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Objective: Newborns' jaundice is the result of bilirubin accumulation as fetal hemoglobin is metabolized by the immature liver. This study aimed to estimate the prevalence of mother-reported newborn jaundice and associated factors., Methods: A cross-sectional study was carried out using data from a longitudinal study involving 914 children. The data were reviewed using Poisson regression with a robust estimator in a hierarchical model in which the sociodemographic variables constituted the first level, those related to the conditions of the pregnancy constituted the second level, and those related to the report of jaundice, the third level. Prevalence ratios and their relevant confidence intervals were estimated., Results: The prevalence of reported jaundice in newborns was 17.9%. The variables late pregnancy, urinary infection during pregnancy, and preterm and post-term birth were independently statistically associated with a higher prevalence of newborn jaundice reports., Conclusion: We can conclude that mother-reported newborn jaundice was 17.9% associated with maternal and birth aspects.

Objective: The aim of this study was to estimate the prevalence of current smoking and its associated factors in adults aged 50 years and older in Brazil., Methods: This cross-sectional study utilized data from the ELSI-Brazil study, encompassing 9,412 adults aged 50 years or over. A multivariate model using Poisson regression with a robust estimator was employed, estimating prevalence ratios and their 95% confidence intervals., Results: The prevalence of current smoking was 17.04%. It was positively and independently associated with male gender, age up to 62 years, living without a partner, illiteracy, chronic obstructive pulmonary disease, depression, poor or very poor sleep quality, and alcohol intake more than once a month. Conversely, systemic arterial hypertension, hypercholesterolemia, diabetes mellitus, and repetitive strain injuries showed an inverse and independent association with current smoking., Conclusion: The prevalence of current smoking among adults over 50 years old in Brazil was approximately 17%, with associations found with certain sociodemographic conditions and self-reported comorbidities.

Background: The American College of Obstetricians and Gynecologists, in its opinion of the Committee on Midwifery Practice, points out that planned home birth is a woman's and family's right to experience, but also to choose and be informed about, their baby's place of birth. The aim of this study was to understand obstetric nurses' perceptions of planned home childbirth care within the framework of the Brazilian obstetric model., Method: A qualitative study, with Snowball Sampling recruitment, totaling 20 obstetric nurses through semi-structured interviews between September 2022 and January 2023, remotely, using the Google Meet application and the recording feature. After the data had been collected, the material was transcribed in full and subjected to content analysis in the thematic modality with the support of ATLAS.ti 8.0 software., Results: Obstetric care at home emerged as a counterpoint to hospital care and the biomedical model, providing care at home based on scientific evidence and humanization, bringing qualified information as a facilitator of access and financial costs as an obstacle to effective home birth., Conclusion: Understanding obstetric nurses' perceptions of planned home birth care in the context of the Brazilian obstetric model shows the need for progress as a public policy and for strategies to ensure quality and regulation., (© 2023. The Author(s).)

In the wood processing industry, working with machines exposes workers to occupational risks. This study evaluates the biomechanics of work activities carried out in a wood processing operation in tropical forest regions to identify risks associated with the development of musculoskeletal injuries. Data were collected in a wood processing industry from a tropical forest region in Midwest Brazil. Forty forest workers were evaluated, equivalent to 100% of the population of the company participating in the study. Biomechanical movements were measured using the Three-Dimensional Biomechanical Model for Predicting Stances and Static Forces. There was a risk of injury to the joints of the upper limbs (wrists and shoulders), as well as to the torso. When splitting and manually stacking wood, a risk of spinal injury was identified. All workers had a high risk of developing injuries in all joints evaluated in addition to a risk of serious spinal injury. In this way, the development of these activities without any ergonomic interventions makes the risk of developing musculoskeletal injuries in the workers involved imminent, with consequent early professional incapacity.

