Interleukin-17 plays a role in dental pulp inflammation mediated by zoledronic acid: a mechanism unrelated to the Th17 immune response?

Objective: To evaluate the influence of RORγT inhibition by digoxin on inflammatory changes related to interleukin-17 (IL-17) in the pulp of rats treated with zoledronate (ZOL). Methodology: Forty male Wistar rats were divided into a negative control group (NCG) treated with saline solution, a positive control group (PCG) treated with ZOL (0.20 mg/kg), and three groups treated with ZOL and co-treated with digoxin 1, 2, or 4 mg/kg (DG1, 2, and 4). After four intravenous administrations of ZOL or saline solution in a 70-day protocol, the right molars were evaluated by histomorphometry (number of blood vessels, blood vessels/µm2, cells/µm2, total blood vessel area, and average blood vessel area) and immunohistochemistry (IL-17, TNF-α, IL-6, and TGF-β). The Kruskal-Wallis/Dunn test was used for statistical analysis. Results: PCG showed an increase in total blood vessel area (p=0.008) and average blood vessel area (p=0.014), and digoxin treatment reversed these changes. DG4 showed a reduction in blood vessels/µm2 (p<0.001). In PCG odontoblasts, there was an increase in IL-17 (p=0.002) and TNF-α (p=0.002) immunostaining, and in DG4, these changes were reversed. Odontoblasts in the digoxin-treated groups also showed an increase in IL-6 immunostaining (p<0.001) and a reduction in TGF-β immunostaining (p=0.002), and all ZOL-treated groups showed an increase in IL-17 (p=0.011) and TNF-α (p=0.017) in non-odontoblasts cells. Conclusion: ZOL induces TNF-α- and IL-17-dependent vasodilation and ectasia, and the classical Th17 response activation pathway does not seem to participate in this process

Caracterização epidemiológica da Leishmaniose Tegumentar Americana no município de Jequié-Bahia

Objetivou-se com este estudo analisar o perfil epidemiológico dos casos de Leishmaniose Tegumentar Americana (LTA) notificados no município de Jequié, inserido na mesorregião do centro sul baiano, no período de 2010 a 2020. Trata-se de um estudo epidemiológico transversal, descritivo e de abordagem quantitativa, cujos dados foram coletados do Sistema de Informação de Agravos de Notificação, utilizando-se das varáveis: faixa etária, sexo, raça/cor, tipo de entrada, forma clínica, classificação epidemiológica, critério de confirmação e evolução do caso. Posteriormente, os dados foram analisados por meio de estatística descritiva. Foram notificados 1.661 casos de LTA durante o período de estudo, com maior frequência observada em 2012 (16,20%), e menor nos anos de 2019 e 2020, ambos com 0,72%. Os indivíduos mais acometidos foram do sexo masculino (66,65%), entre 20 a 39 anos (27,63%) e da cor/raça parda (51,29%). A forma cutânea foi a mais incidente (89,89%) e 87,84% dos casos notificados foram novos, todos de caráter importado. Além disso, a confirmação foi realizada, predominantemente, através do critério clínico-laboratorial (67,49%), com evolução para cura em 80,98% dos casos. Os dados deste estudo estão em consonância com a literatura vigente, tendo relevância local para o planejamento e à implementação de medidas em saúde pelas autoridades competentes. Contudo, novos estudos devem ser realizados de modo a elucidar as lacunas sobre a doença ainda existentes

Hope and trust in times of Zika: the views of caregivers and healthcare workers at the forefront of the epidemic in Brazil.

This article investigates how hope and trust played out for two groups at the forefront of the Zika epidemic: caregivers of children with congenital Zika syndrome and healthcare workers. We conducted 76 in-depth interviews with members of both groups to examine hope and trust in clinical settings, as well as trust in public institutions, in the health system and in the government of Brazil. During and after the Zika epidemic, hope and trust were important to manage uncertainty and risk, given the lack of scientific evidence about the neurological consequences of Zika virus infection. The capacity of healthcare workers and caregivers to trust and to co-create hope seems to have allowed relationships to develop that cushioned social impacts, reinforced adherence to therapeutics and enabled information flow. Hope facilitated parents to trust healthcare workers and interventions. Hope and trust appeared to be central in the establishment of support networks for caregivers. At the same time, mistrust in the government and state institutions may have allowed rumours and alternative explanations about Zika to spread. It may also have strengthened activism in mother's associations, which seemed to have both positive and negative implications for healthcare service delivery. The findings also point to distrust in international health actors and global health agenda, which can impact community engagement in future outbreak responses in Brazil and other countries in Latin America

Stigmas of congenital Zika syndrome: family perspectives.

