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Background and Objective: Long COVID (LC) refers to persistent symptoms after acute COVID-19 infection, which may persist for months or years. LC affects millions of people globally, with substantial impacts on quality of life, employment, and social participation. Ensuring access to effective, patient-centered care for LC demands evidence, grounded in inclusive representation of those affected by the condition. Yet survey studies frequently under-represent people with the most disabling disease presentations and racially and socioeconomically marginalized groups. We aimed to describe a patient-engaged approach to developing a survey to inform public LC health care and to assess its implementation in terms of enabling participation by diverse LC patients in Brazil., Methods: Survey development was iterative, achieved through an interdisciplinary collaboration among researchers including people living with LC, and grounded in 3 guiding principles: (1) evidence-based; (2) inclusive, intersectional, and patient-centered understanding of chronic illness and research participation; and (3) sensitivity to the context of health-care access., Results: The product of our collaboration was a longitudinal survey using a questionnaire assessing: LC symptoms; their clinical and functional evolution; and impacts on quality of life, household income, health service access, utilization, and out-of-pocket expenses. We illustrate how we operationalized our 3 principles through survey content, instrument design, and administration. Six hundred fifty-one participants with diverse LC symptoms, demography, and socioeconomic status completed the survey. We successfully included participants experiencing disabling symptoms, Black and mixed race participants, and those with lower education and income., Conclusion: By centering patient experience, our novel, principles-based approach succeeded in promoting equity, diversity, and inclusion in LC survey research. These principles guiding patient-engaged collaboration have broad transferability. We encourage survey researchers working on chronic illness and in other contexts of marginalization and inequality to adopt them., Competing Interests: Declaration of competing interest M.C.P. and M.M. are recipients of productivity fellowships from the Brazilian National Council of Research and Technological Development (CNPq). There are no competing interests for any other author., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Solitary bees and wasps that nest in cavities in tree trunks are important components of terrestrial ecosystems, providing pollination services, and in the case of wasps, the regulation of their prey populations. However, little is known about the vertical strata where bees and wasps build their nests. This is especially the case of urban forest remnants in the Amazon, which is relevant in the context of the global crisis in insect losses. We investigated the existence of vertical stratification in the nesting of solitary bees and wasps in an urban forest in Rio Branco, state of Acre, in the western Brazilian Amazon. We focused on whether wood temperature, ants, and termites are predictors of bee and wasp nesting. We sampled bee and wasp nests in the forest using trap-nests made with wooden blocks containing cavities with three different diameters for twelve months. Trap-nests were installed randomly at three heights in the forest. We collected 145 nests of 25 species, belonging to 11 genera and 6 families. A higher number of nests and species were collected in the upper stratum of the forest, strengthening the hypothesis that there is vertical stratification in the assemblage of solitary bees and wasps. Wood surface temperature and termite attacks on trap-nests were significantly different between strata, which may explain the vertical stratification of bee and wasp assemblages. Considering the importance of these insects for tropical forest ecosystems, the conservation of structurally complex and stratified forests is of paramount importance to maintain the diversity of this insect group., (© 2024. Sociedade Entomológica do Brasil.)

