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Two species of manatees are found in Northern Brazil—the Antillean manatee (Trichechus manatus), which is found along the coast from Florida to Northeastern Brazil, and the Amazonian manatee (Trichechus inunguis), endemic to the Amazon drainage basin. These species show a sympatric distribution in the region of the Marajó Archipelago, an estuarine area surrounding the Amazon River mouth. There is evidence of the occurrence of interspecific hybrids in this area, based on mitochondrial DNA analyses, although the use of nuclear markers has not corroborated this proposal. Considering that these species show very distinct karyotypes, despite being closely related (2n = 48 in T. manatus and 2n = 56 in T. inunguis), hybrids would present distinct chromosome numbers. Based on this, we conducted cytogenetic analyses using classic and molecular techniques in three calves found stranded in the Marajó Island and Amapá coast. The results showed that one of them, morphologically classified as T. inunguis, presented the correspondent karyotype, with 2n = 56. However, the other two, which were phenotypically similar to T. manatus, showed 2n = 49. Despite the same diploid number, their G-banding patterns revealed some differences. The results of the distribution of some microsatellite sequences have also confirmed the heterozygosity of some chromosomal pairs in these two individuals. These results are the first indubitable confirmation of the occurrence of natural hybrids between T. manatus and T. inunguis, and also brings about some issues concerning the viability of hybrids, considering that these two individuals do not correspond to an F1 hybrid, but instead, both presented a possible F2 karyotype.

Background Increased aortic stiffness has been associated with cognitive decline and dementia, but the results are inconsistent. This study investigated the longitudinal association of aortic stiffness and age with decreased cognitive performance in 3 cognitive tests. Methods and Results This study included 6927 participants, with a mean age of 58.8 years at baseline (2008–2010), who participated in the second wave (2012–2014) of the ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health) (interval between visits ranging from 2–6 years). Cognitive performance was evaluated by Memory, Phonemic, and Semantic Verbal Fluency and Trail B Tests, applied at both cohort visits. Associations with the carotid‐femoral pulse wave velocity and age at baseline were investigated using linear models with mixed effects after adjusting for confounders. After all the adjustments, including for systolic blood pressure, the interaction term carotid‐femoral pulse wave velocity×time proved to be statistically significant for Memory and Verbal Fluency Tests, indicating that the higher carotid‐femoral pulse wave velocity at baseline was associated with a faster decline in cognitive performance in these tests between waves. The interaction term age×time was statistically significant for all cognitive tests, suggesting that increasing age at baseline was also associated with a faster decline in cognitive performance between waves. Conclusions In this relatively young cohort, and after a relatively short interval, an increased aortic stiffness at baseline was associated with a sharper decline in cognitive performances in memory and verbal fluency, regardless of systolic blood pressure levels. This study also showed that the decline in cognitive performance was faster among older individuals than among younger ones at baseline.

Objective: To compare intimate partner violence (IPV) prevalence rates in 2006 and 2012 in a nationally representative household sample in Brazil. The associations between IPV and substance use were also investigated. Methods: IPV was assessed using the Conflict Tactic Scale-R in two waves (2006/2012) of the Brazilian Alcohol and Drugs Survey. Weighted prevalence rates and adjusted logistic regression models were calculated. Results: Prevalence rates of IPV victimization decreased significantly, especially among women (8.8 to 6.3%). The rates of IPV perpetration also decreased significantly (10.6 to 8.4% for the overall sample and 9.2 to 6.1% in men), as well as the rates of bidirectional violence (by individuals who were simultaneously victims and perpetrators of violence) (3.2 to 2.4% for the overall sample). Alcohol increased the likelihood of being a victim (odds ratio [OR] = 1.6) and perpetrator (OR = 2.4) of IPV. Use of illicit drugs increased up to 4.5 times the likelihood of being a perpetrator. Conclusions: In spite of the significant reduction in most types of IPV between 2006 and 2012, violence perpetrated by women was not significantly reduced, and the current national rates are still high. Further, this study suggests that use of alcohol and other psychoactive drugs plays a major role in IPV. Prevention initiatives must take drug misuse into consideration.

Objective: Childhood adversities (CAs) comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women. Methods: Parental mental illness, substance misuse, criminality, death, divorce, other parental loss, family violence, physical abuse, sexual abuse, neglect, physical illness, and economic adversity were assessed in a general-population sample (n=5,037). Exploratory and confirmatory factor analysis determined gender-related dimensions of CA. The contribution of each individual adversity was explored through Rasch analysis. Results: Adversities were reported by 53.6% of the sample. A three-factor model of CA dimensions fit the data better for men, and a two-factor model for women. For both genders, the dimension of family maladjustment – encompassing physical abuse, neglect, parental mental disorders, and family violence – was the core cluster of CAs. Women endorsed more CAs than men. Rasch analysis found that sexual abuse, physical illness, parental criminal behavior, parental divorce, and economic adversity were difficult to report in face-to-face interviews. Conclusion: CAs embrace sensitive personal information, clustering of which differed by gender. Acknowledging CAs may have an impact on medical and psychiatric outcomes in adulthood.

