Abstract A second deadlier wave of COVID-19 and the causes of the recent public health collapse of Manaus are compared with the Spanish flu events in that city, and Brazil. Historic sanitarian problems, and its hub position in the Brazilian airway network are combined drivers of deadly events related to COVID-19. These drivers were amplified by misleading governance, highly transmissible variants, and relaxation of social distancing. Several of these same factors may also have contributed to the dramatically severe outbreak of H1N1 in 1918, which caused the death of 10% of the population in seven months. We modelled Manaus parameters for the present pandemic and confirmed that lack of a proper social distancing might select the most transmissible variants. We succeeded to reproduce a first severe wave followed by a second stronger wave. The model also predicted that outbreaks may last for up to five and half years, slowing down gradually before the disease disappear. We validated the model by adjusting it to the Spanish Flu data for the city, and confirmed the pattern experienced by that time, of a first stronger wave in October-November 1918, followed by a second less intense wave in February-March 1919.

Abstract In the Bom Jardim de Goiás region, the Transbrasiliano Lineament shows evidence of a fault reactivation along NE-SW structures (main direction) and secondary directions related to subsequent events. To study the structural framework and reactivation inputs toward tectonic events, distinctive features of the northern Paraná Basin border were analyzed by integrating gamma spectrometry and radar data, both supported by field research. The remote sensing database obtained by the Advanced Land Observing Satellite (ALOS) Phased Array type L-band Synthetic Aperture Radar (PALSAR) sensor allowed detecting lineaments and morphometric derivatives. Besides, the developed morphogenetic process images attest to the importance of structural control on relief evolution while concentrating lineaments as a function of lithological and geomorphological domains. Airborne gamma-ray spectrometry data processing focused on Kd (Anomalous Potassium) and F-Parameter indices. In this context, the fuzzy logic and Index Overlay Method allowed multivalued integration that indicated hydrothermal products and weathering processes correlated with Kd and F-Parameter anomalies. Thus, the joint interpretation of lineaments, geomorphological domains, and Kd/F-Parameter anomalies allowed differentiating primary geological elements and products from surface dynamics, directly or indirectly related to tectonic reactivation processes.

Abstract The spread of SARS-CoV-2 and the distribution of cases worldwide followed no clear biogeographic, climatic, or cultural trend. Conversely, the internationally busiest cities in all countries tended to be the hardest hit, suggesting a basic, mathematically neutral pattern of the new coronavirus early dissemination. We tested whether the number of flight passengers per time and the number of international frontiers could explain the number of cases of COVID-19 worldwide by a stepwise regression. Analysis were taken by 22 May 2020, a period when one would claim that early patterns of the pandemic establishment were still detectable, despite of community transmission in various places. The number of passengers arriving in a country and the number of international borders explained significantly 49% of the variance in the distribution of the number of cases of COVID-19, and number of passengers explained significantly 14.2% of data variance for cases per million inhabitants. Ecological neutral theory may explain a considerable part of the early distribution of SARS-CoV-2 and should be taken into consideration to define preventive international actions before a next pandemic.

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Resumo Objetivo: Descrever apresentação clínica incomum de sequestro pulmonar extralobar intra-abdominal em um paciente de dois anos e nove meses e avaliar aspectos diagnósticos e de tratamento dessa patologia. Descrição do caso: Uma massa intra-abdominal indefinida em topografia suprarrenal direita de feto masculino. A avaliação pós-natal com imagens de ultrassom, tomografia computadorizada, ressonância magnética e testes laboratoriais não foi suficiente para determinar a natureza da lesão. Após dois anos, a resseção laparoscópica da massa e o exame histopatológico do espécime cirúrgico permitiram estabelecer o diagnóstico de sequestro pulmonar extralobar intra-abdominal. Comentários: Essa malformação pode ser monitorada clinicamente; entretanto, a excisão cirúrgica frequentemente é feita, provavelmente devido à impossibilidade de diagnóstico com métodos não invasivos, como ocorreu no presente caso, na qual a lesão apresentou-se em posição não habitual para sequestro pulmonar extralobar intra-abdominal. Desse modo, a abordagem cirúrgica parece ser a chave para o diagnóstico e a condução desde tipo de malformação congênita.

