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The COVID-19 pandemic, caused by the highly transmissible SARS-CoV-2 virus, has overloaded health systems in many contexts Conant and Wolfe (2008). Brazil has experienced more than 345,000 deaths, as of April/2021 Conant and Wolfe (2008), with dire consequences for the country's public and private health systems. This paper aims to estimate the synchronization graph between the cities' contagion waves from public COVID-19 data records. For this purpose, the Motif-Synchronization method Magwire et al. (2011) was applied to publicly available COVID-19 data records to determine the sequential relationship of occurrence of the waves among Bahia's cities. We find synchronization between waves of infection between cities, suggesting diffusion of the disease in Bahia and a potential role for inter-city transportation Saba et al. (2018), Saba et al. (2014), Araújo et al. (2018) in the dynamics of this phenomenon McKee and Stuckler (2020), Chinazzi et al. (2020), Tizzoni et al. (2014). Our main contribution lies in the use of the Motif-Synchronization method applied to COVID-19 data records, with the results revealing a pattern of disease spread that extends beyond city boundaries.

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AIM: This study aimed to assess an ex situ model of biofilm-associated wounds on porcine skin for the study of Staphylococcus aureus and Pseudomonas aeruginosa biofilms in a host-like environment, after 48 to 120 h of incubation. MATERIAL AND RESULTS: Ex situ and in vitro biofilms were comparatively analysed. Overall, CFU-counts and matrix quantification yielded significantly (P < 0·05) higher results for ex situ than in vitro biofilms. Confocal microscopy revealed greater (P < 0·05) biomass and thickness at 48-72 h and greater (P < 0·05) robustness at 72 h of growth. S. aureus ex situ biofilms produced less (P < 0·05) siderophore and proteases than in vitro biofilms, while P. aeruginosa ex situ biofilms produced more (P < 0·05) siderophores and less proteases than in vitro biofilms. CONCLUSIONS: Biofilms grown ex situ present a greater amount of bacterial cells and polymeric matrix than their in vitro counterparts, reaching maturity at 72 h of growth. Moreover the production of virulence factors differs between ex situ and in vitro biofilms. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings emphasize the importance of using ex situ biofilm models, once they mimic in vivo conditions. The use of these models brings perspectives for the pursuit of therapeutic alternatives, as tests may be performed in a host-like environment.

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Cylindrospermopsis raciborskii (Woloszynska) is a photosynthetic cyanobacterium that can produce cytotoxic (cylindrospermopsin) and neurotoxic cyanotoxins (saxitoxins). In Brazil the strains of C. raciborskii are reported to produce only saxitoxins (STX) and their effect on fish parasites has not been tested to date. The fish Poecilia vivipara Bloch and Schneider is a common host for the trematode Pygidiopsis macrostomum Travassos off the coast of Rio de Janeiro, and this fish-parasite interaction is a model for behavioural and ecotoxicological studies. The aim of this work was to evaluate the motility of metacercariae of P. macrostomum from P. vivipara exposed to 40 mg l-1 and 400 mg l-1 of crude lyophilized extract of the cyanobacterium C. raciborskii (CYRF-01) for 48 h. The fish were separated into groups of ten individuals and, after exposure, five fish from each group were dissected for counting and checking the motility of metacercariae. The other five fish were dissected after 48 h in clean water. The detection and quantification of STX in the solutions of cyanobacteria, and the gills and guts of fish, were performed by an enzyme-linked immunosorbent assay. The crude extract of C. raciborskii caused temporary paralysis in metacercariae of P. macrostomum after exposure of fish to both concentrations, and the motility recovered after the fish were kept for 48 h in clean water. STX was detected in the guts and gills of all fish analysed, suggesting that this toxin is involved in the paralysis of metacercariae. This is the first report on the action of neurotoxins in metacercariae of fish.

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INTRODUCTION: Obturator hernia is a rare condition accounting for less than 1% of all intra abdominal hernias. Clinical diagnosis is considered a challenge for most surgeons. It usually appears as an intestinal obstruction. Confirmation of diagnosis is carried out by means of imaging or during surgery. CASE REPORT: An 85-year-old female patient, with symptoms of intestinal obstruction of 24h duration was admitted to the emergency room of Unimed Hospital - Belo Horizonte. Abdominal computed tomography (CT) demonstrated a herniation of the small bowel through the right obturator canal with an intestinal distension proximally. At laparotomy, the presence of a right obturator hernia with an ileal strangulation was confirmed. Segmental enterectomy with primary anastomosis and herniorrhaphy for the closure of the obturator foramen were performed. DISCUSSION: Obturator hernias typically affect women, elderly, emaciated and multiparous. Symptoms are non-specific and associated with an intestinal obstruction. Howship-Romberg sign, considered pathognomonic, is generally absent. Abdominal CT scan can aid in pre-operative diagnosis and the treatment is surgical. CONCLUSION: Early diagnosis and surgical treatment are imperative in obturator hernias due to the high morbidity and mortality that occur in cases where the intervention is delayed.

