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Dermanura gnoma (Handley, 1987) is a phyllostomid bat that occurs in South America. In Brazil, most of the records are concentrated in the Amazon Forest, with sparse data from Cerrado and Atlantic Forest. This study presents the first record of D. gnoma for Alagoas state, and for the Pernambuco Endemism Center (PEC), the most threatened region of the Brazilian Atlantic Forest, characterized by its high rate of endemism, habitat loss, and fragmentation. The species was surveyed at Murici Ecological Station and its identification was supported by morphological and molecular data. We provide the first COI and CYTB gene sequences for this species in the entire Atlantic Forest. Phylogenetic analyses reveal that the generated sequences were recovered in the same clade as the published sequences of D. gnoma from the Amazonian Forest, corroborating the disjunct distribution pattern between Amazonia and PEC, as already reported for other vertebrate taxa. Also, this record increases the number of bat species to 71 for the PEC and extends the geographic distribution of D. gnoma by 758 kilometers to the northeast of its range.

Objective: Hepatitis B is an important public health concern. Currently, the COVID-19 pandemic is a major challenge for health systems, and the access to pharmacologic and non-pharmacologic treatment of chronic diseases, such as hepatitis B, may have been affected due to the contingency measures. This study aimed to evaluate the access to antiviral therapy during the ongoing pandemic., Methods: This was a descriptive analysis of the access to treatment for chronic hepatitis B at a tertiary-level university hospital in São Paulo, integrated with the Brazilian health system. The study was conducted from April to December 2020., Results: Access to antiviral therapy for 225 patients was assessed. The majority of the population was male (59%). The main type of service was the Programa Medicamento em Casa (Home Medication Delivery Program), which was availed by 144 (64%) patients. Women had poorer access to antiviral therapy (56%, p<0.05), and patients registered in the HMDP (68%, p<0.05) had better access. The age group of >48 years represented 70% of the group without access to antiviral therapy. Twenty-two pharmaceutical appointments were conducted through phone calls with patients without access to antiviral therapy., Conclusion: This study contributes to the rationalization of efforts in a public health crisis through the identification of groups with the highest risk of poor access to antiviral therapy and the demonstration of the benefits of a medication delivery system.

Objective: To analyze the effect of motivational interviewing on self-care for people with chronic heart failure., Method: A multicenter randomized clinical trial, which divided people into an intervention group (n=59) and a control group (n=59), followed for 60 days in centers of Brazil and Uruguay. The intervention group received three consultations per motivational interviewing, with an interval of 30 days, and the control group maintained conventional follow-up in specialized clinics. The data were assessed using the Self-Care of Heart Failure Index 6.2, before and after intervention in each of the centers. They were analyzed using the mean, median, t-test, correlation analysis using the Spearman coefficient and effect of the intervention by Cohen's d., Results: One hundred and eighteen people completed the study. In view of the assessment of the effect of the motivational interviewing on self-care, compared to conventional follow-up, a medium effect on maintenance and management (Cohen's d=0.6723; 0.5086) and high on self-care confidence (Cohen's d=0.9877)., Conclusion: Motivational interviewing was effective in improving self-care in patients with heart failure, being a feasible strategy to be implemented in specialized clinics. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR-6fp5qt.

Histiotus are vespertilionid bats endemic to South America, easily recognized by its very long ears. During a twelve-month bat inventory in northeastern Brazil, eleven specimens of Histiotus were collected with a unique combination of characters that did not match those of any known species. In this paper, we describe these specimens as a new species. Histiotus sp. nov is distinguished from its congeners by its pale transparent wings and translucent ears, a triangular-shaped ear with a prominent lobe in the inner border connected by a band (~4 mm) across the forehead; its general golden-brownish body color and well-marked bicolor dorsal hairs. Its geographic distribution is unique among vespertilionids, arranged in a northeast-southwest diagonal across South America, includes the Caatinga and Cerrado of Brazil and Chaco of Bolivia. The available data suggest a seasonal reproductive pattern, with births occurring in the mid to late rainy season.

Rotavirus has been considered the main agent of infectious diarrhea especially among younger children. We addressed the prevalence of rotavirus-associated diarrhea and the diversity of circulating electropherotypes by immunochromatography and RNA electrophoresis. Stool samples were taken from 391 children (267 with diarrhea) from the lower socioeconomic stratum who sought treatment in the Hospital Infantil João Paulo II/Belo Horizonte, during 2005 and 2006. Rotavirus was detected in 79/20.2% of subjects, 64/24.0% with diarrhea and 15/12.1% with no diarrhea. The virus was strongly associated with diarrhea (p = 0.003). A total of 76/19.4% and 69/17.6% rotavirus-positive children were identified by immunochromatography and electrophoresis, respectively. Rotavirus-associated diarrhea was more frequently detected in dry months (p < 0.001) and almost exclusively in children aged up to three years. Long profile strains prevailed (54/78.3%) but a shift toward short electropherotype was identified. Despite the decrease seen in 2006, rotavirus infection is still very common in our area. Although viral RNA electrophoresis is useful as a typing method, it should not be used exclusively in the diagnosis of rotavirus infection. We confirmed a shift from long to short profile strains, as already described for other South American countries.

