ABSTRACT Introduction: Antiretroviral therapy increased the survival and life expectancy of People living With HIV (PWH). Frailty-related syndromes among older PWH (aged 50+ years) may affect their Health-related Quality of Life (HQoL). Additionally, the COVID-19 pandemic has impacted health-related outcomes. This study aimed to estimate the prevalence of frailty and pre-frailty among older PWH, and to explore associations of HQoL with the study assessment period and frailty status. Methods: Cross-sectional study conducted pre- (23-Mar-2019 to 5-Mar-2020) and post-COVID-19 pandemic onset (23-Jun-2021 to 5-May-2022), among older PWH at INI-Fiocruz, the largest cohort of PWH in Rio de Janeiro, Brazil. We measured frailty using Fried assessment, consisting of five domains: unintentional weight loss; self-reported exhaustion, weakness, slow walking speed, low physical activity. HQoL was assessed using the ACTG SF-21, which contains 21 questions divided into 8 domains. We used Chi-Square test, Fisher’s exact test, Kruskal-Wallis and ranksum test for comparisons. Results: We included 250 older PWH: 109 (43.6 %) pre- and 141 (56.4 %) post-COVID-19 pandemic onset. Median age was 60-years (IQR: 55‒64). Most self-identified as cisgender men 152 (60.8 %), Pardo/Black 146 (58.4 %), with completed secondary education or less 181 (72.7 %) and low income 132 (52.8 %). Overall, prevalence of frailty and pre-frailty were 9.2 % (95 % CI: 8.1‒10.3) and 61.6 % (95 % CI: 54.0‒69.2). Prevalence of frailty in the pre- and pos-COVID-19 pandemic periods were 7.3 % and 10.6 % (p = 0.66). HQoL scores were lower among participants with frailty compared to those with non-frailty and pre-frailty in all eight domains, and among those included in the post-COVID-19 compared to pre-COVID-19 period for four domains. Conclusions: We observed low prevalence of frailty, but high prevalence of pre-frailty among older PWH. Frailty status did not differ according to the COVID-19 assessment period. Assessment of frailty and HQoL should be incorporated in clinical practice for older PWH. Programs to reverse or prevent frailty should be implemented within the public health system. Introduction . (PWH) Frailtyrelated related aged 50 years Healthrelated Health HQoL. (HQoL) Additionally COVID19 COVID 19 COVID-1 healthrelated outcomes prefrailty pre Methods Crosssectional Cross sectional 23Mar2019 Mar 23 2019 (23-Mar-201 5Mar2020 5 2020 5-Mar-2020 postCOVID19 postCOVID post post-COVID-1 23Jun2021 Jun 2021 (23-Jun-202 5May2022, 5May2022 May 2022 , 5-May-2022) INIFiocruz, INIFiocruz INI Fiocruz, Fiocruz INI-Fiocruz Janeiro Brazil domains loss selfreported self reported exhaustion weakness speed activity SF21, SF21 SF 21, SF-21 2 ChiSquare Chi Square Fishers Fisher s KruskalWallis Kruskal Wallis comparisons Results 25 10 43.6 436 43 6 (43. 14 56.4 564 56 4 (56. 60years 60 IQR (IQR 55‒64. 5564 55‒64 55 64 55‒64) selfidentified identified 15 60.8 608 (60. %, PardoBlack Pardo Black 58.4 584 58 (58. 18 72.7 727 72 7 (72. 13 52.8 528 52 (52. %. Overall 92 9 9. 95 (9 CI 8.1‒10.3 81103 1 3 616 61 61. 54.0‒69.2. 540692 54.0‒69.2 54 0 69 54.0‒69.2) posCOVID19 posCOVID pos pos-COVID-1 73 7. 106 10. p 0.66. 066 0.66 66 0.66) nonfrailty non preCOVID19 preCOVID pre-COVID-1 Conclusions system (PWH (HQoL COVID1 COVID- 23Mar201 201 (23-Mar-20 5Mar202 202 5-Mar-202 postCOVID1 post-COVID- 23Jun202 (23-Jun-20 5May202 5-May-2022 SF2 SF-2 43. (43 56. (56 556 55‒6 60. (60 58. (58 72. (72 52. (52 ( 8.1‒10. 8110 54069 54.0‒69. posCOVID1 pos-COVID- 06 0.6 preCOVID1 pre-COVID- 23Mar20 20 (23-Mar-2 5Mar20 5-Mar-20 post-COVID 23Jun20 (23-Jun-2 5May20 5-May-202 SF- (4 (5 55‒ (6 (7 8.1‒10 811 5406 54.0‒69 pos-COVID 0. pre-COVID 23Mar2 (23-Mar- 5Mar2 5-Mar-2 23Jun2 (23-Jun- 5May2 5-May-20 8.1‒1 81 540 54.0‒6 23Mar (23-Mar 5Mar 5-Mar- 23Jun (23-Jun 5May 5-May-2 8.1‒ 54.0‒ 5-Mar 5-May- 8.1 54.0 5-May 8. 54.

