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Objective: To evaluate the relationship between vitamin D status and hypertriglyceridemic‐waist (HTW) phenotype and cardiometabolic markers in individuals with type 2 diabetes mellitus (T2DM) living in regions with high solar incidence (10° south). Methods: An observational, cross‐sectional study, with 122 individuals with T2DM, of both sexes, aged between 19 and 59 years, residing in Sergipe/Brazil. Measurements included serum 25‐hydroxyvitamin D (25[OH]D), glucose, insulin, total cholesterol, LDL‐c, HDL‐c, triacylglycerols, blood pressure, body mass index, %body fat, and waist circumference. Participants were classified by the presence or absence of the HTW phenotype, according to increased waist circumference and triacylglycerols concentrations. Logistic and linear regression models were applied to verify the association among the concentration of 25(OH)D, HTW phenotype, and lipid profile variables. Results: Triacylglycerols concentrations (p =.013) and %body fat (p =.011) were higher in women with serum 25(OH)D insufficient/deficient than in those with adequate 25(OH)D levels. Individuals with serum 25(OH)D insufficiency/deficiency were 2.595 times more likely to present the HTW phenotype than those with adequate 25(OH)D levels (p =.021). Additionally, a negative association was observed between the concentration of 25(OH)D and total cholesterol (Beta = −0.204, p =.049). Conclusion: Insufficiency/deficiency of serum 25(OH)D in individuals with T2DM increases the chances of developing the HTW phenotype. [ABSTRACT FROM AUTHOR]

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Purpose - To analyze the possible association between non-financial risk disclosure and the (in) existence of reputation in the most prominent Brazilian publicly traded companies considering the legitimacy theory. Design/methodology/approach - The sample assembles 118 corporations listed on B3 and 345 reference forms from 2006 to 2018. In the analysis of corporate reputation, the presence or absence on ISE and, or ICO2 from B3 was considered. For non-financial risk disclosure, a factor checklist containing 31 risks was taken, categorized under operational, damage, integrity, and strategic risks, from the analysis of Reference Forms. A tree regression, a multiple correspondence analysis, and a T-test of the difference between means were used for data analysis. Findings - There is scientific evidence that the companies with reputations demonstrate non-financial risk disclosure superior to the others. This behavior is confirmed in the subcategories of integrity and strategic risks. Moreover, risk factors in the subcategory of integrity risks were crucial to non-financial risk disclosure. Originality/value - This research paves the way to deepen the early debate surrounding risk disclosure and corporate reputation, especially regarding the quality of non-financial risk disclosure. [ABSTRACT FROM AUTHOR]

During these past years, several studies have provided serological evidence regarding the circulation of West Nile virus (WNV) in Brazil. Despite some reports, much is still unknown regarding the genomic diversity and transmission dynamics of this virus in the country. Recently, genomic monitoring activities in horses revealed the circulation of WNV in several Brazilian regions. These findings on the paucity of genomic data reinforce the need for prompt investigation of WNV infection in horses, which may precede human cases of encephalitis in Brazil. Thus, in this study, we retrospectively screened 54 suspicious WNV samples collected between 2017 and 2020 from the spinal cord and brain of horses with encephalitis and generated three new WNV genomes from the Ceará and Bahia states, located in the northeastern region of Brazil. The Bayesian reconstruction revealed that at least two independent introduction events occurred in Brazil. The first introduction event appears to be likely related to the North American outbreak, and was estimated to have occurred in March 2013.The second introduction event appears to have occurred in September 2017 and appears to be likely related to the South American outbreak. Together, our results reinforce the importance of increasing the priority of WNV genomic monitoring in equines with encephalitis in order to track the dispersion of this emerging pathogen through the country. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920qa adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes "tooth loss" and "reason for the last dental appointment" were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health. [ABSTRACT FROM AUTHOR]

The authors examine the impact of countertransference in two clinical cases of transgender patients treated by two cisgender analysts who are accustomed to receiving nonconforming gender patients in France and Brazil. The context is that of contemporary views of transphobic countertransference reactions, specifically the work of Griffin Hansbury, who describes these reactions in terms of "unthinkable anxieties." Like other theorists with expanding notions of countertransference, the authors view transphobia in analysis as an "instrument of research" and consider how taking responsibility for the transference is particularly relevant in respect to clinical cases that also reflect societal changes. Following the authors' case presentations, they identify four different fantasies and countertransferential reactions that sprang from their efforts to be safe analysts or, in other words, analysts concerned about the perpetuation of discrimination, violence, and oppression that may have guided their work. [ABSTRACT FROM AUTHOR]