Abstract Objective: To describe an unusual clinical presentation of intra-abdominal extralobar pulmonary sequestration in a 2-year, 9 month-old patient and assess diagnostic and treatment aspects of this pathology. Case description: An undefined intra-abdominal mass was identified in the right adrenal region in a male fetus. Postnatal evaluation with ultrasound images, computed tomography, magnetic resonance imaging and laboratory testing was insufficient to determine the nature of the lesion. After two years, laparoscopic resection of the mass and histopathological examination of the surgical specimen allowed to establish the diagnosis of intra-abdominal extralobar pulmonary sequestration. Comments: This malformation can be monitored clinically; however, surgical excision is often performed, probably due to the impossibility of attaining diagnosis with non-invasive methods, such as in the present case, in which the lesion appeared in an unusual position for intra-abdominal extralobar pulmonary sequestration. Therefore, the surgical approach seems to be the key to attain the diagnosis and establish the conduct for this type of congenital malformation.

Trypanosoma cruzi infection may be caused by different strains with distinct discrete typing units (DTUs) that can result in variable clinical forms of chronic Chagas disease. The present study evaluates the immune response and cardiac lesions in dogs experimentally infected with different T. cruzi strains with distinct DTUs, namely, the Colombian (Col) and Y strains of TcI and TcII DTU, respectively. During infection with the Col strain, increased levels of alanine aminotransferase, erythrocytes, haematocrit and haemoglobin were observed. In addition, CD8+ T-lymphocytes isolated from the peripheral blood produced higher levels of interleukin (IL)-4. The latter suggests that during the acute phase, infection with the Col strain may remain unnoticed by circulating mononuclear cells. In the chronic phase, a significant increase in the number of inflammatory cells was detected in the right atrium. Conversely, infection with the Y strain led to leucopoenia, thrombopoenia, inversion of the ratio of CD4+/CD8+ T-lymphocytes and alterations in monocyte number. The Y strain stimulated the production of interferon-γ by CD4+ and CD8+ T-lymphocytes and IL-4 by CD8+ T-cells. In the chronic phase, significant heart inflammation and fibrosis were observed, demonstrating that strains of different DTUs interact differently with the host.

Trata-se de pesquisa do PET-Saúde que objetivou realizar levantamento das concepções sobre drogas de profissionais da rede de saúde mental e da atenção primária de Belo Horizonte. Adotou-se a abordagrm quantitativa, com emprego de entrevista estruturada na coleta de dados e análise estatística por meio do software SPSS. Utilizou-se o conceito de repertório interpretativo na elaboração das análises realizadas que, em síntese, revelaram que os entrevistados orientam-se predominantemente por dois repertórios sobre drogas - o discurso da saúde pública e o discurso jurídico-moral -, produzindo práticas de atenção contraditórias.

This research on the Education Program for Working in Health (PET-Health) has as objective to survey the drug-related conceptions of professionals engaged in network services of mental health and primary care of the city of Belo Horizonte. A quantitative methodology was used by means of structured questionnaire, being the data statistical analysis accomplished through SPSS. The concept of interpretative repertoire was applied to the analysis, which, in summary, revealed that the interviewed professionals are guided mainly by two interpretative repertoires on drugs: the public health discourse and the moral legal discourse. Both repertoires appear with the same intensity, producing ambiguous and contradictory care practices.

Trata-se de pesquisa do PET-Saúde que objetivou realizar levantamento das concepções sobre drogas de profissionais da rede de saúde mental e da atenção primária de Belo Horizonte. Adotou-se a abordagrm quantitativa, com emprego de entrevista estruturada na coleta de dados e análise estatística por meio do software SPSS. Utilizou-se o conceito de repertório interpretativo na elaboração das análises realizadas que, em síntese, revelaram que os entrevistados orientam-se predominantemente por dois repertórios sobre drogas - o discurso da saúde pública e o discurso jurídico-moral -, produzindo práticas de atenção contraditórias.