A quantitative descriptive study based on Brazilian Active Pharmacovigilance of Dolutegravir (DTG) Project was performed to describe the adverse drug reactions (ADRs) to DTG reported and to evaluate the noncompleteness of data from DTG active pharmacovigilance in Brazil. ADRs and clinical and individual data were obtained from information from the Pharmacovigilance Questionnaire from April 2017 to August 2019. The reported ADRs were classified using the Medical Dictionary for Regulatory Activities (MedDRA). In the evaluated period, 249,066 individuals using DTG participated in the active pharmacovigilance of DTG, with 3472 (1.39%) reporting ADRs at least once. A total of 6312 ADRs were reported, of which 57.56% were persistent and 81.46% were not serious according to the individuals' reports. Most of the reported ADRs were gastrointestinal, neurological and psychiatric. ADRs related to neural tube defects and serious neuropsychiatric ADRs have been reported. Completion of more than half of the fields in the Pharmacovigilance Questionnaire was excellent. The frequency of ADR was low in relation to the number of people living with HIV (PLHIV) using DTG in Brazil, which suggests good tolerability and safety of DTG. The DTG active pharmacovigilance database in Brazil showed good data completeness.

Objective: To measure the incidence of neuropsychiatric adverse drug reactions (ADRs) in individuals living with HIV who initiated antiretroviral therapy (ART) with first-line regimens containing dolutegravir (DTG) or efavirenz (EFV) and associated factors., Methods: Prospective cohort study with individuals living with HIV who started ART with DTG or EFV associated with tenofovir disoproxil and lamivudine in Belo Horizonte, Brazil. Sociodemographic, clinical, and laboratory data were collected from September 2015 to October 2018 in three specialized HIV care services through interviews, clinical records, and computerized systems. We analysed the frequency of neuropsychiatric ADRs recorded in clinical records 12 months after starting antiretroviral use, and the associated factors were investigated using binary logistic regression., Results: A total of 152 (35.1%) of the 433 individuals included had neuropsychiatric ADRs. The incidence density was 35.3/100 person-years. The subjects mainly had sleep disorders and disturbances (21.3%), neurological disorders (13.9%), headaches (8.1%), and anxiety disorders and symptoms (3.0%), more frequently in individuals using EFV. A lower likelihood of neuropsychiatric ADRs was associated with using a DTG-based antiretroviral regimen (OR = 0.24; 95% CI = 0.14-0.40) and anxiety or depression signs and symptoms at the onset of treatment (OR = 0.57; 95% CI = 0.37-0.89)., Conclusion: The incidence of neuropsychiatric ADRs was high in individuals starting ART with a lower likelihood of using a DTG-based regimen. The DTG-based regimen had a better safety profile for neuropsychiatric ADRs than the EFV-based regimen.

Objective: to analyze the trend in hospitalization rates for mental and behavioral disorders due to alcohol use (ICD-10: F10.0), Brazil and its five regions, 2010-2020., Methods: this was an ecological time-series study using data from the Hospital Information System of the Brazilian National Health System; to calculate the trend in hospitalizations, we used the Prais-Winsten generalized linear regression model and the Stata Statistical Software 14.0; a decreasing trend was considered when p-value < 0.05, and the regression coefficient was negative., Results: in the period analyzed, there were 423,290 hospitalizations for mental and behavioral disorders due to alcohol use in the country; the data analyzed showed a decreasing trend in adult hospitalization rates for this cause in the country (p-value < 0.001; 95%CI -0.094;-0.079) and in all its regions, for both sexes (p-value < 0.001)., Conclusion: hospitalizations for mental and behavioral disorders due to alcohol use have reduced in Brazil and in its macro-regions.

