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Mycobacterium leprae is the etiological agent of leprosy. Macrophages (Mφs) are key players involved in the pathogenesis of leprosy. In this study, immunohistochemical analysis was performed to examine the phenotype of Mφ subpopulations, namely M1, M2, and M4, in the skin lesions of patients diagnosed with leprosy. Based on the database of treatment-naïve patients treated between 2015 and 2019 at the Department of Dermatology of the University of the State of Pará, Belém, routine clinical screening samples were identified. The monolabeling protocol was used for M1 macrophages (iNOS, IL-6, TNF-α) and M2 macrophages (IL-10, IL-13, CD163, Arginase 1, TGF-β, FGFb), and the double-labeling protocol was used for M4 macrophages (IL-6, MMP7, MRP8, TNF-α e CD68). To confirm the M4 macrophage lineage, double labeling of the monoclonal antibodies CD68 and MRP8 was also performed. Our results demonstrated a statistically significant difference for the M1 phenotype among the Virchowian (VV) (4.5 ± 1.3, p < 0.0001), Borderline (1.6 ± 0.4, p < 0.0001), and tuberculoid (TT) (12.5 ± 1.8, p < 0.0001) clinical forms of leprosy. Additionally, the M2 phenotype showed a statistically significant difference among the VV (12.5 ± 2.3, p < 0.0001), Borderline (1.3 ± 0.2, p < 0.0001), and TT (3.2 ± 0.7, p < 0.0001) forms. For the M4 phenotype, a statistically significant difference was observed in the VV (9.8 ± 1.7, p < 0.0001), Borderline (1.2 ± 0.2, p < 0.0001), and TT (2.6 ± 0.7, p < 0.0001) forms. A significant correlation was observed between the VV M1 and M4 (r = 0.8712; p = 0.0000) and between the VV M2 × TT M1 (r = 0.834; p = 0.0002) phenotypes. The M1 Mφs constituted the predominant Mφ subpopulation in the TT and Borderline forms of leprosy, whereas the M2 Mφs showed increased immunoexpression and M4 was the predominant Mφ phenotype in VV leprosy. These results confirm the relationship of the Mφ profile with chronic pathological processes of the inflammatory response in leprosy.

Knowing the determinants of food choices allows the nutritionist to develop more assertive guidelines considering biopsychosocial factors to produce effective changes in eating practices. This cross-sectional, descriptive, and analytical study aimed to test the correlation between the determinants of food choices and the socioeconomic and demographic factors of individuals with hepatitis B and C. Patients with hepatitis B and/or C aged between 20 and 74 years were evaluated from August 2020 to August 2021. Their socioeconomic and demographic data and clinical data were collected, and The Eating Motivation Survey (TEMS) was applied. A total of 145 individuals were evaluated, with a mean age of 53.54 ± 12.14 years. There were positive weak correlations between gender ( p 2 = 0.193; p = 0.020) and age ( p 2 = 0.177; p = 0.033) with the scale "preference"; negative correlations between age and the scales "price" ( p 2 = -0.204; p = 0.014) and "emotion control" ( p 2 = -0.168; p = 0.044); negative correlations between education and the scales "convenience" ( p 2 = -0.172; p = 0.039) and "social norms" ( p 2 = -0.206; p = 0.013); and income showed a negative correlation with "price" ( p 2 = -0.208; p = 0.012) and a positive correlation with "weight control" ( p 2 = 0.186; p = 0.025). These findings contribute to the development of more realistic and feasible eating strategies that favor food autonomy.

Arboviruses, such as yellow fever virus (YFV), dengue virus (DENV), and chikungunya virus (CHIKV), present wide global dissemination and a pathogenic profile developed in infected individuals, from non-specific clinical conditions to severe forms, characterised by the promotion of significant lesions in different organs of the harbourer, culminating in multiple organ dysfunction. An analytical cross-sectional study was carried out via the histopathological analysis of 70 samples of liver patients, collected between 2000 and 2017, with confirmed laboratory diagnoses, who died due to infection and complications due to yellow fever (YF), dengue fever (DF), and chikungunya fever (CF), to characterise, quantify, and compare the patterns of histopathological alterations in the liver between the samples. Of the histopathological findings in the human liver samples, there was a significant difference between the control and infection groups, with a predominance of alterations in the midzonal area of the three cases analysed. Hepatic involvement in cases of YF showed a greater intensity of histopathological changes. Among the alterations evaluated, cell swelling, microvesicular steatosis, and apoptosis were classified according to the degree of tissue damage from severe to very severe. Pathological abnormalities associated with YFV, DENV, and CHIKV infections showed a predominance of changes in the midzonal area. We also noted that, among the arboviruses studied, liver involvement in cases of YFV infection was more intense., Competing Interests: The authors declare no conflicts of interest.

