Search

Brazil currently ranks second in absolute deaths by COVID-19, even though most of its population has completed the vaccination protocol. With the introduction of Omicron in late 2021, the number of COVID-19 cases soared once again in the country. We investigated in this work how lineages BA.1 and BA.2 entered and spread in the country by sequencing 2173 new SARS-CoV-2 genomes collected between October 2021 and April 2022 and analyzing them in addition to more than 18,000 publicly available sequences with phylodynamic methods. We registered that Omicron was present in Brazil as early as 16 November 2021 and by January 2022 was already more than 99% of samples. More importantly, we detected that Omicron has been mostly imported through the state of São Paulo, which in turn dispersed the lineages to other states and regions of Brazil. This knowledge can be used to implement more efficient non-pharmaceutical interventions against the introduction of new SARS-CoV variants focused on surveillance of airports and ground transportation.

Monogenic forms of diabetes mellitus may affect a significant number of patients of this disease, and it is an important molecular cause to be investigated. However, studies of the genetic causes of monogenic diabetes, especially in populations with mixed ethnic backgrounds, such as the one in Brazil, are scarce. The aim of this study was to screen several genes associated with monogenic diabetes in fifty-seven Brazilian patients with recurrence of the disease in their families and thirty-four relatives. Inclusion criteria were: Age of onset ≤ 40 years old, BMI < 30 kg/m², at least two affected generations and negative anti-GAD and anti-IA2 antibodies. MODY genes HNF4A , GCK , HNF1A , HNF1B , NEUROD1 , KLF11 , PAX4 , INS , KCNJ11 , and MT-TL1 were sequenced by Sanger sequencing. We identified a total of 20 patients with variants, 13 GCK-MODY, four HNF1A-MODY, and one variant in each of the following genes, HNF4A , HNF1B and MT-TL1 . Segregation analysis was performed in 13 families. Four variants were novel, two in GCK (p.(Met115Val) [c.343A>G] and p.(Asp365GlufsTer95) [c.1094&#95;1095insGCGA]) and two in HNF1A (p.(Tyr163Ter) [c.489C>G] and p.(Val380CysfsTer39) [c.1136&#95;1137insC]). Here we highlight the importance of screening for monogenic diabetes in admixed populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abreu, Tarantino, da Fonseca, Andrade, de Souza, Soares, Cambraia, Cabello, Rodacki, Zajdenverg, Zembrzuski and Campos Junior.)

Polar regions are among the most affected areas by the current global warming. In the Southern Hemisphere (SH), impacts of a warmer climate include decrease in sea-ice extent, changes in oceanic and in atmospheric circulation. Recently, some of these impacts were reinforced by the positive phase of the Southern Annular Mode (SAM). SAM is the dominant mode of variability of the SH extratropical climate and manifests as a "ring-shape" regular pattern of atmospheric mean sea level pressure (MSLP) with opposite sign between mid and high SH latitudes. Over the last three decades, SAM has presented a positive trend, and some studies associate it to stratospheric ozone depletion and to an increase in greenhouse gases concentration. As this debate is still open, climate models constitute useful tools to understand the SH variability in future scenarios. Here we use monthly MSLP outputs from the Brazilian Earth System Model (BESM) to examine SAM temporal and spatial behavior in future climate scenarios compared to the historical period. Our results for the BESM simulations suggest that the mean spatial pattern of SAM does not change with global warming, but an increase in the radiative forcing may reinforce positive SAM values obtained for the historical period.

Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period., Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization., Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2., Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

