28492 research outputs found
Sort by
Free-living Amoebae and Their Relationship to Air Quality in Hospital Environments: Characterization of Acanthamoeba Spp. Obtained From Air-Conditioning Systems
No full textFree-living amoebae (FLA) are widely dispersed in the environment, can cause opportunistic and non-opportunistic infections in humans and other animals. The aim of the present study was characterize FLA obtained from air-conditioners of a public hospital in the city of Florianópolis, SC, Brazil. Fifty-four dust samples were collected of air conditioners, and were inoculated on 1.5% non-nutrient agar, overlaid with layers of Escherichia coli. Subsequently the isolates were axenised in PYG growth medium. The morphological and molecular characterization of the isolates was performed, as well as the tolerance (physiological) assays were used to evaluate the pathogenic potential. The results revealed the presence of FLA in 42 (77.8%) of the collected samples. Of these, 39 (92.9%) axenic isolates of FLA were obtained for morphological and genotypic studies. All the isolates characterized belong to the genus Acanthamoeba. Nineteen (48.7%) isolates belong to the genotype T4, 16 (41.0%) to the T5 genotype and 4 (10.3%) to genotype T11. Seven (18.0%) isolates were considered potentially pathogenic in tolerance assays. These findings require attention, considering the isolation environment and immunocompromised characteristics of many hospitalized patients.2100-01-0
Salvar vidas ou a economia é falso dilema
No full textDevido a pandemia mundial do COVID-19, o artigo da revista foi liberado em acesso aberto durante o ano de 2020, visando divulgação e disseminação
Neonatal surveillance for congenital Zika infection during the 2016 microcephaly outbreak in Salvador, Brazil: Zika virus detection in asymptomatic newborns
No full textHRP Alliance, part of the UNDP/
UNFPA/UNICEF/WHO/World Bank Special Programme of Research,
Development and Research Training in Human Reproduction (HRP)
and the UNICEF/UNDP/World Bank/WHO Special Programme for
Research and Training in Tropical Diseases (TDR), both cosponsored
programs hosted by the World Health Organization (WHO). The Pan
American Health Organization (PAHO) provided technical support
throughout project implementation. Financial support was also provided
by the National Council for Scientific and Technological Development
(CNPq) (425380/2016, 440685/2016-8, and 443875/2018) and by
Coordination for the Improvement of Higher Education Personnel
(CAPES) (88887.130716/2016-00 and 88881.130825/2016-00). The
authors are grateful to the physicians and nurses charged with the patients’
clinical care and would also like to thank the Arboviral Diseases Branch
Diagnostic and Reference Team (Vector-Borne
Diseases Division of the
Centers for Disease Control and Prevention) for kindly providing the reagents
necessary for MAC-ELISA
serological testing. Andris K. Walter provided
English language revision and manuscript copyediting assistance.To identify newborns with congenital Zika infection (CZI) at a maternity hospital in Salvador, Brazil, during the 2016 microcephaly outbreak. Methods: A prospective study enrolled microcephalic and normocephalic newborns
with suspected CZI between January and December 2016. Serology (immunoglobulins
IgM and IgG) and quantitative reverse transcriptase polymerase chain reaction
(RT-qPCR)
for the Zika virus were performed. Demographic and clinical characteristics
of newborns with and without microcephaly were compared.
Results: Of the 151 newborns enrolled, 32 (21.2%) were classified as microcephalic.
The majority of these cases were born between January and May 2016. IgM and
IgG Zika virus antibodies were detected in 5 (23.8%) and 17 (80.9%) microcephalic
newborn blood samples, respectively. Six (24%) microcephalic newborns tested
positive for Zika virus by RT-qPCR
in urine or placenta samples. Thirteen (11.8%)
normocephalic newborns also tested positive for Zika virus by PCR in urine,
plasma, or placenta samples, while IgM antibodies against Zika were detected in 4
(4.2%) others.
