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In Brazil, Visceral Leishmaniases is caused by Leishmania infantum, and domestic dogs are the main reservoirs in its urban transmission cycle. As an alternative to euthanizing dogs, miltefosine has been used to treat canine visceral leishmaniasis since 2016. In this study, we have assessed the efficacy of miltefosine for treating canine visceral leishmaniasis in a new endemic area through follow-up of naturally infected dogs was evaluated. The clinical, parasitological, and histopathological characteristics of 21 dogs naturally infected with L. infantum were assessed at three time points: on the day before initiating miltefosine treatment (T0), immediately after treatment completion (T1), and 6 months after treatment completion (T2). Three dogs were treated exclusively with miltefosine, while eighteen received combination therapy with miltefosine with other treatments such as allopurinol, domperidone and immunotherapy. Skin biopsies were obtained from the abdomen to assess inflammatory responses and to quantify parasite loads using qPCR. The parasites were isolated using aspirates acquired from popliteal lymph nodes. Molecular and parasitological analyses confirmed the presence of L. infantum in all dogs, validating the effectiveness of skin and lymph node samples for diagnosis. The clinical conditions of the infected animals were improved and the skin parasite load decreased after treatment, even when distinct combination therapies were performed. The histopathological assessment revealed a miltefosine-induced reduction in the inflammatory response and a decrease in amastigotes number. Furthermore, a positive correlation was established between the reduction in parasite load and the enhancement of clinical scoring, as well as a reduction in the skin inflammatory response. Our findings suggest that miltefosine-based combination therapies reduce skin parasite load and improve clinical outcomes, while the dogs treated with miltefosine alone showed increased parasitic load and worsened clinical staging at T2. Considering this data belonging to a recent transmission area, treatment strategy suggests effective in controlling canine visceral leishmaniasis.

Ceftriaxone has been increasingly used in pediatric population, due to its bacteriological and pharmacokinetic features. Association between ceftriaxone and biliary sludge/pseudolithiasis formation has been documented in the literature. More rarely, biliary symptoms and cholecystitis during ceftriaxone therapy have been reported. We present a case of acute cholecystitis related to ceftriaxone administration and its management.

The western mesoregion of the state of Santa Catarina (SC), Southern Brazil, was heavily affected as a whole by the COVID-19 pandemic in early 2021. This study aimed to evaluate the dynamics of the SARS-CoV-2 virus spreading patterns in the SC state from March 2020 to April 2021 using genomic surveillance. During this period, there were 23 distinct variants, including Beta and Gamma, among which the Gamma and related lineages were predominant in the second pandemic wave within SC. A regionalization of P.1-like-II in the Western SC region was observed, concomitant to the increase in cases, mortality, and the case fatality rate (CFR) index. This is the first evidence of the regionalization of the SARS-CoV-2 transmission in SC and it highlights the importance of tracking the variants, dispersion, and impact of SARS-CoV-2 on the public health systems.

É minha intenção levantar breves questões a partir da experiência, amplamente partilhada, de termos um corpo que, por vezes, é um corpo em estado de «doença». Sob fundo de interdito, o corpo foi objecto, nos últimos séculos, de uma vigilância que adensou o desconhecimento sobre as suas manifestações, gerando uma enorme opacidade na relação de cada um com o corpo que tem. Interrogaremos aqui o corpo como uma entidade complexa que gere e emite informações, e não como mero receptáculo para vírus e outros agentes do «mal». Diferentes contextos e motivações revelam corpos distintos. E assim, o «corpo doente» será entendido a partir do princípio de um corpo em transformação, cuja leitura será possível à luz do seu percurso, físico, emocional e relacional.