Robust evidence on the involvement of genetic factors in the etiology of Parkinson's disease (PD) expands our knowledge about monogenic causes that contribute for this important neurodegenerative disorder. Mutations in the CHCHD2 gene have been linked to autosomal dominant forms of PD, although there is still lack of evidence for CHCHD2 variants leading to the disease in mixed populations as those from South America. To assess the contribution of CHCHD2 as a causal factor for familial PD in Brazil, one of the most heterogeneous populations in the world, we conducted the first molecular analysis of the CHCHD2 gene in a cohort of 122 index cases from Brazilian families with autosomal dominant forms of PD. Genomic DNA was isolated from peripheral blood and the 4 exons of the CHCHD2 gene, and their intron-exon boundaries were analyzed by bidirectional Sanger sequencing. No pathogenic or risk variants were found, suggesting that genetic variants of CHCHD2 are not a common cause of familial PD in Brazilian patients., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The notification of the Human Immunodeficiency Virus (HIV) in Brazilian children was first reported in 1984. Since that time more than 21 thousand children became infected. Approximately 99.6% of the children aged less than 13 years old are vertically infected. In this context, most of the children are abandoned after birth, or lose their relatives in a near future, growing with uncertain identification. The present study aims to estimate the dental age of Brazilian HIV patients in face of healthy patients paired by age and gender. The sample consisted of 160 panoramic radiographs of male (n: 80) and female (n: 80) patients aged between 4 and 15 years (mean age: 8.88 years), divided into HIV (n: 80) and control (n: 80) groups. The sample was analyzed by three trained examiners, using Willems' method, 2001. Intraclass Correlation Coefficient (ICC) was applied to test intra- and inter-examiner agreement, and Student paired t-test was used to determine the age association between HIV and control groups. Intra-examiner (ICC: from 0.993 to 0.997) and inter-examiner (ICC: from 0.991 to 0.995) agreement tests indicated high reproducibility of the method between the examiners (P<0.01). Willems' method revealed discrete statistical overestimation in HIV (2.86 months; P=0.019) and control (1.90 months; P=0.039) groups. However, stratified analysis by gender indicate that overestimation were only concentrated in male HIV (3.85 months; P=0.001) and control (2.86 months; P=0.022) patients. The significant statistical differences are not clinically relevant once only few months of discrepancy are detected applying Willems' method in a Brazilian HIV sample, making this method highly recommended for dental age estimation of both HIV and healthy children with unknown age., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: In this article we present the plants used for the treatment of malaria and associated symptoms in Santa Isabel do Rio Negro in the Brazilian Amazon. The region has important biological and cultural diversities including more than twenty indigenous ethnic groups and a strong history in traditional medicine., Objective: The aims of this study are to survey information in the Baniwa, Baré, Desana, Piratapuia, Tariana, Tukano, Tuyuca and Yanomami ethnic communities and among caboclos (mixed-ethnicity) on (a) plant species used for the treatment of malaria and associated symptoms, (b) dosage forms and (c) distribution of these anti-malarial plants in the Amazon., Methods: Information was obtained through classical ethnobotanical and ethnopharmacological methods from interviews with 146 informants in Santa Isabel municipality on the upper Negro River, Brazil., Results: Fifty-five mainly native neotropical plant species from 34 families were in use. The detailed uses of these plants were documented. The result was 187 records (64.5%) of plants for the specific treatment of malaria, 51 records (17.6%) of plants used in the treatment of liver problems and 29 records (10.0%) of plants used in the control of fevers associated with malaria. Other uses described were blood fortification ('dar sangue'), headache and prophylaxis. Most of the therapeutic preparations were decoctions and infusions based on stem bark, root bark and leaves. These were administered by mouth. In some cases, remedies were prepared with up to three different plant species. Also, plants were used together with other ingredients such as insects, mammals, gunpowder and milk., Conclusion: This is the first study on the anti-malarial plants from this region of the Amazon. Aspidosperma spp. and Ampelozizyphus amazonicus Ducke were the most cited species in the communities surveyed. These species have experimental proof supporting their anti-malarial efficacy. The dosage of the therapeutic preparations depends on the kind of plant, quantity of plant material available, the patient's age (children and adults) and the local expert. The treatment time varies from a single dose to up to several weeks. Most anti-malarial plants are domesticated or grow spontaneously. They are grown in home gardens, open areas near the communities, clearings and secondary forests, and wild species grow in areas of seasonally flooded wetlands and terra firme ('solid ground') forest, in some cases in locations that are hard to access. Traditional knowledge of plants was found to be falling into disuse presumably as a consequence of the local official health services that treat malaria in the communities using commercial drugs. Despite this, some species are used in the prevention of this disease and also in the recovery after using conventional anti-malarial drugs., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

The aim this study was to determine the in vitro susceptibility to fosfomycin of bacteria isolated from urine samples of pregnant women with urinary tract infection. Samples of urine culture with bacterial growth of pregnant women were collected from clinical laboratories in Tubarão, state of Santa Catarina, Brazil, between September 2012 and May 2013. In the experimental stage, the colonies were tested for sensitivity to fosfomycin by using the Kirby-Bauer method. The following information relating to the samples was also collected: patients' age, colony count, type(s) of identified bacterial(s) and result of the antimicrobial sensitivity test. Student's t-test was used for mean comparison. A total of 134 samples were selected for the study. The age of the subjects ranged from 15 to 40 years (mean 26.7). Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive) were the most commonly identified species. In 89% of cases, the microorganisms were sensitive to fosfomycin. E. coli and S. aureus were the main species of bacteria responsible for urinary tract infections in women in the study area. The most prevalent microorganisms in pregnant women with urinary tract infection were susceptible to fosfomycin., (Copyright © 2015. Published by Elsevier Editora Ltda.)

In the present work, we evaluated the mineral composition of three sugarcane varieties from different areas in northeast Brazil and their influence on the fermentation performance of Saccharomyces cerevisiae. The mineral composition was homogeneous in the different areas investigated. However, large variation coefficients were observed for concentrations of copper, magnesium, zinc and phosphorus. Regarding the fermentation performances, the sugarcane juices with the highest magnesium concentration showed the highest ethanol yield. Synthetic media supplemented with magnesium also showed the highest yield (0.45 g g(-1)) while the excess of copper led to the lowest yield (0.35 g g(-1)). According to our results, the magnesium is the principal responsible for the increase on the ethanol yield, and it also seems to be able to disguise the inhibitory effects of the toxic minerals present in the sugarcane juice.

