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Objective: The aim of this study was to evaluate the association between the lack of a functional dentition and edentulism with mortality in a cohort of older adults in a Southern Brazilian city., Materials and Methods: This is a longitudinal study carried out with community-dwelling older adults (≥60 years old) from Pelotas, Brazil, using data from the baseline (2014) and the first follow-up (2017). Main exposures were functional dentition (20+ teeth present) and edentulism (absence of all teeth), derived from self-reported number of teeth. All-causes mortality was evaluated according to the city's Epidemiological Surveillance Department. Potential confounders were age, sex, socioeconomic position, smoking, diabetes, hypertension, and body mass index (BMI). To test the association between functional dentition and edentulism with mortality, Poisson regression models with robust variance were used, to estimate Relative Risks and 95% confidence intervals., Results: A total of 1289 older adults had information on all variables of interest and comprise the analytical sample (from 1451 at baseline). When analysing the presence of functional dentition, only 222 individuals (17.2%) had 20 or more teeth in their mouth, while 490 older adults were edentulous (38.0%). Crude analysis showed an association between tooth loss indicators and mortality. Models adjusted for sociodemographic variables and health conditions and behaviours revelled no association between the exposures and mortality., Conclusions: With the findings of this study, we did not identify an association between edentulism and functional dentition with mortality, after considering important shared risk factors., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Migraine is a neurological and disabling disease whose peripheral manifestations can be addressed with physiotherapy. These manifestations can include pain and hypersensitivity to muscular and articular palpation in the neck and face region, a higher prevalence of myofascial trigger points, limitation in global cervical motion, especially in the upper segment (C1-C2), and forward head posture with worse muscular performance. Furthermore, patients with migraine can present cervical muscle weakness and greater co-activation of antagonists in maximum and submaximal tasks. In addition to musculoskeletal repercussions, these patients can also present balance impairment and a greater risk of falls, especially when chronicity of migraine frequency is present. The physiotherapist is a relevant player in the interdisciplinary team and can help these patients to control and manage their migraine attacks., Purpose: This position paper discusses the most relevant musculoskeletal repercussions of migraine in the craniocervical area under the perspective of sensitization and disease chronification, besides addressing physiotherapy as an important strategy for evaluating and treating these patients., Implications: Physiotherapy as a non-pharmacological treatment option in migraine treatment may potentially reduce musculoskeletal impairments related to neck pain in this population. Disseminating knowledge about the different types of headaches and the diagnostic criteria can support physiotherapists who compose a specialized interdisciplinary team. Furthermore, it is important to acquire competencies in neck pain assessment and treatment approaches according to the current evidence., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Migraine has been associated with balance dysfunction, more pronounced in patients with aura and chronic migraine. Also, it has been suggested that balance deficits are progressive through the migraineurs lifetime., Objective: To analyze the one-year progression of balance parameters and clinical parameters associated with balance in female patients with and without migraine., Design: Prospective cohort study., Methods: The participants were distributed in four groups: control (CG; n = 27) migraine with aura (MA; n = 25), migraine without aura (MwA; n = 26), and chronic migraine (CM; n = 27). They performed the Sensory Organization Test, Motor Control Test and Adaptation Test protocols of dynamic posturography tests. Questionnaires about fear of falls, dizziness disability, and kinesiophobia were administered. These assessments were performed twice: baseline and after 1-year (follow-up). No intervention was performed for balance improvement, and the participants maintained their usual migraine treatment prescribed., Results: None of the groups differed in balance tests between baseline and follow-up. We observed a reduction in migraine frequency in MA (-2.2 days, p = 0.01) and CM (-10.8 days, p < 0.001) groups, and in the migraine intensity (-2.3 points, p = 0.001) in CM group. Significant decreases in the scores of fear of falling, dizziness disability, and kinesiophobia were observed in the migraine groups (p < 0.05), but the differences did not exceed the minimal detectable change of the questionaries scores., Conclusion: Women with different migraine subtypes did not present balance changes in a one-year interval. The improvements in migraine's clinical features were not accompanied by improvements in balance parameters., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to assess the correlation, concurrent validity, and agreement between the isometric cervical force measurements obtained with fixed and portable dynamometers in asymptomatic individuals., Methods: Fifty asymptomatic individuals performed 3 maximal isometric contractions for flexion, extension, and lateral flexion of the cervical spine using fixed and portable dynamometers. The correlation and concurrent validity for the measurements of the portable and fixed dynamometers were analyzed using Spearman's correlation coefficient and the intraclass correlation coefficient (ICC), respectively. The agreement between the force values of the portable and fixed dynamometers was measured using the Bland-Altman method., Results: Isometric cervical force measurements obtained with the fixed dynamometer and portable dynamometer showed a moderately to highly significant correlation for flexion (r s  = 0.74), extension (r s  = 0.82), right lateral flexion (r s  = 0.74), and left lateral flexion (r s  = 0.68). The concurrent validity was moderate to good for all measurements (ICC 2,3  = 0.67-0.80). The fixed and portable dynamometers did not agree, with a significant mean difference between the methods of 2.8 kgf (95% confidence interval [CI], 2.1-3.4 kgf) for cervical flexion, 5.3 kgf (95% CI, 4.2-6.4 kgf) for extension, and 9.1 kgf (95% CI, 0.4-2.1 kgf) for left lateral flexion. The limits of agreement were broad for all movements, with errors that varied between 61% and 77% of the mean force obtained with the fixed dynamometer., Conclusion: The neck strength measurements obtained with the fixed and portable dynamometers demonstrated high to moderate correlation and had moderate to good comparability for asymptomatic participants. However, they did not agree in that the 2 methods did not provide equivalent measurements, and, therefore, based on these findings, the same equipment should always be used when reassessing an individual., (Copyright © 2022. Published by Elsevier Inc.)

