ResearchPad - brazil https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Composition and Natural History of Snakes from Etá Farm region, Sete Barras, south-eastern Brazil]]> https://www.researchpad.co/article/elastic_article_8995 Approximately 140 snake species are known to occur in the Atlantic Forest with nearly half being endemic to this ecoregion. However, the Atlantic forest is one of the most threatened tropical ecoregions, with only 16% of its original area remaining as forest. This extensive habitat loss must have had a negative effect on its snake fauna. Indeed, 53% of the threatened snakes of Brazil occur in the Atlantic forest. Therefore, basic natural history information that can potentially contribute to the conservation of Atlantic forest snakes are urgently needed. Here the natural history of a snake assemblage at Etá Farm region, Sete Barras municipality, south-eastern Brazil is described, and a visual guide and an identification key provided that can be used by researchers and local people to identify snakes from this region. Most of the species found in the field use both open areas and forests, are primarily terrestrial, present diurnal activity, and include frogs in their diet. A higher number of enlarged follicles, eggs, and/or embryos were recorded during the warm and rainy season. Seventeen different types of defensive tactics were recorded in the species found in the field. This study provides useful information for understanding the structure of snake assemblages of the Atlantic Forest and is potentially useful for conservation assessments and for designing conservation plans.

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<![CDATA[Brazilian vegetarians diet quality markers and comparison with the general population: A nationwide cross-sectional study]]> https://www.researchpad.co/article/elastic_article_7851 Vegetarianism is an increasingly common practice worldwide. Despite good evidence from other countries regarding vegetarians’ diet quality, data from the Brazilian population is still scarce.ObjectiveTo characterize the vegetarian Brazilian population and evaluate their diet quality compared to the general Brazilian population.MethodsWe performed a nationwide cross-sectional study using an online self-administered questionnaire, previously validated for the Brazilian population, to evaluate diet quality markers of vegetarians. The invitation to participate in the survey was spread nationwide, aimed at vegetarian communities. Individuals who considered themselves vegetarians and were at least 18 years old were eligible to participate. The results on regular intake and intake adequacy were compared among vegetarians and between genders using the Pearson’s chi-square test. The body mass index (BMI) were analyzed by the Analysis of Variance (ANOVA) followed by Tukey post-hoc test. The Kolmogorov-Smirnov test verified normality. All analyses considered bilateral hypotheses and a significance level of 5% (p <0.05).ResultsBrazilian vegetarians presented better diet quality markers, such as higher regular weekly intake and adequate daily intake of fruits and vegetables, and lower regular intake of soft drinks when compared to the general Brazilian population. Vegetarians also presented a proportionally higher consumption of natural foods and lower consumption of processed foods. Among vegetarians, a higher proportion of vegans showed positive results regarding diet markers analysis, when compared to vegetarians, pesco-vegetarians, and semi-vegetarians.ConclusionsVegetarians showed better results of diet adequacy when compared to the general population in Brazil, and vegans fared better when compared with other vegetarians. Despite the good results found, a large proportion of the participants still did not achieve the fruits and vegetables daily intake, according to the World Health Organization recommendations. ]]> <![CDATA[New estimates of the Zika virus epidemic attack rate in Northeastern Brazil from 2015 to 2016: A modelling analysis based on Guillain-Barré Syndrome (GBS) surveillance data]]> https://www.researchpad.co/article/elastic_article_7754 The mandatory reporting of the Zika virus (ZIKV) disease began region-wide in February 2016, and it is believed that ZIKV cases could have been highly under-reported before that. Given the Guillain-Barré syndrome (GBS) is relatively well reported, the GBS surveillance data has the potential to act as a reasonably reliable proxy for inferring the true ZIKV epidemics. We developed a mathematical model incorporating weather effects to study the ZIKV-GBS epidemics and estimated the key epidemiological parameters. It was found that the attack rate of ZIKV was likely to be lower than 33% over the two epidemic waves. The risk rate from symptomatic ZIKV case to develop GBS was estimated to be approximately 0.0061%. The analysis suggests that it would be difficult for another ZIKV outbreak to appear in Northeastern Brazil in the near future.