Objective: To evaluate the epidemiology and prognostic factors associated with traumatic brain injury by a firearm projectile (FAP)., Methods: We reviewed the medical records of 181 patients in the Department of Neurosurgery of Santa Casa de São Paulo (São Paulo Holy House) diagnosed with traumatic brain injury (TBI) resulting from FAP from January 1991 to December 2005. Were evaluated: age, sex, Glasgow Coma Scale (GCS) on admission, brain region affected by the FAP, type of injury (penetrating or tangential), type of treatment and outcome, based on GCS. The relationship between therapeutic strategy and outcome was analyzed using the Chi-square test with Yates correction. The Fisher test was used to verify the same correlation individually for each group stratified by GCS on admission., Results: Of the 181 patients, 85% were male (n = 154) and 15% female (n = 27). Mean age was 31.04 years (± 10.98). The mostly affected brain region was the frontal lobe (27.6%), followed by temporal (24.86%) and occipital (16.57%) ones. Of the TBIs evaluated, 16% were tangential and 84%, penetrating., Conclusion: Patients undergoing surgical treatment had better outcome than those submitted to conservative treatment, and patients who were more severe at admission (GCS 3-8) have better results with the neurosurgical procedure.

This paper establishes the spawning habitat of the Brazilian sardine Sardinella brasiliensis and investigates the spatial variability of egg density and its relation with oceanographic conditions in the shelf of the south-east Brazil Bight (SBB). The spawning habitats of S. brasiliensis have been defined in terms of spatial models of egg density, temperature-salinity plots, quotient (Q) analysis and remote sensing data. Quotient curves (Q(C)) were constructed using the geographic distribution of egg density, temperature and salinity from samples collected during nine survey cruises between 1976 and 1993. The interannual sea surface temperature (SST) variability was determined using principal component analysis on the SST anomalies (SSTA) estimated from remote sensing data over the period between 1985 and 2007. The spatial pattern of egg occurrences in the SBB indicated that the largest concentration occurred between Paranaguá and São Sebastião. Spawning habitat expanded and contracted during the years, fluctuating around Paranaguá. In January 1978 and January 1993, eggs were found nearly everywhere along the inner shelf of the SBB, while in January 1988 and 1991 spawning had contracted to their southernmost position. The SSTA maps for the spawning periods showed that in the case of habitat expansion (1993 only) anomalies over the SBB were zero or slightly negative, whereas for the contraction period anomalies were all positive. Sardinella brasiliensis is capable of exploring suitable spawning sites provided by the entrainment of the colder and less-saline South Atlantic Central Water onto the shelf by means of both coastal wind-driven (to the north-east of the SBB) and meander-induced (to the south-west of the SBB) upwelling., (© 2010 The Authors. Journal of Fish Biology © 2010 The Fisheries Society of the British Isles.)

The aim of our investigation was to evaluate, with a prevalence study, the modes of transmission of Hepatitis B virus (HBV), within infected subjects and their household contacts in the State of Amazon, western Brazilian Amazon. We studied 97 index cases and 258 household contacts. Out of the 258 household contacts of HBV, 51.6% had serological markers of a past infection, 12.0% signs of active infection, suggesting that the virus circulates within household members. The high prevalence among siblings (23.6%) demonstrates the importance of personal contact in the transmission of this virus. Another indirect indicator of intra-familial transmission was the high prevalence of HBV markers within contacts of a fulminant hepatitis. The vertical transmission of HBV in our region may or may not occur, but if it does it as a rare event. Our results demonstrate the importance of the presence of HBV, and demand other investigations to clarify the inter-familial transmission of these viruses in our region.

Purpose: Our experience with surgical treatment of heart diseases in Indians living in the Amazon rain forest in primitive stages was reviewed., Methods: From 1988 to 1995, 18 patients underwent cardiovascular surgical procedures at the São Paulo Hospital of the Escola Paulista de Medicina. Seven patients had valvar disease, nine congenital heart defects, one submitral aneurysm and one arrhythmia. Thirteen Indians came from tribes of the Amazon rain forest area: three from the Xavante, two from Waiapi, two from Tucano, two from Macuxi, two from Mayoruna, and one of each tribe of Xikrin, Guajajara, Terena, Surui, Galibi, Cinta-Larga and Pataxó., Results: We performed 22 operations, with two hospital deaths. Follow-up was possible in 87.5% of cases, with one late death. The majority of cases were due to congenital heart defects and in this series it was noted the absence of operations to treat coronary artery disease. The incidence of valve disease was higher in accultured or semi-accultured Indians., Conclusion: The surgical treatment of cardiovascular disease has made possible to the surviving indians to return to and be accepted by their fellow tribesmen.