Background
Human herpesvirus 2 (HSV-2) is a major cause of sexually transmitted infections (STIs) worldwide and often occurs synergistically with syphilis, and human immunodeficiency virus (HIV) ...infection. Transgender women (TGW) are disproportionately affected by STIs. The aim of this study was to estimate the prevalence of HSV-2 monoinfection, and HSV-2, syphilis, and HIV coinfection (triple infection) among TGW in Central Brazil.
Methods
A seroprevalence survey was conducted among TGW in Central Brazil from 2018 to 2019. Participants were recruited using respondent-driven sampling and interviewed about their sociodemographic characteristics and STI risk behaviors, and were tested for antibodies to HSV-2,
Treponema pallidum
, and HIV. Multivariable logistic regression models were used to identify variables associated with HSV-2 monoinfection and triple infection.
Results
Of the 431 participants, 345 (80%) were positive for HSV-2 antibodies, of whom 36 were HSV-2 immunoglobulin M–positive, and 340 were HSV-2 immunoglobulin G–positive. Human herpesvirus 2 and HIV coinfection, HIV and syphilis coinfection, and triple infection were detected in 38 participants (9.0%), 58 participants (13.8%), and 27 participants (6.4%), respectively. Report of a previous STI was associated with a decreased risk of HSV-2 monoinfection (adjusted odds ratio, 0.39), and an increased risk of triple infection (adjusted odds ratio, 4.4). Participants who reported sex not only with men had a 2.42-fold increased risk of triple infection.
Conclusions
The high prevalence of HSV-2, syphilis, and HIV coinfection among TGW is a cause for concern. Transgender women should be screened for HIV and other STIs. Further studies of risk factors for triple infection among TGW are warranted.
Resumo: O presente trabalho tem como objetivo descrever a prevalência e fatores associados a eventos adversos a medicamentos (EAM) referidos por usuários de medicamentos no Brasil. Trata-se de um ...estudo transversal de base populacional, realizado no período de setembro de 2013 a fevereiro de 2014, com dados coletados na Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM). Foram consideradas todas as pessoas que referiram o uso de medicamentos; entre elas, foram identificadas as que referiram pelo menos um problema com o uso do medicamento. Realizou-se uma análise descritiva para estimar a prevalência e os intervalos de 95% de confiança (IC95%) de EAM entre as variáveis estudadas, e foram calculadas as razões de prevalência bruta e ajustada, pela regressão de Poisson, na investigação dos fatores associados aos EAM. A prevalência de EAM no Brasil foi de 6,6% (IC95%: 5,89-7,41), sendo maior e estatisticamente significante após a realização da análise multivariada, entre pessoas do sexo feminino; residentes nas regiões Centro-oeste e Nordeste; que consumiam maior número de medicamentos; que percebiam seu estado de saúde como “ruim”; e que se automedicavam. Os EAM foram mais relatados para os medicamentos fluoxetina, diclofenaco e amitriptilina. Os EAM mais referidos pelos entrevistados foram sonolência, dor epigástrica e náuseas. Os EAM mais referidos pelos entrevistados foram de natureza leve, considerados evitáveis e estiveram associados a medicamentos de uso frequente pela população. Em razão desse estudo, foi possível conhecer a dimensão do problema ocasionado pelo uso de medicamentos no Brasil.
Abstract: The aim of this study was to describe the prevalence of adverse drug events (ADEs) and associated factors reported by users of medicines in Brazil. This was a cross-sectional population-based study conducted from September 2013 to February 2014 with data from the Brazilian National Survey on Access, Use, and Promotion of Rational Use of Medicines (PNAUM). The study included all individuals that reported the use of medicines and identified, among them, all those reporting at least one problem with the medicine’s use. A descriptive analysis was performed to estimate ADE prevalence and 95% confidence intervals (95%CI) among the target variables. Crude and adjusted prevalence ratios were calculated using Poisson regression to investigate factors associated with ADEs. Overall ADE prevalence in Brazil was 6.6% (95%CI: 5.89-7.41), and after multivariate analysis, higher prevalence was associated with female gender, residence in the Central and Northeast regions, consumption of more medicines, “bad” self-rated health, and self-medication. The drugs most frequently reported with ADEs were fluoxetine, diclofenac, and amitriptyline. The most frequent ADEs were somnolence, epigastric pain, and nausea. Most reported ADEs were mild, avoidable, and associated with medicines used frequently by the population. The study provided knowledge on the size of the problem with use of medicines in Brazil.