Conclusions: Identification of 17 normocephalic CZI cases, confirmed by IgM serology
or RT-qPCR
for Zika virus, provides evidence that CZI can present asymptomatically at
birth. This finding highlights the need for prenatal and neonatal screening for Zika virus
in endemic regions
Angiostrongylus minasensis n. sp.: nova espécie encontrada parasitando quatis (Nasua nasua) em área de proteção urbana no Brasil
No full textExistem 21 espécies de Angiostrongylus que parasitam as artérias pulmonares ou mesentéricas de
roedores silvestres e domésticos, felídeos, canídeos e homem. Espécies de Angiostrongylus têm uma
distribuição cosmopolita que abrange regiões tropicais, subtropicais e temperadas. O procionídeo
Nasua nasua (quati) é hospedeiro de vários parasitos que podem ser prejudiciais para suas
populações ou conter agentes etiológicos com potencial zoonótico. Nas áreas urbanas, os quatis podem ser encontrados em estreita associação com seres humanos e animais domésticos.
Nós caracterizamos morfológica e molecularmente uma nova espécie de Angiostrongylus
encontrada em N. nasua de uma área protegida na cidade de Belo Horizonte, Brasil. A nova espécie
de Angiostrongylus difere de outras espécies do mesmo gênero pelo comprimento e nível de
bifurcação dos raios lateral e ventral, o comprimento dos espículos e a morfologia da cauda da
fêmea. Resultados moleculares e filogenéticos baseados no gene mitocondrial citocromo c oxidase
subunidade 1 indicam que a espécie recém-identificada pertence a uma linhagem genética
separada de outras espécies de Angiostrongylus. O presente relato descreve uma nova espécie de
Angistrongylus coletada das artérias mesentéricas de N. nasua, denominada Angiostrongylus
minasensis n. sp..Currently, there are 21 species of Angiostrongylus that parasitize the pulmonary or mesenteric arteries of wild and domestic rodents, felids, canids and human. Species of Angiostrongylus have cosmopolitan distribution covering tropical, subtropical and temperate regions. The procyonid Nasua nasua (coati) is a reservoir host for a wide variety of parasites that may be harmful to its populations or may contain etiological agents with zoonotic potential. In urban areas, coatis are usually found in close association with humans and domestic animals. We morphologically and molecularly characterized a new species of Angiostrongylus found in N. nasua in a protected area within Belo Horizonte, Brazil. The new species of Angiostrongylus differs from other species of the same genus in terms of the length and bifurcation level of the lateral and ventral rays, the length of spicules and female tail morphology. Molecular phylogenetic results based on the mitochondrial cytochrome c oxidase subunit 1 gene suggest that the newly identified species belongs to a genetic lineage that is separate from other species of Angiostrongylus. This new species was collected from the mesenteric arteries of N. nasua. It was named Angiostrongylus minasensis n. sp.
