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Vacinômetro: o que já sabemos sobre vacinas contra a covid-19 no mundo
No full textVacinas eficazes e seguras contra a covid-19 já são uma realidade para a ciência. O desafio atual é a oferta de doses para imunizar toda a população. O Brasil conta atualmente com duas vacinas que já começaram a ser distribuídas à população, a partir dos grupos considerados prioritários: a Coronavac, da Sinovac, produzida pelo Instituto Butantan, em São Paulo; e a de Oxford/AstraZeneca, com previsão de ser fabricada pela Fiocruz. Atrasos na entrega do insumo para a produção das doses também comprometem o calendário de imunização. Radis preparou um resumo sobre as principais vacinas disponíveis no mundo, com o que a ciência já sabe e a previsão (ou não) de chegada no Brasil
Susceptibility loci for pancreatic cancer in the Brazilian population
No full textPancreatic adenocarcinoma (PA) is a very aggressive cancer and has one of the poorest prognoses. Usually, the diagnosis is late and resistant to conventional treatment. Environmental and genetic factors contribute to the etiology, such as tobacco and alcohol consumption, chronic pancreatitis, diabetes and obesity. Somatic mutation in pancreatic cancer cells are known and SNP profle by GWAS could access novel genetic risk factors for this disease in diferent population context. Here we describe a SNP panel for Brazilian pancreatic cancer, together with clinical and epidemiological data. Methods: 78 pancreatic adenocarcinoma and 256 non-pancreatic cancer subjects had 25 SNPs genotyped by realtime PCR. Unconditional logistic regression methods were used to assess the main efects on PA risk, using allelic, co-dominant and dominant inheritance models.
Results: 9 SNPs were nominally associated with pancreatic adenocarcinoma risk, with 5 of the minor alleles conferring protective efect while 4 related as risk factor. In epidemiological and clinical data, tobacco smoking, diabetes and pancreatitis history were signifcantly related to pancreatic adenocarcinoma risk. Polygenic risk scores computed using the SNPs in the study showed strong associations with PA risk. Conclusion: We could assess for the frst time some SNPs related with PA in Brazilian populations, a result that could be used for genetic screening in risk population such as familial pancreatic cancer, smokers, alcohol users and diabetes patients
CoronaFatos: Especial - Comunicação e Covid
No full textFicha técnica: Apresentação: Gustavo Audi e Ana Cristina Figueira / Roteiro: Gabriel Fonseca / Produção: Valéria Mauro e Branca Murat / Edição e Finalização: Marcelo Louro / Arte: Marcelo Vianna / Idealização: Canal Saúde - Fundação Oswaldo Cruz.Neste terceiro episódio da série especial com entrevistas do CoronaFatos, tratamos sobre comunicação em tempos de pandemia com a coordenadora da Coordenação de Comunicação Social da Presidência da Fiocruz, Elisa Andries
Neurovascular Interactions in Malaria
No full textMalaria is caused by Plasmodium infection and remains a se rious public health problem worldwide, despite control ef forts. Malaria can progress to severe forms, affecting multi ple organs, including the brain causing cerebral malaria (CM). CM is the most severe neurological complication of malaria, and cognitive and behavior deficits are commonly reported in surviving patients. The number of deaths from
malaria has been reducing in recent years, and as a conse quence, neurological sequelae have been more evident. Neurological damage in malaria might be related to the neu roinflammation, characterized by glia cell activation, neuro nal apoptosis and changes in the blood-brain barrier (BBB) integrity. The neurovascular unit (NVU) is responsible for maintaining the homeostasis of the BBB. Endothelial and pericytes cells in the cerebral microvasculature and neural cells, as astrocytes, neurons, and microglia, compose the
NVU. The NVU can be disturbed by parasite metabolic prod ucts, such as heme and hemozoin, or cytokines that can promote activation of endothelial and glial cells and lead to in creased BBB permeability and subsequently neurodegener ation. In this review, we will approach the main changes that
happen in the cells of the NVU due to neuroinflammation
caused by malaria infection, and elucidate how the systemic
pathophysiology is involved in the onset and progression of
CM
Avaliação de parâmetros da capacidade vetorial para arbovírus em populações de Aedes aegypti e Culex quinquefasciatus
