Soroepidemiologia da doença de Chagas em localidades limítrofes a áreas de risco no Oeste Potiguar

To carry out a seroepidemiological and spatial survey for Chagas Disease in the municipality of Felipe Guerra, located among municipalities with a high prevalence in the Western Mesoregion of the state of Rio Grande do Norte. 423 individuals living in Felipe Guerra / RN were included. Serology for Chagas disease was carried out, questionnaires were applied on risk indicators and knowledge about the disease and home georeferencing. A prevalence of 6.6% (28) of individuals with Chagas disease was identified. There was a predominance of individuals with low schooling, farmers, with low purchasing power and episodes of identification of triatomines in households were reported. The spatial analysis showed the proximity between the homes and the water sources, as well as the municipalities with high prevalence. Given the seroprevalence identified, there is a need to carry out seroepidemiological surveys in municipalities bordering regions characterized by high rates of Chagas disease, since surrounding locations may present similar epidemiological scenarios. Keywords: Chagas Disease. Seroepidemiologic studies. Epidemiology. Health profile.Realizou-se um inquérito soroepidemiológico e espacial para Doença de Chagas no município de Felipe Guerra, situado entre municípios com alta prevalência na Mesorregião Oeste do estado do Rio Grande do Norte. Foram incluídos 423 indivíduos residentes em Felipe Guerra/RN. Realizou-se sorologia para Doença de Chagas, aplicação de questionários sobre indicadores de risco e conhecimento sobre a doença e georreferenciamento domiciliar. Identificou-se uma prevalência de 6,6% (28) de indivíduos acometidos pela condição chagásica. Predominaram indivíduos com baixa escolaridade, agricultores, de reduzido poder aquisitivo e foram referidos episódios de identificação de triatomíneos nos domicílios. A análise espacial mostrou a proximidade entre as residências e as fontes de água, bem como dos municípios de alta prevalência. Dada a soroprevalência identificada, estabelece-se a necessidade para a realização de inquéritos soroepidemiológicos em municípios limítrofes a regiões caracterizadas por elevados índices de Doença de Chagas, uma vez que localidades circunvizinhas podem apresentar cenários epidemiológicos semelhantes. Palavras-chave: Doença de Chagas. Estudos soroepidemiológicos. Epidemiologia. Perfil de saúde

Esophagogastric junction outflow obstruction successfully treated with laparoscopic Heller myotomy and Dor fundoplication : first case report in the literature

BACKGROUND Esophagogastric junction outflow obstruction (EGJOO) is a rare syndrome, characterized by an elevation of the integrated relaxation pressure of the lower esophageal sphincter, not accompanied by alterations in esophageal motility that may lead to the criteria for achalasia. We were unable to find any prior report of the combination of Heller myotomy with anterior partial fundoplication (Dor) as the treatment for EGJOO. We herein report a case of EGJOO treated with laparoscopic Heller myotomy combined with Dor fundoplication. CASE SUMMARY A 26-year-old man presented with a 3-year history of solid dysphagia and a 30-kg weight loss. He was treated with oral nifedipine, isosorbide, and omeprazole, without resolution of symptoms. An upper gastrointestinal series (barium swallow) revealed a “bird’s beak” sign. Esophagogastroduodenoscopy was positive for Los Angeles grade A peptic esophagitis. High-resolution esophageal manometry was compatible with EGJOO. Esophageal pH monitoring showed pathological acid reflux both in orthostatic and decubitus position. An 8-cm laparoscopic Heller myotomy combined with an anterior 220° Dor fundoplication was performed. Solid diet was introduced on postoperative day 2, and the patient was discharged home the same day. At 17-mo follow-up, he reported no symptoms. Barium swallow was compatible with complete radiologic resolution. Both esophageal manometry and upper endoscopy showed normal findings 9 mo after the operation. CONCLUSION Surgical treatment with Heller myotomy and Dor fundoplication is a potential treatment option for EGJOO refractory to medical treatment

Efficacy of sertraline against Trypanosoma cruzi: an in vitro and in silico study

Abstract Background Drug repurposing has been an interesting and cost-effective approach, especially for neglected diseases, such as Chagas disease. Methods In this work, we studied the activity of the antidepressant drug sertraline against Trypanosoma cruzi trypomastigotes and intracellular amastigotes of the Y and Tulahuen strains, and investigated its action mode using cell biology and in silico approaches. Results Sertraline demonstrated in vitro efficacy against intracellular amastigotes of both T. cruzi strains inside different host cells, including cardiomyocytes, with IC50 values between 1 to 10 μM, and activity against bloodstream trypomastigotes, with IC50 of 14 μM. Considering the mammalian cytotoxicity, the drug resulted in a selectivity index of 17.8. Sertraline induced a change in the mitochondrial integrity of T. cruzi, resulting in a decrease in ATP levels, but not affecting reactive oxygen levels or plasma membrane permeability. In silico approaches using chemogenomic target fishing, homology modeling and molecular docking suggested the enzyme isocitrate dehydrogenase 2 of T. cruzi (TcIDH2) as a potential target for sertraline. Conclusions The present study demonstrated that sertraline had a lethal effect on different forms and strains of T. cruzi, by affecting the bioenergetic metabolism of the parasite. These findings provide a starting point for future experimental assays and may contribute to the development of new compounds

Professores e Alunos: o engendramento da violência da escola

The school violence engendering is partially analyzed, considering the violence production in the school environment. This is a bibliographic research with quantitative and qualitative approach. Sources: 77 theses and 15 dissertations carried out in Brazil (2007 to 2012). Data collection and organization: Content Analysis. Main reference: Bernard Charlot and Pierre Bourdieu. Results: the sources showed that Brazilian teachers participate effectively in the school violence engendering, contributing to violence production in the school environment. The students are the main victims. The teacher is less affected by physical and verbal violence. The symbolic power is the most perpetrated by the teacher against the student. The school also plays a major role in it.Analisa-se o engendramento de uma face da violência da escola, tendo em vista a produção da violência em espaço escolar. Pesquisa bibliográfica quanti-qualitativa. Fontes: 77 dissertações e 15 teses produzidas no Brasil (2007 a 2012). Coleta e organização dos dados: Análise de Conteúdo. Fundamentação base: Bernard Charlot e Pierre Bourdieu. Resultados: as fontes apontaram que professores brasileiros são protagonistas na constituição da violência da escola, contribuindo para a produção da violência em espaço escolar. Os alunos são as principais vítimas dessa violência. O professor sofre menos violência física e verbal do que o aluno. A violência simbólica é a mais usada pelo professor contra o aluno. A escola também usa desse expediente