Abstract Background A cost of illness (COI) study aims to evaluate the socioeconomic burden that an illness imposes on society as a whole. This study aimed to describe the resources used, patterns of care, direct cost, and loss of productivity due to systemic lupus erythematosus (SLE) in Brazil. Methods This 12-month, cross-sectional, COI study of patients with SLE (ACR 1997 Classification Criteria) collected data using patient interviews (questionnaires) and medical records, covering: SLE profile, resources used, morbidities, quality of life (12-Item Short Form Survey, SF-12), and loss of productivity. Patients were excluded if they were retired or on sick leave for another illness. Direct resources included health-related (consultations, tests, medications, hospitalization) or non-health-related (transportation, home adaptation, expenditure on caregivers) hospital resources. Costs were calculated using the unit value of each resource and the quantity consumed. A gamma regression model explored cost predictors for patients with SLE. Results Overall, 300 patients with SLE were included (92.3% female, mean [standard deviation (SD)] disease duration 11.8 [7.9] years), of which 100 patients (33.3%) were on SLE-related sick leave and 46 patients (15.3%) had stopped schooling. Mean (SD) travel time from home to a care facility was 4.4 (12.6) hours. Antimalarials were the most commonly used drugs (222 [74.0%]). A negative correlation was observed between SF-12 physical component and SLE Disease Activity Index (- 0.117, p = 0.042), Systemic Lupus International CollaboratingClinics/AmericanCollegeofRheumatology Damage Index (- 0.115, p = 0.046), medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific drugs/day (- 0.113, p = 0.051), and lost productivity (- 0.570, p < 0.001). For the mental component, a negative correlation was observed with medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific medications/day (- 0.113, p = 0.051), and missed appointments (- 0.232, p < 0.001). Mean total SLE cost was US$3,123.53/patient/year (median [interquartile range (IQR)] US$1,618.51 [$678.66, $4,601.29]). Main expenditure was medication, with a median (IQR) cost of US$910.62 ($460, $4,033.51). Mycophenolate increased costs by 3.664 times (p < 0.001), and inflammatory monitoring (erythrocyte sedimentation rate or C-reactive protein) reduced expenditure by 0.381 times (p < 0.001). Conclusion These results allowed access to care patterns, the median cost for patients with SLE in Brazil, and the differences across regions driven by biological, social, and behavioral factors. The cost of SLE provides an updated setting to support the decision-making process across the country. (COI whole (SLE Brazil 12month, 12month month 12 month, 12-month crosssectional, crosssectional cross sectional, sectional cross-sectional ACR 199 Criteria questionnaires (questionnaires records covering profile morbidities 12Item Item Survey SF12, SF12 SF , SF-12) healthrelated health related consultations, consultations (consultations tests medications hospitalization nonhealthrelated non transportation, transportation (transportation adaptation caregivers consumed Overall 30 92.3% 923 92 3 (92.3 female standard SD 118 11 8 11. 7.9 79 7 9 [7.9 years, years years) 10 33.3% 333 33 (33.3% SLErelated 4 15.3% 153 15 (15.3% schooling (SD 44 4. 12.6 126 6 (12.6 hours 222 (22 74.0%. 740 74.0% . 74 0 [74.0%]) SF-1 ( 0117 117 0.117 0.042, 0042 0.042 042 0.042) CollaboratingClinicsAmericanCollegeofRheumatology CollaboratingClinics AmericanCollegeofRheumatology 0115 115 0.115 0.046, 0046 0.046 046 0.046) medicationsday day comorbidities co 0272 272 0.272 0.001, 0001 0.001 001 0.001) SLEspecific specific drugsday 0113 113 0.113 0.051, 0051 0.051 051 0.051) 0570 570 0.570 0.001. 0232 232 0.232 US312353patientyear USpatientyear US 123 53 year interquartile IQR US161851 1 618 51 US$1,618.5 $678.66, 67866 678 66 [$678.66 $4,601.29. 460129 $4,601.29 601 29 $4,601.29]) medication (IQR US91062 910 62 US$910.6 $460, 460 ($460 $4,033.51. 403351 $4,033.51 033 $4,033.51) 3664 664 3.66 erythrocyte Creactive C reactive protein 0381 381 0.38 biological social factors decisionmaking decision making country 19 SF1 92.3 (92. 7. [7. 33.3 (33.3 15.3 (15.3 12. (12. 22 (2 74.0 [74.0%] SF- 011 0.11 004 0.04 04 027 27 0.27 000 0.00 00 005 0.05 05 057 57 0.57 023 23 0.23 patientyear 5 US16185 61 US$1,618. $678.66 6786 67 [$678.6 46012 $4,601.2 60 2 $4,601.29] US9106 91 US$910. $460 ($46 40335 $4,033.5 03 366 3.6 038 38 0.3 92. (92 [7 33. (33. 15. (15. (12 74. [74.0% 01 0.1 0.0 02 0.2 0.5 US1618 US$1,618 $678.6 [$678. 4601 $4,601. US910 US$910 $46 ($4 4033 $4,033. 36 3. 0. (9 [ (33 (15 (1 [74.0 US161 US$1,61 $678. [$678 $4,601 US91 US$91 $4 ($ 403 $4,033 (3 [74. US16 US$1,6 $678 [$67 $4,60 US9 US$9 $ 40 $4,03 [74 US1 US$1, $67 [$6 $4,6 US$ $4,0 US$1 $6 [$ $4,