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The objective of this study was to investigate renal function in a cohort of 98 patients with sickle cell disease (SCD) followed up at a tertiary hospital in Brazil. Clinical and laboratory characteristics at the time of the most recent medical examination were analyzed. Renal function was evaluated by the estimation of glomerular filtration rate (GFR) by the criteria of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). We compared patients with normal GFR to patients with decreased GFR (<60 mL·min(-1)·(1.73 m(2))(-1)) and hyperfiltration (>120 mL·min(-1)·(1.73 m(2))(-1)). Comparison between patients according to the use of hydroxyurea and comparison of clinical and laboratory parameters according to GFR were also carried out. Average patient age was 33.8 ± 13.3 years (range 19-67 years), and 57 (58.1%) patients were females. The comparison of patients according to GFR showed that patients with decreased GFR (<60 mL·min(-1)·(1.73 m(2))(-1)) were older, had lower levels of hematocrit, hemoglobin and platelets and higher levels of urea and creatinine. Independent risk factors for decreased GFR were advanced age (OR = 21.6, P < 0.0001) and anemia (OR = 39.6, P < 0.0001). Patients with glomerular hyperfiltration tended to be younger, had higher levels of hematocrit, hemoglobin and platelets and lower levels of urea and creatinine, with less frequent urinary abnormalities. Hydroxyurea, at the dosage of 500-1000 mg/day, was being administered to 28.5% of the patients, and there was no significant difference regarding renal function between the two groups. Further studies are required to establish the best therapeutic approach to renal abnormalities in SCD.

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OBJECTIVE: To assess the rate of comorbidities and the functional impairment associated with the social anxiety disorder (SAD), with an emphasis on the so-called subthreshold clinical signs and symptoms. METHOD: Psychiatric comorbidities and psychosocial functioning were evaluated in 355 volunteers (college students) who had been diagnosed as SAD (n = 141), Subthreshold SAD (n = 92) or Controls (n = 122). RESULTS: The rate of comorbidities was 71.6% in the SAD group and 50% in subjects with Subthreshold SAD, both significantly greater than Controls (28.7%). Concerning psychosocial functioning, the SAD group had higher impairment than the other two groups in all domains evaluated, and subjects with Subthreshold SAD presented intermediate values. CONCLUSION: The rates of psychiatric comorbidities and the impairment of psychosocial functioning increase progressively along the spectrum of social anxiety. The fact that Subthreshold SAD causes considerable disability and suffering in comparison with control subjects justifies a review of the validity of the diagnostic criteria.

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The seston of the small, shallow, and tropical lake Monte Alegre was tested for quantity and quality for cladocerans by growth bioassays, which were carried out in spring (Daphnia gessneri and Moina micrura), summer (D. gessneri, M. micrura, Ceriodaphnia cornuta, and Simocephalus mixtus), and winter (D. gessneri and D. ambigua). Cohorts of newborns originating from ovigerous females collected in the lake or from laboratory cultures were submitted, at a room temperature of 23 degrees C to the following treatments: (1) the chlorophytes Ankistrodesmus falcatus and/or Scenedesmus spinosus; (2) lake seston; and (3) lake seston + chlorophytes. Growth rate, clutch size, and fecundity were evaluated. Seston alone was not the best food for promoting cladoceran growth. There were seasonal differences in food quantity and quality with spring and summer seston being better for growth than that of the winter. Adding chlorophytes to the seston increased clutch size and fecundity for most species in summer and winter, but not in spring. Energy limitation seems to be the most important factor influencing cladoceran growth in summer and especially in winter.

