Abstract Background SARS-CoV-2 infection has become a major international issue, not only from a medical point of view, but also social, economic and political. Most of the available information comes from the United States, Europe, and China, where the population and the socioeconomic status are very different from Latin American countries. This study evaluates the effect of regional socioeconomic characteristics on mortality due SARS-CoV-2 infection in patients with immune-mediated rheumatic diseases (IMRD) from Argentina, Mexico and Brazil. Methods Data from three national registries, SAR-COVID (Argentina), CMR-COVID (Mexico) and ReumaCoV-Brasil (Brazil), were combined. Adult IMRD patients with SARS-CoV-2 infection were recruited. National data for each province/state, including population density, number of physicians per inhabitant, income, unemployment, GINI index, Municipal Human Development Index (MHDI), stringency index, vaccination rate and most frequent viral strains per period were assessed as risk factors for mortality due to COVID-19. Results A total of 4744 patients were included, 2534 (53.4%) from SAR-COVID, 1166 (24.6%) from CMRCOVID and 1044 (22.0%) from ReumaCoV-Brasil. Mortality due to COVID-19 was 5.4%. In the multivariable analysis, higher number of physicians per 1000 inhabitants and being infected during the vaccination period of each country were associated with lower mortality. After adjustment for socioeconomic factors, there was no association with country of residence and mortality. Conclusion These findings corroborate the complex interplay between socioeconomic factors, rheumatic disease activity, and regional disparities as determinants of death due to COVID-19 in Argentina, Brazil and Mexico. Thus, this research provides valuable insights for guiding public health policies and clinical practice in the ongoing fight against the COVID-19 pandemic. SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- issue view social political States Europe China countries immunemediated immune mediated (IMRD Argentina registries SARCOVID SAR COVID , (Argentina) CMR (Mexico ReumaCoVBrasil ReumaCoV Brasil Brazil, (Brazil) combined recruited provincestate province state province/state density inhabitant income unemployment index MHDI, MHDI (MHDI) COVID19. COVID19 19. 19 474 included 253 53.4% 534 53 4 (53.4% SARCOVID, COVID, 116 24.6% 246 24 6 (24.6% 104 22.0% 220 22 0 (22.0% ReumaCoVBrasil. Brasil. COVID-1 54 5 5.4% analysis 100 activity Thus pandemic SARS-CoV (Argentina (Brazil (MHDI COVID1 1 47 25 53.4 (53.4 11 24.6 (24.6 10 22.0 (22.0 COVID- 5.4 53. (53. 24. (24. 22. (22. 5. (53 (24 (22 (5 (2 (

Extratos brutos de 17 espécies de plantas coletadas em região de Mata Atlântica no Estado de São Paulo (Brasil) foram avaliadas para as atividades: antifúngica, no reparo do DNA e inibição da acetilcolinesterase. Dos 34 extratos obtidos de folhas e galhos das plantas analisadas para a atividade antifúngica com Cladosporium sphaerospermum e C. cladosporioides, 26,5% foram ativos. Todavia, apenas o extrato das folhas de Cabralea canjerana inibiu fortemente o crescimento dos dois fungos. No ensaio de reparo do DNA com linhagens mutantes de Saccharomyces cerevisiae, 11,7% dos extratos foram ativos, sendo que, 100% destes foram seletivos para o mecanismo de reparo do DNA envolvendo topoisomerase II. Das 17 espécies analisadas, 12 demonstraram atividade anticolinesterásica no ensaio qualitativo sobre cromatografia de camada delgada (CCD). No entanto, apenas os extratos de Tetrastylidium grandifolium (galhos) e Sloanea guianensis (folhas e galhos) apresentaram atividade anticolinesterásica maior que 50% no ensaio quantitativo.

Crude extracts from 17 plant species collected from an Atlantic Forest region in the State of São Paulo (Brazil) have been screened for antifungal, DNA-damaging and acetylcholinesterase inhibiting activities. Of the 34 extracts obtained from leaves and stems of plants assayed for antifungal activity with Cladosporium sphaerospermum and C. cladosporioides 26.5% were active. However, only the extract of leaves of Cabralea canjerana showed a strong inhibition of both fungi. The DNA-damaging assay with mutant strains of Saccharomyces cerevisiae resulted in 11.7 % of the extracts being active whereas 100% of them showed selectivity for the DNA-repair mechanism of topoisomerase II. Of the 17 species analysed, 12 showed anticholinesterasic activity in TLC assay. However, only extracts from Tetrastylidium grandifolium (stems) and Sloanea guianensis (leaves and stems) inhibited acetylcholinesterase activity more than 50% in quantitative assay.