Abstract Introduction In Brazil, though Antiretroviral Therapy (ART) is available to all, the benefits may not be experienced uniformly. We projected Life Expectancy (LE) for People Living with HIV (PLHIV) in care as currently observed and estimated the impact of guideline-concordant care. Methods Using a microsimulation model, we projected LE for a cohort of PLHIV and for four population groups: cisgender Men who have Sex with Men (MSM), cisgender Men who have Sex with Women (MSW), Cisgender Women (CGW), and Transgender Women (TGW). Cohort data from Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruz Foundation (INI/Fiocruz) informed model parameters. We modeled five scenarios: 1) Current care: ART initiation, adherence, and retention in care as currently observed, 2) Guideline-concordant care: immediate ART initiation, full adherence to treatment, and consistent retention in care, 3) Immediate ART initiation with observed adherence to treatment and retention in care, 4) Full adherence to treatment with observed timing of ART initiation and retention in care, and 5) Consistent retention in care with observed timing of ART initiation and adherence. Results With current care, LE from age 15 would be 45.9, 44.4, 54.2, and 42.3 years, for MSM, MSW, CGW, and TGW. With guideline-concordant care, LE would be 54.2, 54.4, 63.1, and 53.2 years, for MSM, MSW, CGW and TGW, with TGW experiencing the greatest potential increase in LE (10.9 years). When investigating the components of care separately, MSW and CGW would gain most LE with immediate ART initiation, whereas for MSM and TGW consistent retention in care would be most impactful. Conclusions In settings like INI/Fiocruz, MSW and CGW would benefit most from interventions focused on earlier diagnosis and linkage to care, whereas TGW and MSM would benefit from interventions to sustain engagement in care. Assessment of the HIV care continuum for specific populations should inform care priorities. Brazil (ART all uniformly (LE (PLHIV guidelineconcordant guideline concordant groups , (MSM) (MSW) (CGW) . (TGW) DiseasesOswaldo Diseases Oswaldo INI/Fiocruz INIFiocruz INI Fiocruz (INI/Fiocruz parameters scenarios 1 2 Guidelineconcordant Guideline 3 4 5 459 45 9 45.9 444 44 44.4 542 54 54.2 423 42 42. years 544 54.4 631 63 63.1 532 53 53. 10.9 109 10 (10. years. years) separately impactful priorities (MSM (MSW (CGW (TGW 45. 44. 54. 6 63. 10. (10 (1 (

ABSTRACT The Crop-Livestock Integration system has sustainable potential. But pests such as the defoliating caterpillar Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) can reduce the productivity of this system. The objective was to report transgenic maize and Brachiaria brizantha (A. Rich.) (Poaceae) plants attacked by S. frugiperda in the Crop-Livestock Integration system. Feroz VIP3 ® transgenic maize (SYN8A98 TLTG Viptera) and B. brizantha MG-5 Xaraés plants attacked by S. frugiperda were evaluated 20 days after planting, weekly and for 28 days. The transgenic maize plants were less attacked by S. frugiperda than those of B. brizantha. The negative impact of this pest on B. brizantha suggests the planning and adopting strategies for its control, such as the use of traps, resistant cultivars, and biological or chemical products, minimizing losses in animal production and, consequently, in human food. CropLivestock Crop Livestock potential J. J (J E Smith Lepidoptera (Lepidoptera Noctuidae A. A (A Rich. Rich Poaceae (Poaceae S VIP SYN8A98 SYNA SYN (SYN8A9 Viptera B MG5 MG 5 MG- 2 planting control traps cultivars products consequently food SYN8A9 (SYN8A SYN8A

ABSTRACT Monkeypox (MPX) transmission outside non-endemic countries has been reported since May 2022, rapidly evolving into a multi-country outbreak. A potential role of sexual contact in transmission dynamics, as well as a predominance of anogenitallesions, are remarkable features of current cases. Screening for sexually transmitted infections (STIs) plays an important role in the evaluation of patients with suspected MPX infection. Herein we report the first case of a patient diagnosed with both MPX and acute HIV infection in Latin America. He had no major complications during his clinical course, and antiretroviral therapy was promptly initiated. Diagnosis of acute HIV requires a high level of suspicion and appropriate laboratory investigation. Health practitioners need to consider this diagnosis while evaluating patients with suspected MPX with a recent unprotected sexual contact. (MPX nonendemic non endemic 2022 multicountry multi country outbreak dynamics anogenitallesions cases STIs (STIs America course initiated investigation 202 20 2

ABSTRACT Background: Antiretroviral therapy use has led to a decline in HIV-related mortality yet disparities by gender and/or sexual orientation may exist. In this study, we estimated hazards of death in people living with HIV (PLWH) according to gender and sexual orientation. Methods: We included PLWH ≥ 18 years enrolled between 2000 and 2018 at INI/Fiocruz, Rio de Janeiro, Brazil. Participants were grouped as cisgender or transgender women, cisgender men who have sex with men (MSM) or men who have sex with women, or cisgender men with unknown sexual orientation. We assessed disparities in the hazard of death using Cox proportional hazards models. Results: Among 5,576 PLWH, median age at enrollment was 35 years, 39% were MSM, 28% cisgender women, 23% men who have sex with women, 5% transgender women, and 5% men with unknown sexual orientation. A total of 795 deaths occurred in 39,141 person-years of follow-up. Mortality rates per 1,000 person-years were: 82.4 for men with unknown sexual orientation, 24.5 for men who have sex with women, 18.3 for cisgender, 16.6 for transgender women, and 15.1 for MSM. Compared to MSM, men with unknown sexual orientation had the highest death hazard ratio (adjusted hazard ratio [aHR] 2.93, 95% confidence interval [CI] 2.35–3.81), followed by men who have sex with women (aHR 1.17, 95%CI 0.96, 1.43); death hazard ratios for cisgender and transgender women were not statistically different. Conclusion: We observed disparities in the hazard of death for men with unknown sexual orientation and men who have sex with women despite universal access to antiretroviral therapy in Brazil. Future work should characterize and assist men with unknown sexual orientation with tailored policies and interventions. Increased hazard of death was not observed for transgender women, which probably results from interventions implemented in our service to reach, engage, retain, and support this population. Background HIVrelated related andor exist study (PLWH Methods 1 200 201 INIFiocruz INI Fiocruz INI/Fiocruz Janeiro Brazil MSM (MSM models Results 5576 5 576 5,57 3 39 28 23 79 39141 141 39,14 personyears person followup. followup follow up. up follow-up 1000 000 1,00 824 82 4 82. 245 24 24. 183 18. 166 16 6 16. 151 15 15. adjusted aHR [aHR 293 2 93 2.93 95 CI [CI 2.35–3.81, 235381 2.35–3.81 , 81 2.35–3.81) 117 17 1.17 95CI 096 0 96 0.96 1.43 143 43 1.43) different Conclusion reach engage retain population 20 557 57 5,5 7 3914 14 39,1 100 00 1,0 8 29 9 2.9 23538 2.35–3.8 11 1.1 09 0.9 1.4 55 5, 391 39, 10 1, 2. 2353 2.35–3. 1. 0. 235 2.35–3 2.35– 2.35 2.3