This research on the Education Program for Working in Health (PET-Health) has as objective to survey the drug-related conceptions of professionals engaged in network services of mental health and primary care of the city of Belo Horizonte. A quantitative methodology was used by means of structured questionnaire, being the data statistical analysis accomplished through SPSS. The concept of interpretative repertoire was applied to the analysis, which, in summary, revealed that the interviewed professionals are guided mainly by two interpretative repertoires on drugs: the public health discourse and the moral legal discourse. Both repertoires appear with the same intensity, producing ambiguous and contradictory care practices.

Purpose: The proposal of this study was to determine the prevalence and the associated factors of erectile dysfunction (ED) among hemodialysis (HD) patients. Materials and Methods: This was a cross-sectional study based on data collected from HD male patients. Clinical, demographic and laboratory data of all patients were collected in three HD clinics from December 2010 to June 2011. Patients answered questions of erectile function domain from International Index of Erectile Function. Data were evaluated by descriptive analysis and by univariate (ULRA) and multivariate logistic regression analysis (MLRA). Results: Three hundred and five patients participated of the study. The prevalence of ED was 68.19%. ED was associated with diabetes (DM), benign prostatic hyperplasia, glomerulonephritis as cause of chronic renal failure (CRF), smoking habits, lower creatinine levels (ULRA), use of calcium channel blocker (MLRA), aging, lower education level, alcohol consumption, DM (as cause of CRF) and coronary insufficiency (ULRA and MLRA). Conclusions: ED was highly prevalent in the HD men. It was independently associated with aging, current use of alcohol, long alcohol use (even for those who do not drink more), lower education level, diabetes as cause of CRF, coronary insufficiency and use of channel blockers calcium.

Espectroscopia fotoacústica foi utilizada tanto para obter algumas propriedades ópticas de óleos de soja, canola e oliva quanto para avaliar as alterações ocorridas devido ao tratamento térmico dos óleos. A intensidade do sinal fotoacústico normalizado e a sua fase foram medidas, independentemente, como uma função do comprimento de onda da fonte de radiação. Amostras de óleo foram aquecidas por 30 min após atingido o ponto de fumaça visando sua degradação. Depois disso, as amostras de óleo foram resfriadas e medições fotoacústicas foram conduzidas de forma a obter os espectros de absorção de amostras em ambas as condições degradadas e não degradada. A comparação entre as duas condições indicou que as amostras de óleo degradado exibiram alargamento das bandas de absorção na região ultravioleta do espectro, em relação à respectiva amostra com óleo não-degradado. Os picos das referidas bandas de absorção apresentaram um desvio para a região do vermelho.

Photoacoustic spectroscopy was used to obtain optical properties of edible soybean, canola and olive oils as well to evaluate the oil modifications induced by thermal treatment. The normalized photoacoustic signal intensity and its phase were independently measured as a function of wavelength of the radiation source. The oil samples were heated up to the smoke point and then for additional 30 min in order to degrade them. After, the oil samples were cooled down and photoacoustic measurements were conducted in order to obtain the absorption spectra of samples at both degraded and non-degraded conditions. Comparisons between the two conditions indicate that the degraded oil samples exhibited widening of the absorption bands in ultraviolet region of the spectra, relative to the respective non-degraded sample. Also, the peaks of those absorption bands presented a red shift.

INTRODUÇÃO: Descrevemos um foco de leishmaniose visceral canina (LVC) autóctone na Região Metropolitana de Vitória (RMV) onde um caso humano foi registrado anteriormente. MÉTODOS: Testes sorológicos, parasitológicos e moleculares foram realizados em 201 cães. RESULTADOS: Vinte e seis (13%) e 12 (6%) foram positivos para um teste ELISA in house e rK39, respectivamente. Dois cães apresentaram cultura positiva para Leishmania (Leishmania) chagasi e quatro PCR positivo para Leishmania spp. Um dos cães positivo pertencia ao paciente supracitado. CONCLUSÕES: Embora o vetor não tenha sido encontrado, nossos resultados fornecem evidências da LVC autóctone na RMV, área não-endêmica para leishmaniose visceral.