Regional trends and patterns of public health consortia in Brazil
No full textAs estratégias e instrumentos de cooperação intergovernamental na gestão e prestação de serviços são aspectos importantes para o avanço da regionalização do Sistema Único de Saúde (SUS). Os consórcios públicos são acordos entre entes federativos através da constituição de associação pública ou pessoa jurídica de direito privado, de acordo com a Lei 11.107/2005. A pesquisa teve como objetivo analisar as tendências e os padrões regionais dos consórcios públicos de saúde no Brasil no período de 2005 a 2015. Buscou-se compreender como os consórcios se desenvolveram no país considerando o número, as características e a localização dos municípios consorciados, no contexto da regulamentação federal e estadual sobre o tema. Foram analisados dados sobre municípios consorciados no país considerando a presença de todos os entes federativos utilizando os dados da Pesquisa MUNIC/IBGE. Além disso, se levantou a produção legislativa disponível em todos os estados brasileiros a fim de identificar nos documentos, elementos normativos e processos regionais sobre a implementação dos consórcios anteriores e posteriores à 2005. Os resultados encontrados mostram que embora os consórcios não sejam novas estruturas na gestão pública nacional, ainda existem divergências no campo do Direito Brasileiro acerca de seus formatos organizacionais. As tendências e os padrões regionais sugerem que após a publicação da Lei de Consórcios Públicos, o número de municípios consorciados no setor saúde aumentou para mais de 50 % em números absolutos no período entre 2005 a 2015. Verificou-se o aumento da presença de estados e da União na conformação de consórcios intermunicipais, que foi uma das mudanças relativas à nova legislação. Além disso, identificou-se um aumento do número de municípios consorciados nas regiões nordeste, centro-oeste e norte, regiões que não possuíam tradição de consorciamento se comparada às regiões sul e sudeste. No plano estadual, observou-se um aumento da produção legislativa sobre o tema com maior protagonismo dos entes estaduais nos processos de conformação de consórcios. Os processos de desenvolvimento de consórcios intergovernamentais se colocam como uma profícua agenda futura de pesquisa, assim como um maior aprofundamento dos consórcios públicos como atores da coordenação federativa regional.The strategies and instruments of intergovernmental cooperation in the management and provision of services are important aspects for the advancement of the regionalization of the Unified Health System (SUS). Public consortia are agreements between federative entities through the constitution of a public association or legal entity under private law, in accordance with Law 11.107/2005. The research aimed to analyze the trends and regional patterns of public health consortia in Brazil from 2005 to 2015. We sought to understand how consortia developed in the country considering the number, characteristics and location of the consortium municipalities, in the context of federal and state regulations on the subject. Data on consortium municipalities in the country were analyzed considering the presence of all federative entities using data from the MUNIC/IBGE Survey. In addition, the legislative production available in all Brazilian states was surveyed in order to identify in the documents, normative elements and regional processes on the implementation of consortia before and after 2005. The results show that although the consortia are not new structures in the national public management, there are still divergences in the field of Brazilian law regarding their organizational formats. Regional trends and patterns suggest that after the publication of the Public Consortia Law, the number of municipalities in the health sector increased to over 50% in absolute numbers in the period from 2005 to 2015. There was an increase in the presence of states and the federal government in forming inter-municipal consortia, which was one of the changes related to the new legislation. In addition, an increase in the number of municipalities in the northeast, central-west and north regions was identified, regions that did not have a consortium tradition when compared to the south and southeast regions. At the state level, there was an increase in legislative production on the topic, with a greater role for state entities in the processes of forming consortia. The development processes of intergovernmental consortia stand as a fruitful future research agenda, as well as a greater deepening of public consortia as actors in the regional federative coordination
Nethis Informa
No full textBoletim informativo desenvolvido pelo Nethis/Fiocruz Brasília com os principais eventos e notícias. Edição publicada no dia 21/12/2020
COVID-19 in Brazil: advantages of a socialized unified health system and preparation to contain cases
No full textThe outbreak of new coronavirus disease 2019 (COVID-19) reported for the first time in Wuhan, China in late December 2019 have rapidly spread to other countries and it was declared on January 30, 2020 as a public health emergency of international concern (PHEIC) by the World Health Organization. Before the first COVID-19 cases were reported in Brazil, several measures have been implemented including the adjustment of legal framework to carry out isolation and quarantine. As the cases increased significantly, new measures, mainly to reduce mortality and severe cases, have also been implemented. Rapid and robust preparedness actions have been undertaken in Brazil while first cases have not yet been identified in Latin-American. The outcome of this early preparation should be analyzed in future studies
