ABSTRACT Fingolimod is a sphingosine-1-phosphate receptor modulator used to treat multiple sclerosis. While fingolimod has been associated with an increased risk of cryptococcal meningitis, its correlation with other deep mycoses remains unclear. In this study, we conducted a scoping review of fingolimod associated with histoplasmosis, based on a case report, a literature review, and data from the FDA Adverse Events Reporting System (FAERS) as of January 24th, 2023. A 30-year-old Brazilian woman diagnosed with relapsing-remitting multiple sclerosis, receiving a daily dose of 0.5 mg of fingolimod, presented with a two-month history of fever and unintended weight loss, accompanied by lymphadenopathy, splenomegaly, and lung involvement was investigated. Biopsy of a lung nodule revealed fungal structures suggestive of Histoplasma sp. Additionally, serological testing yielded positive for Histoplasma capsulatum. Disseminated histoplasmosis should be considered in the differential diagnosis of febrile syndromes in patients undergoing fingolimod therapy for multiple sclerosis, particularly in the Americas, where this mycosis is endemic. Treatment with itraconazole and modification of immunotherapy can achieve excellent clinical outcomes. sphingosine1phosphate sphingosinephosphate sphingosine 1 phosphate sclerosis meningitis unclear study report FAERS (FAERS 24th th 2023 30yearold yearold 30 year old relapsingremitting relapsing remitting 05 0 5 0. twomonth two month loss lymphadenopathy splenomegaly investigated sp Additionally capsulatum Americas endemic outcomes 202 3 20 2

Resumen Estudio histórico-social que describe el trabajo de reclutamiento, formación y supervisión de parteras y mujeres curiosas desarrollado por la Fundación Servicio Especial de Salud Pública (FSESP) en Alagoas en el período de 1960 a 1990 y analiza el saber y la práctica de estas parteras y mujeres curiosas. Se utilizaron fuentes documentales y orales, producidas en entrevistas realizadas a partir de la historia oral temática, otorgado por dos visitadores de salud, seis parteras, tres mujeres curiosas, un médico y una enfermera. Los resultados mostraron que parteras y mujeres curiosas fueron reclutadas y capacitadas por los visitadores de salud. Cuando pudieron ayudar en el parto, recibieron una bolsa con materiales y fueron acompañados por visitadores de salud o enfermeras para limpiar la bolsa y renovar las instrucciones. Se analizó la actuación de parteras/ mujeres curiosas a partir del referencial teórico de Marie Françoise Collière, revelando que brindaron cuidados basados en conocimientos y prácticas adquiridas a través de la experiencia, buscando asegurar la continuidad de la vida. Se concluyó que la FSESP era un importante servicio de salud en Alagoas por sus actividades de educación en salud, revisión, cuidado y atención a parturientas y recién nacidos, y también evidenció prácticas que han sido mejoradas a lo largo de los años.

Résumé Cette étude historique-sociale décrit le travail de recrutement, formation et contrôle de sages-femmes curieuses développée par la Fondation Service Spécial de Santé Publique (FSESP) en Algoas entre 1960 et 1990. On analyse aussi le savoir et la pratique de ces sages-femmes, en consultant des sources documentaires et orales, ainsi que des entretiens faites à deux agents de santé, six sages-femmes, trois femmes curieuses, un médecin et une infirmière. Les résultats ont montré les sages-femmes et les femmes curieuses ont été recrutées et formées par les agents de santé. Lorsqu'elles ont pu aider dans les accouchements, elles ont reçu des instruments pour participer de cet événement. Finalement, on a analysé le rôle des sages-femmes à partir des théories de Marie Françoise Collière, lesquelles théories ont permis de montrer que ces femmes ont mis en place des connaissances basées sur l'expérience afin de garantir la continuité de la vie. On conclut que la FSESP était un important service de santé en Alagoas de par ses activités d'éducation en santé, soins et attention aux parturientes et nouveaux nés, des pratiques améliorés au fil des années.

Abstract Carried out by the Fundación Servicio Especial en Salud Pública (FSESP) in Algoas between 1960 and 1990, this is a socio-historical study that describes the work of recruiting, training and supervising midwives and curious women. Both written and oral sources were used, produced in interviews from oral thematic history. The participants were two health visitors, six midwives, three curious women, a doctor, and a nurse. The results showed that the midwives and curious women were recruited and trained by the health visitors. When they could assist a birth, they received a bag with materials and were accompanied by the health visitors or nurses to clean the bags and renew the instructions. The actions of the midwives /curious women were analyzed from the referential theory of Marie Françoise Collière, which revealed that they provided care to patients based on knowledge and practices acquired through experience, seeking to secure the continuity of life. It was concluded that the FSESP was an important health service in Alagoas due to its activities in health education, revision, care and treatment of women in labor and newborns. Additionally, practices that have been improved throughout the years were found.