A utilização das histórias de vida e das narrativas de ficção nas Ciências Sociais tem suscitado, desde sempre, um certo númeero de obstáculos, face à regulação epistemológica que tem dominado a produção do conhecimento no domínio das Ciências Humanas. No entanto, o interesse crescente por este tipo de material levou-nos a fazer uma breve reflexão sobre a sua importância na compreensão das trajectórias individuais bem como dos processos sociais que as condiciona

A abordagem do campo da invenção independente é aqui orientada a partir de noções como inovação, desenvolvimento técnico e circulação e recepção do ‘novo’. Partindo de uma perspectiva geo-sociológica da invenção, destacamos os factores favoráveis à emergência desta e dos modelos de desenvolvimento técnico-económicos que caracterizaram diferentes sociedades nos diferentes continentes, desde que há notícia de grupos sedentarizados. A recepção social da invenção e, em geral, do ‘novo’ tem suscitado diferentes respostas, da resistência à indiferença, passando pela sacralização.Na actualidade, os inventores independentes constituem uma franja minoritária da produção técnico-científica, assistindo-se a uma progressiva institucionalização do processo inventivo. Assim, interrogamos as razões que levam os inventores a perseverar numa actividade que se desenvolve à margem de qualquer vínculo institucional. Tal desvinculação reflecte-se no discurso dos entrevistados que salientam a desvalorização social de que são alvo. Esta persistência leva-nos a interrogar os factores avançados pelos próprios como potenciadores do gosto pela invenção.

OBJETIVO: avaliar o desempenho do rastreamento combinado do primeiro trimestre da gestação na detecção de anomalias cromossômicas em um grupo da população brasileira. MÉTODO: estudo retrospectivo envolvendo gestantes com feto único, referidas ao setor de medicina fetal para a realização do teste de rastreamento do primeiro trimestre da gestação pela combinação da idade materna, a medida da translucência nucal e dois marcadores bioquímicos do soro materno: free B-hCG e PAPP-A. Para avaliar o desempenho do teste foram calculados a sensibilidade, especificidade, valores preditivos positivos e negativos e as taxas de falso positivo, considerando como risco elevado valores superiores a 1:300. RESULTADOS: foram incluídas 456 gestantes submetidas ao teste. A idade materna avançada, acima de 35 anos, ocorreu em 36,2% dos casos. A incidência de cromossomopatia na população estudada foi de 2,2%. Vinte e uma das gestantes (4,6%) apresentou risco elevado ao teste (superior a 1:300). Usando-se este ponto de corte, a sensibilidade do teste foi de 70% para as cromossomopatias em geral e 83,3% para os casos de trissomia do cromossomo 21, com taxa de falso positivo de 3,1%. CONCLUSÃO: o rastreamento combinado do primeiro trimestre foi eficaz na detecção das anomalias cromossômicas, principalmente em relação aos casos de trissomia 21, com baixas taxas de falso positivo. Observou-se importante contribuição do teste em reduzir a indicação do exame invasivo comparado ao uso da idade materna como fator de risco.PURPOSE: to evaluate the performance of the combined first trimester screening for chromosomal abnormalities in a group of the Brazilian population. METHODS: a retrospective study including pregnant women with single fetuses referred to a fetal medicine center to perform the first trimester screening that combines maternal age, nuchal translucency measurement and two maternal serum biochemical markers: free B-hCG and PAPP-A. To evaluate the performance of the test, the detection rate, specificity, negative and positive predicted values and false-positive rates were calculated, considering as high risk the cut-off value above 1 in 300. RESULTS: we studied 456 patients submitted to the test. Advanced maternal age above 35 years was observed in 36.2% of cases. The incidence of chromosomal abnormalities in the study population was 2.2%. Twenty-one patients (4.6%) presented a high risk (above 1:300) by the combined test. Using this cut-off level, the detection rate of the test was 70% for all chromosomal abnormalities and 83.3% for trisomy 21, for a false-positive rate of 3.1%. CONCLUSIONS: the combined first trimester screening was effective to detect chromosomal abnormalities, mainly for trisomy 21, with low false-positive rates. The combined test contributed to decreasing the indication of an invasive test if we compare to maternal age alone as a risk factor.