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. (O séston do lago Monte Alegre, um lago tropical pequeno e raso, foi testado em relação à quantidade e qualidade para os cladóceros por meio de experimentos de crescimento realizados na primavera (Daphnia gessneri e Moina micrura), no verão (D. gessneri, M. micrura, Ceriodaphnia cornuta e Simocephalus mixtus) e no inverno (D. gessneri e D. ambigua). Coortes de recém-nascidos oriundos de fêmeas ovígeras coletadas no lago ou de culturas de laboratório foram submetidas à temperatura de 23ºC aos seguintes tratamentos: (1) as clorofíceas Ankistrodesmus falcatus e/ou Scenedesmus spinosus, (2) séston do lago e (3) séston + clorofíceas. Foram avaliados a taxa de crescimento, o tamanho da ninhada e a fecundidade. O séston sozinho não foi o melhor alimento para promover o crescimento dos cladóceros. Houve diferenças sazonais quanto à quantidade e à qualidade do alimento, sendo o séston da primavera e o do verão melhores para promover o crescimento que o do inverno. A adição de clorofíceas ao séston aumentou o tamanho da ninhada e a fecundidade para a maioria das espécies no verão e no inverno, mas não na primavera. A limitação de energia parece ser o fator mais importante para o crescimento de cladóceros no verão e, especialmente, no inverno.

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INTRODUCTION: Asthma, as a multifatorial disease, with high prevalence and frequent recurrence, attack people, independently of age, sex and geographical area. Because of lack of consensus about the definition of asthma, many questionnaires have been developed to standardize epidemiological criteria of suspicion and diagnosis. Among them, the European Community Respiratory Health Survey (ECRHS) is an important tool for prevalence studies on adults aged from 20 to 44 years old, that represented a methodological improvement of epidemiological surveys, turning them comparable about time and place. The objectives of this article are to comment the evolution of asthma concepts and its repercussion on epidemiological surveys, as well as to chronicle the tools used on these surveys, emphasizing the importance of ECRHS and presenting epidemiological data of asthma on 351 universitary hospital servers at Recife City -- Pernambuco -- Brazil.

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AIM: To evaluate the efficiency of buspirone chlorhydrate in a group of patients who all presented sporadic or family primary cerebellar ataxia. PATIENTS AND METHODS: In this open label study of addiction, the following eligibility criteria were used: 1) Clinical: primary cerebellar ataxia; 2) Radiological: nuclear magnetic resonance showing pure cerebellar cortical atrophy; 3) Age: over 20 years old. Any patient with a history of food deficiency, alcoholism, neoplasic, infectious, degenerative and vascular diseases was excluded from taking part in the study. Of the 20 patients examined initially, 18 met the eligibility criteria, and of these 11 reached the end of the study, although drop outs were not related to treatment. Four patients had been diagnosed as suffering from cerebellar cortical atrophy of the sporadic type and the remaining seven had a family type cerebellar cortical atrophy. All the patients were thoroughly evaluated and received scores both at the beginning and at the end of the study, according to the modified Massaquoi scale for clinical evaluation of cerebellar functioning, and the Hamilton Anxiety Scale. They were all administered buspirone chlorhydrate in doses that progressively increased by 5 mg/month over a total period of 12 months. The maximum dose was considered to be 1 mg/kg body weight, without exceeding 60 mg. The increase in dosage was stopped if it was not well tolerated by the patient

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Objetivo. Evaluar la eficacia del clorhidrato de buspirona en un grupo de pacientes que se caracteriza por presentar una ataxia cerebelar primaria de tipo esporádico o familiar. Pacientes y métodos. Se trata de un estudio prospectivo de adición (open label study).Se utilizaron los siguientes criterios de inclusión: 1) Clínico: ataxia cerebelar primaria; 2) Radiológico: resonancia magnética que mostró una atrofia cortical cerebelar pura; 3) Edad: por encima de los 20 años. Se excluyeron del estudio todos los pacientes con historial de deficiencia alimentaria, alcoholismo, enfermedades neoplásicas, infecciosas, degenerativas y vasculares. De los 20 pacientes examinados inicialmente, 18 cumplieron los criterios de inclusión. De éstos, tan sólo 11 llegaron hasta el final del estudio, sin que los abandonos estuvieran relacionados con el tratamiento. Cuatro pacientes tenían un diagnóstico de atrofia cortical cerebelar de tipo esporádica, y siete, de atrofia cortical cerebelar de tipo familiar. Todos los pacientes se evaluaron de manera minuciosa y recibieron puntuaciones tanto al inicio como al final del estudio, según la escala de Massaquoi modificada para la evaluación clínica de la función cerebelar y según la escala de Hamilton para la ansiedad. A todos los pacientes se les administró clorhidrato de buspirona, con un aumento progresivo de la dosis de 5 mg/mes, durante un total de 12 meses. La dosis máxima considerada fue de 1 mg/kg de peso, sin sobrepasar los 60 mg. La progresión de la dosis se interrumpió cuando el paciente no la toleró (AU)