INTRODUCTION: We investigated autochthonous canine visceral leishmaniasis (CVL) in the metropolitan region of Vitória (MRV), an area in which a human case was previously reported. METHODS: Serological, parasitological, and molecular tests were performed in 201 dogs. RESULTS: Twenty-six (13%) and 12 (6%) dogs were identified as positive using in-house enzyme-linked immunosorbent assay (ELISA) and rK39 tests, respectively. Two dogs had a positive culture for Leishmania chagasi, and 4 were polymerase chain reaction (PCR)-positive for Leishmania spp. One positive dog belonged to the aforementioned patient. CONCLUSIONS: Although the responsible vector was not found, our results provide evidence of autochthonous CVL in the MRV, a non-endemic area for VL.

OBJETIVO: Avaliar as medidas da camada de fibras nervosas da retina com a tomografia de coerência óptica (OCT) "time domain" (TD) e "spectral domain" (SD), e testar a habilidade diagnóstica de ambas as tecnologias em pacientes com perda assimétrica glaucomatosa de hemicampo visual. MÉTODOS: Trinta e seis pacientes com glaucoma primário de ângulo aberto com perda de campo visual em um hemicampo (acometido) e ausência de perda no hemicampo oposto (não-acometido), e 36 controles pareados por idade tiveram o olho de estudo examinado com Stratus-OCT (Carl Zeiss Meditec Inc., Dublin, California, USA) e 3 D OCT-1000 (Topcon, Tokyo, Japan). As medidas de espessura da camada de fibras nervosas da retina peripapilar e classificação normativa fornecida pelos aparelhos foram registrados para análise. A média aritmética dos valores do gráfico de desvio total em cada hemicampo foi calculada para cada indivíduo. "Índices de assimetria" para campo visual e camada de fibras nervosas da retina foram calculados como a razão entre hemicampos acometido e não-acometido e hemirretinas correspondentes, respectivamente. RESULTADOS: As medidas da camada de fibras nervosas da retina em hemicampos não-acometidos (média [SD] 87.0 [17.1] µm e 84.3 [20.2] µm, para TD e SD-OCT, respectivamente) foram menores do que em controles (119.0 [12.2] µm e 117.0 [17.7] µm, P<0.001). O banco de dados normativo classificou como alterado 42% e 67% das hemirretinas correspondentes a hemicampos não-acometidos com TD e SD-OCT, respectivamente (P=0.01). As medidas da camada de fibras nervosas da retina foram consistentemente mais espessas com TD comparados com SD-OCT. Índices de assimetria da camada de fibras nervosas da retina foram semelhantes entre TD (0.76 [0.17]) e SD-OCT (0.79 [0.12]) e significantemente maiores do que o índice de assimetria do campo visual (0.36 [0.20], P<0.001). CONCLUSÃO: Os hemicampos normais de pacientes com glaucoma apresentaram camada de fibras nervosas da retina mais fina do que olhos saudáveis. As medidas da camada de fibras nervosas da retina foram mais espessas com TD do que com SD-OCT, que por sua vez detectou anormalidades na espessura da camada de fibras nervosas da retina mais frequentemente do que o TD-OCT.