Trichophoromyia auraensis (Mangabeira, 1942) (Diptera, Psychodidae, Phlebotominae) has a wide geographic distribution in the western region of the Amazon biome, where it is a putative Leishmania vector. Here, we reported for the first time a population of this species in the Brazilian state of Maranhão, in the eastern Amazon, from which we DNA-barcoded and compared with previously processed specimens from Acre State, in the western Amazon. For this, we analyzed the DNA barcoding fragment (658 bp) of the mitochondrial cytochrome c oxidase subunit I (COI) gene and the nuclear internal transcribed spacer 2 (ITS2) of Trichophoromyia species using phylogenetic gene trees, and species delimitation algorithms. The analyses of COI barcodes showed high values of genetic distance (mean K2P = 5.17) and well-supported clades/MOTUs for the eastern and western populations of T. auraensis, which may indicate a possible complex of cryptic species. The western population of this taxon merged with the close-related sand fly Trichophoromyia velezbernali Posada-López, Galvis and Galati, 2018 from Colombia, which may be associated with the recent speciation history and introgression between these populations. These evidences should be evaluated with a more comprehensive sampling in terms of analyzed populations and molecular markers., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Fungi exhibit three adverse effects on human health: inflammatory, allergic and toxic effects, these implications affect mainly immunodepressed patients. The objective of this work was to analyze the fungal microbiota of the ambient air of an Intensive Care Unit. Three collections were carried out in an Intensive Care Unit in the city of Rio Branco, Acre, Western Amazon, Brazil from March to May 2017. 126 Petri dishes were exposed with the culture medium Agar Sabouraud with chloramphenicol and Agar Mycosel, considering the distribution of the 21 air conditioners, split residential model. The plates were incubated for seven days at room temperature and the growth of Colony Forming Units was observed. Colony counting and isolation for the morphological characterization of the granted fungi was performed. After quantification, the concentration of fungi per cubic meters of air (CFU.m-3) was settled. The third collection had a larger number of colony forming units with 48.6%. In the total of the analyzed samples, filamentous fungi (85.5%) and yeasts (14.5%) were isolated. Thirteen genera of fungi were identified, with the most frequent filaments being Cladosporium spp. 33.0%, Aspergillus spp. 30.4% and Penicillium spp. 19.6%, and yeasts Candida spp. 52.6%, Trichosporon spp. 36.9%. The colony-forming unit per cubic meter (CFU.m-3) did not shown any difference between the Cores in the same collection period, however in the 1st and 3rd collection, Core 1 had the highest average. The fungal microbiota of this Unit presented thirteen different genera potentially pathogenic, revealing the need for monitoring microorganisms and prevention actions.

Indigenous societies are known to have occupied the Amazon basin for more than 12,000 years, but the scale of their influence on Amazonian forests remains uncertain. We report the discovery, using LIDAR (light detection and ranging) information from across the basin, of 24 previously undetected pre-Columbian earthworks beneath the forest canopy. Modeled distribution and abundance of large-scale archaeological sites across Amazonia suggest that between 10,272 and 23,648 sites remain to be discovered and that most will be found in the southwest. We also identified 53 domesticated tree species significantly associated with earthwork occurrence probability, likely suggesting past management practices. Closed-canopy forests across Amazonia are likely to contain thousands of undiscovered archaeological sites around which pre-Columbian societies actively modified forests, a discovery that opens opportunities for better understanding the magnitude of ancient human influence on Amazonia and its current state.

The aim of the present study was to report on the occurrence of parasitism by Amblyomma rotundatum ticks on two species of Teiidae lizards and test the presence of rickettsiae in the collected ticks, in the western Brazilian Amazon region. Ticks were collected in July 2019, from a fragment of terra firme forest in the municipality of Senador Guiomard, Acre, Brazil. Two lizards that were infested by immature stages of ticks were caught using mist net and Tomahawk traps. Ectoparasites were collected manually, and the lizard specimens were identified and released at the same location where they had been caught. Three nymphs and 49 larvae were collected from Ameiva ameiva, while 25 nymphs and nine larvae were collected from Tupinambis cuzcoensis, which are both in the family Teiidae. The ticks were identified morphologically as belonging to the genus Amblyomma. Nymphs were identified at species level through molecular analysis, resulting in the tick species Amblyomma rotundatum. This is the first record of parasitism by the tick A. rotundatum on T. cuzcoensis lizard, and the first report of an association between A. rotundatum and the lizard species A. ameiva and T. cuzcoensis in Acre, in the western part of the Amazon region.

The aim of this paper is to describe the profile of maternal mortality of COVID-19 in the state of Ceará, Brazil, in the period 2020. Ecological, exploratory, cross-sectional study, with secondary data from the Influenza Epidemiological Surveillance Information System, were made available by the Obstetric Observatory Brazilian COVID-19. A total of 485 pregnant and postpartum women were included, and the analysis considered the notifications from the year 2020. The variables of interest and the outcome (death/cure by COVID-19) were analyzed in a descriptive way. Most pregnant and postpartum women were between 20 and 35 years old, brown/white skin color and residing in an urban area. The proportion of deaths was 5.8% in the year 2020. In that period, the rates of hospitalization in the ward increased by 95.5%, 12.6% of hospitalization in the Unit of Intensive Care (ICU), and 7.2% needed invasive ventilatory support. Maternal mortality from COVID-19 suggests an emergency in terms of the development of health actions and policies due to the aggravation and risks due to this disease.