Resumen: El presente trabajo tiene como objetivo describir la prevalencia y factores asociados a eventos adversos con medicamentos (EAM), informados por usuarios de medicamentos en Brasil. Se trata de un estudio transversal de base poblacional, realizado durante el período de septiembre de 2013 a febrero de 2014, con datos recogidos en la Encuesta Nacional sobre el Acceso, Utilización y Promoción del Uso Racional de Medicamentos en Brasil (PNAUM). Se consideraron a todas las personas que informaron del uso de medicamentos; entre ellas, se identificaron a las que informaron de por lo menos un problema con el uso del medicamento. Se realizó un análisis descriptivo para estimar la prevalencia y los intervalos de confianza a 95% (IC95%) de EAM entre las variables estudiadas, y se calcularon las razones de prevalencia bruta y ajustada, por la regresión de Poisson, en la investigación de los factores asociados a los EAM. La prevalencia de EAM en Brasil fue de un 6,6% (IC95%: 5,89-7,41), siendo mayor y estadísticamente significante tras la realización del análisis multivariado, entre personas del sexo femenino; residentes en las regiones Centro-Oeste y Nordeste; que consumían un mayor número de medicamentos; que percibían su estado de salud como “malo”; y que se automedicaban. Se informaron de más EAM en medicamentos como: fluoxetina, diclofenaco y amitriptilina. Los EAM más referidos por los entrevistados fueron somnolencia, dolor epigástrico y náuseas. Los EAM más referidos por los entrevistados fueron de naturaleza leve, considerados evitables y estuvieron asociados a medicamentos de uso frecuente por la población. Con motivo de este estudio, fue posible conocer la dimensión del problema ocasionado por el uso de medicamentos en Brasil.
ABSTRACT
Background
Coronavirus disease 2019 (COVID-19) has spread worldwide, causing a high burden of morbidity and mortality, and has affected the various health service systems in the world, ...demanding disease monitoring and control strategies. The objective of this study was to identify risk areas using spatiotemporal models and determine the COVID-19 time trend in a federative unit of northeastern Brazil.
Methods
An ecological study using spatial analysis techniques and time series was carried out in the state of Maranhão, Brazil. All new cases of COVID-19 registered in the state from March 2020 to August 2021 were included. Incidence rates were calculated and spatially distributed by area, while the spatiotemporal risk territories were identified using scan statistics. The COVID-19 time trend was determined using Prais–Winsten regressions.
Results
Four spatiotemporal clusters with high relative risks for the disease were identified in seven health regions located in the southwest/northwest, north and east of Maranhão. The COVID-19 time trend was stable during the analysed period, with higher rates in the regions of Santa Inês in the first and second waves and Balsas in the second wave.
Conclusions
The heterogeneously distributed spatiotemporal risk areas and the stable COVID-19 time trend can assist in the management of health systems and services, facilitating the planning and implementation of actions toward the mitigation, surveillance and control of the disease.
A Síndrome Respiratória Aguda Grave (SRAG) é uma manifestação grave da infeção por COVID-19 que, em alguns casos, pode resultar em morte. No cenário epidemiológico global atual, o Brasil é o segundo ...país em número de óbitos pela doença, assim, faz-se necessário conhecer características clínico-epidemiológicas dos óbitos e como se distribuem espacialmente pelos territórios. Desse modo, objetivou-se descrever as características clínico-epidemiológicas e a distribuição espacial dos óbitos de SRAG por COVID-19 nas unidades federativas do Brasil. Trata-se de estudo descritivo e ecológico dos óbitos de SRAG por COVID-19 nos estados brasileiros, no período de março de 2020 a junho de 2021, a partir de dados secundários disponíveis no openDataSUS. Realizou-se estatística descritiva para as variáveis clínico-epidemiológicas e determinaram-se as taxas de mortalidade mensais por unidade federada e foram confeccionados mapas temáticos no software QGIS versão 2.4.17. Foram registrados 196.109 óbitos no período investigado, sendo predominante o sexo masculino, idade avançada, cor branca e baixa escolaridade. Nas variáveis clínicas, destacaram-se tosse, desconforto respiratório, dispneia e presença de comorbidades. Observou-se distribuição espacial heterogênea dos óbitos, com taxas variando de 0,00 a 24,59 óbitos/100 mil habitantes, as maiores taxas foram nos estados do Rio de Janeiro, Amazonas, Ceará, Sergipe, São Paulo e Pernambuco. Tais achados suscitam a necessidade de investimentos por parte da gestão pública e dos sistemas e serviços de saúde dos estados mais afetados, aperfeiçoamentos da vigilância epidemiológica, educação permanente em saúde, ampliação do acesso à imunização e medidas de prevenção de saúde para controle e monitoramento da SRAG por COVID-19.