Resumo Estudo histórico-social que descreve o trabalho de recrutamento, treinamento e supervisão das parteiras e curiosas desenvolvido pela Fundação Serviço de Saúde Pública (FSESP) em Alagoas no recorte temporal de 1960 a 1990 e analisa o saber e o fazer destas parteiras e curiosas. Foram utilizadas fontes documentais e orais, estas produzidas em entrevistas realizadas com recurso da história oral temática, concedidas por duas visitadoras sanitárias, seis parteiras, três curiosas, um médico e uma enfermeira. Os resultados evidenciaram que as parteiras e curiosas eram recrutadas por visitadoras sanitárias para serem treinadas. Quando estavam aptas para partejar, recebiam uma bolsa com materiais e eram supervisionadas pelas visitadoras ou enfermeiras a fim de realizar a limpeza da bolsa e renovar as instruções. A atuação das parteiras/curiosas fora analisada com base no referencial teórico de Marie Françoise Collière, revelando que as mesmas prestavam cuidados a partir de saberes e fazeres adquiridos pela experiência buscando assegurar a continuidade da vida. Concluiu-se que a FSESP foi um importante serviço de saúde em Alagoas tendo em vista suas atividades de educação em saúde, reciclagem, atenção e cuidado às parturientes e recém-nascidos, além de revelar práticas que foram sendo aperfeiçoadas ao longo dos anos.

O peso ao nascer constitui característica produtiva de elevada importância zootécnica, devido à sua relação com a taxa de sobrevivência à desmama e com os pesos nas demais fases de desenvolvimento do animal, quer seja para a produção de carne, leite ou em animais que se destinam à reprodução. O objetivo deste trabalho foi obter estimativas de herdabilidade e tendências fenotípicas e genéticas do peso ao nascer, em bubalinos do Estado do Pará, Brasil. Foram calculadas as estatísticas descritivas e realizado o teste de Normalidade de Shapiro-Wilk por meio do pacote estatístico Statistical Analisys System. As estimativas de herdabilidade foram obtidas por inferência Bayesiana. O peso ao nascer apresentou média de 36,6 kg. O modelo de análise considerou como fixos os efeitos de sexo, ano de nascimento e composição racial do animal e como efeitos aleatórios animal, efeito materno e residual. A distribuição da herdabilidade direta apresentou-se platicúrtica (achatada) e com maior assimetria, tendo uma distribuição bimodal com a primeira moda próxima a 0,10 e a segunda próxima a 0,30; a materna apresentou-se trimodal, com picos bem próximos a 0,15 e outro menos evidente próximo a 0,20. A tendência genética direta do peso ao nascer mostrou-se negativa (-0,03kg ano-1) e a tendência genética materna próxima à zero (0,001 kg ano-1), ainda que a tendência fenotípica tenha sido positiva (0,156kg ano-1). Existe variabilidade genética possível de ser trabalhada em um programa de melhoramento, no entanto, pouco foi feito quanto à seleção para crescimento em búfalos no Estado do Pará.

Birth weight is a performance parameter of great zootechnical importance for both meat and dairy production, as well as for breeding animals, mainly due to its relation to survival rate at weaning, and the weight of animals throughout their developmental and growth phases. Therefore, the objective of this work was to establish heritability estimates, as well as phenotypic and genetic trends of birth weight of water buffaloes from State of Pará, Brazil. Descriptive statistics were calculated and the Shapiro-Wilk Normality test was performed with a Statistical Analysis System package. Heritability estimates were established by Bayesian inference. BW was 36.6 kg in average. The statistical model considered sex, year of birth and breed composition of the animals as fixed effects, and animal, maternal and residual as random effects. Direct heritability was platykurtic (flattened) and with higher asymmetry, presenting a bimodal distribution with the first mode close to 0.10, and the second mode close to 0.30; the maternal heritability was trimodal, with peaks very close to 0.15, and another, less evident, close to 0.20. The direct genetic trend of birth weight was negative (-0.03kg year-1) and maternal genetic trend was close to zero (0.001kg ano-1), even though the phenotypic trend had been positive (0.156 kg year-1). There is genetic variability to be addressed in a breeding program, however, very little was done as far as selection for growth of water buffaloes in the State of Pará.

Domestic buffaloes are divided into two group based on cytogenetic characteristics and habitats: the "river buffaloes" with 2n = 50 and the "swamp buffaloes", 2n = 48. Nevertheless, their hybrids are viable, fertile and identified by a 2n = 49. In order to have a better characterization of these different cytotypes of buffaloes, and considering that NOR-bearing chromosomes are involved in the rearrangements responsible for the karyotypic differences, we applied silver staining (Ag-NOR) and performed fluorescent in situ hybridization (FISH) experiments using 18S rDNA as probe. Metaphases were obtained through blood lymphocyte culture of 21 individuals, including river, swamp and hybrid cytotypes. Ag-NOR staining revealed active NORs on six chromosome pairs (3p, 4p, 6, 21, 23, 24) in the river buffaloes, whereas the swamp buffaloes presented only five NOR-bearing pairs (4p, 6, 20, 22, 23). The F1 crossbreed had 11 chromosomes with active NORs, indicating expression of both parental chromosomes. FISH analysis confirmed the numerical divergence identified with Ag-NOR. This result is explained by the loss of the NOR located on chromosome 4p in the river buffalo, which is involved in the tandem fusion with chromosome 9 in this subspecies. A comparison with the ancestral cattle karyotype suggests that the NOR found on the 3p of the river buffalo may have originated from a duplication of ribosomal genes, resulting in the formation of new NOR sites in this subspecies.