HIV-related stigma and discrimination lead to poorer mental health, lower levels of services usage, and less adherence to antiretroviral medications. Due to the overlap of different kinds of stigmas, HIV-positive key populations are the most susceptible to negative health outcomes. The Stigma Index is an instrument that measure worldwide trends in HIV-related stigma from the perspective of people living with HIV/AIDS (PLWHA). The present community-based study aims to estimate the prevalence of HIV-related discrimination in the past 12 months in HIV-related care, comparing general and key populations in Brazil. A total of 30 PLWHA were trained to recruit participants among their peer networks; 1768 PLWHA participated in the study and were asked if, in the past 12 months when seeking HIV-specific healthcare, they had experienced discrimination from health facility staff because of their HIV status. Overall, 269 (15.21%) participants experienced this kind of discrimination. The odds of experiencing discrimination in HIV-specific healthcare settings in the general versus key populations was OR 1.77 95% CI [1.30 -2.42]. It is noteworthy that in Brazil, after four decades of a human rights-based approach to the epidemic, we found high levels of discrimination in the HIV-specific healthcare context affecting the key populations more severely.

Background: Supplementation with omega-3 polyunsaturated fatty acids (ω-3 PUFA) and low-dose aspirin (ASA) have been proposed as a host modulation regimen to control chronic inflammatory diseases. The aim of this study was to investigate the clinical and immunological impact of orally administered ω-3 PUFA and ASA as adjuncts to periodontal debridement for the treatment of periodontitis in patients type 2 diabetes., Methods: Seventy-five patients (n = 25/group) were randomly assigned to receive placebo and periodontal debridement (CG), ω-3 PUFA + ASA (3 g of fish oil/d + 100 mg ASA/d for 2 months) after periodontal debridement (test group [TG]1), or ω-3 PUFA + ASA (3 g of fish oil/d + 100 mg ASA/d for 2 months) before periodontal debridement (TG2). Periodontal parameters and GCF were collected at baseline (t0), 3 months after periodontal debridement and ω-3 PUFA + ASA or placebo for TG1 and CG (t1), after ω-3 PUFA + ASA (before periodontal debridement) for TG2 (t1), and 6 months after periodontal debridement (all groups) (t2). GCF was analyzed for cytokine levels by multiplex ELISA., Results: Ten patients (40%) in TG1 and nine patients (36%) in TG2 achieved the clinical endpoint for treatment (less than or equal to four sites with probing depth ≥ 5 mm), as opposed to four (16%) in CG. There was clinical attachment gain in moderate and deep pockets for TG1. IFN-γ and interleukin (IL)-8 levels decreased over time for both test groups. IL-6 levels were lower for TG1. HbA1c levels reduced for TG1., Conclusion: Adjunctive ω-3 and ASA after periodontal debridement provides clinical and immunological benefits to the treatment of periodontitis in patients with type 2 diabetes., (© 2020 American Academy of Periodontology.)