Bemisia tabaci is an important agriculture pests and vector of viruses. The MEAM1 species of B. tabaci, first described in Brazil in the 90s is now the most prevalent species and primary cause of the emergence of begomoviruses in tomatoes. The Mediterranean species (MED) was recently detected in Brazil and is a new concern for Brazilian agriculture. The potential impact of this species as a vector of economically important virus in Brazil is unknown. We therefore evaluated the ability of MED to transmit four whitefly transmitted viruses prevalent in Brazil, Cowpea mild mottle virus (CpMMV, carlavirus), Bean golden mosaic virus (BGMV, begomovirus) infecting beans; and the Tomato severe rugose virus (ToSRV, begomovirus), Tomato chlorosis virus (ToCV, crinivirus) infecting tomatoes. The colony of MED harbouring the secondary endosymbionts was tested: 14% positive for Hamiltonella and 29% positive for Rickettsia. After six months being maintained on cotton plants, this colony changed the frequency of endosymbionts (97% of Hamiltonella and 1% of Rickettsia) and was denominated as MEDH. Additionally, a colony of MEAM1 (98% positive for Hamiltonella and 91% positive for Rickettsia) was also tested. The viruses were efficiently transmitted by MED, but transmission efficiency varied among the MED and MEDH, being CpMMV, BGMV and ToCV better transmitted by MEDH. Moreover, transmission efficiency of ToSRV and ToCV by MEDH was even significantly better than MEAM1. We conclude that specimens from B. tabaci MED are good vectors of virus infecting tomato and beans in Brazil and populations with Hamiltonella prevalence increased the virus transmission. [ABSTRACT FROM AUTHOR]

Leishmaniasis is an infectious disease caused by a protozoan belonging to Leishmania genus. Different clinical outcomes can be observed depending on the parasite species and patient's health condition. The outcomes can range from single cutaneous lesions to lethal visceral form. The treatment of all forms of leishmaniasis is based on pentavalent antimonials, and, in some cases, the second-line drug, amphotericin B, is used. Beside the toxicity of both classes of drugs, in some areas of the world, parasites are resistant to antimonial. These detrimental features make fundamental the discovery and characterization of new drugs or plant extracts with leishmanicidal effects. Brazil is a well-known country for its biodiversity. Additionally, the common knowledge inherited for generations in small villages makes Brazil a source of new information and resources for the discovery and development of new drugs. Based on ethnopharmacology, elderlies were interviewed about plants they commonly used for skin diseases and infections. Five native plants from Atlantic forest were indicated; EtOH and n-hexane extracts were prepared with the vegetative organs of the plants and assayed against promastigote and amastigote forms of L. (L.) amazonensis. The major molecules of each extract were detected using qualitative nuclear magnetic resonance. Among all tested extracts, the n-hexane extract from the leave of Eugenia uniflora (Myrtaceae), enriched in myricitrin and quercitrin flavonoids, was the most effective against L. (L.) amazonensis amastigotes. This data supports the ethnopharmacology approach as a successful tool for the discovery of new drugs with leishmanicidal effects. [ABSTRACT FROM AUTHOR]