The human population of the Brazilian Amazon possesses a rich body of beliefs and practices that relate to river dolphins, which are also known as botos (Inia and Sotalia species). There is a widespread belief in their magical powers in relation to love enchantments. One form that this takes is “dolphin love charms” and these are widely in use in northern Brazil, and also in the largest southern cities. This paper considers the trade of cetacean products in the form of love charms in Brazil. Samples were obtained in the north (n = 70), northeast (n = 3) and southeast (n = 59) regions from 34 shops or municipal markets. A total of 38 of the 131 collected samples were evaluated by complete cytochrome b sequencing, revealing the use of two species: the Guiana dolphin (Sotalia guianensis) (n = 3) and the domestic pig (Sus scrofa) (n = 10) and samples containing no animal material (n = 10) were also detected. Pigs are used to fake love charm products in Rio de Janeiro. However, whereas in the southeast there is no actual use of dolphin tissues in love charms, there is a widespread use of dolphin tissue in northern Brazil, including, muscle, eyes, penis and vagina. The data confirm a regular trade of dolphin products in large cities in the north and northeast of Brazil and the need for more intense actions from governmental agencies in order to curb this illegal trade.

The swamp rats are distributed in Argentina, southern Paraguay, Uruguay and southern Brazil, with two species currently accepted: Scapteromys aquaticus Thomas, 1920 and Scapteromys tumidus Waterhouse, 1837. While S. aquaticus occurs in Argentina, Paraguay and western Uruguay, S. tumidus occurs in Brazil and Uruguay. Here we report for the first time the occurrence of S. aquaticus in gallery forest remnants in Southern Brazil. Karyologic analysis showed 2n = 32 and FNa = 40. Phylogenetic analyses, based on DNA sequences from the mitochondrial cytochrome-b gene indicate that the Brazilian and the Argentinian specimens of S. aquaticus shared one haplotype, while median joining analysis showed lack of population structure. This register, plus the karyotype data available for Brazilian population, recovered four karyomorphotypes in Brazil, corresponding to the two known species of Scapteromys and two unnamed species. This scenario indicates that more multidisciplinary studies are necessary to understand the actual diversity of Scapteromys.

Objective: Most countries fail to treat individuals with psychopathologies. Investigating treatment barriers and reasons for dropout are key elements to overcoming this scenario. Methods: A representative sample of 2,942 urban-dwelling adults was interviewed face-to-face within a cross-sectional, stratified, multistage probability survey of the general population. Psychiatric diagnosis, severity level, use of services, reasons for not seeking treatment, and treatment dropout were investigated. Results: Only 23% of individuals with a psychopathology of any severity level in the last 12 months received treatment. Low perceived need for treatment (56%) was the most common reason for not seeking treatment. The most visited settings were psychiatric, other mental health care, and general medical care. Among those with a perceived need for treatment (44%), psychological barriers were the most common reason for not seeking it. Treatment dropout was more prevalent among those who visited a general medical care setting. Among individuals still in treatment, human services and psychiatric care were the most common types. Female sex was associated with structural barriers (OR = 2.1). Disorder severity was negatively associated with need barriers (OR = 0.4), and positively associated with structural barriers (OR = 2.5) and psychological barriers (OR = 2.5). Conclusion: Despite the need for treatment and better services, psychological barriers were the major reason for not seeking treatment. Apart from providing more specialists, investing in awareness, de-stigmatization, and information is the ultimate strategy for improving psychiatric care.

Objective: To analyze factors associated with the prevalence of maltreatment and bullying and to identify types of involvement (verbal, physical, social, sexual, cyberbullying) among high school students aged 15 to 19 years. Methods: A cross-sectional, school-based epidemiological survey was performed. The sample included 2,293 adolescents from public and private schools in the Greater Vitoria area (state of Espírito Santo, Brazil). A modified version of the Brazilian Portuguese Olweus Bully/Victim Questionnaire was used. Results: Among maltreatment behaviors, 43.3% of adolescents reported having been victims vs. 40.4% reporting to be aggressors. Among bullying behaviors, 41% reported victimization and 29.1% aggression. The most frequent types of bullying were verbal (victim = 33.8%, bully = 23.1%), social (victim = 21.8%, bully = 16.9%), and physical bullying (victim = 15.1%, bully = 8.7%). Of those reporting to be victims, 37.5% stated that they did not react as frequently as they were attacked. Almost half of the students (50.9%) identified themselves as victims, without practicing any type of aggression against another schoolmate. School network (public or private) and gender were significantly associated with victimization and aggression behaviors. Conclusion: The adolescents identified as victims did not generally attack other students, i.e., did not identify themselves as perpetrators. The high prevalence of maltreatment and bullying detected in this study, especially the verbal, social, and physical types, underscores the need for interventions addressing bullying in schools.