Aims: To investigate the use of ω-3 fatty acids and low-dose aspirin as adjuncts to periodontal debridement in a patient with periodontitis and metabolic syndrome., Methods: Periodontal and systemic parameters were assessed at baseline and 6 months. Gingival crevicular fluid was analyzed for interleukin (IL)-1β, IL-6 and interferon (IFN)-γ levels by multiplex ELISA at baseline, 3 and 6 months., Results: The treatment was effective in reducing probing depth, clinical attachment level, bleeding on probing and plaque index, and glycated hemoglobin, triglycerides IL-1β, IL-6 and IFN-γ levels over time., Conclusions: The adjunctive use of ω-3 and low-dose aspirin to periodontal debridement might have potential benefits in the treatment of periodontitis in a patient with metabolic syndrome., Competing Interests: The authors declare no conflicts of interest., (Copyright© by the International Academy of Periodontology.)

The present work emphasizes the value of periodic density functional theory (DFT) calculations in the assessment of the vibrational spectra of molecular crystals. Periodic calculations provide a nearly one-to-one match between the calculated and observed bands in the inelastic neutron scattering (INS) spectrum of crystalline 4-phenylbenzaldehyde, thus validating their assignment and correcting previous reports based on single molecule calculations. The calculations allow the unambiguous assignment of the phenyl torsional mode at ca. 118-128 cm -1 , from which a phenyl torsional barrier of ca. 4000 cm -1 is derived, and the identification of the collective mode involving the antitranslational motion of CH···O bonded pairs, a hallmark vibrational mode of systems where C-H···O contacts are an important feature.

Background: To assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one-stage full-mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP)., Methods: For this parallel, double-masked, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with AMX (500 mg three times a day) and MET (400 mg three times a day) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg twice a day) for 7 days. Clinical parameters were evaluated at baseline, 3, and 6 months post-treatment. The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction., Results: Both treatments significantly improved all clinical parameters compared with baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts (P > 0.05). CLM succeeded in decreasing T. forsythia at 6 months (P < 0.05), but no antibiotic was able to reduce F. nucleatum. There was no difference between the two protocols regarding the reported adverse effects (P > 0.05)., Conclusions: The results suggest that CLM is not superior than AMX + MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928)., (© 2019 American Academy of Periodontology.)

Background: This study's aim was to evaluate the local effect of clarithromycin associated with antimicrobial photodynamic therapy (aPDT) in the treatment of generalized aggressive periodontitis., Materials and Methods: The study sample comprised 72 periodontal pockets on single-rooted teeth in multiple quadrants, with both probing depth and clinical attachment level ≥5 mm, and with bleeding on probing. The pockets were randomly distributed into four groups (n = 18 each) that received ultrasonic periodontal debridement in addition to placebo (the UPD group), systemic clarithromycin (the UPD + CLM group), aPDT (the UPD + aPDT group), or both systemic clarithromycin and aPDT (the UPD + CLM + aPDT group). The measurements were performed prior to treatment (baseline) and at 3 and 6 months postoperatively. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level. A 5% significance level was used in the statistical analysis., Results: At 3 months, UPD + aPDT, UPD + CLM, and UPD + CLM + aPDT groups all exhibited reduced probing depths relative to the UPD group (p <  0.05). However, at 6 months, the reduction in mean probing depth was greater in the antibiotic groups (UPD+CLM and UPD+CLM+aPDT) than in the UPD and UPD+aPDT groups (p <  0.05). Regarding clinical attachment level, only the UPD+CLM+aPDT group presented a significant gain relative to the UPD and UPD + PDT groups (p <  0.05)., Conclusions: Ultrasonic periodontal debridement has greater clinical advantages when associated with clarithromycin than with associated with aPDT. However, the joint application of aPDT and clarithromycin did not present additional benefits., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This corrects the article on p. 406 in vol. 10, PMID: 29949837., (Copyright © 2018 The Korean Academy of Asthma, Allergy and Clinical Immunology · The Korean Academy of Pediatric Allergy and Respiratory Disease.)