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<![CDATA[Epidemiologic and Clinical Progression of Lobomycosis among Kaiabi Indians, Brazil, 1965–2019]]> https://www.researchpad.co/article/Nbb02a593-139a-467b-b787-d897c27b8f09

Lobomycosis is a rare granulomatous skin disease with a high prevalence in the Amazon region. The Kaiabi Indians are an especially affected group. We studied the current epidemiologic and clinical progression of lobomycosis among the Kaiabi in Brazil, from initial case reports in 1965 through 2019. A total of 60 lobomycosis cases had been reported among the Kaiabi, and we identified 3 new cases in our review. Of 550 cases of lobomycosis ever reported worldwide, 11.5% were among the Kaiabi. We note a high incidence among female Kaiabi and a precocious onset of disease in this indigenous population. Male Kaiabi frequently are infected with the multicentric form and women more frequently exhibit the localized form. Ulcerated lesions are observed more often in the multicentric form. The prevalence among this indigenous group could be explained by genetic susceptibility and lifestyle, which exposes them to a particular agent in the habitats in which they live.

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<![CDATA[Long-term effect of the Brazilian Workers’ Food Program on the nutritional status of manufacturing workers: A population-based prospective cohort study]]> https://www.researchpad.co/article/N23375fc9-a89d-407e-9d06-75f348bd7d78

Background

The Brazilian Workers Food Program (WFP) is a public policy program of nutritional assistance to workers, with the main objective of improving nutritional conditions, which was implemented 40 years ago and serves over 21.4 million workers.

Objectives

To compare the long-term change in anthropometric indicators of the nutritional status and dietary intake between workers of manufacturing industries adherent to and non-adherent to the WFP.

Methods

A prospective cohort study, based on a combined stratified and multistage probability sampling, was carried out, with two waves with a 4-year interval. The change in body mass index (BMI), waist circumference (WC) and dietary intake at lunch by the 24-hour recall method were compared between groups with analysis of covariance.

Results

A total of 273 workers in 16 industries from an initial cohort of 1069 workers in 26 industries of the State of Rio Grande do Norte in Brazil were evaluated in the two waves. The mean age was 37±10 years and 53.1% were male, with no differences between groups in age and sex distribution. BMI increased in both groups (0.44 kg/m2 in non-WFP, p = 0.003, and 0.56 kg/m2 in WFP, p = 0.0006) and WC increased in the WFP group (1.50 cm, p = 0.0006). BMI change over time did not show statistical differences between groups (p = 0.54) but WC had a greater increase in the WFP group (difference 1.37 cm, p = 0.047). There were no differences between groups in the change over time of the dietary intake.

Conclusion

BMI and WC increased over time in manufacturing workers of industries both adherent and non-adherent to the WFP, but with a greater increase of WC in the WFP group. In order to achieve the objectives of the WFP, there will be a need for periodic evaluation and monitoring of nutritional indicators in these workers and implementation of monitoring and enforcement actions of the WFP.

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<![CDATA[Identification of NUDT15 gene variants in Amazonian Amerindians and admixed individuals from northern Brazil]]> https://www.researchpad.co/article/N0a09703b-e69a-40d3-8ae4-dfe23e56b45d

Introduction

The nudix hydrolase 15 (NUDT15) gene acts in the metabolism of thiopurine, by catabolizing its active metabolite thioguanosine triphosphate into its inactivated form, thioguanosine monophosphate. The frequency of alternative NUDT15 alleles, in particular those that cause a drastic loss of gene function, varies widely among geographically distinct populations. In the general population of northern Brazilian, high toxicity rates (65%) have been recorded in patients treated with the standard protocol for acute lymphoblastic leukemia, which involves thiopurine-based drugs. The present study characterized the molecular profile of the coding region of the NUDT15 gene in two groups, non-admixed Amerindians and admixed individuals from the Amazon region of northern Brazil.

Methods

The entire NUDT15 gene was sequenced in 64 Amerindians from 12 Amazonian groups and 82 admixed individuals from northern Brazil. The DNA was extracted using phenol-chloroform. The exome libraries were prepared using the Nextera Rapid Capture Exome (Illumina) and SureSelect Human All Exon V6 (Agilent) kits. The allelic variants were annotated in the ViVa® (Viewer of Variants) software.