Background: The Respiratory Syndromes Surveillance System was created by the Brazilian Ministry of Health in 2000 to monitor influenza in this country. With the emergence of the new coronavirus pandemic, it became incorporated into the surveillance network for influenza and other respiratory viruses., Objective: To analyze the transmission of coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) in the state of Acre through its hierarchical urban network., Design and Setting: Cross-sectional, descriptive and ecological study, using a spatiotemporal approach and using secondary data. This study was conducted in the state of Acre, northern Brazil., Methods: This study used secondary data, and epidemiological weeks and municipalities were taken to be the units of analysis. Incidence rates and kernel intensities were calculated for four study periods. Spatiotemporal analysis was performed using scan statistics to identify clusters of SARS cases and considering the population of each municipality., Results: In general, it could be observed that there were higher kernel rates and intensities in municipalities located in the north and south of this state (i.e. its most populous municipalities)., Conclusion: Priority areas for interventions to control transmission of COVID-19 were highlighted, with the aim of reducing the risks of transmission to more distant areas in the urban hierarchy of the state of Acre.

The Amazon region may present a high diversity of endoparasites with a high degree of endemism. In this sense, this study describes the endoparasite fauna in freshwater fish from the Upper Juruá, in the Western Amazon. The study was carried out around the municipalities of Cruzeiro do Sul, state of Acre, and Guajará, state of Amazonas, Brazil. Fish were caught between periods of droughts and floods, using passive and active sampling methods. In the laboratory, specimens were biometrically analysed and necropsied. As a result, a total of 23,740 endoparasites were recorded, belonging to 62 species, with 91 new host reports and 91 new occurrences for the Western Amazon. Nematoda and Digenea were the most diverse and abundant groups, and the increase in host fish richness and diversity influenced the diversity and richness of endoparasites in the environments. In this sense, the present study expands the number of new reports, and contributes data on the distribution and richness of endoparasites for South America.

Background: Malaria elimination in Brazil poses several challenges, including the control of Plasmodium falciparum foci and the hidden burden of Plasmodium vivax in pregnancy. Maternal malaria and fetal health outcomes were investigated with a perinatal surveillance study in the municipality of Cruzeiro do Sul, Acre state, Brazilian Amazon. The research questions are: what are the causal effects of low birth weight on low Apgar at 5-min and of perinatal anaemia on stillbirth?, Methods: From November 2018 to October 2019, pregnant women of ≥ 22 weeks or puerperal mothers, who delivered at the referral maternity hospital (Juruá Women and Children's Hospital), were recruited to participate in a malaria surveillance study. Clinical information was obtained from a questionnaire and abstracted from medical reports. Haemoglobin level and presence of malarial parasites were tested by haematology counter and light microscopy, respectively. Low Apgar at 5-min and stillbirth were the outcomes analysed in function of clinical data and epidemiologic risk factors for maternal malaria infection using both a model of additive and independent effects and a causal model with control of confounders and use of mediation., Results: In total, 202 (7.2%; N = 2807) women had malaria during pregnancy. Nearly half of malaria infections during pregnancy (n = 94) were P. falciparum. A total of 27 women (1.03%; N = 2632) had perinatal malaria (19 P. vivax and 8 P. falciparum). Perinatal anaemia was demonstrated in 1144 women (41.2%; N = 2779) and low birth weight occurred in 212 newborns (3.1%; N = 2807). A total of 75 newborns (2.7%; N = 2807) had low (< 7) Apgar scores at 5-min., and stillbirth occurred in 23 instances (30.7%; n = 75). Low birth weight resulted in 7.1 higher odds of low Apgar at 5-min (OR = 7.05, 95% CI 3.86-12.88, p < 0.001) modulated by living in rural conditions, malaria during pregnancy, perinatal malaria, and perinatal anaemia. Stillbirth was associated with perinatal anaemia (OR = 2.56, 95% CI 1.02-6.42, p = 0.0444) modulated by living in rural conditions, falciparum malaria during pregnancy, perinatal malaria, and perinatal fever., Conclusions: While Brazil continues its path towards malaria elimination, the population still faces major structural problems, including substandard living conditions. Here malaria infections on pregnant women were observed having indirect effects on fetal outcomes, contributing to low Apgar at 5-min and stillbirth. Finally, the utility of employing multiple statistical analysis methods to validate consistent trends is vital to ensure optimal public health intervention designs., (© 2021. The Author(s).)