The aims of this study were to investigate dental students' attitudes toward people living in poverty and the extent to which their perceptions were associated with their willingness to treat those patients in their future practice. All 910 dental students enrolled in three Brazilian public universities in 2010 were invited to take part in a cross-sectional survey. A total of 766 students (83.7% response rate) completed the self-administered questionnaire on their perceptions of and attitudes about poverty and their intention to provide dental care to poor people. The responding students showed slightly positive attitudes about people living in poverty; however, a high percentage (35%) reported thinking they were different from the rest of the population. Nevertheless, most of these students expressed willingness to provide care to underserved populations in their future practice; this willingness was found to be associated with their beliefs about poverty (OR 1.65; 95% CI=1.41-1.94). Overall, the study found that these dental students had altruistic views toward people living in poverty. However, they seemed to lack a deep understanding of poverty that may prevent them from acting on their good intentions. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of asthma in a population of inner-city Brazilian children.Methods: In a cross-sectional study, we selected children with asthma and healthy controls from public schools (8–16 years) from a capital city of Southern Brazil. Divided into three phases, questionnaires were administered, assessing lung function, body mass index and allergic sensitization.Results: From 2500 children initially included in the study (48.4% males; mean age of 11.42 ± 2.32 years), asthma prevalence was detected in 28.6% (715/2500). The disease was not controlled in 42.7% (305/715) of the children, with 7.6% of hospitalization rate. School absenteeism (at least one day of missing school because of asthma) and sedentary behavior were high (57.1 and 67.2%, respectively), with 47.9% of subjects requiring oral steroids in the previous year, and physical well-being significantly lower than controls, directly interfering with quality of life, and therefore in the daily activities of these students. Moreover, 38% of the parents admitted to being non-adherent to treatment with their children and 31.1 and 53.6%, respectively, believed that rescue medication and exercise might be harmful.Conclusions: The burden of asthma in Brazilian children seems to be substantial. New international guidelines with a special focus in developing countries settings, with more pragmatic approaches, should be a priority for discussion and implementation actions. [ABSTRACT FROM AUTHOR]

Objective: To describe the frequency of popular myths about and features of asthma treatment in children and adolescents in an urban area in southern Brazil. Methods: The parents or legal guardians of public school students (8-16 years of age) completed a specific questionnaire regarding their understanding of asthma, asthma control, and treatment characteristics. The sample included parents or legal guardians of students with asthma (n = 127) and healthy controls (n = 124). Results: The study involved 251 parents or legal guardians, of whom 127 (68.5%) were the mothers and 130 (51.8%) were White. The mean age of these participants was 38.47 ± 12.07 years. Of the participants in the asthma and control groups, 37 (29.1%) and 26 (21.0%), respectively, reported being afraid of using asthma medications, whereas 61 (48%) and 56 (45.2%), respectively, believed that using a metered dose inhaler can lead to drug dependence. However, only 17 (13.4%) and 17 (13.7%) of the participants in the asthma and control groups, respectively, reported being afraid of using oral corticosteroids. In the asthma group, 55 students (43.3%) were diagnosed with uncontrolled asthma, only 41 (32.3%) had a prescription or written treatment plan, and 38 (29.9%) used asthma medications regularly. Conclusions: Popular myths about asthma treatment were common in our sample, as were uncontrolled asthma and inappropriate asthma management. Further studies in this field should be conducted in other developing countries, as should evaluations of pediatric asthma treatment programs in public health systems. [ABSTRACT FROM AUTHOR]

Investigating career motivations and intentions of dental students provides a better understanding of their role in society and contributes to the debate on dental education and practices. This study describes the profile, career choice motivations, and career intentions of Brazilian dental students and evaluates factors related to these choices. A cross-sectional study was carried out among dental students from three Brazilian public universities (N=915), with a response rate of 83.7 percent. Students (N=766) responded to a self-administered questionnaire about sociodemographic factors, reasons for choosing dentistry as a career, and future career intentions. Job conception was found to be the main reason for choosing dentistry as a profession. Most students intended to become specialists and work in both the public and private sectors simultaneously. Female students (OR 2.23, 95 percent CI=1.62-3.08), low-income students (OR 1.86, 95 percent CI=1.10-3.13), and students beginning their program (OR 1.87, 95 percent CI= 1.22-2.85) were more likely to work in the public and private sectors simultaneously than other types of students. This study suggests that choice of career and career plans are influenced by factors related to the students' characteristics and their conception of the profession. The opportunity to combine private and public dental practice may be viewed as a way to achieve income and job security. [ABSTRACT FROM AUTHOR]