We examined trends in the prevalence of post-exposure prophylaxis following sexual exposure (PEPSE) per million population (2011-2019) and the proportion of repeated PEPSE within 365 days of the first PEPSE dispensing (2011-2018) in Brazil. We also compared the prevalence of repeated PEPSE according to patient and health services characteristics in 2018. The prevalence of PEPSE increased 55.5% from 2011 to 2019. Repeated PEPSE increased 11.8%, reaching 8.4% among people with their first dispensing in 2018. The prevalence of repeated PEPSE was higher in cis men or trans women (versus cisgender women); homosexuals (versus heterosexuals); and people aged 25-29 years (versus other age groups). We also observed greater prevalence of repeated PEPSE in HIV services in populous cities or services with elevated caseloads. Our findings highlight the need for strategies to reduce repeated PEPSE and promote other HIV-prevention technologies, particularly among young adults, cisgender men, transgender women, and homosexuals., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Cryptococcosis is a global fungal infection caused by the Cryptococcus neoformans/Cryptococcus gattii yeast complex. This infection is acquired by inhalation of propagules such as basidiospores or dry yeast, initially causing lung infections with the possibility of progressing to the meninges. This infection mainly affects immunocompromised HIV and transplant patients; however, immunocompetent patients can also be affected. This review proposes to evaluate cryptococcosis focusing on studies of this mycosis in Brazilian territory; moreover, recent advances in the understanding of its virulence mechanism, animal models in research are also assessed. For this, literature review as realized in PubMed, Scielo, and Brazilian legislation. In Brazil, cryptococcosis has been identified as one of the most lethal fungal infections among HIV patients and C. neoformans VNI and C. gattii VGII are the most prevalent genotypes. Moreover, different clinical settings published in Brazil were described. As in other countries, cryptococcosis is difficult to treat due to a limited therapeutic arsenal, which is highly toxic and costly. The presence of a polysaccharide capsule, thermo-tolerance, production of melanin, biofilm formation, mechanisms for iron use, and morphological alterations is an important virulence mechanism of these yeasts. The introduction of cryptococcosis as a compulsory notification disease could improve data regarding incidence and help in the management of these infections., (© 2022. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Objective: To evaluate the prevalence and factors associated with HIV/syphilis co-infection in people initiating antiretroviral therapy in Belo Horizonte, capital of the state of Minas Gerais., Methods: A sectional section of a prospective cohort study was carried out with people living with HIV, treatment-naive, initiating antiretroviral therapy, older than 16 years, and in follow-up treatment at specialized HIV/Aids care services in Belo Horizonte. Sociodemographic, behavioral, clinical, laboratory and pharmacological treatment-related data were obtained through interviews, medical records, and information systems for logistical control of antiretroviral medications and laboratory tests. The dependent variable was the first episode of active syphilis, recorded by the physician in clinical records, within 12 months after beginning of the antiretroviral therapy. Factors associated with HIV/syphilis co-infection were assessed using binary multiple logistic regression., Results: Among the 459 individuals included, a prevalence of 19.5% (n = 90) of sexually transmitted infections (STI) was observed, with syphilis (n = 49) being the most frequent STI in these individuals. The prevalence of HIV/syphilis co-infection was 10.6% (n = 49), and the associated independent factors were alcohol use (OR = 2.30; 95%CI: 1.01-5.26), and having a diagnosis of other sexually transmitted infections (OR = 3.33; 95%CI: 1.24-8.95)., Conclusions: There was a high prevalence of HIV/syphilis co-infection in people living with HIV initiating antiretroviral therapy in Belo Horizonte. HIV/syphilis co-infection was associated with behavioral and clinical factors, such as alcohol use and diagnosis of other sexually transmitted infections. Prior knowledge about the factors associated with this co-infection may support the decisions of health professionals engaged in the care to people living with HIV, with regard to timely diagnosis, guidance, follow-up and adequate treatment, both for syphilis and HIV.

Background: Malaria remains a major public health problem in South America, mostly in the Amazon region. Among newly proposed ways of controlling malaria transmission to humans, paratransgenesis is a promising alternative. Paratransgenesis aims to inhibit the development of parasites within the vector through the action of genetically modified bacteria. The first step towards successful paratransgenesis in the Amazon is the identification of Anopheles darlingi symbiotic bacteria, which are transmitted vertically among mosquitoes, and are not pathogenic to humans., Methods: Culturable bacteria associated with An. darlingi and their breeding sites were isolated by conventional microbiological techniques. Isolated strains were transformed with a GFP expressing plasmid, pSPT-1-GFP, and reintroduced in mosquitoes by feeding. Their survival and persistence in the next generation was assessed by the isolation of fluorescent bacteria from eggs, larvae, pupae and adult homogenates., Results: A total of 179 bacterial strains were isolated from samples from two locations, Coari and Manaus. The predominant genera identified in this study were Acinetobacter, Enterobacter, Klebsiella, Serratia, Bacillus, Elizabethkingia, Stenotrophomonas and Pantoea. Two isolated strains, Serratia-Adu40 and Pantoea-Ovo3, were successfully transformed with the pSPT-1-GFP plasmid and expressed GFP. The fluorescent bacteria fed to adult females were transferred to their eggs, which persisted in larvae and throughout metamorphosis, and were detected in adult mosquitoes of the next generation., Conclusion: Serratia-Adu40 and Pantoea-Ovo3 are promising candidates for paratransgenesis in An. darlingi. Further research is needed to determine if these bacteria are vertically transferred in nature.