The Brazilian Amazon has a specific epidemiological profile for cryptococcosis, considering its social and economic inequality, health reality, and low access to health services. Furthermore, Brazil and Colombia have the highest cryptococcosis incidence rates in Latin America. In this study, we identified the areas of risk for cryptococcosis in the state of Pará in the Brazilian Amazon. This was an ecological study of patients admitted to a referral hospital from 2008 to 2018, aged 13 years or older, and of both sexes. The spatial distribution was determined using ArcGis 10.3.1 software. Cryptococcosis was confirmed in 272 cases. The incidence rate was 3.41 cases/100,000 inhabitants. Spatial distribution was concentrated in the Metropolitana de Belém, Nordeste Paraense, and Marajó mesoregions. The sociodemographic profile consisted of 62% men, aged between 24 and 34 years (36%), without completed secondary education (64.7%), and with occupations varying between agricultural activities (13.8%) and household activities (22%). The mean hospitalization time was 39 days; the prevalent clinical form was neurological (89.7%). The mortality rate among patients with cryptococcosis was up to 40%. Knowledge of the real magnitude of the disease in the Brazilian Amazon makes it possible to identify areas with the greatest risks and to propose control and epidemiological surveillance programs.

Leprosy is a chronic infection caused by Mycobacterium leprae . There is a lack of data regarding environmental reservoirs, which may represent a serious public health problem in Brazil, especially in the state of Pará, which occupies the fourth position in incidence of cases in the country. Previous studies report evidence of infection occurring among armadillos, mangabei monkeys, and chimpanzees. In the present study, wild animals were captured and tested for the presence of anti-PGL-1 antibodies and M. leprae DNA. Fieldwork was carried out from October to November of 2016 in the cities of Curionópolis and Canaã dos Carajás, southeast of Pará state. Small and medium-sized wild animals were captured using appropriate traps. A total of 15 animals were captured. Sera and viscera fragments were collected and tested by ELISA and PCR methods. The presence of M. leprae DNA was confirmed by sequencing of specific gyrase gene in three animals of two different species, including one Necromys lasiurus (liver sample) and two Proechimys roberti (kidney and liver samples). This unprecedented finding suggests that species other than those previously reported are responsible for maintaining M. leprae in nature.

Yellow fever (YF) is a pansystemic disease caused by the yellow fever virus (YFV), the prototype species of the family Flaviviridae and genus Flavivirus , and has a highly complex host-pathogen relationship, in which endothelial dysfunction reflects viral disease tropism. In this study, the in situ endothelial response was evaluated. Liver tissue samples were collected from 21 YFV-positive patients who died due to the disease and five flavivirus-negative controls who died of other causes and whose hepatic parenchyma architecture was preserved. Immunohistochemical analysis of tissues in the hepatic parenchyma of YF cases showed significantly higher expression of E-selectin, P-selectin, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and very late antigen-4 in YFV-positive cases than in flavivirus-negative controls. These results indicate that endothelium activation aggravates the inflammatory response by inducing the expression of adhesion molecules that contribute to the rolling, recruitment, migration, and construction of the inflammatory process in the hepatic parenchyma in fatal YF cases.

Introduction: The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barré syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection., Methods: Twelve fatal cases of neonates, whose mothers were infected with ZIKV during pregnancy, were examined; cases included nine neonatal deaths due to microcephaly, one miscarriage, and two stillbirths. Tissue samples were obtained from all cases at necropsy and were submitted for virological investigation (RT-qPCR and virus isolation) and/or histopathology (hematoxylin and eosin staining) and immunohistochemical assay for the detection of ZIKV antigens., Results: ZIKV antigens and/or ZIKV RNA were detected in tissue samples of all 12 cases examined. ZIKV was recovered in one case. Results of the virological and immunohistochemical analyses, as well as the anatomic abnormalities and histopathologic changes observed at necropsy on the 12 fatal cases, are presented., Conclusions: Data from these 12 cases provide strong evidence of the causal relationship between ZIKV and congenital disease in fetuses of women who were infected with the virus during pregnancy., Competing Interests: The authors declare no conflict of interest.