Caulerpa scalpelliformis grows on rocky and sandy bottoms at different depths in Jacuacanga Cove, Ilha Grande Bay, where it can form dense patches. The invasive behavior of this and other species of Caulerpa is well documented in the literature. This study analyzed the variation of the vegetative development of C. scalpelliformis from Baleia Beach (23º01'63''S and 44º14'18''W) in Jacuacanga Cove, from June 2003 to September 2004, including plants from rocky and sandy substrates. Morphometric and dry weight data from the erect and prostrate portions were used. Plants were collected from 20 x 20 cm² plots (n=3), randomly positioned on the rocky boulders (≅1.5 m depth) and on contiguous sandy bottom (≅3.0 m depth). During the study period, C. scalpelliformis occurred on both substrates as a pseudo-perennial species, showing partial loss of the erect portions from winter to spring; the height and dry weight of the erect portions increased from summer to autumn on both substrates. The temporal variation of C. scalpelliformis vegetative development in Baleia Beach was similar to that described for the invasive C. racemosa and C. taxifolia from different geographical regions of the world.Caulerpa scalpelliformis cresce sobre substrato rochoso e arenoso a diferentes profundidades na Enseada de Jacuacanga, Baía da Ilha Grande, onde pode formar bancos densos. O comportamento invasor desta e de outras espécies de Caulerpa é bem documentado na literatura. Este estudo analisou a variação do desenvolvimento vegetativo de C. scalpelliformis da Praia da Baleia (23º01'63''S e 44º14'18''W), Enseada de Jacuacanga, de junho de 2003 a setembro de 2004, considerando plantas do substrato rochoso e do fundo de areia. Dados morfométricos e de peso seco das porções prostrada e ereta foram usados. Plantas foram coletadas em quadrados de 20 cm de lado (n=3), posicionados aleatoriamente sobre o substrato rochoso (profundidade ≅ 1,5 m) e sobre o substrato arenoso (profundidade ≅ 3,0 m). Durante o período de estudo, C. scalpelliformis ocorreu nos dois substratos como espécie pseudo-perene, mostrando perda parcial das porções eretas do talo do inverno para a primavera; altura e massa seca das porções eretas mostraram tendência de aumento do verão para o outono nos dois substratos. A variação temporal do desenvolvimento vegetativo de C. scalpelliformis na Praia da Baleia foi similar à descrita para C. racemosa e C. taxifolia, espécies invasoras em diferentes regiões do mundo.

We retrospectively investigated six cases of discrepancy between prenatal fetal karyotype and postnatal findings. In five cases, the chromosomal abnormalities initially found by CVS or amniocentesis were not confirmed by later analyses and postnatal examination. In one case, the fetal karyotype found to be normal by CVS had to be checked due to sonographic features and clinical anomalies found after birth. In most cases, the normal development on sonographic examination raised the doubt about the abnormal fetal karyotype. Discrepant findings between fetal karyotype results and sonographic findings require great caution in their interpretation and counseling of parents. Placental confined mosaicism seems to be the most frequent cause of such discrepant results. The interpretation of fetal karyotype results should always be correlated with sonographic and clinical findings.