Purpose: The use of patient-orientated questionnaires is of utmost importance in assessing the outcome of spine surgery. Standardisation, using a common set of outcome measures, is essential to aid comparisons across studies/in registries. The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument validated for patients with spinal disorders. This study aimed to produce a Brazilian-Portuguese version of the COMI., Methods: A cross-cultural adaptation of the COMI into Brazilian-Portuguese was carried out using established guidelines. 104 outpatients with chronic LBP (>3 months) were recruited from a Public Health Spine Medical Care Centre. They completed a questionnaire booklet containing the newly translated COMI, and other validated symptom-specific questionnaires: Oswestry Disability Index (ODI) and Roland Morris disability scale (RM), and a pain visual analogue scale. All patients completed a second questionnaire within 7-10 days to assess reproducibility., Results: The COMI summary score displayed minimal floor and ceiling effects. On re-test, the responses for each individual domain of the COMI were within 1 category in 98% patients for the domain 'function', 96% for 'symptom-specific well-being', 97% for 'general quality of life', 99% for 'social disability' and 100% for 'work disability'. The intraclass correlation coefficients (ICC(2,1)) for COMI pain and COMI summary scores were 0.91-0.96, which compared favourably with the corresponding values for the RM (ICC, 0.99) and ODI (ICC, 0.98). The standard error of measurement for the COMI was 0.6, giving a "minimum detectable change" (MDC95%) of approximately 1.7 points i.e., the minimum change to be considered "real change" beyond measurement error. The COMI scores correlated as hypothesised (Rho, 0.4-0.8) with the other symptom-specific questionnaires., Conclusions: The reproducibility of the Brazilian-Portuguese version of the COMI was comparable to that of other language versions. The COMI scores correlated in the expected manner with existing but longer symptom-specific questionnaires suggesting good convergent validity for the COMI. The Brazilian-Portuguese COMI represents a valuable tool for Brazilian study-centres in future multicentre clinical studies and surgical registries.

The objective of this study was to estimate the number of psychiatric beds occupied per State in Brazil and the amount paid by the Unified National Health System (SUS) for hospitalizations, professional services, tests, and medicines in the country in 2004. The mean number of psychiatric beds occupied, estimated on the basis of total days of hospitalization during the year, and the amount paid by the SUS were obtained from the Hospital Admissions Authorizations (AIH). A total of 45 thousand psychiatric beds were occupied by the SUS in 2004. The SUS paid a total of BRL$487 million (some U$270 million) for hospitalization of patients with mental disorders in 2004. Private hospitals accounted for 78.8% of all psychiatric beds occupied by the SUS. Although the deactivation of 15 mil psychiatric beds could currently generate BRL$162 million (U$90 million) to be reallocated to non-hospital psychiatric services, planning and implementation of the Psychiatric Reform have been very limited. The precarious extra-hospital network has been used as a barrier to deactivation of psychiatric beds, although the latter generates the necessary resources for the former.

Objective: The study assesses AIDS survival time per AIDS-case definition and exposure category in Sao Paulo State, Brazil during the periods 1992 to 1995 and 1998 to 2001., Methods: Case-fatality rate per AIDS case, Cox proportional hazards analysis, and Kaplan-Meier survival time., Results: The case-fatality rate per AIDS case in 1998 to 2001 was 37.6% for symptomatic (Centers for Disease Control and Prevention/modified and/or Paho/Caracas) and 9.7% for the Brazilian asymptomatic CD4 count<350 cells/mm3 AIDS-case definitions. Heterosexual/female patients were diagnosed earlier and presented the lowest case-fatality rate, followed by homosexual/male patients, heterosexual/male patients, and injecting drug users. In the multivariate Cox proportional hazards model, the period of diagnosis (hazard ratio=2.66; 95% confidence interval [CI]: 2.58 to 2.74) and AIDS-case definition (hazard ratio=4.48; 95% CI: 4.53 to 5.16) were strong predictors of survival. For the total AIDS cases, excluding death definition and undetermined exposure category, the estimated first quarter survival time improved from 4 months in 1992 to 1995 to 50 months in 1998 to 2001. Considering only the symptomatic AIDS-case definition, however, the improvement was from 4 months in the period 1992 to 1995 to 14 months in the period 1998 to 2001., Conclusion: The survival improvement in Sao Paulo State was attributable to the introduction of antiretroviral therapy with free universal access in 1996 and to earlier diagnosis associated with the introduction in 1998 of the Brazilian asymptomatic CD4 count<350 cells/mm3 AIDS-case definition with superior sensitivity compared with the symptomatic AIDS-case definitions.