Results

Four NUDT15 variants were identified: rs374594155, rs1272632214, rs147390019, andrs116855232. The variants rs1272632214 and rs116855232 were in complete linkage disequilibrium, and were assigned to the NUDT15*2 genotype. These variants had high frequencies in both our study populations in comparison with other populations catalogued in the 1000 Genomes database. We also identified the NUDT15*4 haplotype in our study populations, at frequencies similar to those reported in other populations from around the world.

Conclusion

Our findings indicate that Amerindian and admixed populations from northern Brazil have high frequencies of the NUDT15 haplotypes that alter the metabolism profile of thiopurines.

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<![CDATA[Detection of Rocio Virus SPH 34675 during Dengue Epidemics, Brazil, 2011–2013]]> https://www.researchpad.co/article/N733d798a-2ce9-4e2a-ad85-11125f123f9e

Recent seroprevalence studies in animals detected Rocio virus in regions of Brazil, indicating risk for re-emergence of this pathogen. We identified Rocio virus RNA in samples from 2 human patients for whom dengue fever was clinically suspected but ruled out by laboratory findings. Testing for infrequent flavivirus infections should expedite diagnoses.

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<![CDATA[Needlestick-Associated Rocky Mountain Spotted Fever, Brazil]]> https://www.researchpad.co/article/Nd90fca0b-4f12-4808-8785-7ed0b279465f

We report a fatal case of Rocky Mountain spotted fever (RMSF) in a man in Brazil without recent history of tick bites or environmental exposure. He received an accidental needlestick while working as a nurse. The nurse and his patient died. Both cases were confirmed as RMSF by molecular methods.

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<![CDATA[Cytogenetic data for sixteen ant species from North-eastern Amazonia with phylogenetic insights into three subfamilies]]> https://www.researchpad.co/article/N5c11beef-ba61-4138-8b81-734b1f2aa203
Abstract

Ants play essential roles in most terrestrial ecosystems and may be considered pests for agriculture and agroforestry. Recent morphological and molecular data have challenged conventional ant phylogeny and the interpretation of karyotypic variations. Existing Neotropical ant cytogenetic data focus on Atlantic rainforest species, and provide evolutionary and taxonomic insight. However, there are data for only 18 Amazonian species. In this study, we describe the karyotypes of 16 ant species belonging to 12 genera and three subfamilies, collected in the Brazilian state of Amapá, and in French Guiana. The karyotypes of six species are described for the first time, including that of the South American genus Allomerus Mayr, 1878. The karyotype of Crematogaster Lund, 1831 is also described for the first time for the New World. For other species, extant data for geographically distinct populations was compared with our own data, e.g. for the leafcutter ants Acromyrmex balzani (Emery, 1890) and Atta sexdens (Linnaeus, 1758). The information obtained for the karyotype of Dolichoderus imitator Emery, 1894 differs from extant data from the Atlantic forest, thereby highlighting the importance of population cytogenetic approaches. This study also emphasizes the need for good chromosome preparations for studying karyotype structure.

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<![CDATA[‘Don’t put your head under water’: enteric viruses in Brazilian recreational waters]]> https://www.researchpad.co/article/5ca110d4d5eed0c48456d64a

Like in many other countries, virologic analyses are not routinely performed in Brazil in monitoring water quality for recreational purposes. We surveyed current research regarding viral contamination of recreational water environments in Brazil. Among the enteric viruses studied in Brazilian recreational waters, we highlight adenoviruses, rotaviruses, enteroviruses and noroviruses. Although there has been relatively little research on outbreaks related to bathing in recreational water environments in Brazil, noroviruses and adenoviruses are the viruses that are most often related to outbreaks. Better surveillance of the occurrence of enteric viruses in water could improve the assessment of risk to human health as well as indicate the sources of contamination and thus demonstrate the importance of adequate environmental sanitation.