Ozonation process was used for leachate treatment from a landfill located in Rio de Janeiro, Brazil. The influence of pH and ozone concentration on COD (Chemical Oxygen Demand), TOC (Total Organic Carbon), Absorbance at 254 nm (ABS254nm), and True color was evaluated through RCCD (Rotatable Central Composite Design) experimental design, resulting in mathematical models that were statistically analyzed in Statistica and Design Expert software. The removals obtained was up to 26.1%, 29.9%, 56.9%, and 97.9% for COD ([COD] 0 =3,323 mg/L), TOC ([TOC] 0 =1,275 mg/L), ABS254nm (ABS 0 =32.2), and True color ([True color] 0 =3,467 mgPt-Co/L), respectively. Statistical and variance analysis of the experimental data revealed that one quadratic model obtained in Statistica was valid, ABS254nm reduction. However, by applying the Design Expert software, modified models were generated to predict the behavior of all dependent variables. Thus, the optimum point for the best response after ozonation of the landfill leachate was at the highest pH and the lowest ozone dose (9 and 2.2 mgO 3 /m 3 , respectively). Toxicity toward Allivibrio fischeri bacteria was abated at the same time that it decreased the impact of the effluent to Danio rerio fish (from 125 UT to 62 UT) on the treated leachate.

Objective: To assess longitudinally the change in quality of life in people living with HIV initiating antiretroviral therapy in three public reference services specialized in HIV care in Belo Horizonte, Brazil., Methods: Prospective cohort study among people living with HIV, aged 18 years or older, and initiating antiretroviral therapy. We obtained sociodemographic, behavioral, clinical data related to pharmacological treatment and to the service by face-to-face interviews, and supplemented these data with information from clinical records and Information Systems of the Brazilian HIV/AIDS Program. We measured the quality of life using the WHOQOL-HIV bref instrument, with a minimum interval of six months between the baseline and the follow-up interviews. We used paired t-test to assess the mean change in quality of life between the two interviewsand evaluated factors associated with this outcome using multiple linear regression., Results: The overall quality of life, as well as the physical, psychological, level of independence, environment and spiritual quality of life domains were statistically higher in people living with HIV using antiretroviral therapy at the end of the follow-up. Factors independently associated with the increase in quality of life were having religious belief and living with other people. Having signs or symptoms of anxiety and depression and the number of adverse drug reactions reported were predictors associated with worsening quality of life., Conclusions: These results show an improvement in the quality of life over time in people living with HIV on antiretroviral therapy. They also highlight the need to monitor and provide health care support, especially for individuals with signs and symptoms of anxiety and depression and that report adverse reactions to medicines at the beginning of treatment.

Guanabara Bay, the second largest bay on the Brazilian coast, has tropical to subtropical, hypereutrophic water conditions. A survey of the macroalgae flora conducted over the past 200 years (1800-2013) yielded a list of 245 species, which represents 15.7% of the total macroalgae recorded in the Tropical Western Atlantic, while comprehends 29.9% and 50.2% of the marine flora in Brazil and Rio de Janeiro, respectively. When evaluating the macroalgal list throughout different periods, it is noticeable the gradual loss of biodiversity as anthropization increased over the last two centuries. The use of phytogeographic indexes and beta diversity confirmed the negative changes in macroalgae assemblages as a response to increasing environmental degradation. The use of floristic surveys to establish the reference conditions employing historical data and/or regionally referenced prove to be an efficient tool using macroalgae as an ecological indicator for water quality., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To estimate the prevalence of smoking and evaluate the factors associated with this outcome in people living with HIV (PLHIV)., Methods: This is a cross-sectional study of a prospective concurrent cohort of 462 individuals initiating antiretroviral therapy at three HIV/AIDS specialized services in Belo Horizonte between 2015 and 2017. The following smoking status were used: current smoker (CS), former smoker (FS) and non-smoker (NS). Multinomial logistic regression was performed with NS as the reference category., Results: Most participants were men (81.4%), young (up to 34 years old; 57.2%) and non-white (75.7%). Of the total number of individuals, 27.7% were CS, 22.9% FS, and 49.4% NS. Most smokers were light smokers (65.1%), consumed up to 10 cigarettes per day and had been smoking for more than 10 years (63.3%), starting on average at 17.2 years of age (SD = 5.1). In the multivariate analysis, higher chances of being CS were associated with: being female, having up to 9 years of schooling, current or prior use of alcohol and illicit drugs (marijuana, cocaine and crack) and presenting signs and/or symptoms of anxiety or depression. Higher chances of being FS were associated with having up to 9 years of schooling and current or prior use of alcohol and illicit drugs (marijuana and crack)., Conclusions: The results show that smoking is highly prevalent among PLHIV, indicating the need for HIV specialized services to prioritize smoking cessation interventions. These interventions should consider the use of alcohol and illicit drugs and be targeted especially to young people, those with low schooling and with signs and/or symptoms of anxiety or depression.