ABSTRACT Syndemic psychosocial and reproductive factors affecting women’s retention in HIV care remain understudied. We analyzed correlates of non-retention in a cohort of women with HIV in Brazil from 2000–2015. Participants self-reported exposure to physical/sexual violence, illicit drug use, adolescent pregnancy, or induced abortion. Lifetime history of these psychosocial stressors were used to create a syndemic score based on the presence or absence of these conditions. All dichotomous variables were summed (range 0 to 4), with greater scores indicating more syndemic factors experienced. Logistic regression models identified predictors of non-retention, defined as < 2 HIV viral load or CD4 results within the first year of enrollment. Of 915 women, non-retention was observed for 18%. Prevalence of syndemic factors was adolescent pregnancy (53.2%), physical/sexual violence (38.3%), induced abortion (27.3%), and illicit drug use (17.2%); 41.2% experienced > 2 syndemic conditions. Syndemic scores of 2 and 3 were associated with non-retention, as well as low education, years with HIV and seroprevalent syphilis. Psychosocial and reproductive syndemics can limit women’s retention in HIV care. Syphilis infection predicted non-retention and could be explored as a syndemic factor in future studies. womens s understudied nonretention non 20002015 2000 2015 2000–2015 selfreported self reported physicalsexual physical sexual conditions range 4, 4 , 4) nonretention, retention, CD enrollment 91 18 18% 53.2%, 532 53.2% 53 (53.2%) 38.3%, 383 38.3% 38 (38.3%) 27.3%, 273 27.3% 27 (27.3%) 17.2% 172 17 (17.2%) 412 41 41.2 education syphilis studies 2000201 200 201 2000–201 9 1 53.2 5 (53.2% 38.3 (38.3% 27.3 (27.3% 17.2 (17.2% 41. 200020 20 2000–20 53. (53.2 38. (38.3 27. (27.3 17. (17.2 20002 2000–2 (53. (38. (27. (17. 2000– (53 (38 (27 (17 (5 (3 (2 (1 (

Abstract Introduction Oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir (FTC/TDF) is highly effective in preventing HIV infection. This study aimed to identify factors associated with PrEP early loss to follow-up (ELFU) among gay, bisexual and other men who have sex with men (MSM), travestis and transgender women (TGW). Methodology This was a prospective cohort study evaluating TGW and MSM who initiated PrEP at the Evandro Chagas National Institute of Infectious Diseases (INI-Fiocruz) from 2014 to 2020. ELFU was defined as not returning for a PrEP visit within 180 days after first dispensation. Exposure variables included age, gender, race, education, transactional sex, condomless anal intercourse [CAI] (both in the past six months), binge drinking and substance use (both in past three months) and syphilis diagnosis at baseline. Multilevel logistic regression models with random intercepts and fixed slopes were used to identify factors associated with ELFU accounting for clustering of participants according to their PrEP initiation study/context (PrEP Brasil, PrEParadas, ImPrEP and PrEP SUS). Results Among 1,463 participants, the median age was 29 years (interquartile range 24-36), 83% self-identified as MSM, 17% as TGW, 24% were black, 37% mixed-black/pardo and 30% had < 12 years of education. Fifteen percent reported transactional sex, 59% reported CAI, 67% binge drinking, 33% substance use, and 15% had a syphilis diagnosis. Overall, 137 participants (9.7%) had ELFU. Younger age (18-24 years) (adjusted odds ratio [aOR] 1.9, 95%CI:1.2-3.2), TGW (aOR 2.8, 95%CI:1.6-4.8) and education < 12 years (aOR 1.9, 95%CI:1.2-2.9) were associated with greater odds of ELFU. Conclusion TGW, young individuals and those with lower education were at higher risk of PrEP ELFU. Our results suggest that the development of specific strategies targeting these populations should be a priority, through policies that aim to reduce the incidence of HIV infection. preexposure pre exposure emtricitabinetenofovir emtricitabine tenofovir FTC/TDF FTCTDF FTC TDF (FTC/TDF infection followup follow up (ELFU gay , (MSM) TGW. . (TGW) INIFiocruz INI Fiocruz (INI-Fiocruz 201 2020 18 dispensation gender race CAI [CAI both months, months baseline studycontext context Brasil PrEParadas SUS. SUS SUS) 1463 1 463 1,46 2 interquartile 2436, 2436 24 36 24-36) 83 selfidentified self identified 17 black 37 mixedblack/pardo mixedblackpardo mixed black/pardo pardo 30 59 67 33 15 Overall 13 9.7% 97 9 7 (9.7% 1824 (18-2 adjusted aOR [aOR 19 1.9 95%CI1.23.2, 95CI1232 CI 95%CI 1.2 3.2 95 3 95%CI:1.2-3.2) 28 8 2.8 95%CI1.64.8 95CI1648 1.6 4.8 6 4 95%CI:1.6-4.8 95%CI1.22.9 95CI1229 2.9 95%CI:1.2-2.9 priority (MSM (TGW 20 202 146 46 1,4 243 24-36 mixedblack blackpardo 5 9.7 (9.7 182 (18- 1. CI1 23 95%CI1.23.2 95CI123 95CI 32 3. 95%CI:1.2-3.2 2. 64 95%CI1.64. 95CI164 16 48 4. 95%CI:1.6-4. 22 95%CI1.22. 95CI122 95%CI:1.2-2. 14 1, 24-3 9. (9. (18 95%CI1.23. 95CI12 95%CI:1.2-3. 95%CI1.64 95CI16 95%CI:1.6-4 95%CI1.22 95%CI:1.2-2 24- (9 (1 95%CI1.23 95CI1 95%CI:1.2-3 95%CI1.6 95%CI:1.6- 95%CI1.2 95%CI:1.2- ( 95%CI1. 95%CI:1.6 95%CI:1.2 95%CI1 95%CI:1. 95%CI:1 95%CI:

