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Free-living amoebae (FLA) are amphizoic protozoans with a cosmopolitan distribution. Some strains of species are associated with infections in humans. They feed on microorganisms by phagocytosis; however, some of these can become endocytobionts by resisting this process and taking shelter inside the amoeba. The whole world is experiencing increasing shortage of water, and sewage is being reused, so the study of this environment is important in public health context. The objective of this work was to identify FLA present in sewage treatment plants in Porto Alegre, Brazil. About 1 L samples were collected from eight stations (raw and treated sewage) in January, February, July, and August 2022. The samples were sown in monoxenic culture, and the isolated amoebae were subjected to morphological and molecular identification. Polymerase chain reaction results indicated the presence of the genus Acanthamoeba in 100% of the samples. Gene sequencing showed the presence of Acanthamoeba lenticulata and Acanthamoeba polyphaga - T5 and T4 genotypes - respectively, which are related to pathogenicity. The environment where the sewage is released can be used in recreational activities, exposing individuals to potential interactions with these amoebae and their potential endocytobionts, which may pose risks to public health. [ABSTRACT FROM AUTHOR]

Free-living amoebae (FLA) are protozoa dispersed in different environments and are responsible for different infections caused to humans and other animals. Microorganisms such as Acanthamoeba spp., Vermamoeba sp., and Naegleria sp. are associated with diseases that affect the central nervous system, in addition to skin infections and keratitis, as occurs in the genus Acanthamoeba and with Vermamoeba vermiformis. Due to the concerns of these FLA in anthropogenic aquatic environments, this work aimed to identify these microorganisms present in waters of Porto Alegre, Brazil. One litre sample was collected in two watercourses during the summer of 2022 and inoculated onto non-nutrient agar plates containing heat-inactivated Escherichia coli. Polymerase chain reaction results indicated the presence of FLA of the genera Acanthamoeba, Vermamoeba, and Naegleria in the study areas. Genetic sequencing indicated the presence of V. vermiformis and Naegleria gruberi. These aquatic and anthropogenic environments can serve as a means of spread and contamination by FLA, which gives valuable information on public health in the city. [ABSTRACT FROM AUTHOR]

Occurrences of young and immature individuals, relatively rare in the fossil record, are important due to the great amount of morphological and evolutionary information they reveal about a lineage's development. Although crocodylomorphs are the most abundant terrestrial vertebrates found in the Bauru Basin, southeastern Brazil, even outnumbering dinosaurian materials, much remains to be understood about their anatomy, ecology, and ontogeny. Egg fragments, nests and nesting sites attributed to Baurusuchus have been previously described, but unfortunately none of these yielded embryonic or hatchling remains. Here, we describe, for the first time, skeletal material of a small notosuchian yearling, recovered from the Adamantina Formation, with osteological features consistent with a baurusuchid affinity. We provide and discuss osteological and histological evidence of its ontogenetic stage, revealing morphological characters distinct from most adult forms, including conspicuous centro-parapophyseal laminae and developed ventral keels. Computerised tomography data also allowed for the identification of incipient ossification and a novel ontogenetic feature in the diminishing volume of the frontal´s internal recesses. Similar materials will increase our understanding of notosuchian ontogeny and diversity, thus requiring growth characters to be integrated into future phylogenies. [ABSTRACT FROM AUTHOR]