The reverse osmosis (RO) process has been increasingly applied to landfill leachate treatment. The published literature reports several studies that investigated the technical feasibility of RO. However, information about process costs is scarce. Also, companies that run leachate treatment plants do not provide actual costs. To fill this gap, this study aimed to evaluate the treatment costs of a full-scale RO for the treatment of landfill leachate located in Rio de Janeiro State, Brazil. A procedure was proposed to estimate the capital expenses (CAPEX), operational expenses (OPEX), and specific total treatment cost, the total cost per m 3 of treated leachate, of the leachate treatment by membrane process, and the results obtained are discussed. The CAPEX for this full-scale RO was estimated at MUS$ 1.413, and OPEX ranged from US$ 0.132 to US$ 0.265 m -3 per year. The cost of leachate treatment has been estimated at US$ 8.58 m -3 considering the operation of the RO-unit for 20 years after landfill closure.

Toothache is a public health problem that causes great inconvenience to psychoactive substances users. The objective was to verify the prevalence of dental pain and its associations among psychoactive substances users from Alcohol and Drug Psychosocial Care Centers (CAPS AD) in Vitoria, Vila Velha and Serra, Espírito Santo, Brazil. A transversal study was conducted with 280 participants between June 2015 and February 2016, using five scripts: one for socio-demographic data and health perception; another for oral health; the Oral Health Impact Profile; the Alcohol Smoking and Substance Involvement Screening Test and the World Health Organization Quality of Life Test. Data were organized in frequency tables and analyzed with the SPSS 20 statistical package. Comparisons were made with Fisher's test and the Odds Ratio (OR) was used to check the strength of the association between the variables. The prevalence of pain in the population studied was 59.3%, and individuals whose quality of life was impacted due to their oral conditions were 2.2 times more likely to report toothache in the last 6 months. The population studied showed a high prevalence of dental pain and the study indicates that dental pain interferes in the quality of life of psychoactive substances users who are treated at CAPS AD services in these three cities.

We performed an epidemiological, clinical and histopathological analysis of oral lymphoid lesions (OLLs) during a 47-year period. Data regarding patient age, sex, duration, location, symptomatology, type of growth, implantation, staining, presence of ulceration and bleeding of all cases were compiled from the clinical data. For the histopathological analyses, all slides stained by H/E were reassessed. During the analyzed period, 14,565 patients with oral and maxillofacial lesions were diagnosed, with 45 cases diagnosed as OLLs. The most prevalent location was the tongue. Females were more affected, and the mean age was 40.8 years. OLLs presented a heterogeneous frequency, with the prevalence of reactive lesions (42.3%) followed by developmental lesions (35.6%). Among the reactive lesions, foreign body granulomas were the most common. Regarding diagnosed neoplasms, malignant represented 13.2% of the cases. The average time of evolution of OLLs in general was of 22.2 months. Regarding the histopathological characteristics, the presence of primary lymphoid follicles was observed in 37.8% of the cases, while inflammatory infiltrates were diffuse in 66.7% and epimyoepithelial islands were observed in 13.3%. Our study concludes that OLLs involves a broad spectrum of lesions that share the presence of the lymphoid component, which can range from indolent to more aggressive behavior.