ABSTRACT Background: An outbreak of acute hepatitis of unknown etiology in children was recently reported worldwide. We aimed to describe the burden of hospitalizations due to hepatitis of unknown etiology in children/adolescents in Brazilian public hospitals. Methods: We retrieved a database of all hospitalizations in the Brazilian Unified Health System (SUS) from January/2019 to February/2022 using the “microdatasus” R package. Hepatitis of unknown etiology was defined by the following International Classification of Diseases [ICD-10] codes: B19, B19.0, B19.9, K72.0, K72.9, K75, K75.9, R94.5, or R93.2. The incidence rates (95% confidence interval, IC) per 1,000 all-cause hospitalizations in different age strata [< 6 years; 6–11 years and 12–17 years] were estimated. Results: A total of 94,198 hospitalizations due to hepatic or infectious diseases with potential liver injury were analyzed. Of them, 1,535 children/adolescents [48.2% male sex, 41.6% aged < 6 years] were hospitalized with hepatitis with unknown etiology. The top ICD-10 codes were B19.9 [unspecified viral hepatitis without hepatic coma; 39.9% (n = 612)], K72.9 [hepatic failure, unspecified; 29.8% (n = 457)], and K72.0 [hepatic failure, not elsewhere classified; 14.5% (n = 223)]. A total of 8.5% (n = 131) of individuals required liver transplantation and 7.0% (n = 107) died during the hospital-stay. In 2021, the incidence rates (95% CI) of hospitalizations for hepatitis with unknown etiology were 7.80 (7.63–7.98), 17.96 (17.46–18.48) and 13.28 (12.95–13.62) per 1,000 all-cause hospitalizations in subjects aged < 6 years, 6–11 years and 12–17 years-old, respectively. Similarly, the incidence rates of hospitalization due to hepatitis with unknown etiology per 1,000 all-cause hospitalizations (CI95%) in January-February/2022 were 7.52 (7.11–7.94), 16.82 (15.68–18.03), and 13.96 (13.10–14.85) for children/adolescents with age < 6 years, 6–11 years, and 12–17 years, respectively. Conclusions: A non-negligible number of hospitalizations due to hepatitis with unknown etiology in children/adolescents was observed in the last years in Brazil. Up to 15% of those cases needed liver transplantation or died. Background worldwide childrenadolescents adolescents hospitals Methods SUS (SUS January2019 January 2019 January/201 February2022 February 2022 February/202 microdatasus “microdatasus package ICD10 ICD 10 [ICD-10 B19 B B190 0 B19.0 B199 9 K720 K K72 K729 K75 K759 K75.9 R945 R94 5 R94.5 R932 R93 2 R93.2 95% 95 (95 interval IC 1000 1 000 1,00 allcause cause [ 611 11 6–1 1217 12 17 12–1 estimated Results 94198 94 198 94,19 analyzed them 1535 535 1,53 48.2% 482 48 [48.2 sex 416 41 41.6 ICD-1 B19. unspecified coma 399 39 39.9 n 612, 612 , 612)] K72. failure 298 29 8 29.8 457, 457 457)] classified 145 14 14.5 223. 223 . 223)] 85 8.5 131 70 7 7.0 107 hospitalstay. hospitalstay hospital stay. stay hospital-stay 2021 CI 780 80 7.8 7.63–7.98, 763798 7.63–7.98 63 98 (7.63–7.98) 1796 96 17.9 17.46–18.48 17461848 46 18 (17.46–18.48 1328 13 28 13.2 12.95–13.62 12951362 62 (12.95–13.62 yearsold, yearsold old, old years-old respectively Similarly CI95% CI95 (CI95% JanuaryFebruary/2022 JanuaryFebruary2022 JanuaryFebruary January-February/202 752 52 7.5 7.11–7.94, 711794 7.11–7.94 (7.11–7.94) 1682 16 82 16.8 15.68–18.03, 15681803 15.68–18.03 15 68 03 (15.68–18.03) 1396 13.9 13.10–14.85 13101485 (13.10–14.85 Conclusions nonnegligible non negligible Brazil January201 201 January/20 February202 202 February/20 ICD1 [ICD-1 B1 K7 K75. R9 R94. R93. (9 100 00 1,0 61 6– 121 12– 9419 19 94,1 153 53 1,5 48.2 4 [48. 41. ICD- 3 39. 612) 29. 45 457) 14. 22 223) 8. 7. 78 76379 7.63–7.9 (7.63–7.98 179 17. 17.46–18.4 1746184 (17.46–18.4 132 13. 12.95–13.6 1295136 (12.95–13.6 CI9 (CI95 JanuaryFebruary/202 JanuaryFebruary202 January-February/20 75 71179 7.11–7.9 (7.11–7.94 168 16. 1568180 15.68–18.0 (15.68–18.03 139 13.10–14.8 1310148 (13.10–14.8 January20 20 January/2 February20 February/2 [ICD- ( 1, 941 94, 48. [48 7637 7.63–7. (7.63–7.9 17.46–18. 174618 (17.46–18. 12.95–13. 129513 (12.95–13. (CI9 JanuaryFebruary/20 JanuaryFebruary20 January-February/2 7117 7.11–7. (7.11–7.9 156818 15.68–18. (15.68–18.0 13.10–14. 131014 (13.10–14. January2 January/ February2 February/ [ICD [4 763 7.63–7 (7.63–7. 17.46–18 17461 (17.46–18 12.95–13 12951 (12.95–13 (CI JanuaryFebruary/2 JanuaryFebruary2 January-February/ 711 7.11–7 (7.11–7. 15681 15.68–18 (15.68–18. 13.10–14 13101 (13.10–14 76 7.63– (7.63–7 17.46–1 1746 (17.46–1 12.95–1 1295 (12.95–1 JanuaryFebruary/ January-February 71 7.11– (7.11–7 1568 15.68–1 (15.68–18 13.10–1 1310 (13.10–1 7.63 (7.63– 17.46– 174 (17.46– 12.95– 129 (12.95– 7.11 (7.11– 156 15.68– (15.68–1 13.10– (13.10– 7.6 (7.63 17.46 (17.46 12.95 (12.95 7.1 (7.11 15.68 (15.68– 13.10 (13.10 (7.6 17.4 (17.4 12.9 (12.9 (7.1 15.6 (15.68 13.1 (13.1 (7. (17. 12. (12. 15. (15.6 (13. (7 (17 (12 (15. (13 (1 (15

