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Background: Dengue cases can progress to severe ant life-threating forms particularly in subsequent heterologous infections. However, recent studies had explored additional risk factors, including underlying health conditions, even in individuals without prior exposure to dengue, notably, in patients with endothelial dysfunction and chronic inflammation. This study examines the link between diabetes and the development of severe dengue disease in dengue-naive patients during the 2019 dengue outbreak in São Jose do Rio Preto, Brazil. Methodology: We enrolled 529 laboratory-confirmed dengue cases, identified through DENV RT-PCR or NS1 antigen assays in a hospital cohort of acute febrile illness. Subsequently, we investigated the presence of anti-dengue and anti-Zika IgG antibodies. Samples testing positive for Zika were excluded from the analyses. Two groups were analyzed: naïve (DV-), and dengue history (DV+). Results: Initially, presence of diabetes and kidney disease, as well as being dengue-naive, were associated with a higher frequency of severe and potentially severe clinical outcomes. Multivariate analysis identified diabetes as a risk factor, while the presence of anti-dengue antibodies was considered protective. Analysis of dengue naïve samples, highlighted diabetes as an independent risk factor to severe forms of dengue disease. In DV+ patients, no condition was highlighted as a risk factor by univariate analysis or multivariate analysis. Conclusions: We investigated and confirmed diabetes as a risk factor for severe dengue disease in individuals without prior dengue or Zika exposure. Our conclusions raise significant concerns given diabetes' ever increasing global prevalence and its potential impact on patients with or previous dengue exposure.

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OBJECTIVE: Excessive skin exposure to deleterious environmental variables results in inflammation as well as molecular and cellular impairments that compromise its functionality, aesthetic qualities, and overall well-being. The implementation of topical administration of antioxidants and other compounds as a method for preventing or reversing damage is a rational approach. Numerous phenolic compounds derived from plants have demonstrated capabilities such as scavenging free radicals and promoting tissue healing. However, the primary obstacle lies in effectively delivering these compounds to the specific place on the skin, and accurately forecasting their diffusion through the skin can assist in determining the most effective tactics. Hence, this article provides a comprehensive analysis of recent literature pertaining to the in vitro skin diffusion characteristics of plant phenolics. The aim is to gain a deeper understanding of their behaviour when present in various forms such as solutions, suspensions, and formulations. METHOD: The data on plant extracts and isolated plant phenolic compounds in vitro skin diffusion assays published over the last six years were compiled and discussed. RESULTS: Even though the gold standard Franz diffusion cell is the most commonly used in the assessment of in vitro plant phenolic skin diffusion profiles, a plethora of skin models and assay conditions are reported for a variety of compounds and extracts in different vehicles. CONCLUSION: The presence of numerous models and vehicles poses a challenge in creating correlations among the existing data on plant phenolic compounds. However, it is possible to draw some general conclusions regarding molecular, vehicle, and skin characteristics based on the gathered information.

OBJECTIF: Une exposition excessive de la peau a des variables environnementales délétères entraîne une inflammation ainsi que des déficiences moléculaires et cellulaires qui compromettent sa fonctionnalité, ses qualités esthétiques et son bien­être général. La mise en œuvre de l'administration topique d'antioxydants et d'autres composés comme méthode de prévention ou d'inversion des dommages est une approche rationnelle. De nombreux composés phénoliques dérivés de plantes ont démontré des capacités telles que l'élimination des radicaux libres et la promotion de la cicatrisation des tissus. Cependant, le principal obstacle réside dans l'administration efficace de ces composés à un endroit spécifique de la peau, et une prévision précise de leur diffusion a travers la peau peut aider à déterminer les tactiques les plus efficaces. Par conséquent, cet article fournit une analyse complète de la littérature récente concernant les caractéristiques de diffusion cutanée in vitro des composés phénoliques végétaux. L'objectif est de mieux comprendre leur comportement lorsqu'ils sont présents sous diverses formes telles que solutions, suspensions et formulations. MÉTHODES: Les données sur les extraits de plantes et les composés phénoliques végétaux isolés in vitro par diffusion cutanée, publiées au cours des six dernières années, ont été compilées et discutées. RÉSULTATS: Même si la cellule de diffusion Franz de référence est la plus couramment utilisée dans l'évaluation des profils de diffusion cutanée phénoliques végétales in vitro, une pléthore de modelés de peau et de conditions d'analyse sont rapportées pour une variété de composés et d'extraits dans différents véhicules. CONCLUSION: La présence de nombreux modèles et véhicules pose un défi dans la création de corrélations entre les données existantes sur les composés phénoliques végétaux. Cependant, il est possible de tirer des conclusions générales concernant les caractéristiques moléculaires du véhicule et de la peau sur la base des informations recueillies.