Knowledge of medicinal plants is often the only therapeutic resource of many communities and ethnic groups. "Erva-baleeira," Cordia verbenacea DC, is one of the species of plants currently exploited for the purpose of producing a phytotherapeutic product extracted from its leaves. In Brazil, its major distribution is in the region of the Atlantic Forest and similar vegetation. The crude extract is utilized in popular cultures in the form of hydroalcoholic, decoctions, and infusions, mainly as antimicrobial, anti-inflammatory, and analgesic agents. The aim of the present study was to establish a chemical and comparative profile of the experimental antibacterial activity and resistance modifying activity with ethnopharmacological reports. Phytochemical prospecting and HPLC analysis of the extract and fractions were in agreement with the literature with regard to the presence of secondary metabolites (tannins and flavonoids). The extract and fraction tested did not show clinically relevant antibacterial activity, but a synergistic effect was observed when combined with antibiotic, potentiating the antibacterial effect of aminoglycosides. We conclude that tests of antibacterial activity and modulating the resistance presented in this work results confirm the ethnobotanical and ethnopharmacological information, serving as a parameter in the search for new alternatives for the treatment of diseases. [ABSTRACT FROM AUTHOR]

Madariaga virus (MADV) is a member of the eastern equine encephalitis virus (EEEV) complex that circulates in Central and South America. It is a zoonotic, mosquito-borne pathogen, belonging to the family Togaviridae. Disturbances in the natural transmission cycle of this virus result in outbreaks in equines and humans, leading to high case fatality in the former and acute febrile illness or neurological disease in the latter. Although a considerable amount of knowledge exists on the eco-epidemiology of North American EEEV strains, little is known about MADV. In Brazil, the most recent isolations of MADV occurred in 2009 in the States of Paraíba and Ceará, northeast Brazil. Because of that, health authorities have recommended vaccination of animals in these regions. However, in 2019 an equine encephalitis outbreak was reported in a municipality in Ceará. Here, we present the isolation of MADV from two horses that died in this outbreak. The full-length genome of these viruses was sequenced, and phylogenetic analyses performed. Pathological findings from postmortem examination are also discussed. We conclude that MADV is actively circulating in northeast Brazil despite vaccination programs, and call attention to this arbovirus that likely represents an emerging pathogen in Latin America. [ABSTRACT FROM AUTHOR]

Background: West Nile virus (WNV) was first sequenced in Brazil in 2019, when it was isolated from a horse in the Espírito Santo state. Despite multiple studies reporting serological evidence suggestive of past circulation since 2004, WNV remains a low priority for surveillance and public health, such that much is still unknown about its genomic diversity, evolution, and transmission in the country. Methods: A combination of diagnostic assays, nanopore sequencing, phylogenetic inference, and epidemiological modeling are here used to provide a holistic overview of what is known about WNV in Brazil. Results: We report new genetic evidence of WNV circulation in southern (Minas Gerais, São Paulo) and northeastern (Piauí) states isolated from equine red blood cells. A novel, climate-informed theoretical perspective of the potential transmission of WNV across the country highlights the state of Piauí as particularly relevant for WNV epidemiology in Brazil, although it does not reject possible circulation in other states. Conclusion: Our output demonstrates the scarceness of existing data, and that although there is sufficient evidence for the circulation and persistence of the virus, much is still unknown on its local evolution, epidemiology, and activity. We advocate for a shift to active surveillance, to ensure adequate preparedness for future epidemics with spill-over potential to humans. [ABSTRACT FROM AUTHOR]

Ayahuasca is a psychoactive infusion with a large pharmacological application normally prepared with Banisteriopsis caapi, which contains the monoamine oxidase inhibitors β-carbolines, and Psichotria virids, which contains the serotonin receptor agonist N,N dimethyltryptamine (DMT). The objectives of this study were to investigate the chemical profile of B. caapi and of ayahuasca collected in various Brazilian regions. In total, 176 plant lianas, of which 159 B.caapi and 33 ayahuasca samples were analyzed. Dried liana samples were powdered, extracted with methanol, diluted, and analyzed by LC-MS/MS. Ayahuasca samples were diluted and analyzed. Mean concentrations in B. caapi were 4.79 mg/g harmine, 0.451 mg/g harmaline, and 2.18 mg/g tetrahydroharmine (THH), with a high variability among the samples (RSD from 78.9 to 170%). Native B. caapi samples showed significantly higher harmine concentrations than cultivated ones, and samples from the Federal District/Goiás had higher THH content than those collected in the State of Acre. The other Malpighiaceae samples did not contain β-carbolines, except for one D. pubipetala sample. Concentrations in ayahuasca samples ranged from 0.109 to 7.11 mg/mL harmine, 0.012 to 0.945 mg/mL harmaline, 0.09 to 3.05 mg/mL THH, and 0.10 to 3.12 mg/mL DMT. The analysis of paired ayahuasca/B. caapi confirmed that harmine is reduced to harmaline and to THH during the brew preparation. This is the largest study conducted with Malpighiaceae samples and showed a large variability in the main β-carbolines present in B. caapi. This biodiversity is a challenge for standardization of the material used in ethnopharmacological studies of B.caapi and ayahuasca. [ABSTRACT FROM AUTHOR]