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From 2016 to 2019, Southeastern Brazil faced an outbreak of yellow fever (YF) affecting both humans and New World primates (NWP). The outbreak was associated with a marked increase in traumatic lesions in NWP in the affected regions. Non-thrombotic pulmonary embolization (NTPE) can be a consequence of massive traumatic events, and it is rarely reported in human and veterinary medicine. Here, we describe NTPE of the brain, liver, and bone marrow in free-ranging NWP, highlighting the epidemiological aspects of these findings and the lesions associated with this condition, including data on traumatic injuries in wild NWP populations during the course of a recent YF outbreak. A total of 1078 NWP were necropsied from January 2017 to July 2019. Gross traumatic injuries were observed in 444 marmosets (44.3%), 10 howler monkeys (23.2%), 9 capuchins (31.0%), 1 titi-monkey (50.0%), and 1 golden lion tamarin (33.3%). NTPE was observed in 10 animals, including 9 marmosets (2.0%) and 1 howler monkey (10.0%). NTPE was identified in the lung and comprised hepatic tissue in 1 case, brain tissue in 1 case, and bone marrow tissue in 8 cases. Although uncommon, it is important to consider NTPE with pulmonary vascular occlusion during the critical care of traumatized NWP. In addition, this study highlights the importance of conservational strategies and environmental education focusing on One Health, not only to protect these free-ranging NWP populations but also to maintain the efficacy of epidemiological surveillance programs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to encourage graduate students to facilitate a participatory mapping activity with high school students, to have their voices heard in the disaster risk reduction (DRR) agenda. Design/methodology/approach: A participatory mapping, youth-led session, was conducted with 22 high school students, where they had to identify flood and landslide-prone areas. Then, they were asked to propose and plan DRR measures in collaboration with local partners in São Luiz do Paraitinga, Brazil. Findings: The participatory method engaged the graduate students and the high school students in the DRR debate, allowing them to map hazards and vulnerabilities, and to discuss five incubation projects for enhancing DRR in the city. Originality/value: This research highlights the importance of involving young people in DRR formulation and planning to build local capacities in younger generations. The outputs were shared with the local civil defense and a local non-governmental organization (NGO), who suggested recommendations to improve the five incubation projects. [ABSTRACT FROM AUTHOR]

The challenge in the search for relationships between urban space, physical mobility, and health status, is detecting indicators able to link the environment with healthy life habits. Therefore, the objective was to design an urban index for the identification of urban environment propensity for physical activity (PA) and to determine how it relates to lifestyle and anthropometric parametrization of obesity. Participants (N = 318–60.4% women and 39.6% men) were recruited from a mid-sized city with epidemiology and morbidity rates below the average for the mid-west region of Brazil. Body mass index (BMI) was measured and a questionnaire was applied to gather information about PA and life habits. The spatial urban health index (SUHI) was designed in a geographic information system using data from demographic, environmental and urban physical features. The relationship between BMI and PA was verified with multiple linear regression, controlled for SUHI levels. Regarding the BMI of the population, 69.5% were classified in the eutrophic or overweight ranges, with no effect of gender and age. The SUHI classified 63.7% of the urban area favorable to PA. The PA routine was adequate (≥3 sessions with ≥1 h each) for ~80% of the population, as well as healthy habits such as non smoking (~94%) and non alcohol abuse (~55%). The SUHI strengthens the relationships of BMI to weekly frequency (r = -0.68; t = -9.4; p<0.001) and session duration (r = -0.66; t = -2.8; p<0.001) for the whole group by improving the explanatory coefficient in ~25% (R2Adj = 0.61 to R2Adj = 0.85). The SUHI indicated that the urban environment is able to promote healthy life habits by diminishing the "obesogenic" features of the city when physical structures are planned to facilitate PA, whatever the gender and age group. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos PAGU is the property of Universidade Estadual de Campinas - Portal de Periodicos Eletronicos Cientificos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Few data are available regarding the prevalence of alcohol abuse (AB) and alcohol dependence (AD) and their association with sociodemographic variables, anxiety and depression in medical students.Objectives: Estimate the prevalence of AB and AD and investigate their relation with sociodemographic variables, depression and anxiety in medical students.Methods: Structured questionnaires regarding alcohol use (AUDIT), depression (PHQ-9) and anxiety (GAD-7) were given to 659 medical students. Data were analyzed using descriptive statistics and logistic regression analyses.Results: The prevalence of AB and AD was, respectively, 28.4% and 15.6%. Multivariate analysis showed statistically significant higher rates of both conditions in men (AB: OR 2.54. AD: OR 2.32) and lower prevalence of these conditions among those in a relationship (AB: OR 0.55. AD: OR 0.43). AB was higher among those living with friends or in a university dorm (OR: 1.65). Prevalence was lower among those currently attending the second (AB: OR 0.48. AD: OR 0.36) and fourth (AB only: OR 0.35) years of medical school. A significant correlation between AD and depression (OR 1.74) was identified.Conclusions: The findings highlight the high prevalence of AB and AD in medical students and identify variables associated with these conditions. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the prevalence, distribution and clinical profile of neurological diseases and syndromes from a neurology outpatient clinic in the city of Rio de Janeiro. This is a quantitative, cross-sectional study. 180 medical records of firsttime visits conducted through 18 months were analyzed. Age, gender and comorbidities were collected to identify the sample's profile and the neurological diagnoses found were classified in predefined groups of syndromes according to the ICD-10 classification, which were further stratified according to age and gender. 157 (87,2%) of the patients had a neurological disease, of which the mean age was 51,05 years and 67,5% were women. The most frequent comorbidities were: hypertension (55,6%); dyslipidemia (20,4%); and diabetes (14,6%). The most common neurological diseases were: Sequelae of Cerebrovascular Disease (12,7%); Unspecified Dementia (8,9%); and Migraine without Aura (7,6%). The main neurological syndromes were: Headache (24,8%); Dementia (15,9%); Cerebrovascular Disease (13,4%); Movement Disorders (12,1%); and Radiculopathy (10,8%). The age and gender profile of these syndromes was further described. These data contribute to better understand the distribution of neurological diseases in the neurological outpatient setting. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Higiene e Sanidade Animal is the property of Associacao Cientifica dos Medicos Veterinarios do Ceara and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This work proposes hybrid models combining time-series models (using linear functions) and artificial intelligence (using a nonlinear function) that can be used to provide monthly mean wind speed predictions for the Brazilian northeast region. These might be useful for wind power generation; for example, they could acquire important information on how the local wind potential can be usable for a possible wind power plant through understanding future wind speed values. To create the proposed hybrid models, it was necessary to set the wind speed variable as a dependent variable of exogenous variables (i.e., pressure, temperature, and precipitation). Thus, it was possible to consider the meteorological characteristics of the study regions. It is possible to verify the hybrid models' efficiency in providing perfect adjustments to the observed data. This statement is based on the low values found in the error statistical analysis, i.e., an error of approximately 5.0% and a Nash-Sutcliffe coefficient near to 0.96. These results were certainly important in predicting the wind speed time-series, which was similar to the observed wind speed time-series profile. Great similarities of maximums and minimums between the series were evident and showed the capacity of the models to represent the seasonality characteristics. [ABSTRACT FROM AUTHOR]

