Resumo O objetivo desta pesquisa foi investigar a ocorrência de enterobactérias em passeriformes do gênero Sporophila, provenientes do tráfico ilegal de animais, e analisar sua resistência antimicrobiana. Um total de 35 aves, aparentemente saudáveis e provenientes de criações ilegais, foram encaminhadas ao Laboratório de Estudos Ornitológicos da Universidade Estadual do Ceará (Fortaleza, Ceará, Brasil) por órgãos ambientais. Amostras obtidas a partir de suabes cloacais foram coletadas de cada ave e submetidas a processamento microbiológico tradicional, utilizando técnicas padrão de cultivo e identificação bacteriana. O teste de sensibilidade aos antimicrobianos foi avaliado pelo método de disco de difusão. Das amostras examinadas, 23 (65,7%) apresentaram a presença de enterobactérias, sendo Escherichia coli (28,6%) e Serratia liquefaciens (25,7%) as mais frequentes. A resistência antimicrobiana referente aos isolados totais foi observada com mais frequência em relação à ciprofloxacina (28,1%), seguida por tetraciclina (25,0%) e enrofloxacina (18,8%). Especificamente em relação à Serratia liquefaciens, a taxa de resistência foi a mais altas, atingindo 66,6% dos isolados. Com base nos resultados obtidos, podemos concluir que as amostras cloacais das aves apresentaram isolamento de diversos membros da ordem Enterobacteriales, sendo E. coli e S. liquefaciens as mais frequentes. Também foi observada a ocorrência de resistência antimicrobiana a diversos fármacos utilizados, assim como casos de multiresistência, o que mostra que esse problema está presente em pássaros silvestres oriundo de manutenções ilegais. Isso ressalta a necessidade de considerar a presença de bactérias resistentes a antimicrobianos em programas de soltura, visando evitar a dispersão desses microrganismos no meio ambiente. Sporophila animais 3 ilegais Fortaleza, Fortaleza (Fortaleza Brasil ambientais tradicional bacteriana difusão examinadas 2 65,7% 657 65 7 (65,7% 28,6% 286 28 6 (28,6% 25,7% 257 25 (25,7% frequentes 28,1%, 281 28,1% , 1 (28,1%) 25,0% 250 0 (25,0% 18,8%. 188 18,8% . 18 8 (18,8%) altas 666 66 66,6 obtidos Enterobacteriales E S utilizados multiresistência soltura ambiente 65,7 (65,7 28,6 (28,6 25,7 (25,7 28,1 (28,1% 25,0 (25,0 18,8 (18,8% 66, 65, (65, 28, (28, 25, (25, (28,1 18, (18,8 (65 (28 (25 (18, (6 (2 (18 ( (1

Abstract We investigate the occurrence of enterobacteria and antimicrobial resistance in passerines of the genus Sporophila seized from illegal trafficking. A total of 35 birds, apparently healthy and from illegal breeding, were sent to the Laboratory of Ornithological Studies at the State University of Ceará (Fortaleza, Ceará, Brazil) by environmental agencies. Cloacal swabs were collected from each bird and subjected to traditional microbiological processing, using standard cultivation and bacterialidentification techniques. We conducted antimicrobial susceptibility testing using the disc-diffusion method. Twenty-three birds (65.7%) exhibited enterobacteria, with Escherichia coli (28.6%) and Serratia liquefaciens (25.7%) being the most common. Antimicrobial resistance in total isolates was observed most frequently in relation to ciprofloxacin (28.1%), followed by tetracycline (25.0%) and enrofloxacin (18.8%). The rate of resistance to Serratia liquefaciens was the highest (i.e., 66.6% of isolates). The birds’ cloacal samples revealed several members of the Enterobacterales order, with E. coli and S. liquefaciens being the most prevalent. We also observed antimicrobial resistance to several drugs, as well as cases of multi-resistance. Antimicrobial resistance is clearly present in wild birds resulting from illegal keeping. These findings highlight the importance of considering antimicrobial-resistant bacteria in release programs to prevent these microorganisms from dispersing into the environment. trafficking 3 breeding Fortaleza, Fortaleza (Fortaleza Brazil agencies processing techniques discdiffusion disc diffusion method Twentythree Twenty three 65.7% 657 65 7 (65.7% 28.6% 286 28 6 (28.6% 25.7% 257 25 (25.7% common 28.1%, 281 28.1% , 1 (28.1%) 25.0% 250 0 (25.0% 18.8%. 188 18.8% . 18 8 (18.8%) i.e., ie i e (i.e. 666 66 66.6 isolates. isolates) order E S prevalent drugs multiresistance. multiresistance multi resistance. multi-resistance keeping antimicrobialresistant resistant environment 65.7 (65.7 28.6 2 (28.6 25.7 (25.7 28.1 (28.1% 25.0 (25.0 18.8 (18.8% i.e. (i.e 66. 65. (65. 28. (28. 25. (25. (28.1 18. (18.8 i.e (65 (28 (25 (18. (6 (2 (18 ( (1