A importância da vigilância entomológica de Simulium damnosum s.l. (Diptera: Simuliidae) como um dos indicadores para o controle do nível de endemicidade, do risco de transmissão e eliminação da Oncocercose na Guiné-Bissau
No full textDesde o início da implementação das ações de luta contra a Oncocercose, após a independência do país em 1988, passaram-se quase 29 anos. As referidas ações de luta até hoje foram possíveis graças ao apoio dos parceiros no fornecimento gratuito dos medicamentos Ivermectina (Mectizan®) e Albendazol, apoio financeiro e a capacitação de recursos humanos, o que tem permitido ao país fazer face as ações de luta e de prevenção da Oncocercose. A partir do estudo de cartografia realizado, concluído nos finais de anos 90, foram descobertos dois focos endêmicos importantes, um mesoendêmico (35-60%) nas comunidades do rio Geba, e outro hipermesodêmico (>60%) no rio Corubal; por biopsia cutânea na zona leste, nomeadamente na Região de Bafatá e região de Gabu. Essa zona endêmica para Oncocercose é banhada por dois grandes Rios - Geba e Corubal, que favorecem a bioecologia do inseto vetor transmissor da doença. Ao longo dos anos, foram feitos vários estudos epidemiológicos para avaliação do impacto do tratamento, assim como de estudos de avaliação entomológica para avaliar o nível da taxa de infeção parasitaria do inseto vetor, de infectividade e do risco de transmissão A prevalência sorológica no último estudo epidemiológico em 2015, variou entre 1% a 14,92% e a entomológica mostrou que nos pontos de captura tradicionais, somente um ponto de captura no rio Corubal, mostra ainda a presença de larvas de parasitas infetantes nos Simulídeos maior que o limiar que corresponde a taxa de prevalência 3,1432 0 /00 das fêmeas capturadas. Fato que vem evidenciar a redução da transmissão da Onchocerca volvulus por S. damnosum s.l. e da cmfl (Carga de microfilária comunitária) para a Fase - 1.b para à Fase -2, segundo o quadro conceptual de APOC de eliminação de Oncocercose. Assim sendo, vê-se importante a realização de um estudo de avaliação entomologia da doença no país mais atual, o que permitirá saber se ainda existe o risco de transmissão deste parasita ao homem, sendo esta uma estratégia de vigilância para monitorar a possibilidade de recrudescência da doença. Por outro lado, foi formalizada a parceria e assistência técnica entre o Laboratório de Referência Nacional em Simulídeos, Oncocercose e Mansonelose do Instituto Oswaldo Cruz-Fiocruz e o PNLO, através do INASA, este acordo de cooperação estabelecido permitirá a formação de técnicos, troca de experiência e construção do laboratório de entomologia médica na antiga Sede do Programa de Luta Contra a Oncocercose em GabuAlmost 29 years have passed since the implementation of actions to combat onchocerciasis after the country's independence in 1988. The aforementioned fight actions have been made possible thanks to the support of partners in the free supply of the drugs Ivermectin (Mectizan®) and Albendazole, financial support and the training of human resources, which has allowed the country to face the actions of struggle and prevention of onchocerciasis. From the cartography study carried out, completed in the late 1990s, two important endemic foci were discovered, one with a mesoendemic prevalence (35-60%) in the communities of the river Geba and another with a hypermesodemic prevalence (>60%) in the river Corubal, by skin biopsy in the east, namely in the Bafatá Region and Gabu region. This endemic area for onchocerciasis is bathed by two large rivers - Geba and Corubal, which favor the bioecology of the insect vector that transmits the disease. Over the years, several epidemiological studies have been carried out to assess the impact of treatment, as well as studies of entomological assessment to assess the level of the parasitic infection rate of the vector insect, infectivity and the risk of transmission The sorological prevalence in the last epidemiological study in 2015 varied between 1% to 14.92%, and the entomological test showed that in traditional capture points, only one capture point in the Corubal River, also shows the presence of larvae of infectious parasites in the Simulids greater than the threshold corresponding to the prevalence rate of 3.1432% of the captured females. This fact shows that the reduction in transmission of Onchocerca volvulus by S. damnosum s.l. and Cmfl (Community microfilaria charge) for Phase - 1.b for Phase -2, according to the APOC conceptual framework for eliminating onchocerciasis. Therefore, it is important to carry out a study to evaluate entomology of the disease in the most current country, which will allow to know if there is still a risk of transmission of this parasite to man, which is a surveillance strategy to monitor the possibility of recrudescence. disease. On the other hand, in the framework of partnership and technical assistance, in the National Reference Laboratory of Simulids, Onchocerciasis and Mansoneliasis of the Oswaldo Cruz Institute-Fiocruz and PNLO, through INASA, the agreement established and the consequent cooperation flowchart, will allow the training of technicians, exchange of experience and construction of the medical entomology laboratory at the former Headquarters of the Program to Fight Onchocerciasis in Gab
Public health emergencies: brief history, concepts, and applications
No full textOs processos históricos de mudanças nos padrões de morbidade e mortalidade no mundo, a
partir da segunda metade do século passado, têm sido denominados de transição epidemiológica.