Widespread microplastic pollution is raising growing concerns as to its detrimental effects upon living organisms. A realistic risk assessment must stand on representative data on the abundance, size distribution and chemical composition of microplastics. Raman microscopy is an indispensable tool for the analysis of very small microplastics (<20 μm). Still, its use is far from widespread, in part due to drawbacks such as long measurement time and proneness to spectral distortion induced by fluorescence. This review discusses each drawback followed by a showcase of interesting and easily available solutions that contribute to faster and better identification of microplastics using Raman spectroscopy. Among discussed topics are: enhanced signal quality with better detectors and spectrum processing; automated particle selection for faster Raman mapping; comprehensive reference libraries for successful spectral matching. A last section introduces non-conventional Raman techniques (non-linear Raman, hyperspectral imaging, standoff Raman) which permit more advanced applications such as real-time Raman detection and imaging of microplastics., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: The use of tolerogenic dendritic cells (TolDCs) to control exacerbated immune responses may be a prophylactic and therapeutic option for application in autoimmune and allergic conditions. The objective of this work was to evaluate the effects of TolDC administration in a mouse model of allergic airway inflammation caused by mite extract., Methods: Mouse bone marrow-derived TolDCs were induced by incubation with granulocyte-macrophage colony-stimulating factor (GM-CSF) and dexamethasone, and then characterized by flow cytometry and cytokine production by enzyme-linked immunosorbent assay (ELISA). For the in vivo model of Blomia tropicalis-induced allergy, mice transplanted with antigen-pulsed TolDCs were sensitized intraperitoneally with B. tropicalis mite extract (BtE) adsorbed to aluminium hydroxide. After challenge by nasal administration of BtE, bronchoalveolar lavage fluid (BALF), lungs, spleen and serum were collected for analysis., Results: Induction of TolDCs was efficiently achieved as shown by low expression of major histocompatibility complex (MHC) II, programmed death-ligand (PD-L) 2 and pro-inflammatory cytokine production, and up-regulation of interleukin (IL)-10, upon LPS stimulation in vitro. Transplantation of 1 or 2 doses of BtE-pulsed TolDCs reduced the number of inflammatory cells in BALF and lungs as well as mucus deposition. Moreover, compared to saline-injected controls, TolDC-treated mice showed lower serum levels of anti-BtE immunoglobulin E (IgE) antibodies as well as reduced Gata3 and IL-4 gene expression in the lungs and decreased IFN-γ levels in the supernatant of splenocyte cultures Transplantation of TolDCs increased the percentage of the regulatory T cells in the spleen and the lungs., Conclusions: Preventive treatment with TolDCs protects against dust mite-induced allergy in a mouse model, reinforcing the use of tolerogenic dendritic cells for the management of allergic conditions., Competing Interests: There are no financial or other issues that might lead to conflict of interest., (Copyright © 2018 The Korean Academy of Asthma, Allergy and Clinical Immunology · The Korean Academy of Pediatric Allergy and Respiratory Disease.)

Objective: To assess associations between subjective well-being (SWB), religiosity, anxiety and other factors in a sample of Brazilian medical students from a public university in northeastern Brazil., Methods: The present study followed a cross-sectional, observational, analytical approach. Data were collected by administering a self-applicable questionnaire composed of questions focused on sociodemographic data and based on the Satisfaction With Life Scale (SWL), Positive Affect and Negative Affect Scale (PANAS), Penn State Worry Questionnaire (PSWQ), and the Duke Religiosity Index (DUREL)., Results: The sample comprised 417 medical school students (73.54% of all the enrolled students). The medical students assessed presented a medium level of satisfaction with life, low mean positive emotion levels and high anxiety/uneasiness levels. Surprisingly, lower anxiety and intrinsic religiosity (IR) scores were associated with higher scores in the two SWB parameters (positive emotions and satisfaction with life). Furthermore, the factors leisure activities, good sleep quality, financial support, age, and gender were associated with the highest SWB scores (with emotional and cognitive components, or with only one of these two components)., Conclusions: Data in the current study corroborated the negative association between SWB and anxiety; however, in opposition to the literature, they also evidenced a negative association between SWB and IR. In addition, the present research signaled the need for creating preventive intervention programs to increase SWB through positive psychological techniques and/or to decrease anxiety by applying, for instance, cognitive-behavioral therapy paradigms and/or mindfulness techniques to medical students.