• mHealth apps offer potential to assist the self-management of UI. • Apps for UI in Brazil are not credible and need major improvements. • None of the apps were used as an intervention in a RCT. Urinary incontinence (UI) is a serious condition for which often times insufficient non-surgical treatment options are provided or sought. Mobile health (mHealth) applications (apps) offer potential to assist with the self-management of UI. To perform a systematic review of available mHealth apps for UI in Brazil. A search for UI mHealth apps from the Google Play Store and AppStore in Brazil was performed by two independent reviewers on June 4 2020, and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Of the 1111 mHealth apps found, 12 were eligible for inclusion. Four offered exclusively exercise programs, six offered exercise and educational content, and two offered tools to track patient-reported symptoms. The included apps scored poorly on the MARS quality scale, with a mean ± standard deviation score of 2.7 ± 0.6 on a 0–5 scale. Most apps scored poorly based on credibility, user interface and experience, and engagement. Although there is growing interest in the development of mHealth technologies to support patients with UI, currently available tools in Brazil are of poor quality and limited functionality. Effective collaboration between industry and research is needed to develop new user-centered mHealth apps that can empower patients with UI. [ABSTRACT FROM AUTHOR]

[Display omitted] • Brazilian honey comes from a megadiversity of bee flora, making it difficult to discriminate samples regarding their geographic origin. • The establishment of complementary analytical protocols is necessary for fraud detection and for typification of honey. • The UV–vis and NMR spectroscopic techniques coupled to chemometrics (PCA) proved to be effective for the discrimination of Brazilian honey according to the geographic origin. Honey is considered a complex matrix for presenting a range of secondary metabolites originating from the regional flora. It has been highlighted as a functional food consumed worldwide and frequently suffering from adulteration. Fraud methods have been sophisticated over the years, indicating the need of a continuous updating of the existing analysis methods. For this reason, analytical techniques applied to honey have been expanded, allowing the detection of fraud and the determination of geographic and botanical origin, to guarantee the authenticity of the product. In this sense, this study aimed to characterize floral honey samples in 2019–2020 and 2020–2021 harvests in the states of Santa Catarina (SC, southern Brazil – n = 73) and São Paulo (SP, southeastern Brazil – n = 59), through UV–vis, NIR, and NMR spectroscopies. The total reduced capacity showed a wide variation (0.76–12.8 mg GAE.g−1) among the SC and SP samples. Spectroscopic analyses through UV–vis and NMR with the application of PCA proved effective for discriminating honey samples according to their geographical origin. The honey UV–vis spectral profiles allowed to detect wavelengths that can be associated with honey adulteration, however further studies are needed to establish the accuracy of detection regarding fraud. In summary, a set of analytical protocols is presented to determine the geographical origin of floral honey, even when originated from regions with great biodiversity such as Brazil. [ABSTRACT FROM AUTHOR]

The synthesis and differential allocation of reserve compounds is an important adaptive mechanism that enables species to resprout in fire-prone ecosystems. The analysis of compound allocation dynamics (differential accumulation of compounds between plant organs) provides insights into plant responses to disturbances. The aim was to quantify reserves in eight legume species from Cerrado open savannas with high fire frequency in order to investigate the patterns of allocation and distribution of compounds between leaves and underground organs, drawing ecophysiological inferences. The species were collected in 'campo sujo' areas of the Cerrado. Leaves and underground organs (xylopodium, taproot tubers) were subjected to physiological analyses. Overall, underground organs were characterised by greater deposits of carbohydrates, mainly soluble sugars, and also with the accumulation of proteins and amino acids. This suggests that nitrogen reserves, as well as carbohydrates, may have an ecophysiological function in response to fire, being allocated to the underground organs. Phenols were mainly evident in leaves, but a morphophysiological pattern was identified, where the two species with taproot tubers tended to concentrate more phenols in the underground portion compared to species with xylopodium, possibly due to functional differences between these organs. Such data allow inferring relevant ecophysiological dynamics in legumes from open savannas.