Resumo Objetivo: identificar fatores associados à contaminação e internação hospitalar por COVID-19 em profissionais de enfermagem. Método: estudo transversal, realizado em hospital especializado em cardiologia, com 415 profissionais de enfermagem. Foram avaliadas as variáveis sociodemográficas, comorbidades, condições de trabalho e questões relacionadas ao adoecimento pela COVID-19. Na análise dos dados, utilizaram-se os testes Qui-Quadrado, Fisher, Wilcoxon, Mann-Whitney e Brunner Munzel, a razão de chances para internação hospitalar, além de regressão logística binária. Resultados: a taxa de profissionais de enfermagem acometidos pela COVID-19 foi de 44,3% e os fatores associados à contaminação foram o número de pessoas no mesmo domicílio com COVID-19 (OR 36,18; p<0,001) e o uso de transporte público (OR 2,70; p=0,044). Ter sintomas graves (OR 29,75), pertencer ao grupo de risco (OR 3,00), apresentar taquipneia (OR 6,48), falta de ar (OR 5,83), cansaço (OR 4,64), febre (OR 4,41) e/ou mialgia (OR 3,00) aumentou as chances de internação hospitalar dos profissionais com COVID-19. Conclusão: habitar o mesmo domicílio que outras pessoas com a doença e usar transporte público aumentou o risco de contaminação pelo novo coronavírus. Os fatores associados à internação hospitalar dos profissionais contaminados foram a presença de fatores de risco para doença, a gravidade e o tipo dos sintomas apresentados.

Abstract Objective: to identify factors associated with infection and hospitalization due to COVID-19 in nursing professionals. Method: a cross-sectional study carried out with 415 nursing professionals in a hospital specialized in cardiology. The sociodemographic variables, comorbidities, working conditions and issues related to illness due to COVID-19 were evaluated. Chi-Square, Fisher’s, Wilcoxon, Mann-Whitney and Brunner Munzel tests were used in data analysis, as well as Odds Ratio for hospitalization, in addition to binary logistic regression. Results: the rate of nursing professionals affected by COVID-19 was 44.3% and the factors associated with infection were the number of people living in the same household infected by COVID-19 (OR 36.18; p<0.001) and use of public transportation (OR 2.70; p=0.044). Having severe symptoms (OR 29.75), belonging to the risk group (OR 3.00), having tachypnea (OR 6.48), shortness of breath (OR 5.83), tiredness (OR 4.64), fever (OR 4.41) and/or myalgia (OR 3.00) increased the chances of hospitalization in professionals with COVID-19. Conclusion: living in the same household as other people with the disease and using public transportation increased the risk of infection by the new coronavirus. The factors associated with the hospitalization of contaminated professionals were presence of risk factors for the disease, severity and type of the symptoms presented.