PURPOSE: To evaluate the retinal nerve fiber layer measurements with time-domain (TD) and spectral-domain (SD) optical coherence tomography (OCT), and to test the diagnostic ability of both technologies in glaucomatous patients with asymmetric visual hemifield loss. METHODS: 36 patients with primary open-angle glaucoma with visual field loss in one hemifield (affected) and absent loss in the other (non-affected), and 36 age-matched healthy controls had the study eye imaged with Stratus-OCT (Carl Zeiss Meditec Inc., Dublin, California, USA) and 3 D OCT-1000 (Topcon, Tokyo, Japan). Peripapillary retinal nerve fiber layer measurements and normative classification were recorded. Total deviation values were averaged in each hemifield (hemifield mean deviation) for each subject. Visual field and retinal nerve fiber layer "asymmetry indexes" were calculated as the ratio between affected versus non-affected hemifields and corresponding hemiretinas. RESULTS: Retinal nerve fiber layer measurements in non-affected hemifields (mean [SD] 87.0 [17.1] µm and 84.3 [20.2] µm, for TD and SD-OCT, respectively) were thinner than in controls (119.0 [12.2] µm and 117.0 [17.7] µm, P<0.001). The optical coherence tomography normative database classified 42% and 67% of hemiretinas corresponding to non-affected hemifields as abnormal in TD and SD-OCT, respectively (P=0.01). Retinal nerve fiber layer measurements were consistently thicker with TD compared to SD-OCT. Retinal nerve fiber layer thickness asymmetry index was similar in TD (0.76 [0.17]) and SD-OCT (0.79 [0.12]) and significantly greater than the visual field asymmetry index (0.36 [0.20], P<0.001). CONCLUSIONS: Normal hemifields of glaucoma patients had thinner retinal nerve fiber layer than healthy eyes, as measured by TD and SD-OCT. Retinal nerve fiber layer measurements were thicker with TD than SD-OCT. SD-OCT detected abnormal retinal nerve fiber layer thickness more often than TD-OCT.

A regeneração tecidual guiada (RTG) utiliza membranas para favorecer a regeneração dos tecidos periodontais danificados pela doença periodontal. As membranas usadas ainda apresentam limitações, principalmente quanto à capacidade de manter o espaço do defeito. Dois biomateriais de origem brasileira, a hidroxiapatita (HAP) e o polihidroxibutirato (PHB), foram utilizados para fabricar membranas rígidas para RTG, contendo 25, 35 ou 50% de HAP em matriz de PHB pelo método de moldagem por injeção. As membranas apresentaram alta cristalinidade, sendo que, inicialmente, a topografia de superfície era pouco complexa em que os grânulos de HAP não estavam expostos. As membranas foram desgastadas com broca odontológica, de modo similar à cirurgia para sua implantação in vivo. Este procedimento resultou na exposição dos grânulos de HAP numa superfície com poros e estruturas lineares de dimensões que variaram de 3,55 µm ± 1,14 a 75,98 µm ± 30,76, portanto, característica microtopográfica. Observou-se, ainda, que a HAP é responsável por conferir uma topografia de superfície mais complexa às membranas. Portanto, espera-se que membranas com as características de rigidez e superfície microtopográfica possam proporcionar estabilidade ao defeito periodontal e permitir migração celular mais intensa, assim favorecendo a regeneração periodontal.

Guided tissue regeneration (GTR) is a technique that applies membranes to favor the regeneration of periodontal tissues lost due to periodontal disease. The membranes normally used have limitations however, mainly related to the difficulty in stabilizing the defect. In this study, two biomaterials of Brazilian origin, hydroxyapatite (HAP) and polyhydroxybutyrate (PHB), were used to make rigid membranes for GTR. Membranes were made with 25, 35 or 50% HAP in a PHB matrix by injection molding. The membranes were highly crystalline, with an initial smooth surface topography where HAP particles were not exposed. Membranes were grinded with a dental bur, similarly to the surgery procedure for their implantation in vivo. This procedure resulted on the HAP granules being exposed on a surface with pores and linear features of dimensions varying from 3.55 µm ± 1.14 to 75.98 µm ± 30.76, which are thus characterized as microtopography. Additionally, HAP was responsible for a greater surface complexity. Therefore, these characteristics of rigidity and surface microtopography may be able to provide stability to a periodontal defect and allow a greater cell migration, both favoring periodontal regeneration.