The last decades are witnessing a growing concern about environmental impacts due to human activities. Within this context, studies are being developed to understand the impacts on the diversity of natural elements. This article presents a method to identify geomorphological diversity hotspots at a detailed scale through a quantitative approach, which was applied to a protected coastal area in Rio de Janeiro State, SE Brazil. These hotspots are understood as areas that present significant diversity of landforms and, at the same time, risks of degradation, which justifies the definition of priorities for the territorial management aiming at nature conservation purposes. The results allowed the identification of five hotspots, showing that, even though the area is legally protected, it still faces problems related to threats caused by human activities. Therefore, specific problems of territorial management in a protected area were identified through the creation of a product that indicates the priority areas for conservation in a different way and can be easily applied as a tool to support managers. Furthermore, several subproducts were created in the process, which also can be used for other purposes. • The hotspot map is a tool for the definition of priority areas for conservation. • Threat fronts and threatened landforms can be identified by the threat index map. • All the index and subindex maps present relevant management information. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Scientific Administration / Revista Brasileira de Administração Científica is the property of CBPC - Companhia Brasileira de Producao Cientifica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Studies have evaluated how the urban expansion process impacts ecosystem services and human well-being in coastal areas. Conceptual models have been proposed to analyze this cause-effect relationship, such as DPSWIR (Driving Force-Pressure-State-Impact-Well-being-Response). However, analysis of the effects on human well-being, including health, is explored to a limited extent in the model. This study proposes to adapt the DPSIWR model to better integrate the potential effects on human health and well-being in the analysis due to the loss of coastal ecosystem services caused by the urban expansion process. As a case study, the model is applied to the municipality of Armação dos Búzios, in the southeast of Brazil. From a temporal analysis in which urban expansion was measured in the period between 1976 and 2019, it was registered that the urban area in the municipality went from 1.9% of the territory in 1976 to 20.5% in 2019. Consequently, the ecosystems and their services have been severely affected, which can harm subsistence, security, social relations, and the health of the population. The main group of services impacted by urban expansion was the regulation and maintenance, especially the ones related to the regulation of water flow. These findings indicate an alert for decision makers, mainly regarding the risk of flood events and the emergence of parasitic infectious diseases. As a management response, it is important to consider the integration of environmental and health policies in coastal urban planning plans and strategies. For this, there is a need for better coordination between the public health, urban planning and environment sectors in the municipality. This study proposes a management tool that contributes to an integrated assessment between the aspects of planning, environmental conservation and effects on public health and social well-being, allowing a broader and holistic view of the reality of the territory, thus contributing to the establishment good governance practices. [Display omitted] • We proposed to adapt the DPSIWR framework to improve coastal urban planning. • We analyzed the impacts of urban expansion on ecosystem services and human well-being. • Urban expansion impacts mainly regulation and maintenance services in the study area. • Loss of coastal ecosystem servises can increase the emergence of cases of diseases. [ABSTRACT FROM AUTHOR]