PURPOSE: To report the initial experience in our country with a new technique for twin to twin transfusion syndrome (TTTS) treatment, using laser to coagulate the placental vessels responsible for the twin transfusion during gestation. METHODS: Prospective study of eight cases diagnosed with TTTS evaluated in our service from january 2001 to june 2005. Through percutaneous introduction of a 2,0mm diameter fetoscope in the uterine cavity, placental surface vessels where directly visualized. Those identified as responsible for the transfusion were laser coagulated. The procedure combines ultrasonography and fetoscopy, in a so-called sonoendoscopic technique (FETENDO). RESULTS: Among the eight pregnancies evaluated, five cases were submitted to the procedure (10 fetuses). All fetuses survived for at least five weeks after surgery. A total of eight fetuses were born alive and five survived the neonatal period. In a 18 months follow-up after birth, all five are still alive and well and their mean age is now 10,6 months. The total survival rate was 50% and in three pregnancies, at least one fetus survived. CONCLUSIONS: Laser fetoscopy is actually the "gold-standard" treatment of TTTS. Nevertheless is a sophisticated technique that epends of proper training. Our service is the first in our country to offer this therapeutic technique. Our success rate is comparable with the international literature.OBJETIVO: Nosso objetivo é relatar a experiência inicial no país com uma nova técnica de tratamento para a síndrome de transfusão feto-fetal (STT), onde se utiliza o raio laser para coagulação dos vasos placentários responsáveis pela transfusão entre gêmeos durante a gravidez. MÉTODOS: Estudo prospectivo de 8 casos com diagnóstico de STT avaliados pelo nosso serviço de janeiro de 2001 a junho de 2005. Introduzindo-se um fetoscópio de 2,0 mm de diâmetro na cavidade uterina, por via percutânea, foram diretamente visualizados os vasos da superfície placentária. Aqueles vasos identificados como responsáveis pela transfusão foram coagulados através do laser. O procedimento combina a ultra-sonografia e a fetoscopia, no que se denomina uma abordagem sono-endoscópica (FETENDO). RESULTADOS: Dentre as oito gestações avaliadas, o procedimento foi realizado em cinco casos (10 fetos). Todos os fetos sobreviveram por um período mínimo de cinco semanas após a cirurgia. Na evolução, oito fetos nasceram vivos e cinco sobreviveram ao período neonatal. No seguimento pós-natal de 18 meses, todos os cinco estão vivos e bem, tendo atualmente uma idade média de 10,6 meses. A sobrevida geral foi de 50%, sendo que em três gestações, pelo menos um feto sobreviveu. CONCLUSÕES: A fetoscopia com laser é atualmente considerada "gold-standard" no tratamento da STT. No entanto, a técnica é sofisticada e depende de treinamento adequado. Nosso serviço é o primeiro do país a oferecer esta técnica cirúrgica e nossos índices de sucesso se comparam aos índices mundiais.

O papel desempenhado pelos objectos na criação do espaço doméstico sugere que os consideremos como extensões do próprio indivíduo e, neste sentido, sujeitos a um processo de familiarização. Sem inviabilizar os critérios de distinção associados às práticas de consumo que os objectos asseguram enquanto mecanismos de classificação social- e é sob este ângulo que a Sociologia tem concentrado o seu olhar sobre os objectos - procuramos aqui salientar uma outra dimensão a que estes também respondem, na sua qualidade de «arquivo de memórias», Nesta medida, os objectos asseguram um papel relevante de identificação dos indivíduos consigo próprios. Tratando-se de dispositivos com forte poder evocativo, permitindo a cada um de nós reconstituir o seu mapa de memórias, afectos e segredos, os objectos participam activamente nos mecanismos de apropriação que actualizam, em permanência, a relação dos indivíduos com a sua parte visível do «cosmos», que é o universo doméstico.

We report on a prenatal diagnosis of ring chromosome 15 in a fetus with left congenital diaphragmatic hernia (CDH) and severe intrauterine growth restriction (IUGR). A 31-year-old woman, gravida 2 para 1, was referred because of increased nuchal translucency at gestational age of 13 weeks. Comprehensive fetal ultrasound examination was performed at 19 weeks revealing an early onset IUGR, left CDH with liver herniation, and hypoplastic nasal bone. Three-dimensional ultrasound (rendering mode) showed low set ears and depressed nasal bridge. Amniocentesis was performed with a result of a 46,XX,r(15) fetus after a cytogenetic study. A 1,430 g infant (less than third percentile) was born at 36 weeks. The infant presented with respiratory failure and died at 2 h of life. Postnatal karyotype from the umbilical cord confirmed the diagnosis of 15-ring chromosome. We described the main prenatal 2D- and 3D-ultrasound findings associated with ring chromosome 15. The interest in reporting the present case is that CDH can be associated with the diagnosis of 15-ring chromosome because the critical location of the normal diaphragm development is at chromosome 15q26.1-q26.2.

