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Background: Active case-finding is an effective strategy for combating leprosy, especially in early multibacillary cases in endemic regions. This early approach includes systematic actions such as epidemiological investigations, community surveys, and awareness campaigns to identify leprosy cases. This study reports new leprosy cases diagnosed through an active case-finding initiative conducted in 12 underserved populations from Amazonas in 2023., Methods: This is a cross-sectional descriptive study focused on patients diagnosed with leprosy and other dermatological diseases during the multi-professional Amazon Skin Health Program. Data collected for all suspected cases of leprosy encompassed epidemiological information, clinical details, slit skin smear test, histopathological examination, and polymerase chain reaction (PCR) test., Results: Among 13,023 individuals examined, 69 (0.53%) new cases of leprosy were detected: 46.38% were characterized as paucibacillary and 53.62% as multibacillary. Regarding their age and neurologic involvement, 10.1% were detected in children under 15 years, and 20.9% had grade II disability. This effort accounted for an increase of 21.8% in the year-based diagnoses of leprosy in the state of Amazonas., Conclusions: Active case-finding can unveil hidden cases of leprosy in endemic areas, contributing to early detection to prevent neurological impairment and limit disease transmission. Additionally, the results advocate for targeted public health interventions, including the involvement of dermatologists in the diagnostic process and enhanced training for health professionals in differentiating leprosy from other cutaneous diseases., (© 2025 the International Society of Dermatology.)

Background: Sporotrichosis is a neglected tropical disease and the most common subcutaneous mycosis, mainly caused by Sporothrix species, particularly S. brasiliensis, S. schenckii and S. globosa, which exhibit varying biological behaviours and virulence. The epidemic of sporotrichosis in Brazil, initiated in Rio de Janeiro in the late 1990s, rapidly spread to other states, including Amazonas in 2021. This study aimed to identify the specific Sporothrix species responsible for the human sporotrichosis outbreak in the Brazilian Amazon., Methods: A cross-sectional study was conducted by enrolling clinically suspected cases of sporotrichosis attended at a reference dermatologic centre, in Manaus (Brazil). Biological material was collected from their skin lesions for culture (Mycosel) and for species identification (qPCR)., Results: Sporothrix cultures were obtained from 150 cases. Sporotrichosis predominantly affected females (67.3%), aged 44.5 years on average, with lymphocutaneous lesions (72.7%). Sporothrix brasiliensis was identified in 89.3% of patients. Up to 83.3% of these patients reported contact with cats previously to the skin lesion, and the time-spatial progression of the human cases followed the notification of cases in cats, in the metropolitan region of Manaus., Conclusion: Sporothrix brasiliensis is the dominant species in the zoonotic outbreak of human sporotrichosis in the Brazilian Amazon, with cats identified as the primary vectors. Effective sanitary control measures, education and responsible pet ownership are crucial to mitigating zoonotic sporotrichosis' impact in Brazil and preventing its spread to neighbouring Latin American cities., (© 2024 John Wiley & Sons Ltd.)

Background: Germline mutations in BRCA1 and BRCA2 genes are among the main causes of hereditary ovarian cancer. Identifying these mutations may reduce cancer risk, facilitate early detection, and enable personalized treatment. However, genetic testing is limited in the Brazilian Public Health System, and data regarding germline mutations in many regions are scarce. Therefore, the study aimed to investigate the prevalence of germline mutations in BRCA1 and BRCA2 in women with ovarian cancer treated in the Public Health System in Pernambuco, Brazil., Methods: A cross-sectional study was conducted in the Hereditary Cancer Program from two reference oncological centers in Pernambuco. Women (n = 45) with high-grade serous ovarian cancer underwent genetic counseling and DNA sequencing for BRCA1 and BRCA2 genes., Results: The prevalence of deleterious mutations in the BRCA1 and BRCA2 genes was 33%. Of the 15 germline mutations found, 13 were in BRCA1 and 2 in BRCA2; two mutations of unknown clinical significance were also found in BRCA2. Mutations c.5266dupC and c.2215 A > T were the most frequent; each was mutation observed in three patients. Additionally, the mutations c.7645dupT and c.921dupT were reported for the first time., Conclusion: One in three women showed a pathogenic mutation, demonstrating a significant prevalence of germline mutations in this sample. Additionally, the small sample revealed an interesting number of mutations, indicating the need to explore more regions of the country., (© 2024. The Author(s).)