Objective: To identify the epidemiological, spatial, and temporal pattern of TB-HIV coinfection in Brazil during the period from 2001 to 2020., Methods: Ecological study using space-time analysis techniques. It included cases of TB-HIV coinfection registered in Brazil from 2001 to 2020. The temporal trend analysis was performed using segmented regression by Joinpoint regression. For spatial analysis, Moran indices were calculated and choropleth maps were produced using TerraView and QGIS software., Results: A stable temporal trend was observed in the incidence rates of TB-HIV coinfection in Brazil during the analyzed period. In addition, high-risk areas for coinfection located in states in the North, Southeast, South, and Midwest regions were identified., Conclusion: There was stability in the incidence of TB-HIV coinfection in Brazil over the last 20 years and heterogeneous geographic distribution of risk areas for the condition.

This is an original article that addresses the healthcare workforce (HW) in Brazil, as well as comorbidities and mental health changes during the COVID-19 pandemic. This study was conducted by the Oswaldo Cruz Foundation and collected data through an online questionnaires from a total of 36,612 participants, health professionals (HP, with higher education level), and invisible healthcare workers (IHW, with a technical mid-level education). The overall prevalence of comorbidities in Brazil was 26.1% and 23.9%; the highest was arterial hypertension (27.4% and 31.9%), followed by obesity (18.4% and 15.1%), chronic respiratory diseases (15.7% and 12.9%), diabetes mellitus (10.3% and 10.4%), and depression/anxiety (9.1% and 11.7%), in the HW and IHW, respectively. The region with the highest frequency was the southeast, where the largest contingent of workers is located. The HW, affected with a high burden of non-communicable chronic diseases and exposed to SARS-CoV-2, proved to be vulnerable to illness and death. Mental symptoms and intense psychological suffering have been reported. These results allow us to estimate the impacts upon physical and mental health, as well as upon living and working conditions of the HW. The health and life of workers, leading role in facing health challenges of the pandemic, are a high priority in public policies.

Aim: There is not much information about breast health in transgender (transexual) persons given the historical stigma that this population suffers. This research aimed to describe breast imaging patterns in transgender (trans) women and men that had been using gender affirmation hormone treatment for at least 3 years., Material and Methods: In this observational, cross-sectional study, 67 transgender individuals (34 trans women and 33 trans men) had mammography and breast ultrasound performed. We also classified the findings by the American College of Radiology - Breast Imaging Reporting and Data System (ACR BI-RADS®)., Results: We found that there was a higher frequency of dense breasts in trans women (75.8%) and in trans men (66,6%) than expected for cisgender (cis) women., Conclusions: This study highlights the importance of a deeper understanding of the image patterns of transgender breasts because of hormonal effects that the gender transition entails so we can offer better health care and preventive services in the transgender (transexual) population.

Objective: To estimate the mortality trend and to analyze the potential years of life lost (PYLL) due to leukemias and lymphomas in Brazil and Mato Grosso, from 2001 to 2019., Methods: Time-series study on deaths from leukemias and lymphomas with data obtained from the Mortality Information System. Trends were calculated by age group by the Joinpoint regression method, using calendar year as regressor variable, estimated annual percentage change (APC) and mean annual percentage change, considering 95% confidence intervals. PYLL rates were collected from the Cancer Mortality Atlas., Results: In Brazil, the mortality rate trend remained stable for both diseases in the period: leukemias (APC=0.2; 95%CI 0.0-0.3) and lymphomas (APC=0.2; 95%CI 0.4-0.1). In Mato Grosso state, the rate for leukemias was also stable (APC=0.3; 95%CI 1.0-1.6). For lymphomas, the trend was ascendant (APC=2.3; 95%CI 0.5-4.2), but descending among people younger than 59 years. For leukemias, PYLL rates were 64 and 65/100,000 in Brazil and Mato Grosso, respectively. For lymphomas, 27 and 22/100,000, respectively, with the highest rates found among males., Conclusion: The behavior of mortality rates from leukemia and lymphoma in Mato Grosso was different from that observed nationally, with an upward trend for lymphomas and no differences between age groups for both diseases. PYLL rates for leukemias were similar, while for lymphomas they were higher among men and lower in Mato Grosso when compared to Brazil.