This is an ecological and time-series study using secondary data on perinatal mortality and its components from 2008 to 2017 in Espírito Santo, Brazil. The data were collected from the Mortality Information System (SIM) and Live Births Information System (SINASC) of the Unified Health System Informatics Department (DATASUS) in June 2019. The perinatal mortality rate (×1000 total births) was calculated. Time series were constructed from the perinatal mortality rate for the regions and Espírito Santo. To analyze the trend, the Prais-Winsten model was used. From 2008 to 2017 there were 8132 perinatal deaths (4939 fetal and 3193 early neonatal) out of a total of 542,802 births, a perinatal mortality rate of 15.0/1000 total births. The fetal/early neonatal ratio was 1.5:1, with a strong positive correlation early neonatal mortality rate, perinatal mortality rate, r (9) = 0.8893, with a significance level of p = 0.000574. The presence of differences in trends by health region was observed. Risk factors that stood out were as follows: mother's age ranging between 10 and 19 or 40 and 49 years old, with no education, a gestational age between 22 and 36 weeks, triple and double pregnancy, and a birth weight below 2499 g. Among the causes of death, 49.70% of deaths were concentrated in category of the tenth edition of the International Classification of Diseases, fetuses and newborns affected by maternal factors and complications of pregnancy, labor, and delivery (P00-P04), and 11.03% were in the category of intrauterine hypoxia and birth asphyxia (P20-P21), both related to proper care during pregnancy and childbirth. We observed a slow reduction in the perinatal mortality rate in the state of Espírito Santo from 2008 to 2017.

The sexing of species is an important tool for population management. In tortoises and turtles, sexing is usually done according to secondary characteristics, such as plastron morphology or phallus eversion techniques. In this paper, we present the phallus eversion method and compare its efficiency to other existing techniques. This new method aims at shortening the management time and reducing the physical aftereffects on the animals, fostering the clinical and reproductive management of Geoffroy's side-necked turtle (Phrynops geoffroanus) and related species. A sample of fifty individuals was taken in the central region of Piauí state, Northeastern Brazil. The proposed method consisted of moving the head from its resting position. The methods achieving a success rate higher than 80% were compared to each other as for the stimulation time required for phallus eversion. The method as here proposed achieved 100% efficiency in the sex determination of specimens with a linear carapace length between 10 and 34 cm. Also, when compared to the second most efficient method, it substantially reduced the time needed for managing the specimens (91%), avoiding possible sequelae in the individuals handled.

The state of Acre is in the western part of the Brazilian Amazon region and few studies involving ticks are available. The aim of the present study was to provide the first report of occurrence of Amblyomma latepunctatum and the second record of Ixodes luciae in Acre. Ticks were collected in October 2020 inside an open forested area in the municipality of Rio Branco, the state capital of Acre. Ixodid ticks were identified according to their external morphological characteristics. Three specimens were found on the vegetation by means of a visual search and were identified as Amblyomma scalpturatum (one male and one female) and Amblyomma latepunctatum (one male). Another specimen was found parasitizing a Didelphis marsupialis female that was caught using a Tomahawk trap; this was identified as Ixodes luciae (one male). This first report of A. latepunctatum in the state of Acre increases the number of species recorded here to 22. In addition, presence of I. luciae is confirmed in this state (second record), in the western Brazilian Amazon region.