No full textZika (ZIKV) e chikungunya (CHIKV)representam um problema de saúde pública mundial. Conhecer aspectos da capacidade vetorial de seus transmissores é importante para a definição de estratégias de controle mais eficazes. O objetivo deste trabalho foi avaliar o custo biológico da exposição aos ZIKV e CHIKVem Aedes aegyptie Culex quinquefasciatus. Amostras de campo foram coletados em Recife, Pernambuco. Ae. aegyptide campo (AeCamp) e de laboratório (RecLab) e Cx. quinquefasciatus de laboratório (CqSLab) foram expostas à alimentação sanguínea artificial com ZIKV e CHIKV. Avaliou-se fecundidade, fertilidade, sobrevida, longevidade, atividade de repasto sanguíneo e resposta aos DEET e Picaridina. A sobrevida de RecLab foi duas vezes menor entre os grupos expostosao ZIKV, com relação aos não expostos,e a longevidade não foi alterada.Em AeCamp, o ZIKV não alterou a sobrevida e longevidade das fêmeas. A fecundidade e fertilidade de RecLab não sofreu impacto pelo ZIKV, enquanto AeCamp teve a fertilidade reduzida, nos grupos expostos. Infectadas com CHIKV, fêmeas de RecLab tiveram redução na sobrevida e longevidade. O CHIKV reduziu a fecundidade em AeCamp e a fertilidade nas duas colônias avaliadas. Em CqSLab, a exposição ao ZIKV reduziu a fecundidade e fertilidade entre os grupos expostos, mas não entre aqueles que foram expostas e desenvolveram a infecção. A atividade de repasto sanguíneo não foi alterada pelos ZIKV e CHIKV nas três colônias avaliadas. Expostas ao ZIKV, fêmeas de RecLab tiveram redução na resposta ao DEET, a 1%, mas não a 5%. Conclui-se que o ZIKV impacta diferentemente no fitnessde Ae. aegyptie Cx. quinquefasciatus. O impacto do CHIKV em Ae. aegyptié maior com relação ao custo biológico das fêmeas expostas ao ZIKV. Estes resultados podem contribuir para a definição de métodos mais eficazes de controle vetorial, de modo a potencializar o custo da exposição aos vírus, aqui caracterizado pela redução na fecundidade, fertilidade e resposta ao DEET (AU).Zika (ZIKV) and chikungunya (CHIKV) represent a global public health problem. Knowing aspects of the vectorial capacity of your transmitters is important for defining more effective control strategies. The objective of this work was to evaluate the biological cost of exposure to ZIKV and CHIKV in Aedes aegyptiand Culex quinquefasciatus. Field samples were collected in Recife, Pernambuco. Ae. aegyptifrom field (AeCamp) and from laboratory (RecLab) and Cx. quinquefasciatusfrom laboratory (CqSLab) were exposed to artificial blood feed with ZIKV and CHIKV. Fecundity, fertility, survival, longevity, blood meal activity and response to DEET and Picaridin were evaluated. RecLab survival was twice as low amonggroups exposed to ZIKV, compared to non-exposed ones, and longevity was not altered. In AeCamp, ZIKV did not change female survival and longevity. The fecundity and fertility of RecLab was not impacted by ZIKV, while AeCamp had reduced fertility in the exposed groups. Infected with CHIKV, females from RecLab had reduced survival and longevity. CHIKV reduced fecundity in AeCamp and fertility in the two colonies evaluated. In CqSLab, exposure to ZIKV reduced fecundity and fertility among exposed groups, but not among those who were exposed and developed the infection. The blood repast activity was not altered by ZIKV and CHIKV in the three colonies evaluated. Exposed to ZIKV, females from RecLab had a reduced response to DEET, at 1%, but not at 5%. It is concluded that the ZIKV impacts differently on the fitness of Ae. aegyptiand Cx. quinquefasciatus. The impact of CHIKV on Ae. aegyptiis higher in relation to the biological cost of females exposed to ZIKV. These results may contribute to the definition of more effective vector control methods, in order to increase the cost of exposure to the virus, here characterized by a reduction in fertility, fertility and response to DEET (AU)
Significance of a neglected tropical disease: Lessons from a paradigmatic case of ‘success in translation’
Get PDFEm publicação anterior, enfatizei a importância fundamental da pesquisa para a melhoria da saúde usando como exemplo o controle da doença de Chagas nas Américas.(1) Para tanto, analisei os principais avanços científicos e eventos de saúde pública desde a descoberta da doença de Chagas e seu patógeno causador, Trypanosoma cruzi, por Carlos Chagas, em 1909,(2) até o controle bem-sucedido de sua transmissão por insetos vetores em grandes regiões dos países do Cone Sul na década de 90.