The mosquito Aedes aegypti is the main vector of several arthropod-borne diseases that have global impacts. In a previous meta-analysis, our group identified a vector gene set containing 110 genes strongly associated with infections of dengue, West Nile and yellow fever viruses. Of these 110 genes, four genes allowed a highly accurate classification of infected status. More recently, a new study of Ae. aegypti infected with Zika virus (ZIKV) was published, providing new data to investigate whether this "infection" gene set is also altered during a ZIKV infection. Our hypothesis is that the infection-associated signature may also serve as a proxy to classify the ZIKV infection in the vector. Raw data associated with the NCBI/BioProject were downloaded and re-analysed. A total of 18 paired-end replicates corresponding to three ZIKV-infected samples and three controls were included in this study. The nMDS technique with a logistic regression was used to obtain the probabilities of belonging to a given class. Thus, to compare both gene sets, we used the area under the curve and performed a comparison using the bootstrap method. Our meta-signature was able to separate the infected mosquitoes from the controls with good predictive power to classify the Zika-infected mosquitoes.

Background: The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis., Methods: Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one-stage full-mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively., Results: Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001)., Conclusion: Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.

The solids choline chloride and urea, mixed in a 1 : 2 molar proportion, form the iconic deep eutectic solvent "Reline". A combination of computational and vibrational spectroscopy tools, including inelastic neutron scattering (INS), have been used to probe intermolecular interactions in the eutectic mixture. Reline's experimental spectra were estimated using discrete and periodic ab initio calculations of a molecular aggregate with two choline chloride and four urea units. This is the minimum size required to achieve satisfactory agreement with experiment, as smaller clusters cannot represent all of reline's significant intermolecular interactions. The INS spectrum of reline, compared with that of pure choline chloride, reveals a displacement of chloride anions away from their preferred positions on top of choline's methyl groups, whose torsional movement becomes less hindered in the mixture. Urea, which adopts a planar (sp 2 ) shape in the crystal, becomes non-planar (sp 3 ) in reline, a feature herein discussed for the first time. In reline, urea molecules form a wide range of hydrogen bonds, from soft contacts to stronger associations, the latter being responsible for the deviation from ideality. The chloride's interactions with choline are largely conserved at the hydroxyl end while becoming weaker at the cationic headgroup. The interplay of soft and strong interactions confers flexibility to the newly formed hydrogen-bond network and allows the ensemble to remain liquid at room temperature.

We characterized NDM-1-producing Klebsiella isolates from Rio de Janeiro, Brazil. PCR was applied for resistance and virulence determinants. The genetic context of bla NDM was determined by S1 nuclease pulsed-field gel electrophoresis (PFGE) and hybridization. Genotyping was performed by PFGE and multilocus sequence typing (MLST). Most isolates carried multiple resistance genes and remained susceptible to amikacin, fosfomycin-trometamol, polymyxin B, and tigecycline. The spread of NDM-1-producing Klebsiella pneumoniae was not associated with clonal expansion and appears to be associated with Tn 3000 ., (Copyright © 2017 American Society for Microbiology.)

Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.

This study reveals the presence of different carbapenemase genes (blaKPC, blaNDM, blaGES, and blaOXA48-like genes) detected directly from water samples and clonal dispersion (by pulsed-field gel electrophoresis [PFGE] and multilocus sequence typing [MLST]) of KPC-2-producing Enterobacteriaceae in two important urban aquatic matrixes from Rio de Janeiro, Brazil, highlighting the role of aquatic environments as gene pools and the possibility of community spreading., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Background: Extracellular vesicles (EVs) are structures with phospholipid bilayer membranes and 100-1000 nm diameters. These vesicles are released from cells upon activation of surface receptors and/or apoptosis. The production of EVs by dendritic cells, mast cells, macrophages, and B and T lymphocytes has been extensively reported in the literature. EVs may express MHC class II and other membrane surface molecules and carry antigens. The aim of this study was to investigate the role of EVs from Leishmania-infected macrophages as immune modulatory particles., Methodology/principal Findings: In this work it was shown that BALB/c mouse bone marrow-derived macrophages, either infected in vitro with Leishmania amazonensis or left uninfected, release comparable amounts of 50-300 nm-diameter extracellular vesicles (EVs). The EVs were characterized by flow cytometry and electron microscopy. The incubation of naïve macrophages with these EVs for 48 hours led to a statistically significant increase in the production of the cytokines IL-12, IL-1β, and TNF-α., Conclusions/significance: EVs derived from macrophages infected with L. amazonensis induce other macrophages, which in vivo could be bystander cells, to produce the proinflammatory cytokines IL-12, IL-1β and TNF-α. This could contribute both to modulate the immune system in favor of a Th1 immune response and to the elimination of the Leishmania, leading, therefore, to the control the infection.