Objective: To evaluate the performance of tuberculosis control in Brazilian municipalities., Methods: This is an ecological study on Brazilian municipalities that notified at least four new cases of tuberculosis, with a minimum of one new case of pulmonary tuberculosis between 2015 and 2018. The municipalities were stratified according to the population in < 50 thousand, 50-100 thousand, 100-300 thousand, and > 300 thousand inhabitants, and the k-means method was used to group them within each population range according to the performance of six indicators of the disease., Results: A total of 2,845 Brazilian municipalities were included, comprising 98.5% (208,007/211,174) of new tuberculosis cases in the period. For each population range, three groups (A, B, and C) of municipalities were identified according to the performance of the indicators: A, the most satisfactory; B, the intermediates; and C, the least satisfactory. Municipalities in group A with < 100 thousand inhabitants presented results above the targets for laboratory confirmation (≥ 72%), abandonment (≤ 5%), and cure (≥ 90%), and comprised 2% of new cases of the disease. Conversely, municipalities of groups B and C presented at least five indicators with results below the targets - HIV testing (< 100%), contact investigation (< 90%), directly observed therapy (< 90%), abandonment (> 5%), and cure (< 90%) -, and corresponded to 66.7% of new cases of tuberculosis. In group C of municipalities with > 300 thousand inhabitants, which included 19 of the 27 capitals and 43.1% of new cases of tuberculosis, the lowest percentages of contact investigation (mean = 56.4%) and directly observed therapy (mean = 15.4%) were verified, in addition to high abandonment (mean = 13.9%) and low coverage of primary health care (mean = 66.0%)., Conclusions: Most new cases of tuberculosis occurred in municipalities with unsatisfactory performance for disease control. Expanding the coverage of primary health care in these places can reduce abandonment and increase the contact investigation and directly observed therapy.

The swine influenza A virus (SIAV) subtypes/lineages H1N1pdm09, H3N2, H1N2, and H1N1 of seasonal human origin are widespread in Brazilian swine herds. A monovalent inactivated H1N1pdm09 vaccine was licensed in Brazil in 2014. However, there are concerns about its efficacy due to the limited vaccine cross-protection against heterologous viruses and the potential for exacerbated reactions against vaccine strains. Thus, monitoring SIAVs subtypes/lineages that are circulating in the Brazilian swine population is important, by applying a fast and efficient diagnostic test in herd field samples. A RT-PCR assay was developed, using primers specific for HA subtyping of Brazilian SIAV, and was used to evaluate the occurrence of subtypes from samples collected between 2012 and 2019. From 167 field samples positive for influenza A, 117 were subtyped by nested RT-PCR assay. A higher occurrence of H1N1pdm was observed from 2012 to 2015, H3N2 in 2017, and H1hu in 2017 to 2019. A hemagglutination inhibition test was performed in serum samples received from 2017 to 2019, confirming these data. The molecular data highlights the importance of H1hu and H3N2 detection since there are no vaccines available for the subtypes/lineages and raises an alert of H1hu for its potential to infect humans. Serological data suggest a cyclical profile of occurrence between the H3N2 and H1N1pdm over time. Monitoring SIAVs circulating in Brazilian swine herds is necessary, which provides the relevant information for field veterinarians to apply effective control measures on the properties., (© 2021. Sociedade Brasileira de Microbiologia.)

Background: Identifying patients with hepatitis C virus (HCV) infection and enhancing the cascade of care are essential for eliminating HCV infection. This study aimed to estimate the prevalence of positive anti-HCV serology in Brasilia, Brazil, and evaluate the efficiency of the cascade of care for HCV-positive individuals., Methods: This cross-sectional study analyzed 57,697 rapid screening tests for hepatitis C in individuals aged > 40 years between June 2018 and June 2019. HCV-positive patients were contacted and scheduled to undergo the HCV RNA viral test, genotyping, and transient elastography., Results: The prevalence of positive serology was 0.27%. Among 161 patients with positive anti-HCV serology, 124 (77%) were contacted, 109 (67.7%) were tested for HCV RNA viral load, and 69 (42.8%) had positive results. Genotype 1 (75%) was the most prevalent genotype. Among 65 patients (94.2%) who underwent transient elastography, 30 (46.2%) presented with advanced fibrosis. Additionally, of the 161 patients, 55 (34.1%) were referred for treatment, but only 39 (24.2%) complied, with 36 (22.4%) showing sustained virological response. By the end of the study, 16 patients were still awaiting to receive medication., Conclusions: The prevalence of HCV-positive patients was low in Brasilia, and the gaps in the cascade of care for these patients were significantly below the targets of HCV infection elimination. This study opens new avenues for eliminating HCV infection and suggests that partnerships with clinical laboratories to conduct anti-HCV tests are a useful strategy to improve HCV diagnosis., Trial Registration: Research Ethics Committee of the Faculty of Health Sciences of the University of Brasília - UNB (CAAE number 77818317.2.0000.0030) and by the Ethics Committee of the Health Science Teaching and Research Foundation - FEPECS/SES/DF (CAAE number 77818317.2.3001.5553).