Cururu toad (Rhinella marina group) is widely distributed in Brazil. Lesser grison (Galitic cuja) is a South American mustelid. This is the first report of natural poisoning in a free-ranging lesser grison by Rhinella toad parotoid gland secretion (PGS). Five minutes after biting a toad, the lesser grison developed convulsion, dying within 1.5 h. Mass spectrometry analysis of a milky-whitish secretion found in the lesser grison oral cavity allowed identification of a bufotoxin and a new bufonid peptide. • A free-ranging lesser grison had a lethal poisoning after an attempted predation on Rhinella sp. • The lesser grison (Galitic cuja) exposed to the cururu toad poison developed lethal neurologic signs. • A bufotoxin was detected in the toad secretion collected from the oral cavity of the affected lesser grison. • A novel bufonid peptide was discovered in the toad secretion collected from the oral cavity of the affected lesser grison. [ABSTRACT FROM AUTHOR]

Objective: to analyze maternal knowledge about infant development and its matching to the care offered to children during their first year of life. Method: a longitudinal and prospective study, in the stages of pregnancy and of the child's 12th/13th month of life. Interviews were applied to 121 women in a Brazilian city, based on 21 items selected from the Knowledge of Infant Development Inventory, related to the first year of life. Calculation of rates of correct answers was used, as well as regression by Ordinary Least Squares and White's standard error. Results: the participants who answered correctly more aspects have more years of study, are older and present high family incomes. When the "having a partner or not" variable was considered, the correct answers presented a discrete fluctuation. Regarding the themes, there were more correct answers to aspects about health, safety and infant development milestones. Primiparous mothers were more likely to wean, overprotect and have children using electronic devices, and less likely to seek information about child care. Conclusion: there was matching between some maternal knowledge and execution of child care. The connection between them is relevant to indicate in detail the unknowns and uncertainties and to improve positive knowledge, contributing to promoting early childhood development. [ABSTRACT FROM AUTHOR]