Objectives: To perform molecular epidemiology for 113 KPC-producing Klebsiella pneumoniae isolated in 2010 from 12 Brazilian states., Methods: The resistance profile was determined by disc diffusion and Etest. Genetic polymorphism was analysed by PFGE and multilocus sequence typing. The genetic environment of the bla(KPC) gene was determined by PCR and identification of the carrier plasmid was determined by hybridization., Results: Most of the isolates were multidrug resistant, with 15% and 49% being resistant to polymyxin and tigecycline, respectively. Twenty-two sequence types (STs) were observed, with ST11, ST437 and ST340 [clonal complex 11 (CC11)] being the most prevalent (75% of isolates) observed in 10 states. bla(KPC-2) was associated with transposon Tn4401 'b' and in 36% this gene was found in IncN plasmids of 40 kb., Conclusions: In Brazil, the spread of bla(KPC-2) is occurring due to dispersion of Tn4401 'b', carried by IncN plasmids of 40 kb, and mainly the dissemination of CC11, with ST437 and ST11 playing an important role.

Neospora caninum is considered in many countries as one of the key abortion agents in cattle. This study aims to investigate the parasite behavior in dairy cattle in the municipality of Avaré, SP, Brazil, where abortions frequently occur. An ELISA was performed to compare two samplings on a total of 615 animals; tests were performed in the same herds with a gap of 3 years. An increase in the percentage of reactive animals was observed, ranging from 21.6% at the first sampling to 38.9% at the second sampling. Of the 176 animals tested at both samplings, 61.93% retained a non-reactive status, 15.9% retained a reactive status, 19.88% switched from non-reactive to reactive and 2.27% switched from reactive to non-reactive. Of the 100 animals with reproductive disturbances, 50% presented anti-Neospora antibodies, thereby indicating the presence of the protozoa. When comparing cows and their respective female offspring, a predominance of horizontal infection was observed. Moreover, considering the significant percentage of animals that switched from non-reactive to reactive and the abundant presence of dogs among the herds, the N. caninum transmission may be attributed to presence of carnivores.

Malaria remains an important health problem in tropical countries like Brazil. Thrombocytopenia is the most common hematological disturbance seen in malarial infection. Oxidative stress (OS) has been implicated as a possible mediator of thrombocytopenia in patients with malaria. This study aimed to investigate the role of OS in the thrombocytopenia of Plasmodium vivax malaria through the measurement of oxidant and antioxidant biochemical markers in plasma and in isolated platelets. Eighty-six patients with P. vivax malaria were enrolled. Blood samples were analyzed for total antioxidant and oxidant status, albumin, total protein, uric acid, zinc, magnesium, bilirubin, total thiols, glutathione peroxidase (GPx), malondialdehyde (MDA), antibodies against mildly oxidized low-density lipoproteins (LDL-/nLDL ratio) and nitrite/nitrate levels in blood plasma and GPx and MDA in isolated platelets. Plasma MDA levels were higher in thrombocytopenic (TCP) (median 3.47; range 1.55-12.90 micromol/L) compared with the non-thrombocytopenic (NTCP) patients (median 2.57; range 1.95-8.60 micromol/L). Moreover, the LDL-/nLDL autoantibody ratio was lower in TCP (median 3.0; range 1.5-14.8) than in NTCP patients (median 4.0; range 1.9-35.5). Finally, GPx and MDA were higher in the platelets of TPC patients. These results suggest that oxidative damage of platelets might be important in the pathogenesis of thrombocytopenia found in P. vivax malaria as indicated by alterations of GPx and MDA.

Samples of 413 patient were analyzed and positivity was found in 64.4% (266) of the exams. The intestinal parasites most prevalent were: Ascaris lumbricoides (35.6%); Trichuris trichiura (18.6%); Ancylostomides (9.9%); Strongyloides stercoralis (1%), Enterobius vermiculares (0,5%); Entamoeba histolytica (13.3%) and Giardia lamblia (1%). The presence of varied degrees of anemia were detected in 39.8% of the exams.