The management of municipal solid waste (MSW) presents an ever increasing and more complex challenge in global terms. The disposal of MSW in landfills generates leachate, a liquid highly polluting to the aquatic environment. This review describes the state-of-the-art approaches to treatments applied to leachate in Brazil, highlighting the new technologies and alternatives that are still in the research phase, and compares the leachate treatment technologies applied around the world with the current scenario in Brazil. In Brazilian landfills, along with other technologies, the biological process is commonly applied, since this is a simple and economical approach and often it is the only technique used in small municipalities. The sanitary landfills in large Brazilian cities located in the states of São Paulo and Rio de Janeiro, invest in or outsource landfill activities, where apply advanced treatment technologies, such as membrane filtration. The use of membrane filtration technology in these cases reveals similarities with leachate treatments applied in the developed countries of North America and Europe. Brazilian researchers have highlighted the need to use efficient and economically viable technologies for the treatment of leachate in Brazilian landfills. However, the current scenario of MSW management in Brazil shows deficiencies related to the monitoring of sanitary landfills and limited information is available on the performance of leachate treatment systems., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Combined treatment of urban solid waste leachate and domestic sewage has emerged in Brazil and worldwide as an alternative to minimize the difficulties of treating landfill leachate. Landfill leachate is a complex matrix of organic and inorganic substances, recalcitrant material and xenobiotic organic compounds that are considered to be highly toxic, as well as endocrine disrupting compounds (EDC) that contribute to increased estrogenic activity. Although combined treatment is feasible for removal of organic matter, ammonia and toxicity, the efficiency of the removal of estrogenic substance is poorly investigated. In this study, the activated sludge process in batch and continuous modes was used for the combined treatment of 2% and 5% leachate/sewage mixtures. Estrogenic activity was reduced in reactors in both batch and continuous modes. The activated sludge process achieved average reductions of the estradiol equivalent (EQ-E2) values in the combined treatment of 94.5, 60.8 and 66.4% for the sanitary sewage, 2% mixture leachate in sewage and 5% mixture leachate in sewage reactors, respectively, in batch mode. For continuous reactors, 86%, 72%, and 65% of reduction of EQ-E2were achieved for sanitary sewage, 2 and 5% mixture with sanitary sewage. As for EQ-E2, the increase in the concentration of leachate in the sewage mixture was detrimental to the removal of estrogenic compounds during the biological process. Therefore, a limit on the % leachate/sewage mixtures should be established to achieve efficiency in the combined treatment of leachate in a Wastewater Treatment Plant (WWTP)., (Copyright © 2018. Published by Elsevier Ltd.)

Objective: To evaluate the prevalence of adverse drug reactions (ADR) and associated factors during the use of Highly Active Antiretroviral Therapy (HAART) in patients initiating treatment., Methods: This is a cross-sectional analysis of a prospective study conducted in three public referral services specialized in HIV/AIDS care in Belo Horizonte, Brazil. Self-reported ADR and explanatory variables were obtained from face-to-face interview and from Information Systems. Associated factors with ADR were evaluated by logistic regression in SPSS software v.22., Results: We included 399 patients, of which 85.5% reported at least one and 72.7% up to 5 ADRs after HAART initiation. Neurological reactions were the most frequent, with self-reported ADRs being distinct according to HAART regimen used. The global model showed higher chance of ADRs among females (OR = 3.52) and illicit drug users (OR = 2.28). Lower chance of ADRs was found for patients aged > 33 years (OR = 0.37), DTG/TDF/3TC users (OR = 0.41), and higher physical domain of quality of life (OR = 0.78). The model restricted to patients using the single-tablet regimen EFV/TDF/3TC showed lower ADRs among patients with CD4+ T lymphocyte count > 200 cells/mm 3 (OR = 0.23) and higher independence domain of quality of life (OR = 0.74). The model restricted to DTG/TDF/3TC and to other regimens showed lower ADRs with higher physical domain of quality of life (OR = 0.74 and OR = 0.55, respectively)., Conclusions: The prevalence of self-reported ADRs to first-line antiretroviral regimens was high and patients using DTG/TDF/3TC had a smaller number of ADRs. In addition to HAART regimen, sociodemographic, clinical, and quality of life characteristics were associated with ADRs.