Background: Marmosets (Callithrix sp.), including black-tuffed marmosets (C. penicillata), are neotropical primates that can be highly adapted to urban environments, especially parks and forested areas near cities. Staphylococcus spp. are part of the microbiota of many different hosts and lead to opportunistic severe infection. Isolates from wild animals can be resistant to antimicrobial drugs. However, there are a few studies that evaluated Staphylococcus spp. in neotropical primates. The goal of this study was to evaluate Staphylococcus spp. isolated from free-ranging black-tuffed marmosets., Methods: Marmosets were captured in six urban parks. After sedation, skin and rectal swabs and feces were sampled. Staphylococcus spp. isolates were identified by MALDI-ToF and their antimicrobial susceptibility was determined., Results: Over 30% of captured individuals were positive for Staphylococcus spp., and S. aureus was the most isolated species followed by Mammaliicoccus (Staphylococcus) sciuri. With the exception of the marmoset subjected to necropsy, none of the other had lesions, which supports that notion that Staphylococcus spp. are members of the microbiota, but also opportunistic pathogens. Most isolates were susceptible to all antimicrobials tested; however, one isolate of S. epidermidis was resistant to multiple antimicrobials (penicillin, cefoxitin, ciprofloxacin, clindamycin, and erythromycin). We considered S. aureus as the main staphylococci to colonize black-tuffed marmosets., Conclusions: Black-tuffed marmosets can be colonized by several Staphylococcus species, most frequently by S. aureus, and the majority of isolates were sensible to the antimicrobials tested. One S. epidermidis isolate was considered multidrug resistant., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Mortality resulting from coronary artery disease (CAD) among women is a complex issue influenced by many factors that encompass not only biological distinctions but also sociocultural, economic, and healthcare-related components. Understanding these factors is crucial to enhance healthcare provisions. Therefore, this study seeks to identify the social and clinical variables related to the risk of mortality caused by CAD in women aged 50 to 79 years old in Paraná state, Brazil, between 2010 and 2019., Methods: This is an ecological study based on secondary data sourced from E-Gestor, IPARDES, and DATASUS. We developed a model that integrates both raw and standardized coronary artery disease (CAD) mortality rates, along with sociodemographic and healthcare service variables. We employed Bayesian spatiotemporal analysis with Markov Chain Monte Carlo simulations to assess the relative risk of CAD mortality, focusing specifically on women across the state of Paraná., Results: A total of 14,603 deaths from CAD occurred between 2010 and 2019. Overall, temporal analysis indicates that the risk of CAD mortality decreased by around 22.6% between 2010 (RR of 1.06) and 2019 (RR of 0.82). This decline was most prominent after 2014. The exercise stress testing rate, accessibility of cardiology centers, and IPARDES municipal performance index contributed to the reduction of CAD mortality by approximately 4%, 8%, and 34%, respectively. However, locally, regions in the Central-West, Central-South, Central-East, and Southern regions of the Central-North parts of the state exhibited risks higher-than-expected., Conclusion: In the last decade, CAD-related deaths among women in Paraná state decreased. This was influenced by more exercise stress testing, better access to cardiology centers, improved municipal performance index. Yet, elevated risks of deaths persist in certain regions due to medical disparities and varying municipal development. Therefore, prioritizing strategies to enhance women's access to cardiovascular healthcare in less developed regions is crucial., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Background: Since the implementation of the stroke care line in Brazil, the relationship (adequacy) of costs spent during hospitalization with the Brazilian Ministry of Health indicators for a stroke unit have not yet been analyzed., Aims: This study aimed to assess the adequacy of a comprehensive stroke center for key performance indicators and analyze the costs involved in hospitalization. We verified the association between stroke severity at admission and care costs during hospitalization., Methods: A retrospective medical chart review of 451 patients was performed using semiautomatic electronic data from a single comprehensive stroke center in Brazil between July 2018 and January 2020. Clinical and resource utilization data were collected, and the mean acute treatment cost per person was calculated. The Kruskal-Wallis test with Dunn's post-test was used to compare the total costs between stroke types and reperfusion therapies. A robust linear regression test was used to verify the association between stroke severity at hospital admission and the total hospitalization costs. Good adequacy rates were observed for several indicators., Results: Data from 451 patients were analyzed. The stroke unit had good adaptation to key performance indicators, but some critical points needed revision and improvement to adapt to the requirements of the Ministry of Health. The average total cost of the patient's stay was the USD 2,637.3, with the daily hospitalization, procedure, operating room, and materials/medication costs equating to USD 2,011.1, USD 220.7, USD 234.1, and USD 98.8, respectively. There was a positive association between the total cost and length of hospital stay ( p  < 0.001)., Conclusion: The stroke unit complied with most of the main performance indicators proposed by the Brazilian Ministry of Health. Underfunding of the costs involved in the hospitalization of patients was verified, and high costs were associated with the length of stay, stroke severity, and mechanical thrombectomy., 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 © 2024 Ferreira, Luvizutto, Bazan, Bonome, Winckler, Santos, Chiloff, Modolo, Freitas, Barretti, Lange, Minicucci, Souza and Bazan.)

Free-living amoebae (FLA) are amphizoic protozoans with a cosmopolitan distribution. Some strains of species are associated with infections in humans. They feed on microorganisms by phagocytosis; however, some of these can become endocytobionts by resisting this process and taking shelter inside the amoeba. The whole world is experiencing increasing shortage of water, and sewage is being reused, so the study of this environment is important in public health context. The objective of this work was to identify FLA present in sewage treatment plants in Porto Alegre, Brazil. About 1 L samples were collected from eight stations (raw and treated sewage) in January, February, July, and August 2022. The samples were sown in monoxenic culture, and the isolated amoebae were subjected to morphological and molecular identification. Polymerase chain reaction results indicated the presence of the genus Acanthamoeba in 100% of the samples. Gene sequencing showed the presence of Acanthamoeba lenticulata and Acanthamoeba polyphaga - T5 and T4 genotypes - respectively, which are related to pathogenicity. The environment where the sewage is released can be used in recreational activities, exposing individuals to potential interactions with these amoebae and their potential endocytobionts, which may pose risks to public health.

