RAND-36 domains and Work Ability Index (WAI) was conducted. Results: This validation study included 763 individuals, 400 (52.4%) with chronic liver disease. The most prevalent liver diseases were hepatitis C (13.9%), alcoholic liver disease (11.8%), and steatosis (12.1%). The measurement model tested using the CFA obtained the following adjustment indicators: X2 (df): 599.65 (498); CFI: 0.998; GFI: 0.998; TLI: 0.998; RMSEA: 0.016 (90%CI: 0.011-.021). Convergent validity of RAND-36 and total WAI ranged from medium to large correlation. Conclusion: The RAND-36 is effective in measuring the perception of health-related quality of life in individuals with and without chronic liver disease. The results of our study support the developer’s claims for the reliability of the RAND-36 version 1 as a measure of health-related quality of life. The evidence for the construct validity of the RAND-36 was substantial.

https://doi.org/10.1590/s0004-2803.202202000-36

Work ability and associated factors in people living with human T-cell leukemia virus type 1
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Costa, Dayana Alves

; Carvalho, Fernando Martins

; Vieira, Nicolle Melo

; Falcão, Gleicy Gabriela Spínola Carneiro

; Sarmento, Viviane Almeida

; Brites, Carlos

; Lins-Kusterer, Liliane

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0111-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an estimated 10-15 million people worldwide. However, knowledge of the impact of HTLV-1 infection on work ability is lacking. This study aimed to measure the frequency and identify factors associated with poor work ability in patients living with HTLV-1. Methods: This cross-sectional study included 207 individuals infected with HTLV-1 who attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1 antibodies were detected in the participants’ blood by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blotting. Participants answered a questionnaire on sociodemographic data, personal habits, clinical data, health-related quality of life, and work ability, evaluated using the work ability index questionnaire. A Poisson regression model with a robust variance estimate was used to identify the factors associated with the prevalence of poor work ability. Results: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females, 100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual was classified as having excellent work ability. Poor work ability prevalence was strongly associated (prevalence ratio; 95% confidence interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms (1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98; 0.97-0.99) component summaries of health-related quality of life. Conclusions: Poor work ability among people living with HTLV-1 is associated with sedentarism, neurologic symptoms, and low health-related quality of life.

https://doi.org/10.1590/0037-8682-0111-2022

Science and environmental policy establishment: the case of the Forest Act in the State of São Paulo, Brazil
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Mello, Kaline de

; Brites, Alice

; Borges-Matos, Clarice

; Tavares, Paulo André

; Metzger, Jean Paul

; Rodrigues, Ricardo Ribeiro

; Santos, Zenilda Ledo dos

; Joly, Carlos Alfredo

; Sparovek, Gerd

Biota Neotropica

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2022, Volume 22 N. spe elocation e20211373

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

Resumo Os ecossistemas naturais estão sob grave ameaça em todo o mundo e as políticas ambientais são essenciais para minimizar os impactos presentes e futuros na biodiversidade, nos serviços ecossistêmicos e nas mudanças climáticas. O Novo Código Florestal no Brasil é a principal política de proteção da vegetação nativa em terras privadas, que compreende 54% da vegetação nativa remanescente brasileira. No entanto, os conflitos entre as preocupações ambientais e agrícolas na sua implementação exigem soluções equilibradas e baseadas em evidências científicas. Para enfrentar o desafio de aplicar a ciência no estabelecimento de políticas ambientais, desenvolvemos um projeto científico financiado pela Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) para apoiar a implementação do Novo Código Florestal no Estado de São Paulo, como parte do Programa Biota/FAPESP. O projeto foi conduzido de forma diferente de um projeto de pesquisa regular: o objetivo amplo foi fornecer suporte científico para a implementação do Novo Código Florestal pelo Estado, a partir de uma interação participativa entre as partes interessadas para construir objetivos específicos, métodos e discussão de resultados, dentro de uma equipe de pesquisa interdisciplinar e intersetorial. Aqui, apresentamos as lições aprendidas durante e após os quatro anos de desenvolvimento do projeto de pesquisa para avaliar como o conhecimento científico pode ser produzido e adotado na implementação de uma política ambiental específica. Apresentamos os principais resultados e os desafios enfrentados na tentativa de incluir dados científicos no processo decisório. Apresentamos também desafios atuais e futuros na implementação do Novo Código Florestal que podem ser resolvidos com evidências científicas. As lições aprendidas mostraram que mesmo concebendo o projeto de forma a atender as necessidades de apoio à implementação da política ambiental, evitando dificuldades normalmente apontadas por projetos semelhantes, houve uma grande dificuldade para que contribuições científicas fossem adotadas no processo decisório. A maioria das informações e conselhos científicos, mesmo após discussão e entendimento comum entre um grupo diversificado de partes interessadas, foi ignorada nas fases finais de tomada de decisão.