The purpose of this study was to perform genotypic characterization and to evaluate the virulence of Toxoplasma gondii obtained from aborted fetuses in an abortion outbreak in goats from northeastern Brazil. Brain samples from 32 fetuses were submitted to mouse bioassay for T. gondii isolation. Two isolates were obtained and subjected to genotypic characterization. Isolate virulence was evaluated using murine model in different doses (from 10 5 to 10 1 tachyzoites/mL). In genotyping, both isolates were classified as clonal lineage type II (genotype #1 ToxoDB) and showed to be virulent for mice. This is the first description of genotype #1 in cases of goat abortion, showing the circulation of virulent T. gondii isolate producing reproductive disorders in pregnant goat., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: KPC carbapenemase-producing Klebsiella pneumoniae (KPC-KP) has become a major public health challenge. Accordingly, this study sought to use a systematic review of the scientific literature to ascertain the mortality of KPC-KP infection, and analyze such mortality by country, year of publication, hospital ward, and type of interpretation used to define carbapenem resistance., Methodology: A search without language restrictions was made of the MEDLINE, CENTRAL, EBSCO, LILACS and EMBASE databases from 1996 through June 2017, to locate all studies which had determined the existence of KPC-KP infection. We then performed a meta-analysis of all studies that reported KPC-KP infection-related mortality, and analyzed mortality by subgroup in accordance with standard methodology., Results: A total of 51 papers were included in the systematic review. From 2005 through 2017, data on KPC-KP infection were reported in 5124 patients, with an average of 465 patients per year. The most widely studied type of infection was bacteremia (28∙0%). The meta-analysis showed that overall mortality for the 37 studies was 41.0% (95%CI 37.0-44.0), with the highest mortality rates being observed in oncology patients, 56.0% (95%CI 38.1-73.0), and Brazil, 51.3% (95%CI 43.0-60.0)., Conclusion: KPC-KP infection-related mortality is high, is manifested differently in some countries, and is highest among oncology patients., (Copyright © 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.)

Plasmid-mediated AmpC β-lactamases (PMACBLs) in Enterobacteriaceae encode resistance to third-generation cephalosporins, and these can mediate carbapenem resistance when associated with porin loss. However, no standardized phenotypic method is available for detecting these enzymes in the clinical microbiology laboratory. Limited data are available concerning the frequency of PMACBLs in Enterobacteriaceae in Brazil. This study was conducted in response to an increased cefoxitin (CFO) resistance rate of 3.7% in Escherichia coli isolates from urine samples from patients with suspected urinary tract infections during 2010. We collected 2,266 E. coli isolates prospectively during January 2012. A total of 109 (4.8%) isolates were nonsusceptible to CFO. These strains were further examined using multiplex PCR for the presence of genes encoding PMACBLs and using inhibitor assays with CFO and ceftazidime (CAZ) disks with and without phenylboronic acid. Pulsed-field gel electrophoresis was used to evaluate clonal dissemination. Genes encoding PMACBLs were detected in 1.8% of the isolates from inpatients and 0.46% of isolates from outpatients. The most prevalent gene was blaCMY-2 and blaCMY-4 was also detected. The phenotypic analysis showed 100% sensitivity and specificity for CMY-2 and CMY-4 when CFO-resistant isolates with a minimum zone diameter difference of 5 mm for CAZ or CAZ and CFO were considered positive. Although most of the isolates were nonclonal, one clonal group with two isolates was observed. Thus, the most frequent PMACBL in E. coli from São Paulo, Brazil is CMY-2, and both clonal and plasmid-mediated dissemination occur.

In Enterobacteriaceae, the blaNDM genes have been found in many different genetic contexts, and a wide diversity of plasmid scaffolds bearing those genes has been found. In August 2013, we identified NDM-1-producing Escherichia coli and Enterobacter hormaechei strains from a single rectal swab sample from a patient hospitalized in Rio de Janeiro, Brazil, who had no history of travel abroad. Complete DNA sequencing using the Illumina platform and annotation of the two plasmids harboring the blaNDM-1 gene, one from each strain, showed that they belonged to incompatibility groups IncFIIK and IncX3 and harbored a novel transposon named Tn3000. Similar genetic structures have been identified among other isolates in Brazil but also on plasmids from other continents. Our findings suggest that the blaNDM-1 gene may be transmitted by Tn3000 in different parts of the world., (Copyright © 2015, American Society for Microbiology. All Rights Reserved.)