Resumen Objetivo: identificar los factores asociados al contagio y la hospitalización por COVID-19 en los profesionales de enfermería. Método: estudio transversal, realizado en un hospital especializado en cardiología, con 415 profesionales de enfermería. Se evaluaron las variables sociodemográficas, comorbilidades, condiciones de trabajo y preguntas relacionadas con la enfermedad por COVID-19. En el análisis de los datos, se utilizaron las pruebas de Chi-Cuadrado, Fisher, Wilcoxon, Mann-Whitney y Brunner Munzel, la razón de chance para la hospitalización, además de la regresión logística binaria. Resultados: la tasa de profesionales de enfermería afectados por el COVID-19 fue del 44,3% y los factores asociados al contagio fueron el número de personas en una misma vivienda con COVID-19 (OR 36,18; p<0,001) y el uso de transporte público (OR 2,70; p=0,044). Presentar síntomas graves (OR 29,75), pertenecer al grupo de riesgo (OR 3,00), tener taquipnea (OR 6,48), dificultad para respirar (OR 5,83), cansancio (OR 4,64), fiebre (OR 4,41) y/o mialgia (OR 3,00) aumentó las chances de hospitalización de los profesionales con COVID-19. Conclusión: vivir en el mismo domicilio que otras personas que tienen la enfermedad y utilizar el transporte público aumentó el riesgo de contagio por el nuevo coronavirus. Los factores asociados a la hospitalización de los profesionales contagiados fueron la presencia de factores de riesgo para enfermarse, la gravedad y el tipo de síntomas presentados.

ABSTRACT Evidence indicates that the physiological role of vitamin D goes beyond regulating classical domains of minerals and hormones. It is reported that the low status of Vitamin D may contribute to the occurrence of metabolic disorders, with emphasis on insulin resistance, atherosclerotic events and metabolic syndrome. In this sense, this study aimed to verify the association between metabolic and anthropometric parameters and vitamin D status in patients with chronic kidney disease undergoing hemodialysis. This was a cross-sectional study conducted with 95 patients with chronic kidney disease treated at clinics in Teresina, Piaui, Brazil. Lipid and inflammatory profile, glycemia, insulin and vitamin D status were determined. Data were analyzed using STATA software, adopting significance level of p<0.05. The results pointed to a significant association between vitamin D concentrations and adiposity of patients. It was observed that the high blood glucose and HOMA-IR values presented statistical association with vitamin D concentrations, and conditioned greater chances of their inadequacy. There was no correlation between nutrient concentrations and cytokines evaluated in the study. Therefore, it was concluded that the increase in levels of glycoinsulinemic parameters (insulin and HOMA-IR) seems to influence vitamin D status in patients with chronic kidney disease.

RESUMEN La evidencia indica que el papel fisiológico de la vitamina D va más allá de regular los dominios clásicos del eje mineral y hormonal. Hay trabajos que muestran que el bajo nivel de vitamina D puede contribuir a la aparición de trastornos metabólicos, con énfasis en la resistencia a la insulina, eventos ateroscleróticos y síndrome metabólico. En este sentido, el objetivo de este estudio fue verificar la asociación entre parámetros metabólicos y antropométricos y el estado de vitamina D en pacientes renales crónicos en hemodiálisis. Se trata de un estudio transversal realizado con 95 pacientes con enfermedad renal crónica atendidos en consultas externas de Teresina, Piauí, Brasil. Se determinó el perfil lipídico e inflamatorio, la glicemia, la insulina y el estado de vitamina D. Los datos se analizaron utilizando programa STATA , con un nivel de significancia de p<0,05. Los resultados apuntaron a una asociación significativa entre las concentraciones de vitamina D y la adiposidad de los pacientes. Se observó que los valores elevados de glucosa en sangre y HOMA-IR se asociaron estadísticamente con las concentraciones de vitamina D y condicionaron mayores posibilidades de su insuficiencia. No hubo correlación entre las concentraciones de nutrientes y las citocinas evaluadas en el estudio. Por tanto, se concluyó que el aumento de los niveles de parámetros glucoinsulinémicos (insulina y HOMA-IR) parece influir en el estado de la vitamina D en pacientes con enfermedad renal crónica.