(3) Nos vinte anos desde aquela publicação, o Brasil e os países latino-americanos tiveram que lidar com uma série de sérias ameaças à saúde pública, antigas e novas: (i) recrudescimento de doenças bem conhecidas, como dengue e febre amarela; (ii) surgimento de doenças virais que estavam restritas a outros continentes (Zika, Chikungunya); (iii) novas epidemias (H1N1) ou (iv) pandemias (COVID-19). Ainda há algumas lições dessa história de sucesso contra uma doença negligenciada dos anos 90 que seriam relevantes hoje no contexto desses desafios recentes?In a previous publication, I stressed the fundamental importance of research for improving health using as an example the control of Chagas disease in the Americas.(1) For that purpose, I analysed the major scientific breakthroughs and public health events from the 1909 discovery of Chagas disease and its causative pathogen, Trypanosoma cruzi, by Carlos Chagas,(2) through the successful control of its transmission by insect vectors in large regions of the Southern Cone countries in the 90s.(3) In the twenty years since that publication, Brazil and Latin American countries had to cope with a number of serious public health threats, old and new: (i) recrudescence of well-known diseases, such as dengue and yellow fever; (ii) emergence of viral diseases that had been restricted to other continents (Zika, Chikungunya); (iii) new epidemics (H1N1) or (iv) pandemics (COVID-19). Are there still some lessons from that success story against a neglected disease of the 90s that would be relevant today in the context of these recent challenges
Saúde Amanhã: Textos para Discussão 50: Arranjos institucionais na prestação de serviços de saúde, trabalho em saúde e tecnologias digitais em diferentes cenários prospectivos
No full textPublicação cujo objetivo é divulgar resultados de estudos desenvolvidos no âmbito do Projeto Saúde Amanhã, disseminando informações sobre a prospecção estratégica em saúde, em um horizonte móvel de 20 anos. Busca, ainda, estabelecer um espaço para discussões e debates entre os profissionais especializados e instituições do setor. As opiniões emitidas nesta publicação são de exclusiva e de inteira responsabilidade do autor, não exprimindo, necessariamente, o ponto de vista da Fiocruz/MS. O projeto Saúde Amanhã é conduzido pela Fundação Oswaldo Cruz (Fiocruz) no contexto da “Estratégia Fiocruz para a Agenda 2030”/Fiocruz. É permitida a reprodução deste texto e dos dados nele contidos, desde que citada a fonte. Reproduções para fins comerciais são proibidas.Ana Luiza d´Ávila Viana, Universidade de São Paulo, foi convidada pela Fiocruz, para autoria e desenvolvimento do conteúdo do trabalho.
Hudson Pacífico da Silva, Universidade de São Paulo, foi convidado pela Fiocruz, para autoria e desenvolvimento do conteúdo do trabalho.
Fabíola Lana Iozzi, Universidade Estadual de Campinas, foi convidada pela Fiocruz, para autoria e desenvolvimento do conteúdo do trabalho
Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study
No full textSince January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.This study was supported by grants from the following Brazilian research promotion agencies: Conselho Nacional de Desenvolvimento Científico e Tecnológico --- CNPq (National Council for Scientific and Technological Development - CNPq), Process 401597/2020-2; and Fundac ¸ão Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro FAPERJ (Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro --- FAPERJ), Process E-26/010.000160/2020, grant 2020/0996.Objective: To describe the clinical, laboratory, and radiological characteristics, as well as theoutcomes of children with MIS-C. Method: Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. Results: Fifty-six patients were included, with the following conditions: Kawasaki-like disease(n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1). Median age was 6.2 years (IQR2.4−10.3), 70% were boys, 59% were non-whites, 20% had comorbidities, 48% reported a contact with COVID-19 cases, and 55% had a recent SARS-CoV-2 infection confirmed by RT-PCR and/or serology. Gastrointestinal symptoms were present in 71%, shock symptoms in 59%, and severe respiratory symptoms in less than 20%. d-Dimer was increased in 80% and cardiac dysfunction markers in more than 75%. Treatment included immunoglobulin (89%); corticosteroids, antibi-otics, and enoxaparin in about 50%; and oseltamivir and antifungal therapy in less than 10%. Only 11% needed invasive mechanical ventilation, with a median duration of five days (IQR 5---6.5). The median length of PICU stay was six days (IQR 5---11), and one death occurred (1.8%). Conclusions: Most characteristics of the present MIS-C patients were similar to that of other cohorts. The present results may contribute to a broader understanding of SARS-CoV-2 infection in children and its short-term consequences. Long-term multidisciplinary follow-up is needed, since it is not known whether these patients will have chronic cardiac impairment or other sequelae