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<![CDATA[Behavior and abundance of Anopheles darlingi in communities living in the Colombian Amazon riverside]]> https://www.researchpad.co/article/5c8acc3ed5eed0c48498f2cc

In the past few years, relative frequencies of malaria parasite species in communities living in the Colombian Amazon riverside have changed, being Plasmodium vivax (61.4%) and Plasmodium malariae (43.8%) the most frequent. Given this epidemiological scenario, it is important to determine the species of anophelines involved in these parasites’ transmission. This study was carried out in June 2016 in two indigenous communities living close to the tributaries of the Amazon River using protected human bait. The results of this study showed a total abundance of 1,085 mosquitos, of which 99.2% corresponded to Anopheles darlingi. Additionally, only two anopheline species were found, showing low diversity in the study areas. Molecular confirmation of some individuals was then followed by evolutionary analysis by using the COI gene. Nested PCR was used for identifying the three Plasmodium species circulating in the study areas. Of the two species collected in this study, 21.0% of the An. darlingi mosquitoes were infected with P. malariae, 21.9% with P. vivax and 10.3% with Plasmodium falciparum. It exhibited exophilic and exophagic behavior in both study areas, having marked differences regarding its abundance in each community (Tipisca first sampling 49.4%, Tipisca second sampling 39.6% and Doce de Octubre 10.9%). Interestingly, An. mattogrossensis infected by P. vivax was found for the first time in Colombia (in 50% of the four females collected). Analysis of An. darlingi COI gene diversity indicated a single population maintaining a high gene flow between the study areas. The An. darlingi behavior pattern found in both communities represents a risk factor for the region’s inhabitants living/working near these sites. This highlights the need for vector control efforts such as the use of personal repellents and insecticides for use on cattle, which must be made available in order to reduce this Anopheline’s abundance.

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<![CDATA[Improved calibration estimators for the total cost of health programs and application to immunization in Brazil]]> https://www.researchpad.co/article/5c8977b1d5eed0c4847d3333

Multi-stage/level sampling designs have been widely used by survey statisticians as a means of obtaining reliable and efficient estimates at a reasonable implementation cost. This method has been particularly useful in National country-wide surveys to assess the costs of delivering public health programs, which are generally originated in different levels of service management and delivery. Unbiased and efficient estimates of costs are essential to adequately allocate resources and inform policy and planning. In recent years, the global health community has become increasingly interested in estimating the costs of immunization programs. In such programs, part of the cost correspond to vaccines and it is in most countries procured at the central level, while the rest of the costs are incurred in states, municipalities and health facilities, respectively. As such, total program cost is a result of adding these costs, and its variance should account for the relation between the totals at the different levels. An additional challenge is the missing information at the various levels. A variety of methods have been developed to compensate for this missing data. Weighting adjustments are often used to make the estimates consistent with readily-available information. For estimation of total program costs this implies adjusting the estimates at each level to comply with the characteristics of the country. In 2014, A National study to estimate the costs of the Brazilian National Immunization Program was initiated, requested by the Ministry of Health and with the support of international partners. We formulate a quick and useful way to compute the variance and deal with missing values at the various levels. Our approach involves calibrating the weights at each level using additional readily-available information such as the total number of doses administered. Taking the Brazilian immunization costing study as an example, this approach results in substantial gains in both efficiency and precision of the cost estimate.

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<![CDATA[Adult body weight trends in 27 urban populations of Brazil from 2006 to 2016: A population-based study]]> https://www.researchpad.co/article/5c897752d5eed0c4847d29e8

Objective

We aimed to estimate trends in population-level adult body weight indicators in the 26 state capitals and the Federal District of Brazil.

Methods

Self-reported weight and height data of 572,437 adults were used to estimate the mean body mass index (BMI), and the prevalence of BMI categories ranging from underweight to morbid obesity, in Brazil’s state capitals and Federal District, from 2006 to 2016, by sex. All estimates were standardized by age.

Results

From 2006 to 2016, the main findings showed that: (i) the overall mean BMI increased from 25.4 kg/m2 to 26.3 kg/m2 in men, and from 24.5 kg/m2 to 25.8 kg/m2 in women; (ii) the overall prevalence of overweight increased from 48.1% to 57.5% in men, and from 37.8% to 48.2% in women; (iii) the overall prevalence of obesity increased from 11.7% to 18.1% in men, and from 12.1% to 18.8% in women; (iv) in general, the largest increases in overweight and obesity prevalence were found in state capitals located in the north, northeast, and central-west regions of Brazil; (v) the prevalence of severe obesity surpassed the prevalence of underweight in 22 and 9 state capitals among men and women, respectively; and (vi) the mean BMI trend was stable only in Vitória state capital in men.