Objective: To determine whether a combination of a single intramuscular (IM) dose of pentamidine (7 mg/kg) followed by oral tamoxifen 40 mg/day for 20 days is non-inferior to three IM doses of pentamidine 7 mg/kg in the treatment of cutaneous leishmaniasis with a margin of 15%., Methods: Phase II, randomised, controlled, open-label, non-inferiority clinical trial. Primary outcome was the complete healing of the lesions 6 months after starting treatment. Secondary outcomes were healing 3 months after starting treatment and determining the presence and severity of adverse effects (AE)., Results: The research was concluded with 49 patients; Leishmania (Viannia) guyanensis was the most frequent species isolated. In the primary outcome, 18 (72%) (95% CI: 52.4%-85.7%) of the 25 patients allocated to the intervention group and 24 (100%) (95% CI: 86.2%-100%) of the control group (p = 0.015) met the established criteria of cure. There was no AE with tamoxifen., Conclusion: Although a 72% cure rate presented by the combination of tamoxifen and pentamidine was lower than in the control group that achieved a 100% cure, it is still a safe and is a clinically relevant result. It indicates that the therapeutic scheme evaluated may be a promising option for populations in remote areas, however it should be further studied, in order to include a larger number of patients., (© 2023 John Wiley & Sons Ltd.)

Collagen antioxidant peptides are being widely studied. However, no research has paid attention to biological parameters such as the age and anatomy of collagen-rich tissues, which can determine a change in tissue structure and composition, and then in bioactivity. Moreover, only few research works have studied and assessed peptides antioxidant activity on the food matrix. This work aimed to investigate the effect of bovine's bone age and anatomy, and of six different enzymes, on the antioxidant activity of collagen peptides. Collagen was extracted from young and old bovine femur and tibia; six different enzymes were used for peptides' release. The redox potential, the quenching of stable free radicals, and the antioxidant capacity on bovine meat lipids and proteins was evaluated, under heating from ambient temperature to 80 °C. Age and anatomy showed a significant effect; the influence of anatomy becomes most important with age. Each enzyme's effectiveness toward age and anatomy was not the same. The greatest amount of peptides was released from young bones' collagen hydrolysed with papain. The antioxidant activity was higher at higher temperatures, except for meat proteins. Assessing the effect of age and anatomy of collagen-rich tissues can promote a better application of collagen bioactive peptides.

Background: Human immunodeficiency virus (HIV)-positive women have a high prevalence of human papillomavirus (HPV), and are infected with a broader range of HPV types than HIV-negative women. We aimed to determine the prevalence of cervical cytologic abnormalities, high-risk (HR)-HPV prevalence, type distribution according to the severity of cervical lesions and CD4 cell count and identify factors associated with HR-HPV infection among women living with HIV in Manaus, Amazonas., Methods: We enrolled 325 women living with HIV that attended an infectious diseases referral hospital. Each woman underwent a gynecological exam, cervical cytology, HR-HPV detection by Polymerase chain Reaction (PCR) using the BD Onclarity™ HPV Assay, colposcopy and biopsy, when necessary. We assessed the associations between potential risk factors and HR-HPV infection., Results: Overall, 299 (92.0%) women had a PCR result. The prevalence of HR-HPV- infection was 31.1%. The most prevalent HR-HPV types were: 56/59/66 (32.2%), 35/39/68 (28.0%), 52 (21.5%), 16 (19.4%), and 45 (12.9%). Among the women with HR-HPV infection (n = 93), 43.0% had multiple infections. Women with HPV infection showed higher prevalence of cervical abnormalities than that HPV-negative (LSIL: 22.6% vs. 1.5%; HSIL: 10.8% vs. 0.0%). The prevalence of HR-HPV among women with cytological abnormalities was 87.5% for LSIL and 100.0% for HSIL. Women with CD4 < 200 cell/mm 3 showed the highest HR-HPV prevalence (59.3%) although this trend was not statistically significant (p-value = 0.62). The mean CD4 cell count decreased with increasing severity of cervical lesions (p-value = 0.001). The multivariable analysis showed that increasing age was associated with a decreased risk of HR-HPV infection with an adjusted prevalence odds ratio of 0.9 (95.0% CI: 0.9-1.0, p-value: 0.03) for each additional year. The only factor statistically significant associated with HR-HPV infection was CD4 cell count., Conclusions: HR-HPV and abnormal cytology prevalence are high among women in the Amazonas. The low CD4 cell count was an important determinant of HPV infection and abnormal cytological findings. HPV quadrivalent vaccination used in Brazil might not offer protection for an important fraction of HPV-related disease burden in women living with HIV. This is partly explained by the high presence of non targeted vaccine HR-HPVs, such as the HPV genotype groups 56/59/66, 35/39/68 and individually HPV-52 and HPV-45, some of which contribute to high-grade lesion.