Fire is one of the most powerful modifiers of the Amazonian landscape and knowledge about its drivers is needed for planning control and suppression. A plethora of factors may play a role in the annual dynamics of fire frequency, spanning the biophysical, climatic, socioeconomic and institutional dimensions. To uncover the main forces currently at play, we investigated the area burned in both forested and deforested areas in the outstanding case of Brazil's state of Acre, in southwestern Amazonia. We mapped burn scars in already-deforested areas and intact forest based on satellite images from the Landsat series analyzed between 2016 and 2019. The mapped burnings in already-deforested areas totalled 550,251 ha. In addition, we mapped three forest fires totaling 34,084 ha. Fire and deforestation were highly correlated, and the latter occurred mainly in federal government lands, with protected areas showing unprecedented forest fire levels in 2019. These results indicate that Acre state is under increased fire risk even during average rainfall years. The record fires of 2019 may continue if Brazil's ongoing softening of environmental regulations and enforcement is maintained. Acre and other Amazonian states must act quickly to avoid an upsurge of social and economic losses in the coming years., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Records about Ergasilus colomesus and its interaction with the host fish are scarce. There is only a report describing this species from specimens collected from the gills of Colomelus asellus, in the State of Amazonas, Brazil. In this sense, this is the first record of E. colomesus parasitizing C. asellus for the southwest of the Brazilian Amazon. Fish were collected in the Môa river, located in the municipality of Cruzeiro do Sul, State of Acre, Brazil, during drought and flood. The fish captured were analyzed, and the parasites found were measured, fixed, and identified. We calculated the parasite indices and evaluated whether the seasonal periods (drought and flood) influence the levels of parasite infestation in their hosts. The prevalence and infestation of E. colomesus in C. asellus were higher in the drought, indicating that the infestation of this copepod probably occurred during this period. The lower number of individuals found during the flood indicates that this is the period when E. colomesus detaches from its host to release of eggs into the environment. In this sense, this study expanded the distribution record of E. colomesus parasitizing C. asellus to southwestern Amazonia.

Most freshwater species of Cymothoidae are distributed in South America. They have mainly been recorded in the eastern and western regions of the Amazon River basin. However, in this ecosystem, the biodiversity of this group may be greater if the entire Amazon basin is considered. In this regard, the aim of the present study was to provide an updated list of isopod species of the family Cymothoidae that are found in fish in the Brazilian Amazon region and to report on new fish host occurrences and expanded geographical distributions for cymothoid isopods that parasitize fish in the southwestern Brazilian Amazon region. The parasites found in fish specimens were collected, fixed and identified later. We found eight species of Cymothoidae parasitizing different host fish species in the southwestern Amazon region. However, we found 14 species of Cymothoidae throughout the Brazilian Amazon region. Three additional species are thus reported here, which increases the number of species of Cymothoidae in this region to 17. These additional species are also new records for Brazil. Therefore, this study has contribute to expand the knowledge about the distribution and diversity of Cymothoidae in the Amazon basin.

The scope of this study was to investigate the factors associated with blood pressure levels among pregnant women participating in the MINA-Brazil Study, registered in the Family Health Strategy in Cruzeiro do Sul in the Western Brazilian Amazon. Multiple linear regression models were used, adopting a level of significance of 5%. The majority of pregnant participants were less than 24 years of age, 44% were primigravidae, and 59.1% had excessive weekly gestational weight gain. The frequency of hypertension was 0.7%. Factors positively associated with systolic blood pressure levels in pregnancy were pre-pregnancy body mass index (β = 0.984, CI95%: 0.768-1.200), and weekly gestational weight gain (β = 6.816, CI95%: 3.368-10.264). Diastolic blood pressure levels in pregnancy were positively associated with maternal age (β = 0.111, CI95%: 0.002-0.221), maternal schooling (β = 2.194, CI95%: 0.779-3.609), pre-pregnancy body mass index (β = 0.589, CI95%: 0.427-0.751), and weekly gestational weight gain (β = 3.066, CI95%: 0.483-5.650). These findings stress the importance of the role of antenatal care to prevent hypertensive disorders during pregnancy.

To analyze the prevalence of anemia and associated factors in primiparous parturient.Cross-sectional study conducted in a municipality of the Brazilian Western Amazon from July 2014 to December 2015. A convenience sample of 461 first-time pregnant women were interviewed. Data on their sociodemographic, clinical, obstetric, personal habits and nutritional status were collected. Anemia and iron depletion were measured by peripheral blood collection with hemoglobin, hematocrit, serum ferritin and transferrin saturation index. To test the association between the variables, the χ tests were applied and Poisson regression analysis with a 95% confidence interval was performed, and P < .05 values were considered significant. The Forward stepwise strategy was used to construct the adjusted model. These analyzes were performed using the STATA 14.0 program (College Station, TX, 2013).A higher risk of anemia was identified among adolescent; white; who had a partner; with unpaid occupation, with less than eight years of formal education. Residents in the countryside; smokers; who had more than six prenatal consultations and were overweight.Anemia was reported in 28.20% and iron depletion in 60.52% of parturient women. The variables studied did not have association with the anemia outcome, except alcohol consumption.