Conclusions

The policies for preventing and treating obesity in Brazil over the past years were not able to halt the increase in obesity prevalence either in the state capitals or the Federal District. Thus, a revision of policies is warranted. Furthermore, although policies are necessary in all state capitals, our results suggest that policies are especially necessary in the north, northeast, and central-west regions’ state capitals, where, in general, the largest increases in overweight and obesity prevalence were experienced.

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<![CDATA[Accuracy of the SD BIOLINE Dengue Duo for rapid point-of-care diagnosis of dengue]]> https://www.researchpad.co/article/5c897732d5eed0c4847d268d

Background

Rapid diagnosis tests (RDTs) are easy to carry out, provide fast results, and could potentially guide medical treatment decisions. We investigated the performance of a commercially available RDT, which simultaneously detects the non-structural 1 (NS1) dengue virus (DENV) antigen, and IgM and IgG DENV antibodies, using representative serum samples from individuals in a dengue endemic area in Salvador, Brazil.

Methodology/Principal findings

We evaluated the accuracy of the SD BIOLINE Dengue Duo RDT (Abbott, Santa Clara, USA; former Alere Inc, Waltham, USA) in a random collection of sera. Samples included acute-phase sera from 246 laboratory-confirmed dengue cases and 108 non-dengue febrile patients enrolled in a surveillance study for dengue detection, 73 healthy controls living in the same surveillance community, and 73 blood donors. RDT accuracy was blindly assessed based on the combined results for the NS1 and the IgM test components. The RDT sensitivity was 46.8% (38.6% for the NS1 component and 13.8% for the IgM component). Sensitivity was greater for samples obtained from patients with secondary DENV infections (49.8%) compared to primary infections (31.1%) (P: 0.02) and was also influenced by the result in the confirmatory dengue diagnostic test, ranging from 39.7% for samples of cases confirmed by IgM-ELISA seroconversion between paired samples to 90.4% for samples of cases confirmed by a positive NS1-ELISA. The RDT specificity was 94.4% for non-dengue febrile patients, 87.7% for the community healthy controls, and 95.9% for the blood donors.

Conclusions/Significance

The SD BIOLINE Dengue Duo RDT showed good specificities, but low sensitivity, suggesting that it may be more useful to rule in than to rule out a dengue diagnosis in dengue endemic regions.

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<![CDATA[The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births]]> https://www.researchpad.co/article/5c882414d5eed0c484639707

Background

In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. Reported microcephaly rates in other Zika-affected areas were significantly lower, suggesting alternate causes or the involvement of arboviral cofactors in exacerbating microcephaly rates.

Methods and findings

We merged data from multiple national reporting databases in Brazil to estimate exposure to 9 known or hypothesized causes of microcephaly for every pregnancy nationwide since the beginning of the ZIKV outbreak; this generated between 3.6 and 5.4 million cases (depending on analysis) over the time period 1 January 2015–23 May 2017. The association between ZIKV and microcephaly was statistically tested against models with alternative causes or with effect modifiers. We found no evidence for alternative non-ZIKV causes of the 2015–2017 microcephaly outbreak, nor that concurrent exposure to arbovirus infection or vaccination modified risk. We estimate an absolute risk of microcephaly of 40.8 (95% CI 34.2–49.3) per 10,000 births and a relative risk of 16.8 (95% CI 3.2–369.1) given ZIKV infection in the first or second trimester of pregnancy; however, because ZIKV infection rates were highly variable, most pregnant women in Brazil during the ZIKV outbreak will have been subject to lower risk levels. Statistically significant associations of ZIKV with other birth defects were also detected, but at lower relative risks than that of microcephaly (relative risk < 1.5). Our analysis was limited by missing data prior to the establishment of nationwide ZIKV surveillance, and its findings may be affected by unmeasured confounding causes of microcephaly not available in routinely collected surveillance data.

Conclusions

This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects. The finding of no alternative causes for geographic differences in microcephaly rate leads us to hypothesize that the Northeast region was disproportionately affected by this Zika outbreak, with 94% of an estimated 8.5 million total cases occurring in this region, suggesting a need for seroprevalence surveys to determine the underlying reason.

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<![CDATA[Etiology and severity of diarrheal diseases in infants at the semiarid region of Brazil: A case-control study]]> https://www.researchpad.co/article/5c6730b1d5eed0c484f37eef

Background

Diarrheal diseases are an important cause of morbidity and mortality among children in developing countries. We aimed to study the etiology and severity of diarrhea in children living in the low-income semiarid region of Brazil.