OBJETIVO: Analisar a viabilidade da testagem rápida para o HIV entre gestantes na admissão à maternidade e de intervenções para reduzir a transmissão perinatal do HIV. MÉTODOS: Amostra de conveniência de mulheres que desconheciam sua situação sorológica para o HIV quando admitidas para o parto em maternidades públicas do Rio de Janeiro, RJ, e de Porto Alegre, RS, entre março de 2000 e abril de 2002. As mulheres foram aconselhadas e testadas com teste rápido Determine HIV1/2 na maternidade. Infecção pelo HIV foi confirmada pelo algoritmo brasileiro para o diagnóstico da infecção pelo HIV. A transmissão intra-útero foi determinada pelo PCR-DNA-HIV. Foram realizadas análises descritivas dos dados sociodemográficos, número de gestações e de abortos prévios, número de visitas de pré-natal, momento da testagem para o HIV, resultado do teste rápido para o HIV, intervenções recebidas pelos recém-natos e de transmissão vertical do HIV, de acordo com cada cidade. RESULTADOS: A prevalência de HIV entre as mulheres foi 6,5% (N=1.439) em Porto Alegre e 1,3% (N=3.778) no Rio de Janeiro. A maioria foi testada durante o trabalho de parto em Porto Alegre e no pós-parto, no Rio de Janeiro. Cento e quarenta e quatro crianças nasceram de 143 mulheres infectadas pelo HIV. Todos os recém-natos receberam ao menos a profilaxia com zidovudina oral, exceto um em cada cidade. Foi possível evitar qualquer exposição ao leite materno em 96,8% e 51,1% dos recém-natos em Porto Alegre e no Rio de Janeiro, respectivamente. A zidovudina injetável foi administrada durante o trabalho de parto para 68,8% dos recém-natos em Porto Alegre e 27,7% no Rio de Janeiro. Entre aqueles com amostras de sangue coletadas até 48 horas do nascimento, a transmissão intra-útero foi confirmada em quatro casos no Rio de Janeiro (4/47) e em seis casos em Porto Alegre (6/79). CONCLUSÕES: A estratégia mostrou-se factível nas maternidades do Rio de Janeiro e de Porto Alegre. Esforços devem ser empreendidos para maximizar a testagem durante o trabalho de parto. Forte suporte social precisa ser acoplado a essa estratégia para garantir o acesso dessa população ao sistema de saúde após a alta da maternidade.

OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant women at maternity hospital admission and of subsequent interventions to reduce perinatal HIV transmission. METHODS: Study based on a convenience sample of women unaware of their HIV serostatus when they were admitted to delivery in public maternity hospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 and April 2002. Women were counseled and tested using the Determine HIV1/2 Rapid Test. HIV infection was confirmed using the Brazilian algorithm for HIV infection diagnosis. In utero transmission of HIV was determined using HIV-DNA-PCR. There were performed descriptive analyses of sociodemographic data, number of previous pregnancies and abortions, number of prenatal care visits, timing of HIV testing, HIV rapid test result, neonatal and mother-to-child transmission interventions, by city studied. RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegre and 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women were tested during labor (88.7%), while in Rio de Janeiro most were tested in the postpartum (67.5%). One hundred and forty-four infants were born to 143 HIV-infected women. All newborns but one in each city received at least prophylaxis with oral zidovudine. It was possible to completely avoid newborn exposure to breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio de Janeiro, respectively. Injectable intravenous zidovudine was administered during labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro, respectively. Among those from whom blood samples were collected within 48 hours of birth, in utero transmission of HIV was confirmed in 4 cases in Rio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79). CONCLUSIONS: The strategy proved feasible in maternity hospitals in Rio de Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testing during labor. There is a need of strong social support to provide this population access to health care services after hospital discharge.

OBJETIVO: Analizar la viabilidad de evaluación rápida del HIV entre gestantes en la admisión en la maternidad y de intervenciones para reducir la transmisión perinatal del HIV. MÉTODOS: Muestra de conveniencia de mujeres que desconocían su situación serológica para el HIV al ser admitidas para el parto en maternidades públicas de Rio de Janeiro (Sureste) y de Porto alegre (Sur de Brasil), entre marzo de 2000 y abril de 2002. Las mujeres fueron aconsejadas y evaluadas con prueba rápida Determine HIV1/2 en la maternidad. Infección por el HIV fue confirmada por el algoritmo brasilero para el diagnóstico de la infección por el HIV. La transmisión intra- útero fue determinada por el PCR-DNA-HIV. Fueron realizados análisis descriptivos de los datos sociodemográficos, número de gestaciones y de abortos previos, número de visitas de prenatal, momento de la evaluación para el HIV, resultado de la prueba rápida para el HIV, intervenciones recibidas por los recién nacidos y de transmisión vertical del HIV, de acuerdo con cada ciudad. RESULTADOS: La prevalencia de HIV entre las mujeres fue de 6,5% (N=1.439) en Porto Alegre y 1,3% (N=3,778) en Rio de Janeiro. La mayoría fue evaluada durante el trabajo de parto en Porto Alegre y en el postparto, en Rio de Janeiro. Ciento y cuarenta y cuatro niños nacieron de 143 mujeres infectadas por el HIV. Todos los recién nacidos recibieron al menos la profilaxia con zidovudina oral, excepto uno en cada ciudad. Fue posible evitar cualquier exposición a la leche materna en 96,8% y 51,1% de los recién nacidos en Porto Alegre y en Rio de Janeiro, respectivamente. La zidovudina inyectable fue administrada durante el trabajo de parto a 68,8% de los recién nacidos en Porto Alegre y 27,7% en Rio de Janeiro. Entre aquellos con muestras de sangre colectadas hasta 48 horas de nacimiento, la transmisión intra-útero fue confirmada en cuatro casos en Rio de Janeiro (4/47) y en seis casos en Porto Alegre (6/79). CONCLUSIONES: La estrategia se mostró factible en las maternidades de Rio de Janeiro y de Porto Alegre. Esfuerzos deben ser emprendidos para maximizar la evaluación durante el trabajo de parto. Fuerte soporte social precisa ser acoplado a esa estrategia para garantizar el acceso de dicha población al sistema de salud posterior a ser dado de alta de la maternidad.

OBJETIVO: Analisar a viabilidade da testagem rápida para o HIV entre gestantes na admissão à maternidade e de intervenções para reduzir a transmissão perinatal do HIV. MÉTODOS: Amostra de conveniência de mulheres que desconheciam sua situação sorológica para o HIV quando admitidas para o parto em maternidades públicas do Rio de Janeiro, RJ, e de Porto Alegre, RS, entre março de 2000 e abril de 2002. As mulheres foram aconselhadas e testadas com teste rápido Determine HIV1/2 na maternidade. Infecção pelo HIV foi confirmada pelo algoritmo brasileiro para o diagnóstico da infecção pelo HIV. A transmissão intra-útero foi determinada pelo PCR-DNA-HIV. Foram realizadas análises descritivas dos dados sociodemográficos, número de gestações e de abortos prévios, número de visitas de pré-natal, momento da testagem para o HIV, resultado do teste rápido para o HIV, intervenções recebidas pelos recém-natos e de transmissão vertical do HIV, de acordo com cada cidade. RESULTADOS: A prevalência de HIV entre as mulheres foi 6,5% (N=1.439) em Porto Alegre e 1,3% (N=3.778) no Rio de Janeiro. A maioria foi testada durante o trabalho de parto em Porto Alegre e no pós-parto, no Rio de Janeiro. Cento e quarenta e quatro crianças nasceram de 143 mulheres infectadas pelo HIV. Todos os recém-natos receberam ao menos a profilaxia com zidovudina oral, exceto um em cada cidade. Foi possível evitar qualquer exposição ao leite materno em 96,8% e 51,1% dos recém-natos em Porto Alegre e no Rio de Janeiro, respectivamente. A zidovudina injetável foi administrada durante o trabalho de parto para 68,8% dos recém-natos em Porto Alegre e 27,7% no Rio de Janeiro. Entre aqueles com amostras de sangue coletadas até 48 horas do nascimento, a transmissão intra-útero foi confirmada em quatro casos no Rio de Janeiro (4/47) e em seis casos em Porto Alegre (6/79). CONCLUSÕES: A estratégia mostrou-se factível nas maternidades do Rio de Janeiro e de Porto Alegre. Esforços devem ser empreendidos para maximizar a testagem durante o trabalho de parto. Forte suporte social precisa ser acoplado a essa estratégia para garantir o acesso dessa população ao sistema de saúde após a alta da maternidade.

OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant women at maternity hospital admission and of subsequent interventions to reduce perinatal HIV transmission. METHODS: Study based on a convenience sample of women unaware of their HIV serostatus when they were admitted to delivery in public maternity hospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 and April 2002. Women were counseled and tested using the Determine HIV1/2 Rapid Test. HIV infection was confirmed using the Brazilian algorithm for HIV infection diagnosis. In utero transmission of HIV was determined using HIV-DNA-PCR. There were performed descriptive analyses of sociodemographic data, number of previous pregnancies and abortions, number of prenatal care visits, timing of HIV testing, HIV rapid test result, neonatal and mother-to-child transmission interventions, by city studied. RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegre and 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women were tested during labor (88.7%), while in Rio de Janeiro most were tested in the postpartum (67.5%). One hundred and forty-four infants were born to 143 HIV-infected women. All newborns but one in each city received at least prophylaxis with oral zidovudine. It was possible to completely avoid newborn exposure to breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio de Janeiro, respectively. Injectable intravenous zidovudine was administered during labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro, respectively. Among those from whom blood samples were collected within 48 hours of birth, in utero transmission of HIV was confirmed in 4 cases in Rio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79). CONCLUSIONS: The strategy proved feasible in maternity hospitals in Rio de Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testing during labor. There is a need of strong social support to provide this population access to health care services after hospital discharge.

OBJETIVO: Analizar la viabilidad de evaluación rápida del HIV entre gestantes en la admisión en la maternidad y de intervenciones para reducir la transmisión perinatal del HIV. MÉTODOS: Muestra de conveniencia de mujeres que desconocían su situación serológica para el HIV al ser admitidas para el parto en maternidades públicas de Rio de Janeiro (Sureste) y de Porto alegre (Sur de Brasil), entre marzo de 2000 y abril de 2002. Las mujeres fueron aconsejadas y evaluadas con prueba rápida Determine HIV1/2 en la maternidad. Infección por el HIV fue confirmada por el algoritmo brasilero para el diagnóstico de la infección por el HIV. La transmisión intra- útero fue determinada por el PCR-DNA-HIV. Fueron realizados análisis descriptivos de los datos sociodemográficos, número de gestaciones y de abortos previos, número de visitas de prenatal, momento de la evaluación para el HIV, resultado de la prueba rápida para el HIV, intervenciones recibidas por los recién nacidos y de transmisión vertical del HIV, de acuerdo con cada ciudad. RESULTADOS: La prevalencia de HIV entre las mujeres fue de 6,5% (N=1.439) en Porto Alegre y 1,3% (N=3,778) en Rio de Janeiro. La mayoría fue evaluada durante el trabajo de parto en Porto Alegre y en el postparto, en Rio de Janeiro. Ciento y cuarenta y cuatro niños nacieron de 143 mujeres infectadas por el HIV. Todos los recién nacidos recibieron al menos la profilaxia con zidovudina oral, excepto uno en cada ciudad. Fue posible evitar cualquier exposición a la leche materna en 96,8% y 51,1% de los recién nacidos en Porto Alegre y en Rio de Janeiro, respectivamente. La zidovudina inyectable fue administrada durante el trabajo de parto a 68,8% de los recién nacidos en Porto Alegre y 27,7% en Rio de Janeiro. Entre aquellos con muestras de sangre colectadas hasta 48 horas de nacimiento, la transmisión intra-útero fue confirmada en cuatro casos en Rio de Janeiro (4/47) y en seis casos en Porto Alegre (6/79). CONCLUSIONES: La estrategia se mostró factible en las maternidades de Rio de Janeiro y de Porto Alegre. Esfuerzos deben ser emprendidos para maximizar la evaluación durante el trabajo de parto. Fuerte soporte social precisa ser acoplado a esa estrategia para garantizar el acceso de dicha población al sistema de salud posterior a ser dado de alta de la maternidad.

American cutaneous leishmaniasis (ACL) was investigated in dogs from an urban endemic area in Cianorte, Paraná state, Brazil. Of 169 studied dogs, none presented suspected ACL lesions. Eleven animals (6.6%) had anti-Leishmania braziliensis antibodies (titers > 40) detected by the immunofluorescent antibody test (IFAT) while four (2.4%) showed L. braziliensis-complex DNA by the polymerase chain reaction (PCR). Although no associations were found between IFAT or PCR results and age, sex, origin, free-roaming animals or length of residence at the address, the majority of IFAT- or PCR-positive dogs were from the urban area of the city and were allowed to roam freely beyond their neighborhood. The presence of anti-Leishmania braziliensis antibodies and L. braziliensis-complex DNA in dogs from this urban area near a native-forest park indicates the importance of following up on these dogs to confirm the ACL diagnosis.