Abstract Natural ecosystems are under severe threat worldwide and environmental policies are essential to minimize present and future impacts on biodiversity, ecosystem services and climate change. The New Forest Act in Brazil is the main policy to protect native vegetation in private lands, which comprise 54% of the remaining Brazilian native vegetation. However, conflicts between environmental and agricultural concerns in its implementation demand for balanced solutions based on scientific evidence. To face the challenge of applying science in environmental policy establishment, we developed a scientific project funded by the São Paulo State Research Foundation (FAPESP) to support the implementation of the New Forest Act in São Paulo State, as part of the Biota/FAPESP Program. The project was conducted differently from a regular research project: the broad objective was to provide scientific support to the State’s implementation of the New Forest Act, based on a participatory interaction among stakeholders to build specific objectives, methods, and discussion of results, within an interdisciplinary and intersectoral research team. Here, we present the lessons learned during and after the four years of the research project development to evaluate how scientific knowledge can be produced and adopted in the implementation of a specific environmental policy. We present the main outcomes and the challenges faced in trying to include scientific data in the decision-making process. We also present current and future challenges in the New Forest Act implementation that could be solved with scientific evidence. The lessons learned showed that even designing the project in order to meet the needs to support the implementation of the environmental policy, avoiding difficulties normally pointed out by similar projects, there was a great difficulty for scientific contributions to be adopted in the decision-making process. Most of the scientific information and advice, even after discussion and common understanding among a diverse stakeholder group, were ignored or over-ruled in the final decision-making phases.

https://doi.org/10.1590/1676-0611-bn-2022-1373

Tracing the relationship among HIV-1 sub-subtype F1 strains: a phylodynamic perspective HIV1 HIV 1 HIV- subsubtype sub subtype F strains
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Silva, Gabriela Porto Santos Almeida

; Oliveira, Rodrigo Cunha

; de Souza, Juliana Sacramento Mota

; Giovanetti, Marta

; Guimarães, Monick Lindenmeyer

; Brites, Carlos

; Monteiro-Cunha, Joana Paixão

Memórias do Instituto Oswaldo Cruz

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2022, Volume 117 elocation e220109

Abstract: En | Text: En | PDF: En

BACKGROUND The human immunodeficiency virus type 1, F1 sub-subtype (HIV-1 F1) circulates in three continents: Africa, Europe, and South America. In Brazil, this sub-subtype co-circulates with subtypes B and C and several recombinant forms, mainly BF1 variants. OBJECTIVES This study aimed to reconstruct the dynamic history of HIV-1 F1 in Brazil. METHODS HIV-1 near full-length genome and pol gene nucleotide sequences available in public databases were assembled in two datasets (POL671 and NFLG53) to cover the largest number of F1 sub-subtype sequences. Phylodynamic and temporal analyses were performed. FINDINGS Two main strains of the F1 sub-subtype are circulating worldwide. The first (F1.I) was found among Brazilian samples (75%) and the second (F1.II) among Romanian (62%) and other European and African isolates. The F1 subtype epidemic in Brazil originated from a single entry into the country around 1970. This ancestral sample is related to samples isolated in European countries (France, Finland, and Belgium), which are possibly of African origin. Moreover, further migration (1998 CI: 1994-2003) of strains from Brazil to Europe (Spain and the UK) was observed. Interestingly, all different recombinant BF patterns found, even those from outside Brazil, present the same F1 lineage (F1.I) as an ancestor, which could be related to the acquisition of adaptive advantages for the recombinant progenies. MAIN CONCLUSIONS These findings are important for the understanding of the origin and dynamics of the F1 sub-subtype and a consequent better and greater understanding of the HIV-1 F1 and BF epidemic that still spreads from Brazil to other countries. 1 F subsubtype sub HIV1 HIV (HIV- continents Africa America cocirculates co forms variants HIV- fulllength full length POL671 POL (POL67 NFLG53 NFLG performed worldwide F1.I F1I FI I (F1.I 75% 75 (75% F1.II F1II FII II (F1.II 62% 62 (62% isolates 1970 France, France (France Finland Belgium, Belgium , Belgium) Moreover 1998 (199 CI 19942003 1994 2003 1994-2003 Spain UK observed Interestingly ancestor progenies (HIV POL67 (POL6 NFLG5 7 (75 6 (62 197 199 (19 1994200 200 1994-200 POL6 (POL (7 (6 19 (1 199420 20 1994-20 ( 19942 2 1994-2 1994-

https://doi.org/10.1590/0074-02760220109

10.