Methodology

This is a cross-sectional, age-matched case-control study of diarrhea in children aged 2–36 months from six cities in Brazil’s semiarid region. Clinical, epidemiological, and anthropometric data were matched with fecal samples collected for the identification of enteropathogens.

Results

We enrolled 1,200 children, 596 cases and 604 controls. By univariate analysis, eight enteropathogens were associated with diarrhea: Norovirus GII (OR 5.08, 95% CI 2.10, 12.30), Adenovirus (OR 3.79, 95% CI 1.41, 10.23), typical enteropathogenic Escherichia coli (tEPEC), (OR 3.28, 95% CI 1.39, 7.73), enterotoxigenic E. coli (ETEC LT and ST producing toxins), (OR 2.58, 95% CI 0.99, 6.69), rotavirus (OR 1.91, 95% CI 1.20, 3.02), shiga toxin-producing E. coli (STEC; OR 1.77, 95% CI 1.16, 2.69), enteroaggregative E. coli (EAEC), (OR 1.45, 95% CI 1.16, 1.83) and Giardia spp. (OR 1.39, 95% CI 1.05, 1.84). By logistic regression of all enteropathogens, the best predictors of diarrhea were norovirus, adenovirus, rotavirus, STEC, Giardia spp. and EAEC. A high diarrhea severity score was associated with EAEC.

Conclusions

Six enteropathogens: Norovirus, Adenovirus, Rotavirus, STEC, Giardia spp., and EAEC were associated with diarrhea in children from Brazil’s semiarid region. EAEC was associated with increased diarrhea severity.

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<![CDATA[Socioeconomic vulnerability associated to Toxoplasma gondii exposure in southern Brazil]]> https://www.researchpad.co/article/5c6f14bed5eed0c48467a799

Human toxoplasmosis, a protozoonosis caused by Toxoplasma gondii, has been described as a worldwide foodborne disease with important public health impact. Despite infection has reportedly varied due to differences in alimentary, cultural and hygienic habits and geographic region, social vulnerability influence on toxoplasmosis distribution remains to be fully established. Accordingly, the present study has aimed to assess T. gondii seroprevalence and factors associated to social vulnerability for infection in households of Ivaiporã, southern Brazil, with 33.6% population making half minimum wage or less, ranked 1,055th in population (31,816 habitants), 1,406th in per capita income (U$ 211.80 per month) and 1,021st in HDI (0.764) out of 5,570 Brazilian cities. Serum samples and epidemiological questionnaires were obtained from citizen volunteers with official City Secretary of Health assistance in 2015 and 2016. In overall, serosurvey has revealed 526/715 (73.57%) positive samples for anti-T. gondii antibodies by Indirect Fluorescent Antibody Test. Logistic regression has shown a significant increase associated to adults (p = 0.021) and elderly (p = 0.014) people, illiterates (p = 0.025), unemployment (p <0.001) and lack of household water tank (p = 0.039). On the other hand, sex (male or female), living area (urban or rural), yard hygiene, meat ingestion, sand or land contact, owning pets (dog, cat or both) were not significant variables of positivity for anti-T. gondii antibodies in the surveyed population. Although no significant spatial cluster was found, high intensity areas of seropositive individuals were located in the Kernel map where the suburban neighborhoods are located. In conclusion, socioeconomic vulnerability determinants may be associated to Toxoplasma gondii exposure. The increased risk due to illiteracy, adult or elderly age, unemployment and lack of household water tank were confirmed by multivariate analysis and the influence of low family income for seropositivity by the spatial analysis.

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<![CDATA[Yellow fever virus is susceptible to sofosbuvir both in vitro and in vivo]]> https://www.researchpad.co/article/5c5b52b6d5eed0c4842bcec1