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BACKGROUND: The co-circulation of flaviviruses in tropical regions has led to the hypothesis that immunity generated by a previous dengue infection could promote severe disease outcomes in subsequent infections by heterologous serotypes. This study investigated the influence of antibodies generated by previous Zika infection on the clinical outcomes of dengue infection. METHODOLOGY/PRINCIPAL FINDINGS: We enrolled 1,043 laboratory confirmed dengue patients and investigated their prior infection to Zika or dengue. Severe forms of dengue disease were more frequent in patients with previous Zika infection, but not in those previously exposed to dengue. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that previous Zika infection may represent a risk factor for subsequent severe dengue disease, but we did not find evidence of antibody-dependent enhancement (higher viral titer or pro-inflammatory cytokine overexpression) contributing to exacerbation of the subsequent dengue infection.

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Arbovirus infections are increasingly important causes of disease, whose spectrum of neurological manifestations are not fully known. This study sought to retrospectively assess the incidence of arboviruses in cerebrospinal fluid samples of patients with neurological symptoms to inform diagnosis of central and peripheral nervous system disorders. A total of 255 cerebrospinal fluid (CSF) samples collected from January 2016 to December 2017 were tested for dengue virus (DENV 1-4), Zika virus (ZIKV), and Chikungunya virus (CHIKV) in addition to other neurotropic arboviruses of interest, using genetic and serologic assays. Of the 255 CSF samples analyzed, 3.53% (09/255) were positive for arboviruses presenting mainly as meningitis, encephalitis, and cerebrovascular events, of which ZIKV was detected in 2.74% (7/255), DENV in 0.78% (2/255), in addition to an identified ILHV infection that was described previously. All the cases were detected in adults aged 18 to 74 years old. Our findings highlight the scientific and clinical importance of neurological syndromes associated with arboviruses and demonstrate the relevance of specific laboratory methods to achieve accurate diagnoses as well as highlight the true dimension of these diseases to ultimately improve public health planning and medical case management.

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We describe the circulation of Saint Louis encephalitis virus (SLEV) in two Brazilian States during outbreaks of Dengue and Zika viruses. We detected the virus in a patient from Araraquara, State of São Paulo, and in patients and in a mosquito pool of Culex quinquefasciatus from Sinop, State of Mato Grosso. Phylogenetic analysis grouped samples from this study within genotype V, which are closely related to other strains that previously circulated in other parts of the country. Genotype V seems to have established circulation in Brazil.

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The emergence of several SARS-CoV-2 lineages presenting adaptive mutations is a matter of concern worldwide due to their potential ability to increase transmission and/or evade the immune response. While performing epidemiological and genomic surveillance of SARS-CoV-2 in samples from Porto Ferreira-São Paulo-Brazil, we identified sequences classified by pangolin as B.1.1.28 harboring Spike L452R mutation, in the RBD region. Phylogenetic analysis revealed that these sequences grouped into a monophyletic branch, with others from Brazil, mainly from the state of São Paulo. The sequences had a set of 15 clade defining amino acid mutations, of which six were in the Spike protein. A new lineage was proposed to Pango and it was accepted and designated P.4. In samples from the city of Porto Ferreira, P.4 lineage has been increasing in frequency since it was first detected in March 2021, corresponding to 34.7% of the samples sequenced in June, the second in prevalence after P.1. Also, it is circulating in 30 cities from the state of São Paulo, and it was also detected in one sample from the state of Sergipe and two from the state of Rio de Janeiro. Further studies are needed to understand whether P.4 should be considered a new threat.

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