Abstract Introduction The immune reconstitution (IR) after the allogenic hematopoietic stem cell transplantation (allo-HSCT) is a progressive process intrinsically correlated to the therapeutic success. It is essential to understand the interfering factors in IR to prevent the HSCT-related mortality. Methods We retrospectively evaluated the clinical outcomes, absolute lymphocyte counts (ALCs) and lymphocyte subtypes at different time-points of 111 pediatric patients with allogeneic HSCT for malignant and non-malignant diseases from 2013 to 2018. Results The ALCs gradually increased on D+30, D+100, and D+180 (medians 634/μL, 1022/μL and 1541/μL, respectively). On D+100, the CD3+CD8+ achieved the highest recovery rate (68%), followed by the CD16+CD56+ (47%), CD3+CD4+ (39%) and CD19+ (8%). The adequate ALC recovery was associated with age < 8 years, bone marrow grafts, myeloablative conditioning, non-use of serotherapy and non-haploidentical donors. The ALC and CD3+CD8+ on D+100 counts were higher in patients with the cytomegalovirus infection. The CD3+CD4+ recovery was associated with an age < 8 years, a non-malignant disease and a lower incidence of acute graft-versus-host disease ≥ grade 2. Furthermore, the ALC recovery on D+100 resulted in a higher overall survival, regardless of the disease type (HR 3.65, 1.05 - 12.71, p= 0.04). Conclusion Several factors influenced the IR after the allo-HSCT. The ALC ≥ 500/μL on D+100 was a simple IR predictor of survival, easily available to resource-limited centers. (IR alloHSCT allo (allo-HSCT success HSCTrelated related mortality outcomes (ALCs timepoints time points 11 nonmalignant non 201 2018 D30 D 30 D+30 D100 100 D180 180 D+18 medians 634μL μL 634 634/μL 1022μL 1022 1541μL 1541 1541/μL respectively. respectively . respectively) CD3CD8 CDCD CD3 CD8 CD CD3+CD8 68%, 68 68% , (68%) CD16CD56 CD16 CD56 CD16+CD56 47%, 47 47% (47%) CD3CD4 CD4 CD3+CD4 39% 39 (39% CD19 8%. 8% (8%) years grafts conditioning nonuse use nonhaploidentical haploidentical donors D+10 infection graftversushost graft versus host 2 Furthermore survival HR 365 3 65 3.65 105 1 05 1.0 1271 12 71 12.71 p 0.04. 004 0.04 0 04 0.04) alloHSCT. HSCT. allo-HSCT 500μL 500 resourcelimited resource limited centers 20 D3 D+3 D10 10 D18 18 D+1 63 102 154 CD3CD CD3+CD 6 (68% CD16CD5 CD1 CD5 CD16+CD5 4 (47% (39 (8% 36 3.6 1. 127 7 12.7 00 0.0 50 D+ D1 15 (68 CD16CD CD16+CD (47 (3 (8 3. 12. 0. 5 (6 (4 (

In the present study, we investigated the genetic diversity of Plasmodium vivax metacaspase 1 (PvMCA1) catalytic domain in two municipalities of the main malaria hotspot in Brazil, i.e., the Juruá Valley, and observed complete sequence identity among all P. vivax field isolates and the Sal-1 reference strain. Analysis of PvMCA1 catalytic domain in different P. vivax genomic sequences publicly available also revealed a high degree of conservation worldwide, with very few amino acid substitutions that were not related to putative histidine and cysteine catalytic residues, whose involvement with the active site of protease was herein predicted by molecular modeling. The genetic conservation presented by PvMCA1 may contribute to its eligibility as a druggable target candidate in vivax malaria.