Hydrotalcite is a layered double hydroxide (LDH) consisting of brucite-like sheets of metal ions (Mg-Al). In this work, hydrotalcites were synthesized, and boron removal from oilfield wastewater was evaluated. LDHs were synthesized using the co-precipitation method. The calcined products (CLDHs) were obtained by heating at 500°C and characterized using X-ray diffraction, X-ray fluorescence, thermogravimetric analysis and the specific surface area (BET). The affinity of LDHs for borate ions was evaluated for calcined and uncalcined LDHs as a function of contact time, initial pH of the oilfield wastewater (pH ∼ 9) and the LDH surface area. The tests were conducted at room temperature (approximately 25ºC). The results indicated that 10 min were needed to reach a state of equilibrium during boron removal for calcined LDHs due to the high surface area (202.3 m(2) g(-1)) regardless of the initial pH of the oilfield wastewater, which resulted from the high buffering capacity of the LDHs. The adsorption capacity increased as the adsorbents levels increased for the range studied. After treatment of the oilfield wastewater containing 30 mg L(-1) of boron with Mg-Al-CO3-LDHs, the final concentration of boron was within the discharge limit set by current Brazilian environmental legislation, which is 5 mg L(-1). Pseudo-first-order and pseudo-second-order kinetic models were tested, and the latter was found to fit the experimental data better. Isotherms for boron adsorption by CLDHs were well described using the Langmuir and Freundlich equations.

Objective: To describe the vertical clinical pharmacist service's interventions in prevention of venous thromboembolism., Methods: This prospective study was done at a private hospital. From January to May 2012, the clinical pharmacist evaluated medical patients without prophylaxis for thromboembolism. If the patient fulfilled criteria for thromboembolism and did not have contraindications, the clinical pharmacist suggested inclusion of pharmacologic agents and/or mechanical methods for venous thromboembolism prevention. In addition, the appropriate dose, route of administration, duplicity and replacement of the drug were suggested., Results: We evaluated 9,000 hospitalized medical patients and carried out 77 pharmaceutical interventions. A total of 71 cases (92.21%) adhered to treatment so that non-adherence occurred in 6 cases (7.79%). In 25 cases pharmacologic agents were included and in 20 cases mechanical prophylaxis. Dose adjustments, route, frequency, duplicity and replacement made up 32 cases., Conclusion: The vertical clinical pharmacist service included the prophylaxis for venous thromboembolism and promotion of appropriate use of medicines in the hospital.

The objective of this research was to evaluate the air stripping technology for the removal of ammonia from landfill leachates. In this process, pH, temperature, airflow rate and operation time were investigated. Furthermore, the relationship between the leachate alkalinity and the ammonia removal efficiency during the process was studied. The leachate used in the tests was generated in the Gramacho Municipal Solid Waste Landfill (Rio de Janeiro State, Brazil). The best results were obtained with a temperature of 60(o)C, and they were independent of the pH value for 7 h of operation (the ammonia nitrogen removal was greater than 95%). A strong influence of the leachate alkalinity on the ammonia nitrogen removal was observed; as the alkalinity decreased, the ammonia concentration also decreased because of prior CO2 removal, which increased the pH and consequently favored the NH3 stripping. The air flow rate, in the values evaluated (73, 96 and 120 L air.h(-1).L(-1) of leachate), did not influence the results.

The Brazilians educational institutions need a large energy demand for the operation of laundries, restaurants and accommodation of students. Much of that energy comes from steam generated in boilers with wood fuel. The laboral activity in boiler may present problems for the operator's health due to exposure to excessive heat, and its operation has a high degree of risk. This paper describes an analysis made the conditions of thermal environment in the operation of a B category boiler, located at a Higher Education Institution, located in the Zona da Mata Mineira The equipments used to collect data were Meter WBGT of the Heat Index; Meter of Wet Bulb Index and Globe Thermometer (WBGT); Politeste Instruments, an anemometer and an Infrared Thermometer. By the application of questionnaires, the second phase consisted of collecting data on environmental factors (temperature natural environment, globe temperature, relative humidity and air velocity). The study concluded that during the period evaluated, the activity had thermal overload.