ABSTRACT Reinfection by the severe acute respiratory syndrome coronavirus type 2 (SARS-COV-2) has been reported in many countries, suggesting that the virus may continue to circulate among humans despite the possibility of local herd immunity due to massive previous infections. The emergence of variants of concern (VOC) that are more transmissible than the previous circulating ones has raised particular concerns on the vaccines effectiveness and reinfection rates. The P.1 lineage was first identified in December 2020 in Manaus city and is now globally spread. We report the first case of reinfection of SARS-CoV-2 caused by the P.1 variant outside of Manaus. The potential of these new variants to escape naturally and vaccine- induced immunity highlights the need for a global vigilance.

This paper describes the monitoring of ethyl carbamate concentration in sugar cane spirit from industrial distilleries in Brazil. In total, 18 distilleries from Minas Gerais and São Paulo states were evaluated, with, a total of 336 samples from August 2017 to August 2019. The ethyl carbamate was analyzed using a previously validated mass spectrometric method. Analytical curves presented coefficient of determination (R2) values higher than 0.99, and quality control samples showed a relative standard deviation (RSD) below 9%. Concentrations of ethyl carbamate ranged from not detected to 1608 µg L-1, with mean values of 294.2, 280.7 and 230.0 µg L-1 in 2017, 2018, and 2019, respectively. On average, 46, 44 and 69% of samples presented levels of ethyl carbamate below 210 µg L-1. A variety of factors may have led to distillery A having a low level (ca. 115 µg L-1) of ethyl carbamate, including controlled temperature, yeast strain, post-harvesting quality, sugar cane variety choice, and the treatment process on the sugar cane juice, which goes towards the addition of Ca(OH)2, heating and freezing. These results showed the importance of internal quality control, and that sugar cane juice treatment may be a way to decrease ethyl carbamate in the distilleries.

BACKGROUND Despite efforts to mitigate the impact of dengue virus (DENV) epidemics, the virus remains a public health problem in tropical and subtropical regions around the world. Most DENV cases in the Americas between January and July 2019 were reported in Brazil. São Paulo State in the southeast of Brazil has reported nearly half of all DENV infections in the country. OBJECTIVES To understand the origin and dynamics of the 2019 DENV outbreak. METHODS Here using portable nanopore sequencing we generated20 new DENV genome sequences from viremic patients with suspected dengue infection residing in two of the most-affected municipalities of São Paulo State, Araraquara and São José do Rio Preto. We conducted a comprehensive phylogenetic analysis with 1,630 global DENV strains to better understand the evolutionary history of the DENV lineages that currently circulate in the region. FINDINGS The new outbreak strains were classified as DENV2 genotype III (American/Asian genotype). Our analysis shows that the 2019 outbreak is the result of a novel DENV lineage that was recently introduced to Brazil from the Caribbean region. Dating phylogeographic analysis suggests that DENV2-III BR-4 was introduced to Brazil in or around early 2014, possibly from the Caribbean region. MAIN CONCLUSIONS Our study describes the early detection of a newly introduced and rapidly-expanding DENV2 virus lineage in Brazil.

RESUMO A saúde tem múltiplos fatores determinantes, entre eles, a posse da terra e a posição de classe de um grupo populacional. Este artigo teve como objetivo debater o conceito saúde do campo a partir da construção do conceito ‘do campo’ no caminho percorrido pela educação e pela saúde dentro do Movimento dos Trabalhadores Rurais Sem Terra (MST). Foi realizada a análise documental de textos desenvolvidos pelo próprio MST e de pesquisas sobre o movimento, assim como entrevistas já publicadas a lideranças. O conceito ‘do campo’ tem sido amplamente debatido pelo Setor da Educação e Saúde no MST ressaltando seu significado como lugar de vida, e não somente de produção, que não deve ser definido só a partir do antagonismo da cidade. A educação do campo é pensada pelos próprios camponeses favorecendo sua identidade, costumes e cultura. A saúde é preocupação do MST desde 1980 quando foram criadas as equipes de saúde nas primeiras ocupações de terras. O MST tem desenvolvido encontros e documentos de discussão sobre o tema, refletindo sobre a saúde e reivindicando, além da atenção médica com prioridade à promoção e prevenção, o respeito às diferenças culturais e o fortalecimento das práticas não convencionais em saúde.

