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BackgroundControlling the COVID-19 outbreak in Brazil is a challenge due to the population’s size and urban density, inefficient maintenance of social distancing and testing strategies, and limited availability of testing resources. ObjectiveThe purpose of this study is to effectively prioritize patients who are symptomatic for testing to assist early COVID-19 detection in Brazil, addressing problems related to inefficient testing and control strategies. MethodsRaw data from 55,676 Brazilians were preprocessed, and the chi-square test was used to confirm the relevance of the following features: gender, health professional, fever, sore throat, dyspnea, olfactory disorders, cough, coryza, taste disorders, and headache. Classification models were implemented relying on preprocessed data sets; supervised learning; and the algorithms multilayer perceptron (MLP), gradient boosting machine (GBM), decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), k-nearest neighbors (KNN), support vector machine (SVM), and logistic regression (LR). The models’ performances were analyzed using 10-fold cross-validation, classification metrics, and the Friedman and Nemenyi statistical tests. The permutation feature importance method was applied for ranking the features used by the classification models with the highest performances. ResultsGender, fever, and dyspnea were among the highest-ranked features used by the classification models. The comparative analysis presents MLP, GBM, DT, RF, XGBoost, and SVM as the highest performance models with similar results. KNN and LR were outperformed by the other algorithms. Applying the easy interpretability as an additional comparison criterion, the DT was considered the most suitable model. ConclusionsThe DT classification model can effectively (with a mean accuracy≥89.12%) assist COVID-19 test prioritization in Brazil. The model can be applied to recommend the prioritizing of a patient who is symptomatic for COVID-19 testing.

Natural fruit pulp is highly appreciated because it retains the flavor and nutrients of the fresh fruit. However, fruit pulp is susceptible to contamination by pathogenic bacteria, mainly because of improper handling and storage. Therefore, this study evaluated and quantified the presence of pathogenic bacteria in fruit pulp sold in São Raimundo das Mangabeiras, Maranhão, Brazil. Two fruit pulp samples each of açaí (A and B), acerola (C and D), cajá (E and F), cashew (G and H), and passion fruit (I and J) were obtained from supermarkets and subjected to the following microbiological analyses: enumeration of mesophilic bacteria using plate count agar; quantification of total (TC) and thermotolerant (TTC) coliforms using the multiple tube technique; qualitative detection of Escherichia coli on eosin methylene blue agar and that of Salmonella on xylose lysine base agar and enteric agar. Mesophilic bacteria were found to grow in all the samples, with the highest value obtained for the acerola pulp (sample D; average: 1.08 x 105 colony-forming units g-1). However, all samples were in accordance with the Brazilian legislation for this parameter. The most probable number of colonies (MPN g-1) of TC and TTC were ≥1,100 in açaí (sample A), cajá (sample E), and cashew (sample G) pulps, which is in disagreement with the maximum value allowed. E. coli and Salmonella were not found to grow in the samples evaluated in this study. Collectively, the data indicate inadequate handling and storage in the production chain of fruit pulp sold in the municipality of São Raimundo das Mangabeiras, suggesting that the population in the region is exposed to a probable risk of food contamination.

Background: Fungal keratitis is a severe eye infection that can result in blindness and visual impairment, particularly in developing countries. Fusarium spp. are the primary causative agents of this condition. Diagnosis of Fusarium keratitis (FK) is challenging, and delayed treatment can lead to serious complications. However, there is limited epidemiological data on FK, especially in tropical areas. Objectives: This study aimed to describe the clinical, laboratorial and epidemiological characteristics of FK in a tropical semi‐arid region of Brazil. Patients/Methods: Adult patients with laboratory‐confirmed FK diagnosed between October 2019 and March 2022 were evaluated. Fusarium isolates were characterized at molecular level and evaluated regarding antifungal susceptibility. Results: A total of 226 clinical samples from patients suspected of keratitis were evaluated; fungal growth was detected in 50 samples (22.12%); out of which 42 were suggestive of Fusarium spp. (84%). Molecular analysis of a randomly selected set of 27 isolates identified F. solani species complex (n = 14); F. fujikuroi sensu lato (n = 6) and F. dimerum sensu lato (n = 7); a total of 10 haplotypes were identified among the strains. All but one Fusarium strains were inhibited by amphotericin B, natamycin and fluconazole. Most patients were male (71.42%; 30 out of 42), aged from 27 to 73 years old. Trauma was the most important risk factor for FK (40.47%; 17 out of 42). Patients were treated with antifungals, corticoids and antibiotics; keratoplasty and eye enucleation were also performed. Conclusions: The study provided insights into the characteristics of FK in tropical regions and emphasized the importance of enhanced surveillance and management strategies. [ABSTRACT FROM AUTHOR]

Objetivo: Caracterizar os cuidadores nos doze meses após a morte do doente (dados sociodemográficos, acompanhamento clínico, problemas de saúde e terapêutica farmacológica). Métodos: Realizou-se um estudo observacional, retrospetivo e analítico, ao nível dos cuidados de saúde primários. A população era constituída por cuidadores de doentes falecidos no ano de 2017, identificados pelo médico de família dos últimos. Após envio de convite à participação de todas as Unidades Funcionais foram obtidos os dados que permitiram caracterizar os cuidadores e o acompanhamento clínico no primeiro ano de luto, através dos médicos de família que aceitaram participar. Para a análise descritiva foram utilizadas frequências absolutas e relativas, mediana, mínimo e máximo. Resultados: Dos 308 cuidadores destaca-se a representatividade dos idosos (mediana de idade – 66,5 anos) e das mulheres (79,2%), bem como o acompanhamento exclusivo pelo médico de família em 93,2% das situações. A prescrição de novo e/ou alteração de dosagem de psicotrópicos ocorreu em 35,1% dos cuidadores, contrastando com a baixa taxa de acompanhamento em psicologia (3,5%) e/ou psiquiatria (4,2%) e ausência de avaliação de risco no luto e fornecimento de ferramentas de apoio. Conclusão: As características dos cuidadores foram concordantes com as descritas na literatura. A medicalização do luto pode refletir escassez de formação, tempo de consulta e de recursos de psicologia e psiquiatria. Comprova-se o papel essencial do médico de família no apoio ao luto; a implementação de medidas institucionais e organizacionais pode melhorar a prestação de cuidados no luto.