Essa denominação, estabelecida por Omran, visou estabelecer o que estaria relacionado,
no campo da saúde, com outros processos de mudanças nos padrões populacionais, definido
como transição demográfica. De forma resumida, a redução na taxa de fecundidade das
populações, a redução na mortalidade infantil e o aumento da expectativa de vida ao nascer,
que se observava principalmente nos países desenvolvidos (mas que seria seguido, após um
lapso de tempo e de forma uniforme, pelos países menos desenvolvidos), estariam associados
à redução na mortalidade por doenças transmissíveis, com maior impacto em crianças. Esse
grupo de doenças estava sendo superado pelas doenças crônico-degenerativas, mais frequentes
em grupos etários mais avançados. Às três etapas do processo de transição epidemiológica
descritas inicialmente, que ocorreriam de acordo com o estágio de desenvolvimento do País,
incorporou-se uma quarta etapa, caracterizada pela redução de algumas doenças crônicas,
em especial, das doenças cardiovasculares. Como modelo explicativo para esses processos,
destacava-se a disponibilidade e o uso das tecnologias médicas (especialmente antibióticos e
vacinas), o que justificaria a redução das doenças transmissíveis, mais facilmente controláveis
– em princípio – a essas tecnologias
Platelet activation and platelet-monocyte aggregate formation trigger tissue factor expression in patients with severe COVID-19
No full textSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emergent pathogen responsible for the coronavirus disease 2019 (COVID-19). Since its emergence, the novel coronavirus has rapidly achieved pandemic proportions causing remarkably increased morbidity and mortality around the world. A hypercoagulability state has been reported as a major pathologic event in COVID-19, and thromboembolic complications listed among life-threatening complications of the disease. Platelets are chief effector cells of hemostasis and pathological thrombosis. However, the participation of platelets in the pathogenesis of COVID-19 remains elusive. This report demonstrates that increased platelet activation and platelet-monocyte aggregate formation are observed in severe COVID-19 patients, but not in patients presenting mild COVID-19 syndrome. In addition, exposure to plasma from severe COVID-19 patients increased the activation of control platelets ex vivo. In our cohort of COVID-19 patients admitted to the intensive care unit, platelet-monocyte interaction was strongly associated with tissue factor (TF) expression by the monocytes. Platelet activation and monocyte TF expression were associated with markers of coagulation exacerbation as fibrinogen and D-dimers, and were increased in patients requiring invasive mechanical ventilation or patients who evolved with in-hospital mortality. Finally, platelets from severe COVID-19 patients were able to induce TF expression ex vivo in monocytes from healthy volunteers, a phenomenon that was inhibited by platelet P-selectin neutralization or integrin αIIb/β3 blocking with the aggregation inhibitor abciximab. Altogether, these data shed light on new pathological mechanisms involving platelet activation and platelet-dependent monocyte TF expression, which were associated with COVID-19 severity and mortality