Cinnamaldehyde (CNM) is a cyclic terpene alcohol found as the major compound of essential oils from some plants of the genus Cinnamomum (Lauraceae). CNM has several reported pharmacological ...activities, including antimicrobial, antivirulence, antioxidant, and immunomodulatory effects. These properties make CNM an attractive lead molecule for the development of anti-infective agents. In this descriptive review, we discuss the application of CNM in experimental models of microbial infection using invertebrate and vertebrate organisms. CNM (pure or in formulations) has been successfully applied in the treatment of infections caused by a range of bacterial (such as
) and fungal (such as
and
) pathogens. All these experimental evidence-based findings have promoted the use of cinnamaldehyde as the leading molecule for developing new anti- infective drugs.
The aim of this study was to evaluate the effects of glutamine supplementation or exercise on gastric emptying and intestinal inflammation in rats with ulcerative colitis (UC). Strength exercise ...consisted of jump training 4 × 10 repetitions/5 days a week/8 weeks with progressive overload. Endurance exercise consisted of swimming without overload for a period of 1 h a day/5 days a week/8 weeks. Another group (sedentary) of animals was supplemented with
l
-glutamine (1 g/kg of body weight) orally for 8 weeks before induction of UC. Colitis was induced by intra-colonic administration of 1 mL of 4% acetic acid. We assessed gastric emptying, macroscopic and microscopic scoring, oxidative stress markers, and IL-1β, IL-6, and (TNF-α) levels. The UC significantly increased (
p
< 0.05) the gastric emptying compared with the saline control group. We observed a significantly decrease (
p
< 0.05) in body weight gain in UC rats compared with the control groups. Both exercise interventions and
l
-glutamine supplementation significantly prevented (
p
< 0.05) weight loss compared with the UC group. Strength and endurance exercises significantly prevented (
p
< 0.05) the increase of microscopic scores and oxidative stress (
p
< 0.05).
l
-glutamine supplementation in UC rats prevented hemorrhagic damage and improved oxidative stress markers (
p
< 0.05). Strength and endurance exercises and glutamine decreased the concentrations of inflammatory cytokines IL-1β, IL-6, and TNF-α compared with the UC group (
p
< 0.05). Strength and endurance exercises and
l
-glutamine supplementation prevented intestinal inflammation and improved cytokines and oxidative stress levels without altering gastric dysmotility in rats with UC.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Introduction: The objective was to analyze the prevalence trend, spatial distribution, and TB-HIV co-infection-associated factors in an endemic scenario for TB in Northeastern Brazil.
Methods: An ...ecological and temporal series study was conducted based on secondary data obtained from the Brazilian Notifiable Diseases Information System between January 2008 and December 2019. The prevalence rates were determined for each year and the average for the period. Prais-Winsten regressions were used for temporal variation analysis, scanning techniques were used to detect spatial clusters, and the Poisson regression model was used to explore the factors associated with the outcome.
Results: A total of 947 TB cases were reported, of which 501 (52.9%) underwent HIV testing, and of these, 73 were positive. The average prevalence was 20.0%, ranging from 1.5% in 2018 to 44.4% in 2009. A decreasing trend was found. Sixty-seven cases (92%) were geocoded, and two statistically significant (p < 0.005) high relative risk (RR) spatial clusters were detected. Statistically significant associations (p < 0.05) between the co-infection and variables such as male gender, living in the urban area, entry due to relapse, and case closure due to loss to follow-up were evidenced, and these variables constituted risk factors.