Mortality in hospitalized HIV-infected patients in a referral center in Bahia, Brazil HIVinfected HIV infected Bahia
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Nascimento, Luca

; Improta-Caria, Alex Cleber

; Brites, Carlos

Brazilian Journal of Infectious Diseases

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2022, Volume 26 N. 6 elocation 102716

Abstract: En | Text: En | PDF: En

ABSTRACT The number of people living with HIV / AIDS in the world has increased and, in Salvador, Brazil, the mortality rate is above the state and national rates. This study sought to describe the characteristics of HIV patients who died in a referral hospital. This is a retrospective cohort study between 2012 and 2017 conducted at the, Federal University of Bahia's Hospital, involving patients who died during hospitalization. There were 62 deaths among the 461 hospitalized patients with a predominance of males, blacks, and residents of Salvador. Mean age was 41.4 years. Most patients had at least one associated infection and 13% had a malignant neoplasm. The main reported cause of death was septic shock / HIV-associated infections. About 6.4% had an undetectable viral load and in-hospital survival was longer in this group. The lowest in-hospital survival was seen in patients presenting with pneumonia. Although the HIV / AIDS mortality rate at this center reflects the complexity of the country’s epidemiological scenario poor adherence and therapeutic failure play a key role in the risk of death. Salvador Brazil rates hospital 201 Bahias Bahia s Hospital hospitalization 6 46 males blacks 414 41 4 41. years 13 neoplasm HIVassociated infections 64 6.4 inhospital group pneumonia countrys country 20 1 6. 2

https://doi.org/10.1016/j.bjid.2022.102716

11.

SARS-CoV-2 Incidence, signs and symptoms and main risk factors for COVID-19 infection in Health Care Workers: A hospital-wide survey in Salvador, Brazil
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Montaño-Castellón, Iris

; Lins-Kusterer, Liliane

; Luz, Estela

; Pedroso, Celia

; Paz, Márcia

; Brites, Carlos

Brazilian Journal of Infectious Diseases

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2022, Volume 26 N. 4 elocation 102387

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Brazil is the third country most affected by Coronavirus Disease 2019 (COVID-19) in the world. Health care workers (HCWs) are at higher risk of infection. Despite the increasing numbers of studies on the topic, There are gaps in the knowledge of characteristics and risk factors for infection of HCWS. This information is important to design preventive strategies and to mitigate the disease impact. The objective of this study was to estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, to identify factors associated, and to describe symptoms reported by healthcare workers at a tertiary hospital in Salvador, Brazil. Methods: All HCWs were evaluated in a cross-sectional study conducted between May and September 2020, using self-administered questionnaires, and screening all participants for SARS-COV-2 IgG and IgM antibodies by rapid tests. Reactive IgG samples were retested by ELISA and IgM-positive test had a saliva sample retest by RT-PCR. Univariate associations were estimated by a non-adjusted incidence proportion ratio. Variables associated with COVID-19 incidence at p < 0.20 were selected for inclusion in a binary logistic regression model. Results: A total of 2083 HCWs were included, mean age 41±10 years, 71.8% women, and 77.8% non-white. Of these, 271 (13.0%) and 25 (1.2%) HCWs tested positive for IgG and IgM SARS-CoV-2 antibodies, respectively, and three had a positive RT-PCR. Ancillary work [Odds Ratio (OR): 4.96], elementary education (OR: 2.91), high school education (OR: 2.89), and catholic religion (OR: 2.16) were associated with an increased likelihood of a positive IgG antibodies against SARS-CoV-2. Anosmia [Incidence Proportion Ratio (IPR): 7.41] and ageusia (IPR:8.51) were the most frequent associated symptoms. Conclusion: HCWs with low mean family income, lower level of schooling, ancillary workor being black had a significantly higher likelihood of testing positive for SARS-CoV-2 antibodies. Social vulnerability was an important risk factor for COVID-19 infection.

https://doi.org/10.1016/j.bjid.2022.102387

12.

Consenso de manejo del paciente con diabetes mellitus y patología cardiovascular. Sociedad Argentina de Cardiología (SAC)-Sociedad Argentina de Diabetes (SAD)
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Giorgi, Mariano Aníbal

; Litwak, León E.