Com o objetivo de avaliar a qualidade técnico-científica do cuidado, a acessibilidade aos serviços de saúde e o grau de implantação das ações de controle da diarréia, em um município selecionado do Estado da Bahia, Brasil, realizou-se um estudo de casos múltiplos, com dois níveis de análise: as práticas e a coordenação destas. Cada óbito (três) e hospitalização (oito) por diarréia foram considerados como casos. A totalidade dos óbitos foi investigada e as hospitalizações foram selecionadas de forma intencional. Dimensões e critérios para a avaliação da qualidade técnica e para estimativa do grau de implantação das ações de controle foram derivadas do modelo teórico. As trajetórias assistenciais foram reconstituídas a partir de entrevistas e informações de prontuários médicos. Verificaram-se barreiras organizacionais relacionadas ao elevado tempo de espera para atendimento nas unidades de atenção primária; barreiras geográficas relacionadas à distância entre o serviço e o local de moradia dos usuários e barreiras financeiras decorrentes da escassez de recursos financeiros para o transporte. A qualidade do cuidado foi considerada inadequada e as ações de controle da diarréia foram classificadas como insuficientes em praticamente todas as dimensões analisadas.

In order to evaluate the issues of access and technical quality in actions to control diarrhea in a selected municipality in the State of Bahia, Brazil, a study of multiple cases was conducted with two levels of analysis: practices themselves and the coordination between them. Cases were defined as hospitalization (8) or death (3) due to diarrhea. All deaths were investigated, and hospitalizations were submitted to intentional selection. Aspects and approaches vis-à-vis technical quality evaluation and estimation of the degree of implementation in diarrhea control measures were derived from the theoretical model. Health care trajectories for diarrhea were reconstituted from interviews and patient chart data. The results identified: organizational barriers related to long waiting time at primary care units; geographic barriers, or the distance from users' place of residence to health services; and financial barriers due to shortage of financial resources for transportation. Quality of care was considered inadequate, and diarrhea control measures were classified as insufficient in practically all of the dimensions analyzed.

Com o objetivo de avaliar a qualidade técnico-científica do cuidado, a acessibilidade aos serviços de saúde e o grau de implantação das ações de controle da diarréia, em um município selecionado do Estado da Bahia, Brasil, realizou-se um estudo de casos múltiplos, com dois níveis de análise: as práticas e a coordenação destas. Cada óbito (três) e hospitalização (oito) por diarréia foram considerados como casos. A totalidade dos óbitos foi investigada e as hospitalizações foram selecionadas de forma intencional. Dimensões e critérios para a avaliação da qualidade técnica e para estimativa do grau de implantação das ações de controle foram derivadas do modelo teórico. As trajetórias assistenciais foram reconstituídas a partir de entrevistas e informações de prontuários médicos. Verificaram-se barreiras organizacionais relacionadas ao elevado tempo de espera para atendimento nas unidades de atenção primária; barreiras geográficas relacionadas à distância entre o serviço e o local de moradia dos usuários e barreiras financeiras decorrentes da escassez de recursos financeiros para o transporte. A qualidade do cuidado foi considerada inadequada e as ações de controle da diarréia foram classificadas como insuficientes em praticamente todas as dimensões analisadas.

In order to evaluate the issues of access and technical quality in actions to control diarrhea in a selected municipality in the State of Bahia, Brazil, a study of multiple cases was conducted with two levels of analysis: practices themselves and the coordination between them. Cases were defined as hospitalization (8) or death (3) due to diarrhea. All deaths were investigated, and hospitalizations were submitted to intentional selection. Aspects and approaches vis-à-vis technical quality evaluation and estimation of the degree of implementation in diarrhea control measures were derived from the theoretical model. Health care trajectories for diarrhea were reconstituted from interviews and patient chart data. The results identified: organizational barriers related to long waiting time at primary care units; geographic barriers, or the distance from users' place of residence to health services; and financial barriers due to shortage of financial resources for transportation. Quality of care was considered inadequate, and diarrhea control measures were classified as insufficient in practically all of the dimensions analyzed.