This article uses a socio-anthropological framework to explore the stigmas around interactions with children born with congenital Zika syndrome caused by the Zika virus epidemic in two Brazilian municipalities. Semi-structured interviews were conducted with parents and other relatives. We reflected on the search for meaning when having a baby with unexpected body marks, the moral suffering, the societal ableism, the burden of care, and the need for support networks. We concluded that public policies, especially social policies (health, education, and social assistance), are essential for compensatory mechanisms, recognition, and social inclusion of these children and their families

Social and economic impacts of congenital Zika syndrome in Brazil: Study protocol and rationale for a mixed-methods study

Global concern broke out in late 2015 as thousands of children in Brazil were born with microcephaly, which was quickly linked to congenital infection with Zika virus (ZIKV). ZIKV is now known to cause a wider spectrum of severe adverse outcomes—congenital Zika syndrome (CZS)—and also milder impairments. This study aimed to explore the social and economic impacts of CZS in Brazil. Data was collected through mixed methods across two settings: Recife City and Jaboatão dos Guararapes in Pernambuco State (the epicentre of the epidemic), and the city of Rio de Janeiro (where reports of ZIKV infection and CZS were less frequent). Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. In-depth qualitative interviews were conducted with: mothers and other carers of children with CZS (approximately 30 per setting), pregnant women (10-12 per setting), men and women of child-bearing age (16-20 per setting), and health professionals (10-12 per setting). Thematic analysis was undertaken independently by researchers from at least two research settings, and these were shared for feedback. A case-control study was undertaken to quantitatively explore social and economic differences between caregivers of a child with CZS (cases) and caregivers with an unaffected child (controls). We aimed to recruit 100 cases and 100 controls per setting, from existing studies. The primary caregiver, usually the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, stress, social support, family quality of life, health care and social service use, and costs incurred by families. Multivariable logistic regression analyses were used to compare outcomes for cases and controls. Costs incurred as a result of CZS were estimated from the perspective of the health system, families and society. Modelling was undertaken to estimate the total economic burden of CZS from those three perspectives

Incentivo ao aleitamento materno na atenção primaria a saúde / Encouragement of breastfeeding in primary health care

Além de todos os atributos que a atenção primária a saúde tem, um dos seus objetivos é incentivar a prática do aleitamento. Para isso, deve ser introduzida, juntamente a prática correta da amamentação, todas as crenças e culturas que as mães possuem, respeitando suas individualidades. Dessa forma, através de um domínio prático e teórico, é de extrema importância a realização de ações sociais a fim de gerar um estímulo às nutrizes, com o uso de uma boa comunicação e medidas de promoção ao aleitamento mais efetivo. Nesse contexto, o objetivo desse trabalho foi incentivar o aleitamento materno através da realização de uma ação de promoção e apoio ao aleitamento, orientando as gestantes assistidas na USF São José – João Pessoa/PB, quanto à realização de uma amamentação com técnica adequada, pega e posição correta, informá-las quanto aos cuidados com os mamilos, assim como a importância do aleitamento materno para seu bebê, diretamente na consulta pré-natal. Além disso, foi elaborada e entregue nas consultas uma cartilha explicativa considerando todos os benefícios para o binômio mãe-filho, para que elas coloquem em prática quando seus bebês nascerem.

Cartografia e diplomacia: usos geopolíticos da informação toponímica (1750-1850)

O artigo explora dimensões geopolíticas da toponímia, registradas em documentos cartográficos, desde as reformas empreendidas pelo consulado pombalino em meados do século XVIII, até às primeiras décadas do século XIX, em meio ao processo de afirmação do Estado imperial pós-colonial.This paper explores the geopolitical dimensions of toponymy as registered in cartographic documents dating from the reforms pushed through by the consulate of Marquis of Pombal in the mid 18th century to the early decades of the 19th century, as the post-colonial imperial State established itself

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

A relação dos fármacos agonistas de receptores GLP-1 e a proteção de doença renal para pacientes com Diabetes Mellitus

A diabetes mellitus compreende a incapacidade do organismo de desempenhar a função fisiológica da insulina, ocasionando uma grande carga de doenças, incluindo doença renal ou renal crônica e cardiovasculares. Os agonistas do receptor de GLP-1 são empregados em pacientes com diabetes tipo 2 como terapias de redução da glicose diversos à saúde destes pacientes. O objetivo deste estudo foi analisar a forma de ação dos agonistas de receptores GLP-1 como um fator de proteção à patologia renal crônica, em indivíduos portadores de diabetes mellitus do tipo 2, por meio de uma revisão bibliográfica sistemática. Os dados publicados demonstram que que agonistas do receptor GLP-1 reduzem a morte e incidência de doença renal terminal ou de insuficiência renal. Adicionalmente estes fármacos podem bloquear os mecanismos envolvidos em doenças renais, além de amenizar o estresse oxidativo e apoptose celular no rim. As terapias utilizadas com o uso de agonistas GLP-1 têm se mostrado agentes redutores da glicose e eficazes para pacientes com diabetes mellitus tipo 2, sendo recomendadas por instituições americanas e européias