Envenomation by coral snakes represents a little known burden in Brazilian Amazonia. So far, details on clinical and epidemiological aspects remain obscure in the region. We gathered data from medical charts and from the scientific collection of snakes from Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, finding 26 cases of envenomation by five species of Micrurus in Manaus region, between 1987 and 2018. They represent 0.7% of the snakebites treated in the hospital since the records began, in 1979. Micrurus lemniscatus was responsible for most of the bites (10), followed by M. hemprichii (five), M. spixii (three), M. surinamensis (three) and M. averyi (one). There was no difference between the sexes of the snakes that caused bites. Patients were mostly males, and most of the cases were reported in urban areas. Bites predominated in dry season, and there was a clear geographical segregation among species. We describe seven cases of envenomation, three mild and four severe, all of which evolved to cure. Paresthesia (six), pain (five) and edema (four) were the most common local symptoms. Systemic features such as dyspnea/shallow breath (four), palpebral ptosis (four), blurred vision (three), dysarthria (three) and difficulty to walk (three) were also detected. Two patients bitten by Micrurus sp. and M. hemprichii, showed slight increased serum levels of creatine kinase (reference level <190 U/L), 1184 U/L and 1229 U/L, respectively, indicative of mild systemic myotoxicity. This is the first report of myotoxic manifestation in the envenomation by M. hemprichii. No patient developed respiratory failure, though one bitten by an adult M. spixii required intubation and mechanical ventilation due to decreased level of consciousness during evolution, probably related to induced sedation caused by concurrent alcohol intoxication. All patients were treated with Brazilian Micrurus antivenom (soro antielapídico, median = 10 vials). Six patients were pretreated intravenously with H1 and H2 antagonists and steroids, with two patients developing early adverse reactions. The median length of hospital stay was four days. Envenomations by coral snakes in Manaus region are clinically severe, but rare and sparsely distributed over time, making the detection of epidemiological and clinical patterns a challenge for public health., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background and objectives: Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Espírito Santo, Brazil. Materials and Methods: This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes-SisHiperdia. Results: The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM., Competing Interests: The authors declare no conflict of interest.

In Brazil, species of the genus Ramphocelus with the presence of various endoparasites have already been reported. Coccidia have been the parasites most frequently found. All species of this genus have similar habitats and ecological niches, which makes parasite transmission easy. The aim of this study was to diagnose the presence of endoparasites in fecal samples from specimens of Ramphocelus carbo that were caught in the Cazumbá-Iracema Extractive Reserve (Cazumbá Resex), in the State of Acre. The specimens (n = 30) were caught in mist nets arranged in different ecosystems of the Reserve. After identification, the bird specimens were placed in cloth bags for a maximum of 30 minutes to collect feces. Among the 22 samples collected, 63.63% (n = 14) were positive for endoparasites. The coccidia were the parasites most frequently. Helminths belonging to Ascaridiidae (Nematoda), Strongylida (Nematoda) and Davaneidae (Cestoda) were recorded for the first time in R. carbo in the State of Acre. Parasites belonging to Strongylida and Davaneidae were recorded for the first time in a species of Ramphocelus. These findings add information on the parasitic fauna of wild birds, since in the Amazon region there are few studies on this subject.