ABSTRACT Health has multiple determinants, including land tenure and the class position of a population group. This article aimed to discuss the concept of health in the countryside, based on the construction of the concept of ‘the countryside’ on the path of education and health within the Landless Rural Workers Movement (MST). Documentary analysis of texts developed by the MST itself and research on the movement was carried out, as well as interviews already published to leaders. The concept of ‘the countryside’ has been widely debated by the Education and Health Sector in the MST, emphasizing its meaning as a place of life, and not only of production, which should not be defined only from the antagonism of the city. Rural education is thought by the peasants themselves, favoring their identity, customs and culture. Health has been a concern of the MST since 1980 when health teams were created in the earliest land occupations. The MST has developed meetings and discussion papers on the subject, reflecting on health and claiming, in addition to medical care with priority to promotion and prevention, respect for cultural differences and strengthening of unconventional practices in health.

Abstract INTRODUCTION Chikungunya causes fever and severe and persistent joint pain. METHODS We reported a chikungunya outbreak that occurred in Ceará State, Brazil between 2016 and 2017 with emphasis on epidemiological characterization of cases, high number of deaths, mortality-associated factors, and spatial and temporal spread of the epidemic among municipalities. RESULTS: In November 2015, the first autochthonous cases of chikungunya were confirmed in Ceará, Brazil. In 2016-2017, 195,993 cases were reported, with an incidence of 2,186.5/100,000 inhabitants and 244 confirmed deaths. CONCLUSIONS: Rapid transmission and high mortality rate are serious problems, especially in regions with co-circulating arboviruses.

RESUMO A saúde tem múltiplos fatores determinantes, entre eles, a posse da terra e a posição de classe de um grupo populacional. Este artigo teve como objetivo debater o conceito saúde do campo a partir da construção do conceito ‘do campo’ no caminho percorrido pela educação e pela saúde dentro do Movimento dos Trabalhadores Rurais Sem Terra (MST). Foi realizada a análise documental de textos desenvolvidos pelo próprio MST e de pesquisas sobre o movimento, assim como entrevistas já publicadas a lideranças. O conceito ‘do campo’ tem sido amplamente debatido pelo Setor da Educação e Saúde no MST ressaltando seu significado como lugar de vida, e não somente de produção, que não deve ser definido só a partir do antagonismo da cidade. A educação do campo é pensada pelos próprios camponeses favorecendo sua identidade, costumes e cultura. A saúde é preocupação do MST desde 1980 quando foram criadas as equipes de saúde nas primeiras ocupações de terras. O MST tem desenvolvido encontros e documentos de discussão sobre o tema, refletindo sobre a saúde e reivindicando, além da atenção médica com prioridade à promoção e prevenção, o respeito às diferenças culturais e o fortalecimento das práticas não convencionais em saúde.

ABSTRACT Health has multiple determinants, including land tenure and the class position of a population group. This article aimed to discuss the concept of health in the countryside, based on the construction of the concept of ‘the countryside’ on the path of education and health within the Landless Rural Workers Movement (MST). Documentary analysis of texts developed by the MST itself and research on the movement was carried out, as well as interviews already published to leaders. The concept of ‘the countryside’ has been widely debated by the Education and Health Sector in the MST, emphasizing its meaning as a place of life, and not only of production, which should not be defined only from the antagonism of the city. Rural education is thought by the peasants themselves, favoring their identity, customs and culture. Health has been a concern of the MST since 1980 when health teams were created in the earliest land occupations. The MST has developed meetings and discussion papers on the subject, reflecting on health and claiming, in addition to medical care with priority to promotion and prevention, respect for cultural differences and strengthening of unconventional practices in health.