The epidemiology of Staphylococcus spp. has become a major concern among humans and animals due to increasing antimicrobial resistance and frequent reports of infection. Despite the importance of animals as reservoirs for staphylococci, little is known about the epidemiology of Staphylococcus spp. in most nondomestic species, including canids and felids. This study evaluated the frequency, distribution, and patterns of antimicrobial resistance of staphylococcal species isolated from captive felids and canids from Belo Horizonte Zoo, Brazil. Rectal, oral, and nasal swabs from apparently healthy maned wolves ( Chrysocyon brachyurus , n = 7), a lion ( Panthera leo , n = 1), jaguars ( Panthera onca , n = 3), and one swab of a cougar ( Puma concolor ) with an ear infection were streaked onto mannitol salt agar. Colonies identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry, polymerase chain reaction for the Staphylococcus intermedius group (SIG), and 16S rRNA gene sequencing. Isolates were subjected to antimicrobial susceptibility tests and Staphylococcus pseudintermedius strains were subjected to multilocus sequence typing. Staphylococcus species were isolated from 24 of the 34 samples (70.6%). Among the isolated strains, S. pseudintermedius and Staphylococcus felis were the most frequent species (41.7 and 25%, respectively). Five novel sequence types were identified among the S. pseudintermedius isolates. Resistance to tetracycline (7/24, 29.2%) or penicillin (6/23, 26.1%) was significantly higher than the other antimicrobial agents tested ( P < 0.05). One isolate, Staphylococcus nepalensis , was positive for mecA and resistant to five antimicrobials, and was thus classified as multidrug-resistant. The present work suggests that maned wolves are natural hosts of SIG and also reports the isolation of S. felis in sick and healthy, captive, nondomestic carnivores. The isolated staphylococci were susceptible to most classes of antimicrobials tested. However, the multidrug-resistance capability of an S. nepalensis strain reinforces the hypothesis that felids and canids act as reservoirs of pathogens with antimicrobial resistance.

Background: Performing motor evaluations using videoconferencing for patients with Parkinson's disease (PD) is safe and feasible. However, the feasibility of these evaluations is not adequately studied in resource-limited settings., Objective: To evaluate the feasibility of performing motor evaluations for patients with PD in a resource-limited setting., Methods: The examiners rated motor aspects of parkinsonism of 34 patients with PD from the Brazilian public healthcare system through telemedicine with the patient's own means by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) rating scale. Quality measures of the video meeting were also obtained. The feasibility of rating the motor aspects was the primary outcome whereas the rating of individual motor aspects, video meeting quality and predictors of a complete evaluation served as secondary outcomes., Results: The least assessable parameters were freezing of gait (52.9%), gait (70.6%), leg agility, and rest tremor (both 76.5%). Complete MDS-UPDRS part III was possible in 41.2% of patients and 62 out of 374 motor aspects evaluated (16.6%) were missed. Available physical space for a video evaluation was the worst quality measure. Incomplete evaluations were directly associated with disability ( p  = 0.048, r = 0.34) and inversely with available physical space ( p  = 0.003, r = 0.55)., Conclusion: A significant portion of the MDS-UPDRS part III is unable to be performed during telemedicine-based evaluations in a real-life scenario of a resource-limited setting., Competing Interests: The authors have no conflict of interest to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)

Toxoplasmosis is an important zoonotic disease that affects a wide range of warm-blooded host species. Neotropical primates (New World Primates; NWP) are highly susceptible, developing a lethal acute systemic disease. Toxoplasmosis in free-ranging NWP is poorly described, with only a few studies based on serosurveys. Herein we performed a retrospective study focusing on the epidemiology and pathology of toxoplasmosis among 1,001 free-ranging marmoset (Callithrix spp.) deaths from the Brazilian Atlantic Forest. This study included marmosets necropsied at the Instituto Municipal de Medicina Veterinária Jorge Vaitsman (IJV) from January 2017 to July 2019, which were found dead from all regions in the State of Rio de Janeiro. Histopathology, immunohistochemistry, and transmission electron microscopy were performed to better characterize toxoplasmosis in this free-ranging population. All samples were also tested for Yellow Fever Virus (YFV) RT-qPCR by the official diagnostic service. A total of 1,001 free-ranging marmosets were included in this study, with 16 (1.6%) cases of lethal Toxoplasma gondii infections identified both as individual cases and in outbreaks. Presence of infection was not associated with sex, age, geographical distribution, or year of death, and no co-infection with YFV was observed. The main pathological feature in these cases was random necrotizing hepatitis with detection of intralesional T. gondii zoites in all infected cases. Interstitial pneumonia rich in alveolar foamy macrophages and fibrin deposition, necrotizing myocarditis and necrotizing splenitis were also pathological features in affected marmosets. Therefore, toxoplasmosis was considered the cause of death in 1.6% of free-ranging marmosets in this retrospective series, including some cases associated with outbreaks. Necrotizing random hepatitis was a consistent pathological finding in affected cases and sampling of liver should be ensured from Callitrichid post mortem cases., Competing Interests: The authors have declared that no competing interests exist