BackgroundDiabetes mellitus (DM) is one of the most frequent comorbidities in patients suffering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with a higher rate of severe course of coronavirus disease (COVID-19). However, data about post-COVID-19 syndrome (PCS) in patients with DM are limited.MethodsThis multicenter, propensity score-matched study compared long-term follow-up data about cardiovascular, neuropsychiatric, respiratory, gastrointestinal, and other symptoms in 8,719 patients with DM to those without DM. The 1:1 propensity score matching (PSM) according to age and sex resulted in 1,548 matched pairs.ResultsDiabetics and nondiabetics had a mean age of 72.6 ± 12.7 years old. At follow-up, cardiovascular symptoms such as dyspnea and increased resting heart rate occurred less in patients with DM (13.2% vs. 16.4%; p = 0.01) than those without DM (2.8% vs. 5.6%; p = 0.05), respectively. The incidence of newly diagnosed arterial hypertension was slightly lower in DM patients as compared to non-DM patients (0.5% vs. 1.6%; p = 0.18). Abnormal spirometry was observed more in patients with DM than those without DM (18.8% vs. 13; p = 0.24). Paranoia was diagnosed more frequently in patients with DM than in non-DM patients at follow-up time (4% vs. 1.2%; p = 0.009). The incidence of newly diagnosed renal insufficiency was higher in patients suffering from DM as compared to patients without DM (4.8% vs. 2.6%; p = 0.09). The rate of readmission was comparable in patients with and without DM (19.7% vs. 18.3%; p = 0.61). The reinfection rate with COVID-19 was comparable in both groups (2.9% in diabetics vs. 2.3% in nondiabetics; p = 0.55). Long-term mortality was higher in DM patients than in non-DM patients (33.9% vs. 29.1%; p = 0.005).ConclusionsThe mortality rate was higher in patients with DM type II as compared to those without DM. Readmission and reinfection rates with COVID-19 were comparable in both groups. The incidence of cardiovascular symptoms was higher in patients without DM.

Background COVID‐19 is an infectious illness, featured by an increased risk of thromboembolism. However, no standard antithrombotic therapy is currently recommended for patients hospitalized with COVID‐19. The aim of this study was to evaluate safety and efficacy of additional therapy with aspirin over prophylactic anticoagulation (PAC) in patients hospitalized with COVID‐19 and its impact on survival. Methods and Results A total of 8168 patients hospitalized for COVID‐19 were enrolled in a multicenter‐international prospective registry (HOPE COVID‐19). Clinical data and in‐hospital complications, including mortality, were recorded. Study population included patients treated with PAC or with PAC and aspirin. A comparison of clinical outcomes between patients treated with PAC versus PAC and aspirin was performed using an adjusted analysis with propensity score matching. Of 7824 patients with complete data, 360 (4.6%) received PAC and aspirin and 2949 (37.6%) PAC. Propensity‐score matching yielded 298 patients from each group. In the propensity score‐matched population, cumulative incidence of in‐hospital mortality was lower in patients treated with PAC and aspirin versus PAC (15% versus 21%, Log Rank P=0.01). At multivariable analysis in propensity matched population of patients with COVID‐19, including age, sex, hypertension, diabetes, kidney failure, and invasive ventilation, aspirin treatment was associated with lower risk of in‐hospital mortality (hazard ratio [HR], 0.62; [95% CI 0.42–0.92], P=0.018). Conclusions Combination PAC and aspirin was associated with lower mortality risk among patients hospitalized with COVID‐19 in a propensity score matched population compared to PAC alone.

Analisou-se o comportamento da leishmaniose visceral (LV) no Estado do Maranhão-Brasil, no período de 1982 a 1993. A enfermidade vem ocorrendo predominantemente na Ilha de São Luís-MA em áreas periurbanas, destacando, no período epidêmico, a capital São Luís como principal área endêmica. A maior freqüência de casos ocorreu em 1993, apesar do uso de inseticidas e controle dos cães. Houve predomíyiio na faixa etária de 0 a 4 anos de idade com 58,4% dos casos. Nem a doença humana nem o índice pluviométrico apresentaram variações sazonais significativas, entretanto estiveram moderadamente correlacionados, havendo quase sempre elevação do número de casos após o período de maior precipitação chuvosa. A partir deste estudo, poderão ser levantadas questões para o controle mais eficaz, consoante á urbanização da doença, aliada aos fatores da dinâmica de transmissão em áreas endêmicas do Estado.The authors analysed the visceral leishmaniasis (VL) aspects in the State of Maranhão-Brazil, from 1982 to 1993. The disease happens to occur predominantly in São Luis, Island (MÁ) and during the epidemic period, town of São Luis was pointed out as the main endemic area. The greatest frequency of cases occured in 1993, despite the use of insecticid and dogs control. There was predominance of age between 0 to 4 year old population with 58.04% of cases. Neither the human disease nor the rainfall index had significant seasonal variation. However they were correlated moderately, with high number of cases after the period of great preciptation of rain. After this study, the data obtained will allow a better control of the disease, despite some factors such as: the urbanization, localization and dynamic of transmission in endemic areas in the Maranhão State.

Os autores fazem um breve relato da evolução histórica da leishmaniose visceral no Estado do Maranhão, Brasil, avaliando as possíveis causas da expansão da referida doença no Estado, assim como as medidas de controle adotadas pelo Ministério da Saúde objetivando a diminuição da incidência da mesma.