OBJETIVO: Avaliar o efeito de dois diferentes Intervalos de Recuperação (IR) entre séries de extensões isocinéticas de joelho no Pico de Torque (PT) e no Trabalho Total (TT) em jovens destreinados. MÉTODOS: Dezoito homens (24,22±2,58 anos; 80,42±11,41 kg) realizaram três séries de 10 extensões isocinéticas com o joelho direito a 60° e 180°/s. O IR entre as séries foram de 1 e 2 minutos, contrabalanceados entre os dois dias de teste, separados por, no mínimo, 48 horas. A taxa de trabalho-recuperação foi de 1:3 e 1:6 para 60°/s e 1:6 e 1:12 para 180°/s. Os voluntários não participavam de programas de treinamento resistido há pelo menos 6 meses. A análise estatística foi a ANOVA de medidas repetidas 2 x 3 [IR (1 e 2 minutos) x série (1ª, 2ª e 3ª)]. O nível de significância foi a<0,05. RESULTADOS: Tanto 1 como 2 minutos não conseguiram manter o PT e o TT ao longo das três séries (p<0,05). Porém, a 60°/s, 2 minutos de IR possibilitaram um melhor PT e TT na segunda e na terceira série que 1 minuto (p<0,05). Já a 180°/s, 2 minutos só foi superior (p<0,05) a 1 minuto na terceira série para o TT. CONCLUSÃO: O estudo indicou que durante um protocolo de treinamento isocinético, homens jovens necessitam mais de 2 minutos para recuperar totalmente o PT a 60°/s, e totalmente o TT a 60° e 180°/s. Entretanto, uma melhor recuperação do PT pode ser alcançada com uma taxa de trabalho-recuperação de 1:12 a 180°/s.

OBJECTIVE: To assess the effect of two recovery intervals (RIs) between sets of isokinetic knee extension exercises on peak torque (PT) and total work (TW), among untrained young men. METHODS: Eighteen men (24.22±2.58 years; 80.42±11.41 kg) performed three sets of ten isokinetic extensions of the right knee, at 60° and 180°/s. The RIs between the sets were one and two minutes long, spread over two test days separated by a minimum of 48 hours. The work-to-recovery ratio was 1:3 and 1:6 for 60°/s, and 1:6 and 1:12 for 180°/s. The subjects had not participated in any resistance training programs within the last six months. The statistical analysis consisted of 2 x 3 repeated-measures ANOVA [RI (one or two minutes) x set (1st, 2nd or 3rd)]. The significance level was a<0.05. RESULTS: Neither one minute nor two minutes RIs maintained the PT and TW throughout the three sets (p<0.05). However, at 60°/s, two minutes RIs enabled better PT and TW in the second and third sets than one minute RIs (p<0.05). At 180°/s, two minutes RIs were only better (p<0.05) than one minute RIs for TW in the third set. CONCLUSION: This study indicated that, during an isokinetic training protocol, young men require more than two minutes of RI for full PT recovery at 60°/s and full TW recovery at 60°/s and 180°/s. However, better PT recovery can be attained with a 1:12 work-to-recovery ratio at 180°/s.

INTRODUCTION: Gleason score, which has a high interobserver variability, is used to classify prostate cancer. The most recent consensus valued the tertiary Gleason pattern and recommended its use in the final score of needle biopsies (modified Gleason score). This pattern is considered to be of high prognostic value in surgical specimens. This study emphasized the evaluation of the modified score agreement in needle biopsies and in surgical specimen, as well as the interobserver variability of this score MATERIALS AND METHODS: Three pathologists evaluated the slides of needle biopsies and surgical specimens of 110 patients, reporting primary, secondary and tertiary Gleason patterns and after that, traditional and modified Gleason scores were calculated. Kappa test (K) assessed the interobserver agreement and the agreement between the traditional and modified scores of the biopsy and of the surgical specimen RESULTS: Interobserver agreement in the biopsy was K = 0.36 and K = 0.35, and in the surgical specimen it was K = 0.46 and K = 0.36, for the traditional and modified scores, respectively. The tertiary Gleason grade was found in 8%, 0% and 2% of the biopsies and in 8%, 0% and 13% of the surgical specimens, according to observers 1, 2 and 3, respectively. When evaluating the agreement of the traditional and modified Gleason scores in needle biopsy with both scores of the surgical specimen, a similar agreement was found through Kappa CONCLUSION: Contrary to what was expected, the modified Gleason score was not superior in the agreement between the biopsy score and the specimen, or in interobserver reproducibility, in this study.

Cervical lymph nodes biopsies from 31 HIV positive patients (with or without AIDS) were studied by histologic methods and immunohistochemistry (StreptABC staining of paraffin sections) to identify cellular and extracellular matrix components. The results were the following: (1) the biopsies were included in the stages of follicular hyperplasia without fragmentation FH-FF (4 cases); follicular hyperplasia with follicular fragmentation FH+FF (16 cases); follicular involution FI (6 cases) and diffuse pattern DP (5 cases); (2) the most important alteration was the germinal centers disruption due to follicle lysis, which began in the light zone; (3) there was coincidence between intrafollicular hemorrhages and segmental hyaline mycroangiopathy; (4) during the progression of the disease occurred: (a) an increase in the number of mast cells, CD68+ and Mac387+ macrophages; (b) a diffuse augment of collagen III, elastic fibers, laminin, fibronectin and proteoglycans; (c) maintenance of Factor VIII - related antigens in the vascular endothelial cells, with decrease in the expression of Ulex-Europeus I lectin. Follicular hyperplasia (FH-FF or FH+FF) was the most common histologic pattern recognized in the lymph nodes of patients without AIDS and follicular involution and difuse pattern were seen in those who had AIDS. The results indicate that the lymph node biopsies may provide important information about the evolutive stage of the disease and its prognosis.