This study assesses parasitism and pathologic manifestations in free-ranging Crotalus durissus terrificus . A total of 96 rattlesnakes from the State of Minas Gerais (southeast Brazil) were necropsied between September 2019 and February 2020. Granulomatous gastritis affected 48% (46 of 96) of the snakes evaluated, which were associated with the ascaridid nematodes Ophidascaris sp. and Hexametra sp. Other nematodes found included Kalicephalus costatus costatus and Kalicephalus inermis inermis (Diaphanocephalidae; 7%, 7 of 96) in the intestines, Serpentirhabdias sp. (Rhabdiasidae; 18%, 17 of 96) in the lungs, and Hastospiculum sp. (Diplotriaenidae; 2%, 2 of 96) encapsulated in the serosa of the mesentery. Larval cestodes, probably spargana of Spirometra sp. (Diphyllobothriidae; 2%, 2 of 96), were found in the skeletal muscle and unidentified acanthocephalan cystacanths (Oligacanthorhynchidae; 5%, 5 of 96) in the subcutis and coelomic cavity. The pentastome Porocephalus crotali (Porocephalidae; 2%, 2 of 96) was also found in the lungs. Microscopically, intestinal disease was caused by Sarcocystis sp. (7%, 7 of 96), Cryptosporidium sp. (1%, 1 of 96), and Entamoeba sp. (1%, 1 of 96) and fungi (7%, 7 of 96). In addition, hemoparasites such as Hepatozoon spp. (23%, 22 of 96) and Trypanosoma sp. (1%, 1 of 96) were observed in blood smears. This study expands the knowledge of diseases, parasites, and other infectious agents affecting free-ranging C. durissus terrificus in Brazil.

Background: Acanthocephalosis is an important cause of death in captive New World primates (NWP). Once established in a colony, it is extremely difficult to treat and control, quickly spreading among NWP with a high mortality rate. This study aimed to characterize the disease associated with infection with acanthocephalans according to its epidemiological, clinical, and anatomopathological aspects in a captive NWP population., Methods: From 2010 to 2020, a Brazilian zoo had recurrent deaths of NWP associated to acanthocephalan parasitism. Clinical and pathological profiles of these animals were analyzed considering the host species, sex, age, weight, clinical signs, therapeutic protocols, and pathological findings., Results: A total of 27 deaths associated with acanthocephalosis were recorded, all lethal cases affected tamarins and lion tamarins, corresponding to 67.5% of total deaths during the course of this study. Ten animals died with no previously detected clinical signs, whereas cases with noticeable clinical signs often had apathy and progressive weight loss, resulting in cachexia. Symptomatic NWP were treated with anthelmintic protocols, antibiotics, and support therapy. However, all hospitalized animals died and had grossly detectable adult acanthocephalans in the intestinal lumen that were identified as Prosthenorchis sp., which were associated with transmural and ulcerative enteritis., Conclusions: This report revealed the impact of acanthocephalosis in a naturally infected captive colony of NWP, particularly affecting tamarins (Saguinus spp.) and lion tamarins (Leontopithecus spp.), with failed treatment and control strategies., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality., Methods: The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay., Results: The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal-esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death., Conclusions: The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients., (© 2021. The Author(s).)