Recent data from the municipality of Rio de Janeiro, Brazil, shows a sharp drop in the number of reported occurrences of Zika during the summer of 2016/2017, compared to the previous summer. There is still a much higher incidence among women than men, almost certainly due to sexual transmission. An unexpected feature of the new data is that there are proportionally far more cases affecting children under 15 months than older age classes. By comparing incidence rates in 2016/2017 and 2015/2016, we were able to deduce the proportion of reported cases affecting men and women, and verify that gender disparity is still present. Women and children are still risk groups for Zika infection, even during non-epidemic seasons.

The Bemisia tabaci is a polyphagous insect and a successful vector of plant viruses. B. tabaci is a species complex and in Brazil native species from the New World (NW) group, as well as the invasive species, Middle East-Asia Minor 1 (MEAM1) and Mediterranean (MED) were reported. For better understanding the distribution of the different species four years after the Mediterranean species invasion in Brazil, whiteflies were collected from 237 locations throughout the country between the years of 2013 and 2017, species were identified and the facultative endosymbionts detected. The survey revealed that MEAM1 was the prevalent species found on major crops across Brazil. It is the only species present in North, Northwestern and Central Brazil and was associated with virus-infected plants. MED was found in five States from Southeast to South regions, infesting mainly ornamental plants and was not associated with virus-infected plants. The prevalent endosymbionts identified in MEAM1 were Hamiltonella and Rickettsia; and the mtCOI analysis revealed low genetic diversity for MEAM1. In contrast, several different endosymbionts were identified in MED including Hamiltonella, Rickettsia, Wolbachia and Arsenophonus; and two distinct genetic groups were found based on the mtCOI analysis. Monitoring the distribution of the whiteflies species in Brazil is essential for proper management of this pest.

Introduction: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder, of multifactorial etiology, which affects 6-10% of women of reproductive age. It is considered the leading cause of anovulatory infertility, menstrual disorders and hyperandrogenism in this population. The genetic basis of PCOS is still largely unknown despite significant family clustering; determining its mode of inheritance is particularly difficult given the heterogenic presentation of the disease., Materials and Methods: 130 Brazilian women, aged 14-42 years, who met the 2003 Rotterdam criteria for PCOS diagnosis, were included, and 96 healthy women constituted the control group. Presence of hirsutism was classified using the modified Ferriman-Gallwey score (F-G score) as absent (≤7), mild (8-14), and severe (≥15). Blood levels of luteinizing hormone (LH), total testosterone (TT), dehydroepiandrosterone sulfate (DHEA-S) and androstenedione were determined. The coding region of the luteinizing hormone beta-subunit (LHB) gene was amplified and sequenced. Differences in allelic and genotypic frequency distribution of each polymorphism across controls and cases were estimated by the Mantel-Haenszel chi-square or Fisher's exact test (p<0.05), and the probability of an association between the detection of a polymorphism and presence of a diagnosis of PCOS, by logistic regression., Result(s): Sequencing detected 8 polymorphisms in the LHB gene coding region. Two polymorphisms in linkage disequilibrium were significantly more prevalent in the presence of hyperandrogenemia: rs1800447/rs34349826 (Trp28Arg/Ile35Thr) (p=0.02)., Conclusion(s): In this series, a modulatory effect of LHB polymorphisms on hyperandrogenemia phenotype of PCOS was observed; however, this finding needs to be replicated in other populations., (Copyright © 2014 Elsevier B.V. All rights reserved.)