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The objective of this study was to evaluate the effectiveness of synchronization of follicular wave emergence using steroid hormone treatments in Nelore cows. Donors were placed into three groups. Those that were between days 9 and 12 of their cycle (estrus=day 0) formed the TI group (n=60), whilst those that were in any other stages of their estrus cycle constituted groups TII (n=60) and TIII (n=60). TI donors were submitted to a standard protocol of superovulation, however, TII and TIII donors were treated with the Syncro-Mate-B (SMB) or Controlled Internal Drug Releasing Device (CIDR-B) programs, respectively. Superovulation was induced with p-FSH, divided into eight decreasing doses at intervals of 12h. The donors received cloprostenol 48h after the beginning of the treatment and progestagens were removed 12h later. Artificial inseminations (AI) were done at 12 and 22h after the initiation of estrus and the embryo collections were done 7 days after AI. In the donors which displayed behavioral estrus, mean (+/-S.E.M.) total ova and viable (transferable) embryos were 15.8+/-1.4 and 8.3+/-1.0 (TI, n=56); 15.6+/-1.3 and 8.9+/-1.0 (TII, n=56); 17.3+/-1.0 and 9.9+/-0.9 (TIII, n=57), respectively, with no significant difference (P > or =0.05) among groups. In those animals that did not displayed behavioral estrus, the mean values of total ova and viable embryos were 3.5+/-1.6 and 0.7+/-0.5 (TI, n=4); 11.5+/-3.9 and 9.0+/-4.4 (TII, n=4); 8.7+/-5.0 and 5.0+/-2.9 (TIII, n=3), respectively, with no significant differences (P > or =0.05) among groups. Pregnancy rates of 62.2% (TI, n=235); 66.4% (TII, n=284) and 65.1% (TIII, n=244) were obtained with embryos transferred from these collections and did not differ significantly (P > or =0.05) among groups. It was concluded that the synchronization of the emergence of follicular waves in Nelore donors is usable and does not harm the efficiency of embryo transfer programs. In addition, in contrast to the standard superovulation protocol, this method permits the use of a large number of donors in a short time period, at any stage of the estrus cycle, minimizing the costs of embryo transfer.

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The prevalence of HTLV-I reaches 1.8% among blood donors in Salvador, and 40% among chronic myelopathy patients in the state of Bahia, Brazil. The present study shows the epidemiological and clinical picture of patients attending the HAM/TSP Outpatient Unit at the Foundation of Neurology and Neorusurgery (FNN). 114 patients had epidemiologic data collected and 51 of these patients, who had regularly attended the HAM/TSP Unit for at least 1 year, were evaluated for signs, symptoms and disease progression. Most of the 114 patients were female (70%), of African descent, and with a mean age of 51. Sexually transmitted diseases and blood transfusion were the most common risk factors. Paraparesis with spasticity was the predominant sign (85%), bladder dysfunction occurred in 75%, intestinal dysfunction was recorded in 48%. Sensory examination was normal in 50% of the cases studied. The patients' functional status, as measured by the Kurtzke Disability Scale, during the 1 year observation period changed only in early disease. Steroid therapy with prednisone was the most commonly used treatment in this group.

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Com o objetivo de recuperar Brucella abortus do leite, utilizaram-se 14 amostras de leite in natura de fêmeas bovinas soropositivas para brucelose procedentes de sete propriedades rurais situadas nos municípios de Pedra e Venturosa - PE. As amostras de leite foram centrifugadas a 1431,04 g por trinta minutos, obtendo sobrenadante e sedimento que foram semeados em ágar brucela, contendo antibióticos e antifúngicos, isolando-se apenas uma amostra de Brucella abortus do sedimento, correspondendo a 7,14 por cento dos animais estudados. Os sedimentos obtidos da centrifugaçäo foram tratados com antibióticos e antifúngicos e inoculados em cobaias, por via intraperitoneal. Das vinte e oito cobaias inoculadas cinco (17,85 por cento) apresentaram reaçäo sorológica positiva nos testes de soroglutinaçäo rápida (SAR), soroaglutinaçäo lenta (SAL) e 2-mercaptoetanol (2-ME), demonstrando uma possível infecçäo destes animais pela Brucella abortus presente no leite, apesar do isolamento bacteriano em órgäos como baço, fígado, linfonodo, pulmöes e testículos ter sido obtido em apenas uma amostra. A pesquisa de aglutininas anti-Brucella abortus em soros de humanos observou-se que oito amostras (21,05 por cento) apresentaram reaçäo de 1:100, em pelo menos uma das provas utilizadas na detecçäo de anticorpos, sugerindo possível infecçäo dos humanos através do consumo do leite e subprodutos in natura.