Yellow fever virus (YFV) is a member of the Flaviviridae family. In Brazil, yellow fever (YF) cases have increased dramatically in sylvatic areas neighboring urban zones in the last few years. Because of the high lethality rates associated with infection and absence of any antiviral treatments, it is essential to identify therapeutic options to respond to YFV outbreaks. Repurposing of clinically approved drugs represents the fastest alternative to discover antivirals for public health emergencies. Other Flaviviruses, such as Zika (ZIKV) and dengue (DENV) viruses, are susceptible to sofosbuvir, a clinically approved drug against hepatitis C virus (HCV). Our data showed that sofosbuvir docks onto YFV RNA polymerase using conserved amino acid residues for nucleotide binding. This drug inhibited the replication of both vaccine and wild-type strains of YFV on human hepatoma cells, with EC50 values around 5 μM. Sofosbuvir protected YFV-infected neonatal Swiss mice and adult type I interferon receptor knockout mice (A129-/-) from mortality and weight loss. Because of its safety profile in humans and significant antiviral effects in vitro and in mice, Sofosbuvir may represent a novel therapeutic option for the treatment of YF. Key-words: Yellow fever virus; Yellow fever, antiviral; sofosbuvir

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<![CDATA[Patterns of Internet and smartphone use by parents of children with chronic kidney disease]]> https://www.researchpad.co/article/5c6c7597d5eed0c4843cfede

Background

Smartphones have become a part of universal technology by combining mobile and handheld functions, enabling expanded access to health information sources available on the Internet.

The purpose of this study was to describe the pattern of smartphones and Internet use to search for health information by parents of children with chronic kidney disease (CKD).

Methods

In a cross-sectional study, a questionnaire was applied to 111 parents of patients in a Brazilian pediatric nephrology center. Descriptive assessments were performed on Internet use patterns, and associative analyses were made of the influence of the smartphone use pattern on the search for health information.

Results

Of the 111 participants, 91% (101/111) accessed the Internet, 88% (89/101) searched for health information, and 90% (80/89) searched for CKD information. Smartphones were the most commonly used devices to access the Internet. There was no significant difference between age groups, schooling levels, places of residence and smartphone use to search information about CKD. Physicians continue to be primary sources of information (87%, 88/101), but now they share space with the Internet, which surpassed traditional sources such as books and other health professionals. There seems to be some discomfort on the part of the parents in admitting their research habit to the physician, considering that 65% (52/80) said they did not discuss the fact that they had looked for information on the Internet with their doctor. Obtaining more information about the disease and gaining knowledge regarding its complications were the main reasons that led to performing a search on the Internet, whose results were considered useful by 93% (74/80).

Conclusion

Parents of children with CKD have been using the Internet largely through smartphones to research about CKD, irrespective of age, schooling and place of residence. Given its wide use, the Internet can be an important vehicle for health education and contribute to providing the support needed by parents and patients to cope with the disease.

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<![CDATA[C-shaped canals in first and second mandibular molars from Brazilian individuals: A prevalence study using cone-beam computed tomography]]> https://www.researchpad.co/article/5c6dc9d2d5eed0c48452a238

Introduction

The study aimed to evaluate, through in vivo tomographic analysis, the prevalence of C-shaped canals in mandibular first and second molars of Brazilian individuals, analyzing its frequency by thirds of the roots, and in contralateral teeth.

Methods

Images of 801 mandibular molars (379 first molars and 422 second molars) from 334 Brazilian individuals (142 men and 192 women) were identified through 1544 cone beam computed tomography (CBCT) exams, obtained from a private oral radiologic clinic. The cross-sectional configurations were analyzed to determine the frequency of C-shaped canals at three different axial levels and classified in categories by three experienced endodontists independently.

Results

The incidence of C-shaped canals was 181 (23%). Considering the type of tooth, 91 (24.01%) were identified in the first molars, and 90 (21.32%) were found in the second molars. The incidence was significantly higher in female individuals (P < 0.05) for both first and second molars. The most common C-shaped canal configurations were: C1 (89.01% for first molars and 90% second molars), followed by C2 (8.79% for first molars and 6.66% for second molars) and C4 (2.19% for the first molars and 3.33% for the second molars). Bilateral C-shaped canals were significantly higher than unilateral for both first and second molars (P < 0.01).

Conclusions

The prevalence of C-shaped canals in mandibular molars of the Brazilian individuals was higher than previously reported for both mandibular first (24.01%) and second molars (21.32%). The incidence was significantly higher in female individuals and the coronal portion of the roots. The classic C-shaped format “C1” was the most frequent anatomical configuration. Furthermore, the prevalence of bilateral C-shaped canals was higher for the first molar (61.70%) and lower for the second molar (38.29%).

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