Treacher-Collins syndrome (TCS) is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS) is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS) has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis.

BACKGROUND: Leishmaniasis is a neglected endemic disease with a broad spectrum of clinical manifestations. Pentavalent antimonials have been the treatment of choice for the past 70 years and, due to the emergence of resistant cases, the efficacy of these drugs has come under scrutiny. Second-line drugs are less efficacious, cause a range of side effects and can be costly. The formulation of new generations of drugs, especially in developing countries, has become mandatory. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the anti-leishmanial effect of 17-(allylamino)-17-demethoxygeldanamycin (17-AAG), an HSP90 inhibitor, in vitro. This inhibitor is currently in clinical trials for cancer treatment; however, its effects against intracellular Leishmania remain untested. Macrophages infected with L. amazonensis were treated with 17-AAG (25-500 nM) and parasite load was quantified using optical microscopy. Parasite load declined in 17-AAG-treated macrophages in a dose- and time-dependent manner. Intracellular parasite death became irreversible after 4 h of treatment with 17-AAG, and occurred independent of nitric oxide (NO) and superoxide (O(2) (-)) production. Additionally, intracellular parasite viability was severely reduced after 48 h of treatment. Interestingly, treatment with 17-AAG reduced pro-inflammatory mediator production, including TNF-α, IL-6 and MCP-1, yet IL-12 remained unaffected. Electron microscopy revealed morphological alterations, such as double-membrane vacuoles and myelin figures at 24 and 48 h after 17-AAG treatment. CONCLUSIONS/SIGNIFICANCE: The HSP90 inhibitor, 17-AAG, possesses high potency under low dosage and reduces both pro-inflammatory and oxidative molecule production. Therefore, further studies are warranted to investigate this inhibitor's potential in the development of new generations of anti-leishmanials.

In Brazil, Visceral Leishmaniases is caused by Leishmania infantum, and domestic dogs are the main reservoirs in its urban transmission cycle. As an alternative to euthanizing dogs, miltefosine has been used to treat canine visceral leishmaniasis since 2016. In this study, we have assessed the efficacy of miltefosine for treating canine visceral leishmaniasis in a new endemic area through follow-up of naturally infected dogs was evaluated. The clinical, parasitological, and histopathological characteristics of 21 dogs naturally infected with L. infantum were assessed at three time points: on the day before initiating miltefosine treatment (T0), immediately after treatment completion (T1), and 6 months after treatment completion (T2). Three dogs were treated exclusively with miltefosine, while eighteen received combination therapy with miltefosine with other treatments such as allopurinol, domperidone and immunotherapy. Skin biopsies were obtained from the abdomen to assess inflammatory responses and to quantify parasite loads using qPCR. The parasites were isolated using aspirates acquired from popliteal lymph nodes. Molecular and parasitological analyses confirmed the presence of L. infantum in all dogs, validating the effectiveness of skin and lymph node samples for diagnosis. The clinical conditions of the infected animals were improved and the skin parasite load decreased after treatment, even when distinct combination therapies were performed. The histopathological assessment revealed a miltefosine-induced reduction in the inflammatory response and a decrease in amastigotes number. Furthermore, a positive correlation was established between the reduction in parasite load and the enhancement of clinical scoring, as well as a reduction in the skin inflammatory response. Our findings suggest that miltefosine-based combination therapies reduce skin parasite load and improve clinical outcomes, while the dogs treated with miltefosine alone showed increased parasitic load and worsened clinical staging at T2. Considering this data belonging to a recent transmission area, treatment strategy suggests effective in controlling canine visceral leishmaniasis. [ABSTRACT FROM AUTHOR]