; Sanabria, Hugo

; Lavalle Cobo, Augusto

; Musso, Carla

; Salmeri, Emiliano

; Álvarez, José

; Aranguren, Florencia

; Belcastro, Fernando

; Brites, Fernando

; Buso, Carlos

; Calvagno, Marta

; Caroli, Christian

; Celano, Leonardo

; Cohen Arazi, Hernán

; Comtesse, Daniel

; Corral, Pablo

; Costabel, Juan Pablo

; Elbert, Alicia

; Faingold, Cristina

; Fuente, Graciela

; García Merletti, Pablo

; Giorgi, Mariano Aníbal

; Giunta, Gustavo

; Gómez Santamaría, Héctor

; González Naya, Enrique

; Hadid, Claudio

; Kraselnik, Ariel

; Lavalle Cobo, Augusto

; Litwak, León

; Lobo, Martín

; Lozada, Alfredo

; Majul, Claudio

; Masson, Walter

; Musso, Carla

; Nogueira, Juan

; Persi, Gabriel

; Rodríguez, Martín

; Salmeri, Emiliano

; Sanabria, Hugo

; Schraier, Silvio

; Sinay, Isaac

; Siniawski, Daniel

; Thierer, Jorge

; Salzberg, Susana

; Suárez Cordo, Cristian

; Lerman, Jorge

; Sosa Liprandi, Álvaro

Revista de la Sociedad Argentina de Diabetes

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mar 2021, Volume 55 Suppl. 1 Pages 3 - 70

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

resumen está disponible en el texto completo

Abstract This Consensus comes to light in the midst of one of the worst global health crises in the last 100 years. SARS-CoV-2 and its clinical manifestation, COVID-19, have caused a disruption in how doctors and patients interact. Although it is an infectious disease, one of the most notable characteristics is that its mortality increases in patients with chronic non-communicable diseases and, in particular, with a history of diabetes and cardiovascular disease. In this context, then, we believe that the recommendations made in this document, which aim to identify and protect these patients, become more relevant, while the implementation, beyond the statements, of specific cardiometabolic prevention policies becomes a priority. Methodology: this consensus is the result of the will of two Scientific Societies that have recognized the need to complement the focus on the same problem: that of patients with diabetes mellitus (DM) and cardiovascular disease (CVD), or who are at risk to suffer it. Both the Argentine Society of Cardiology (SAC) and the Argentine Society of Diabetes (SAD) have a recognized track record in the production of practice guidelines and consensus documents, although each has different work practices and cultures. Consequently, the first task that was faced was to agree, not only on the agenda and the approach to the different issues, but also on common working methods: general objective of the document, how to analyze and evalua-te the weight of the information, define the levels of evidence and determine the degrees of recommendation. It was agreed to adopt the modality used by the SAC in all the documents produced by the Consensus and Standards Area, set out in the following table: The experts who collaborated in the drafting of the Consensus were selected and invited to participate with the unanimous agreement of the group of Directors and Secretaries belonging to both Scientific Societies. Colleagues with recognized experience in the disciplines addressed were summoned to analyze the evidence and write the recommendations. All the methodological aspects and the final recommendations of this document were defined by agreement between the group of Directors and Consensus Secretaries.The information consolidation process was slow: from the decision of both companies until the writing of this document, the field of DM and CVD management underwent profound transformations that transcend the appearance of new therapeutic agents. What has been developed is a new approach model that is, in the words of Dr. Alicia Elbert, transdisciplinary. This has implied waiting and being able to understand and "process" all the information that has emerged in these years. This document, which aims to assist physicians in daily practice, has tried to adopt this new integrative perspective.

13.

Validation of the GeneXpert Xpress SARS-CoV-2 PCR assay using saliva as biological specimen
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Vaz, Sara Nunes

; Santana, Daniele Souza de

; Martins Netto, Eduardo

; Wang, Wei-Kung

; Brites, Carlos

Brazilian Journal of Infectious Diseases

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2021, Volume 25 N. 2 elocation 101543

Abstract: En | Text: En | PDF: En

ABSTRACT In the pandemic, rapid and accurate detection of SARS-CoV-2 is crucial in controlling the outbreak. Recent studies have shown a high detection rate using saliva/oral fluids as specimens for laboratory detection of the virus. We intended to evaluate the test performance of the Xpert Xpress SARS-CoV-2 cartridge assay in comparison to a conventional qRT-PCR testing, using saliva as biological specimen. Forty saliva samples from symptomatic participants were collected. Conventional qRT-PCR was performed for amplification of E and RdRp genes and the Xpert Xpress SARS-CoV-2 assay amplified E and N2 genes. In the conventional assay, the median cycle threshold value of the E gene was 34.9, and of the RdRp gene was 38.3. In the Xpert Xpress assay, the median cycle threshold value of the E gene was 29.7, and of the N2 gene was 31.6. These results can allow a broaden use of molecular tests for management of COVID-19 pandemic, especially in resources-limited settings.

https://doi.org/10.1016/j.bjid.2021.101543 112 downloads

14.