Coral snakes constitute a relatively diverse and little known group of venomous snakes. So far, data for this kind of snakebite in the Amazon region are based only on case reports. This study takes advantage of novel data from the Brazilian Health Ministry database from 2010 to 2015 and presents a review of the cases reported in the literature regarding the Amazonian biome both from Brazil and nearby countries. Thirty-four cases reported in the database were used in the study, representing 0.05% of the snakebites in Brazilian Amazonia for that period. The incidence rate was 0.123 cases/100,000 inhabitants/year. The most affected group is that of working age men, suggesting occupational risk. Most of bites were on lower limbs. Pain, edema and paresthesia were the most common symptoms. Systemic symptoms not usually associated with coral snakes envenomings, such as coagulopathy and thrombocytopenia, have been reported in Amazonia. Five patients received less antivenom than indicated by the Health Ministry. Based on these results, we recommend the execution of educational programs to avoid such accidents and to teach both the general public and health professionals the correct treatment for the bites. We also suggest that the covering of Intensive Care Units in the region needs to be improved to avoid deaths., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Brazil is a leading palm oil producer, but the defoliating caterpillars Opsiphanes invirae Hübner Brassolis sophorae L. (Lepidoptera: Nymphalidae) can reduce the productivity of this crop. The aim of this study was to evaluate the development and reproduction of the parasitoid Trichospilus diatraeae Cherian & Margabandhu (Hymenoptera: Eulophidae) in pupae of these oil palm defoliators. Ten O. invirae or B. sophorae pupae with up to two days old were exposed each to 30 T. diatraeae females for 48 hours. Parasitism and emergence of the progeny of T. diatraeae were similar in pupae of both Lepidoptera defoliators. The life cycle of this parasitoid was shorter in O. invirae (21.50 ± 0.42 days) pupae than with those of B. sophorae (27.60 ± 1.80 days). The number of the progeny (669.00 ± 89.62) and dead immature (217.13 ± 58.18) of T. diatraeae were higher in B. sophorae pupae than in those of O. invirae with 447.83 ± 51.52 and 13.50 ± 5.23, respectively. The sex ratio and female and male longevity of T. diatraeae emerged from these hosts were similar. The reproductive traits, especially the number of individuals (offspring) of T. diatraeae were better with B. sophorae pupae than with those of O. invirae.

The clinical outcome of hepatitis B virus (HBV) infection may be related to host and viral genetic factors, as well as to the type of infection (monoinfection and coinfection). To analyze the distribution/combination of HBV/hepatitis D virus (HDV) genotypes and the associated clinical characteristics, 409 serum samples from patients with chronic HBV (94 of them coinfected by HDV) followed at the Viral Hepatitis Referral Center of Rio Branco, Brazil were enrolled. HBV DNA and HDV RNA were amplified, respectively, by polymerase chain reaction (PCR) and nested PCR using specific primers in the PreC/C region and the S gene, and by reverse-transcription PCR and seminested PCR using specific primers in the delta antigen region and sequenced. The proportion of women (56.1%) was significantly higher than males in this cohort ( P < 0.01). Women were significantly younger (39.8 years; 8-77 years) than males (44.7 years; 12-79 years; P < 0.01). Sixty-eight (18%) patients were infected with HBV-F genotype and 264 (69.8%) with HBV/non-F genotypes. Coinfection by HDV was detected in 23.9% (94 of 409) of this population and was more frequent in male (54.2%, 51 of 94) than in female patients (44.7%, 42 of 94; P = 0.015). HDV-3 was the most prevalent (88.9%) genotype. Almost 70% of HDV-3 coinfected patients were infected with HBV/non-F genotypes. Severe liver disease was diagnosed in 41 patients, 60.9% (25 of 41) of them coinfected with HDV. HBV/HDV coinfection was associated with male sex, age above 30 years, severe liver disease, and increased alanine aminotransferase levels. HBV/HDV-3 coinfection is associated with severe liver disease, in Rio Branco, Brazil., (© 2019 Wiley Periodicals, Inc.)

Introduction: We present here the risk from snakebites because of palm extractivism in western Amazonia., Methods: The data were extracted from a cross-sectional sample study, from January 2016 to April 2018, at the Juruá Regional Hospital of Cruzeiro do Sul (Acre)., Results: There were 14 Bothrops incidents involving males, most of them occurring during the harvesting of "açaí" (Euterpe precatoria)., Conclusions: During the harvesting of "açaí," there is the risk of the presence of B. atrox on the ground near the palm tree, and of B. bilineatus at the top of the palm tree.