RESUMO Objetivo Determinar efetividade da terapia de sensibilidade oral em idosos institucionalizados com demência grave. Métodos Uma série de oito casos residentes em instituição de longa permanência. Foram incluídos idosos com diagnóstico de demência grave e disfagia grave, com consentimento da família. Foram excluídos idosos em atendimento fonoaudiológico e com alimentação somente por via alternativa. A divisão entre grupo experimental e grupo controle foi por sorteio. A avaliação pré e pós terapia, realizada por uma fonoaudióloga cega para a intervenção, utilizou protocolo Northwestern Patient Dysphagia Check Sheet (NDPCS), a escala Clinical Dementia Rating (CDR) e a Functional Oral Intake Scale (FOIS). Durante a oferta a velocidade da deglutição e o número de deglutições (pastoso e líquido) foram avaliados. Os participantes do grupo experimental foram submetidos a cinco sessões consecutivas de estimulação tátil-térmica por 30 minutos. Resultados Oito participantes, com idade entre 68 e 98 anos, fizeram parte da amostra seis mulheres e dois homens. No grupo experimental não observou-se modificação na velocidade da deglutição bem como no número de deglutições nas consistências pastosa e líquida. Não foram encontradas diferenças significativas para os itens 23 a 28 do instrumento NDPCS nas duas consistências, bem como não houve modificação na escala FOIS. Também não houve diferenças estatisticamente significativas entre o grupo experimental e o grupo controle para essas duas consistências. Conclusão A estimulação tátil-térmica não modificou o padrão de deglutição em idosos institucionalizados com demência grave.

ABSTRACT Purpose To determine the effectiveness of oral sensitivity therapy, on institutionalized elderly patients with severe dementia. Methods A series of eight cases residing in a long-term institution. With the consent of their families, we included elderly residents diagnosed with severe dementia and severe dysphagia. We excluded elderly patients who were already undergoing swallow therapy and those who used only alternative means of feeding. The experimental and the control groups were randomly allocated by drawing lots. A blind assessor carried out pre- and post-therapy tests, using: Northwestern Dysphagia Patient Check Sheet (NDPCS) protocol, Clinical Dementia Rating scale (CDR) and Functional Oral Intake Scale (FOIS). During tests with food, the assessor evaluated swallowing speed and the number of swallows per serving (puréed texture and liquid). The participants in the experimental group underwent five consecutive sessions of tactile-thermal stimulation for 30 minutes each time. Results There were eight participants, six women and two men, between the ages of 68 and 98. No significant difference was found in the items 23 to 28 of the NDPCS instrument for both liquid and puréed consistencies as well as no difference was observed in the number of swallows or the speed of swallowing. Additionally, there was no change in FOIS scale, and neither anysignificant difference between the experimental and the control group. Conclusion Thermal-tactile stimulation did not change the swallowing patterns of institutionalized elderly patients with severe dementia.

Este artigo descreve a primeira detecção de Cytauxzoon felis em um gato doméstico naturalmente infectado no Brasil, América do Sul, através de técnicas moleculares. Também foi encontrada co-infecção com 'Candidatus Mycoplasma haemominutum'. A detecção molecular da espécie do piroplasmídeo foi realizada através da reação em cadeia pela polimerase (PCR) e sequenciamento. Um fragmento de 284 pb do gene codificador da região 18S do RNA ribossomal do parasito foi sequenciada e mostrou 99% de identidade com outros isolados de C. felis da América do Norte. Ademais, através da análise por meio de PCR-RFLP (Polimorfismo no comprimento de fragmentos de restrição), que amplifica um fragmento de 595 pb do gene codificador da porção 16 do RNA ribossomal de algumas espécies de bactérias, concluiu-se que a espécie com-infectante era 'Candidatus M. haemominutum'.

This article describes the first detection of Cytauxzoon felis, using molecular techniques, in a naturally infected domestic cat from Brazil, South America. Coinfection with 'CandidatusMycoplasma haemominutum' was also found. The molecular identification of the piroplasmid species was performed by Polymerase Chain Reaction (PCR) and sequencing analysis. A 284 pb fragment of the gene encoding the 18S ribosomal RNA region was amplified and showed 99% identity with other C. felis strains from North America. In addition, PCR-RFLP (restriction fragment length polymorphism) analysis, which amplifies a 595 bp fragment of the gene encoding 16S ribosomal RNA of some bacterial species, identified the co-infecting species as 'Candidatus M. haemominutum'.