Conclusions: A decreasing prevalence of TB-HIV co-infection has been found, as well as a heterogeneous spatial distribution with the formation of spatial clusters in urban areas characterized by socio-spatial inequalities associated with clinical-epidemiological factors. Such findings provide subsidies for rethinking health care activities and improving public policies for vulnerable populations.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objetivo: analisar as morbidades autorreferidas relacionadas com as condições sociodemográficas dos usuários de espaços comunitários de atividade física.Materiais e métodos: estudo transversal, com ...abordagem quantitativa, realizado com 433 usuários do Sistema Único de Saúde, na macrorregião Cariri, Ceará, Brasil. A coleta ocorreu por meio de formulário estruturado a partir do modelo de questionário da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, operacionalizada pelo Ministério da Saúde do Brasil.Resultados: a média de idade dos participantes do estudo foi de 42,92 anos (DP ± 17,4); a de renda familiar foi de R$ 1.486,30 (DP ± 1.015,0). Verificou-se predomínio do sexo feminino associado à maior prevalência de hipertensão (p = 0,001) e de dislipidemia (p = 0,003). A idade mais elevada relacionou-se aos diagnósticos médicos de hipertensão (53,85 anos, DP ± 15,64), dislipidemia (59,54 anos, DP ± 15,25) e diabetes (52,42 anos, DP ± 16,66).Conclusão: a análise das características sociais e econômicas permitiu verificar a associação de morbidades como hipertensão, diabetes e dislipidemia com o sexo, a idade, a renda e a escolaridade; esses fatores são causais para o desenvolvimento das doenças crônicas não transmissíveis.
Epidemiological investigations on tuberculosis-diabetes comorbidity using spatial analysis should be encouraged towards a more comprehensive view of the health of individuals affected by such ...comorbidity in different contexts. This study analyzes the territories vulnerable to tuberculosis-diabetes comorbidity in a municipality in northeastern Brazil using spatial analysis techniques.
An ecological study was carried out in Imperatriz, Maranhão, Brazil. Tuberculosis-diabetes cases reported in the Brazilian Notifiable Diseases Information System between 2009 and 2018 were analyzed. Kernel density estimation and spatial scanning techniques were used to identify the areas with the greatest occurrence of spatial clusters.
A heterogeneous spatial distribution was found, ranging from 0.00 to 4.12 cases/km2. The spatial scanning analysis revealed three high-risk spatial clusters with statistical significance (p < 0.05), involving eleven strictly urban sectors with a relative risk of 4.00 (95% CI: 2.60-6.80), 5.10 (95% CI: 2.75-7.30), and 6.10 (95% CI: 3.21-8.92), indicating that the population living in these areas had a high risk of tuberculosis-diabetes comorbidity.
The highest concentration of cases/km2, as well as risk clusters, were found in areas with high circulation of people and socio-economic and environmental vulnerabilities. Such findings reinforce the need for public health interventions to reduce social inequalities.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The incidence of
Candida
species resistant to traditional antifungal drugs is increasing globally. This issue significantly impacts patients' lives and increases healthcare expenses, confirming the ...need to develop novel therapeutic strategies. Recently, a thermostable trypsin inhibitor named ShTI (11.558 kDa), which has antibacterial effects on
Staphylococcus aureus
, was isolated from
Salvia hispanica
L. (chia) seeds. This study aimed to assess the antifungal effect of ShTI against
Candida
species and its synergism with fluconazole and to evaluate its mode of action. Preliminary toxicological studies on mouse fibroblasts were also performed. ShTI exhibited antifungal effects against
C. parapsilosis
(ATCC® 22,019),
C. krusei
(ATCC® 6258), and six clinical fluconazole-resistant strains of
C. albicans
(2),
C. parapsilosis
(2), and
C. tropicalis
(2). The minimum inhibitory concentration (MIC) values were 4.1 µM (inhibiting 50% of the isolates) and 8.2 µM (inhibiting 100% of the isolates). Additionally, when combined with fluconazole, ShTI had a synergistic effect on
C. albicans
, altering the morphological structure of the yeast. The mode of action of ShTI against
C. krusei
(ATCC® 6258) and
C. albicans
involves cell membrane permeabilization, the overproduction of reactive oxygen species, the formation of pseudohyphae, pore formation, and consequently, cell death. In addition, ShTI (8.65 and 17.3 µM) had noncytotoxic and nongenotoxic effects on L929 mouse fibroblasts. These findings suggest that ShTI could be a promising antimicrobial candidate, but further research is necessary to advance its application as a novel antifungal agent.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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