Background: Toxoplasmosis is a zoonotic disease that affects humans and warm-blooded animals. This study describes an outbreak of toxoplasmosis in howler monkeys (Alouatta sp.) and survival of capuchins (Sapajus apella), under the same environmental conditions., Methods: Howler monkeys were submitted to post-mortem examination. Tissue samples were processed to histopathology and immunohistochemistry to detect lesions and tachyzoites of Toxoplasma gondii. Tissue samples were also frozen and submitted to PCR and genotyping of T. gondii., Results: Typical lesions were observed in several organs including the liver, lymph node, and brain, with intralesional cysts and tachyzoites of T. gondii demonstrated by immunohistochemistry. T. gondii genomic sequences were amplified by PCR, and genotyping characterized the same T. gondii clone in all howler monkeys., Conclusions: Our results support the notion that some species of neotropical primates are highly susceptible to toxoplasmosis and the hypothesis that capuchins (S. apella) may be resistant., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The information of twin pregnancy frequencies in buffaloes is scarce in the literature. Evidence even indicates that twin pregnancies are not carried to term, but it does not seem to be the case. In this case report, the event of twin pregnancy in buffaloes is reported as well as its frequency. Twin birth is the presence of two or more embryos in a single gestation. Multiple births are uncommon in buffaloes since the species is uniparous. We studied a population of Murrah buffaloes in which slightly more than 13,000 births were observed. In this study, the frequency of occurrence of twin births in Murrah buffaloes was 0.14%. This low incidence impaired the estimation of genetic parameters. Twins can have advantages and disadvantages depending on the production system, which are discussed in this case report., (© 2019 Blackwell Verlag GmbH.)

Introduction: National chronic dialysis data are fundamental for treatment planning., Objective: To report data of the annual survey of the Brazilian Society of Nephrology about chronic kidney disease patients on dialysis in July 2012., Methods: A survey based on data of dialysis units from the whole country. The data collection was performed by using a questionnaire filled out on-line by the dialysis units in Brazil., Results: 255 (31.9%) of the dialysis units in the country answered the questionnaire. In July 2012, the total estimated number of patients on dialysis in the country was 97,586. The estimated prevalence and incidence rates of chronic kidney disease on maintenance dialysis were 503 and 177 patients per million population, respectively. The estimated number of new patients starting dialysis in 2012 was 34,366. The annual gross mortality rate was 18.8%. For prevalent patients, 31.9% were aged 65 years or older, 91.6% were on hemodialysis and 8.4% on peritoneal dialysis, 30,447 (31.2%) were on a waiting list of renal transplant, 28.5% were diabetics, 36.6% had serum phosphorus > 5.5 mg/dl and 34.4% hemoglobin < 11 g/dl. A venous catheter was the vascular access for 14.5% of the hemodialysis patients., Conclusion: The prevalence and incidence rates of chronic kidney disease patients on dialysis increased, while the mortality rate tended to decrease compared with 2011. The indicators of the quality of maintenance dialysis remained stable with a trend towards decrease in levels of anemia. The data highlight the importance of the census to guide chronic dialysis therapy.

This paper discusses the relationships between social and health care system inequalities analyzing the approach and operational ways used in scientific studies produced after the foundation of Sistema Unico de Saúde (SUS), the Brazilian health care system. A review was conducted having as framework four internationally indexed Brazilian scientific journals, which publish their papers on-line in the Project Scientific Electronic Library Online (SciELO). All empiric research studies on health produced in Brazil from 1988 onwards were included and eight descriptors were used: social inequalities, health inequalities and health concept. The scientific production on the subject focuses on the fact that differences in health status are a direct result of inequalities in access and use of medical services. At the same time, a strong trend towards dealing with social inequalities through traditional economic indicators, such as income was observed.

Objectives: this study is inserted in an Interdisciplinary Program of Research and aims to learn about the nutritional situation and life context of children under five in the rural environment of Arambaré/RS, Brazil, through an epidemiological cross-sectional descriptive study., Method: the data of anthropometrical assessment (Weight/Age, Age/Height, Weight/Height) expressed in Z scores, whose reference population is that of the National Center for Health Statistics (NCHS) were analyzed in the Epinut software, and the semi-structured form applied to the child's responsible was analyzed through descriptive statistics in the Epi-Info 6.04., Results: It is evidenced that the nutritional problems vary within the social heterogeneity present in the municipality. There are different levels of vulnerability to illness., Conclusion: this study demonstrates the importance of understanding the social dynamics modelling individual behavior that reflects on health.