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Background: The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service that provides support to primary healthcare in Minas Gerais, Brazil, performing teleconsultation and tele-electrocardiography. The aim of this study was to assess teleconsultation requests received by the TNMG and to investigate the factors associated with low teleconsultation utilization in most municipalities. Materials and Methods: A cross-sectional study was carried out including 214 municipalities. Indicators were defined to analyze teleconsultation requests. A structured questionnaire was used to investigate factors associated with teleconsultation utilization, which were analyzed by multivariate analysis through a decision tree algorithm (chi-squared automatic interaction detector) to the entire population of the study and logistic regression for municipalities that had used the system during the analyzed period. Results: From May to September 2009, 1,954 teleconsultations were performed. The average number (±standard deviation) of teleconsultations per municipality was 1.71 (±1.50) per month. The majority of the users were located in remote regions with a low Human Development Index. The decision tree showed 'conduction of sufficient training' (p =0.0015) as the factor with the greatest positive impact on teleconsultation utilization, followed by 'ability to discuss clinical cases outside the teleconsultation system' (p =0.0192). Logistic regression analysis revealed two factors associated with increased use of the system: 'complexity of the system' (odds ratio=3.35; 95% confidence interval [CI], 1.58-7.09) and whether they considered that the 'service helps to solve everyday problems' (odds ratio=4.37; 95% CI, 1.14-16.69). Conclusions: The study of factors associated with the low use of the teleconsultation system of the TNMG may help policy makers define strategies to improve the use of teleconsultation services. [ABSTRACT FROM AUTHOR]

Background and Hypothesis: Brazil has the largest number of individuals of African descent outside Africa and a very admixed population. Among cases of lupus nephritis (LN) in the country, there are differences in incidence, and even in severity, depending on the location and characteristics of the population studied. The aim of this study was to describe the clinical and epidemiological characteristics of LN in Brazil, as well as to determine which of those characteristics would be risk factors for a poor renal prognosis., Methods: This was a retrospective, descriptive observational study of patients diagnosed with LN who underwent kidney biopsy between 1999 and 2015 in the Nephrology Department of the Hospital das Clínicas, in São Paulo, Brazil. Data were collected from electronic medical records., Results: We evaluated 398 patients, among who 94.1% and 77.7% tested positive for antinuclear antibodies and anti-DNA antibodies, respectively, whereas 33.7% showed the full-house pattern. The time from LN symptom onset to biopsy was <6 months in 47.5% (early biopsy group) and ≥6 months in 52.5% (late biopsy group). In the early biopsy group, the chronicity index was lower and the activity index was higher. Multivariate analysis showed that a higher chronicity index was the only independent risk factor for progression to requiring kidney replacement therapy., Conclusion: Late biopsy seems to be associated with negative renal outcomes in LN. However, it seems that a higher chronicity index is the main predictor of a poor renal outcome among patients with LN in Brazil., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The determination of the synanthropic index is essential to evaluate the degree of association between species, such as diptera and man, based solely on their degree of preference for urban areas. This research aimed to study the synanthropic behavior of Calliphoridae and Mesembrinellidae flies in Rio de Janeiro, Brazil. The experiment was conducted between 2021 and 2022 in three areas, where four traps containing 300 g of fresh liver or with 48 h of putrefaction were installed, remaining exposed for 48 h; after collection the dipterans were sacrificed and taxonomically identified. A total of 2,826 dipterans were collected, represented by nine species of Calliphoridae (89.24%) and ten of Mesembrinellidae (10.76%), with the first record of Mesembrinella currani in this biome. The Kruskal-Wallis test showed that the abundance of individuals did not differ among the three analyzed environments. The Mesembrinellidae family was exclusively asynanthrope, along with two species of Calliphoridae: Hemilucilia benoisti (Séguy 1925) and Paralucilia nigrofacialis (Mello 1969) which were exclusive of the forest area, while Calliphoridae had varied synanthropy. Lucilia eximia (Wiedemann 1819) alone represented 57.18% of the total sampled, being the most abundant in all environments except the urban area where Hemilucilia segmentaria (Fabricius 1805) totaled 55.73%. No species were exclusive to the urban area, however Cochliomyia hominivorax (Coquerel 1858) and Lucilia cuprina (Wiedemann 1830) were exclusive to the rural area. The most synanthropic species were Chrysomya megacephala (Fabricius 1794) and Chrysomya albiceps (Wiedemann 1819)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Nunes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

After the worldwide cholera epidemic in 1993, permanent environmental monitoring of hydrographic basins was established in Pernambuco, Brazil, where cholera is endemic. After a quiescent period, 4 rfbN (serogroup O1) positive water samples that were culture negative were detected by multiplex single-tube nested PCR (MSTNPCR); 2 of these were also ctxA (cholera toxin) positive. From May to June 2012, 30 V. cholerae O1 isolates were obtained by culturing samples. These isolates were analyzed for the presence of virulence genes by PCR, intergenic spacer region 16S-23S PCR (ISR-PCR), and pulsed field gel electrophoresis (PFGE). The isolates were positive for the rfbN gene and negative for the assessed pathogenic genes and were classified into 2 groups by ISR and the same profile by PFGE. Close genetic similarity was observed between them (2012) and environmental strains from 2004 to 2005, indicating the permanence of endemic V. cholerae O1 in the region.

Background: Low birth weight (LBW) is associated with increased incidence of high blood pressure (BP) and cardiovascular diseases in adulthood., Objective: To evaluate possible changes in Ambulatory Blood Pressure Monitoring (ABPM) in LBW children., Methods: The birth weight (BW) of 1049 school children (ages 8 to 11) living in Goiânia was assessed. Children with low birth weight (BW or= 3.0 Kg). Information on birth weight was obtained from each child's health card. Casual BP and ABPM were measured. Height and weight measurements were obtained to calculate the body mass index (BMI), and sexual maturity was assessed according to Tanner's criteria (those at Tanner stage >or= 2 were excluded)., Results: Thirty-four children had low birth weight (LBW) and 34 had normal birth weight (NBW). Both groups were similar regarding age, gender, race, body weight, height, BMI, and family history of hypertension. Low-birth-weight children had higher casual systolic blood pressure (SBP) (p = 0.007). ABPM recordings showed that these children had higher 24-hour diastolic blood pressure (DBP) (p = 0.009), daytime DBP (p = 0.002), night-time DBP and SBP (p = 0.005 and p = 0.001), and reduced nocturnal dip in SBP and DBP (p = 0.001) than those born with normal weight. Birth weight was positively correlated with nocturnal dip in SBP (p = 0.022) and negatively correlated with sleep SBP (p = 0.032)., Conclusion: Low-birth-weight children have higher BP and changes in circadian rhythm of blood pressure, with reduced nocturnal dipping. These findings may reflect increased risk of adult hypertension and cardiovascular diseases.