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To better understand the origin of human T-cell leukemia virus type l (HTLV-l) in South America, we conducted a phylogenetic study on 27 new HTLV-ls in Brazil. These were obtained from Brazilians of various ethnic origins, such as Japanese immigrants, whites, blacks and mulattos. We amplified and sequenced proviral DNAs of a part of the long terminal repeats. Phylogenetic trees revealed that all but 6 of the new isolates were not only similar to each other but also similar to HTLV-ls of other South American countries, including those from Amerindians. However, the isolates differed from the HTLV-ls of Africa and Japan. The other six isolates were from Japanese immigrants and were phylogenetically almost identical to HTLV-ls in Japan but different from the majority of South American HTLV-ls, including the other new Brazilian HTLV-ls. These findings indicate that the recent introduction of HTLV-1 from Japan is limited to Japanese immigrants. In addition, the results do not support the prevailing hypothesis that HTLV-ls in South America were introduced by blacks who were brought from Africa as slaves. Rather, these results suggest that the majority of HTLV-1s prevailing in South America have spread from Amerindians, some of whom are likely to have possessed this human retrovirus from the beginning of their settlement in South America.

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To study the epidemiology of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Brazil, we conducted a nationwide survey between March 1994 and April 1995. Five centers from three regions of the country participated, enrolling 163 patients. Most patients came from the northeastern and southeastern regions (93.2%). Most enrollees were white women, 42.9% and 64.4%, respectively. The most common risk factors for infection included a history of venereal diseases (30.6%) and blood transfusion (21.6%). The median age at the beginning of the disease was 42 years. The main neurologic findings were spastic paraparesis, widespread brisk tendon jerks, bilateral Babinski's sign, and bladder dysfunction. Some interregional differences reached statistical significance. The ratio of females over males increased from south to north. In addition, in both southern and southeastern regions, whites prevailed, whereas in the northeast, mulattos predominated. This follows the normal distribution of the population in these regions. A significantly higher rate of venereal diseases was found in the southeast compared with the other regions studied. A history of intravenous drug use was more frequent among patients as the sample moves south. Finally, a fluctuating course of the disease was proportionally more frequent in the southern region.

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The superior vena cava obstruction is a relatively rare condition. We report the case of a 42 year old man suffering of hypertension for about fifteen years. He reported a cervical and thoracic pain for one year, that was related to a 95% of occlusion on the right coronary artery. An angioplasty has been done but the patient still related the thoracic pain. Afterwards the patient had recurrent episodes of right hemiplegia and hypertensive emergencies that have been treated with anti-hypertensive agents. A venous disease was suspected because of cyanosis in the face especially when episodes of transient ischemic attacks occurred. A venography showed obstruction of the right jugular vein near the junction with the superior vena cava. In conclusion, it was not possible to define with certainty the relationship between the two pathologies presented by the patient, even so, we call attention to the improvement of the neurological symptoms after the control of superior vena cava obstruction with the treatment.

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Infection by human T-cell lymphotrophic virus type I (HTLV-I) is associated with a myelopathy known as tropical spastic paraparesis (TSP). The prevalence of HTLV-I infection was found to be high in a pilot study in Bahia, Brazil. In the present study, among patients with myelopathy of unclear etiology, 27% (17/62) were immunoblot reactive to HTLV-I/II (serum and CSF), but none of 40 consecutive patients seen at the neurological clinic and having a well-established neurological diagnosis had detectable antibodies against those viruses (discrimination between HTLV-I and HTLV-II was not possible with the tests we used). The clinical syndrome of typical TSP with upper limb hyperreflexia was found to be a significant feature among the HTLV-I/II-seropositive patients compared to seronegative individuals. The 17 HTLV-I/II-reactive individuals had negative tests for syphilis, toxoplasmosis and schistosomiasis. TSP was also associated with female gender (P = 0.001). We conclude that TSP is strongly associated with HTLV-I/II infection in women in Bahia.

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