Background: Ideal Cardiovascular (CV) Health is characterized by four ideal lifestyle parameters and absence of cardiovascular risk factors. The prevalence of ideal CV health in the Amazon Basin and the influence of job strain on CV health in this setting are uncertain., Objective: To evaluate the prevalence of ideal CV health and its relationship with job strain in a secluded area from a developing country., Methods: Job strain was evaluated in 478 employees from an university in the Amazon Basin by a questionnaire that classified participants as passive, active, low or high strain, according to the demand-control model. CV health was evaluated using the American Heart Association 7 health factors (diet, physical activity, body mass index (BMI), smoking, hypertension, diabetes and hypercholesterolemia). Participants were classified as having ideal, intermediate or poor CV health. The level of significance was set at p < 0.05., Results: The mean age was 44.3 ± 12 years, 65% were men, and 35% were faculty. No participant fulfilled the criteria for ideal CV health. Intermediate CV health was found in 44 (9%) and poor in 434 (91%) individuals. Considering low strain as a reference group, individuals classified as high strain, active and passive had a non-significant (p > 0.05) increase in the chances of having poor CV health. When adjusting for possible confounders, high job strain was associated with poor BMI (> 30 kg/m2), (OR 2.11, 95%CI 1.06-4.22; p = 0.034) and poor diet (OR 2.31, 95% CI 1.29-4.13; p = 0.005)., Conclusion: Job strain was not associated with cardiovascular health, but high job strain was related to obesity and poor diet. Given the high prevalence of poor CV health and lack of participants with ideal CV health, policies focusing on health education and lifestyle interventions are paramount to this population.

Introduction: The popular names "surucucu" and "jararaca" have been used in literature for Lachesis muta and Bothrops atrox snakes, respectively. We present the popular names reported by patients who suffered snakebites in the Alto Juruá region., Methods: Fifty-seven (76%) patients saw the snakes that caused the envenomations and were asked about their popular names and sizes., Results: The snakes Bothrops atrox, referred to as "jararaca," were recognized as being mainly juveniles (80.7%) and "surucucu" as mainly adults (81.8%)., Conclusions: The name "surucucu" is used in the Alto Juruá region for the snake B. atrox, mainly for adult specimens.

Drought-induced wildfires have increased in frequency and extent over the tropics. Yet, the long-term (greater than 10 years) responses of Amazonian lowland forests to fire disturbance are poorly known. To understand post-fire forest biomass dynamics, and to assess the time required for fire-affected forests to recover to pre-disturbance levels, we combined 16 single with 182 multiple forest census into a unique large-scale and long-term dataset across the Brazilian Amazonia. We quantified biomass, mortality and wood productivity of burned plots along a chronosequence of up to 31 years post-fire and compared to surrounding unburned plots measured simultaneously. Stem mortality and growth were assessed among functional groups. At the plot level, we found that fire-affected forests have biomass levels 24.8 ± 6.9% below the biomass value of unburned control plots after 31 years. This lower biomass state results from the elevated levels of biomass loss through mortality, which is not sufficiently compensated for by wood productivity (incremental growth + recruitment). At the stem level, we found major changes in mortality and growth rates up to 11 years post-fire. The post-fire stem mortality rates exceeded unburned control plots by 680% (i.e. greater than 40 cm diameter at breast height (DBH); 5-8 years since last fire) and 315% (i.e. greater than 0.7 g cm -3 wood density; 0.75-4 years since last fire). Our findings indicate that wildfires in humid tropical forests can significantly reduce forest biomass for decades by enhancing mortality rates of all trees, including large and high wood density trees, which store the largest amount of biomass in old-growth forests. This assessment of stem dynamics, therefore, demonstrates that wildfires slow down or stall the post-fire recovery of Amazonian forests.This article is part of a discussion meeting issue 'The impact of the 2015/2016 El Niño on the terrestrial tropical carbon cycle: patterns, mechanisms and implications'., (© 2018 The Author(s).)

The Euglenophyceae flora of Lake Amapá I, Rio Branco, Acre State, Brazil, constitutes a contribution to the phycological inventory of the State of Acre. It is based on the study of 15 samples collected with plankton net and by passing an open flask in areas with dense plankton concentrations. Samples were prepared and preserved with Transeau solution. Twenty five taxons were identified. Genera Euglena and Trachelomonas were the most frequently represented.

In this study, 15 samples were collected on a bi-monthly basis, during the period between March and May 1994, and 3 additional samples were collected, one in each of the months of July, October and November 1994. All the samples were collected in Lake Amapá (lat. 10 degrees 2'36"S, long. 67 degrees 50'24"W), which is located in Rio Branco, Acre State, Brazil. Ten táxons, of Chlorophyta were registered: Botryococcaceae (2), Treubariaceae (1), Volvocaceae (2), Closteriaceae (3) e Desmidiaceae (2). All taxa identified are first citations for Acre State.