Characterization and genetic diversity of Coffea canephora accessions in a germplasm bank in Espírito Santo, Brazil
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Ferrão, Maria Amélia Gava

; Mendonça, Rodolfo Ferreira de

; Fonseca, Aymbiré Francisco Almeida

; Ferrão, Romário Gava

; Senra, João Felipe Brites

; Volpi, Paulo Sérgio

; Verdin Filho, Abraão Carlos

; Comério, Marcone

Crop Breeding and Applied Biotechnology

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2021, Volume 21 N. 2 elocation e36132123

Abstract: En | Text: En | PDF: En

Abstract: The state of Espírito Santo is the major producer of Coffea canephora in Brazil. Knowledge of genetic reserves is fundamental to plant breeding. Therefore, the present study characterized and analyzed the genetic diversity of 600 C. canephora accessions from the germplasm bank of Incaper based on 38 traits evaluated in 24-30-month-old plants. Further, the predominant descriptors or traits were identified, and high phenotypic variability was determined. Genetic distances for the grouped (Gower), quantitative, and qualitative datasets were 0.48, 0.61, and 0.92, respectively, with accessions 76 (Conilon) and 407 (Robusta) being the most divergent ones at Incaper. In clustering using the Tocher optimization method, 30 groups were formed, with three accessions introduced from Epamig’s Robusta collection being the most dissimilar ones. Graphical dispersion analysis using the principal coordinate method revealed the predominance of three groups formed by the Robusta, Conilon, and hybrid Robusta × Conilon genotypes.

https://doi.org/10.1590/1984-70332021v21n2a32 42 downloads

15.

Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response
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Pedroso, Célia

; Vaz, Sara

; Martins Netto, Eduardo

; Souza, Daniele

; Deminco, Felice

; Mayoral, Rafaela

; Menezes, Eliana

; Cunha, Ana Patricia Amancio da

; Moreira-Soto, Andres

; Drexler, Jan Felix

; Brites, Carlos

Brazilian Journal of Infectious Diseases

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2021, Volume 25 N. 4 elocation 101603

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Over-the-counter use of ivermectin amongst other drugs as SARS-CoV-2 treatment has been increasingly common, despite the lack of evidence on its clinical efficacy. Objective: To evaluate the effect of ivermectin use on production of antibodies against SARS-CoV-2 in health care workers (HCW) diagnosed with COVID-19 and of Th1/Th2 cytokines by stimulated peripheral blood mononuclear cells of the same cohort (PBMCs). Methods: This cross-sectional study evaluated seroconversion and neutralizing antibodies production in HCW at Complexo Hospitalar Universitário Professor Edgard Santos (Salvador, Brazil), diagnosed with COVID-19 from May to July, 2020, as well as in vitro production of antibody against SARS-CoV-2 and Th1/Th2 cytokines. Analyses were performed between December 2020 and February 2021. Participants were stratified according to the use of ivermectin (≤ 1 dose vs. multiple doses) for treatment of COVID-19. Results: 45 HCW were included (62% women). Mean age was 39 years, and disease severity was similar across groups. Neutralizing antibodies were detected less frequently in multiple doses (70%) vs. ≤ 1 dose (97%) groups, p = 0.02). PBMCs of patients in multiple doses group also were less likely to produce antibodies against SARS-CoV-2 following in vitro stimulation with purified spike protein in comparison with patients in ≤ 1 dose group (p < 0.001). PBMC’s production of Th1/Th2 cytokines levels was similar across groups. Abdominal pain (15% vs 46%, p = 0.04), diarrhea (21% vs. 55%, p = 0.05) and taste perversion (0% vs. 18%, p = 0.05) were more frequently reported by participants that used multiple doses of ivermectin. Conclusions: Although there was no evidence for differential disease severity upon ivermectin use for treatment of COVID-19 it was associated with more gastro-intestinal side-effects and impairment of anti-SARS-CoV2 antibodies production, in a dose dependent manner. This potentially impacts the effectiveness of immune response and the risk of reinfection and warrants additional studies for clarifying the mechanisms and consequences of such immunomodulatory effects.

https://doi.org/10.1016/j.bjid.2021.101603 81 downloads

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