Coinfecção bacteriana em indivíduos com Covid-19: revisão bibliográfica / Bacterial coinfection in individuals with Covid-19: a literature review

Os primeiros casos de Coranavírus foram relados em 2019, na China, devido a sua alta taxa de transmissão a infeccção espalhou-se rapidamente para outros países. A falta de conhecimento no manejo clínico da doença, levou ao uso indiscriminado de antibióticos para o tratamento, resultando em coinfecções bacterianas. O objetivo da pesquisa foi investigar a influência da coinfecção bacteriana sobre o prognóstico de pacientes com COVID-19. A metodologia utilizada foi uma revisão integrativa lda literatura realizada nas bases de dados do Medline (através do PUBMED)

LABORATORY DIAGNOSIS AND CLINICAL SIGNS OF CANINE VISCERAL LEISHMANIASIS IN DOGS EXAMINED AT THE CENTER FOR ZOONOSIS CONTROL IN CAMPO GRANDE – MS, BRAZIL

Visceral leishmaniasis is a type of zoonosis caused by several Leishmania species endemic to tropical, subtropical, and Mediterranean climate regions. Dogs are the primary source of infection in urban areas and can be symptomatic or asymptomatic. This study focused on the observation of clinical signs of leishmaniasis in dogs in Campo Grande, Mato Grosso do Sul, Brazil. Samples from affected animals were analyzed using indirect fluorescent antibody (IFA) tests, an enzyme-linked immunosorbent assay (ELISA), and polymerase chain reaction (PCR) assays to determine the optimal diagnostic tool for use on animals that present clinical symptoms. A predominance of clinical symptoms affecting the integumentary system was observed, and splenomegaly and hepatomegaly were the most important pathological signs. Among the diagnostic tests, the greatest agreement was seen between ELISA and IFA, followed by ELISA and PCR, and finally IFA and PCR. PCR diagnostic results showed the greatest extent of correlation with clinical signs, followed by ELISA and then IFA. When choosing a diagnostic method, veterinarians should consider the clinical signs and health status of the patient

Investigation of Anaplasma marginale, Babesia bovis, Babesia bigemina and Trypanosoma vivax in the brain and spleen of dairy cows of Rio Grande do Sul

Cattle tick fever and bovine trypanosomosis are diseases that negatively impact cattle production in Brazil, causing considerably productive losses and animals death. In this study, the objective was to investigate the presence of the four hemoparasites that mostly affect dairy herds (A. marginale, B. bovis, B. bigemina and T. vivax) using the qPCR technique in discarded dairy cows in the northwestern region of Rio Grande do Sul. For this purpose, brain and spleen tissue biopsies were collected at a local slaughterhouse from 64 dairy cattle from this region. DNA extraction from the samples was performed using the Brazol® reagent, their quantity and purity were obtained through spectrophotometer analysis with NanoDropTM. In the brain samples, DNA detection was performed for T. vivax and B. bovis, and in the spleen, DNA of the four agents was verified. From a total of 64 brain samples analyzed, 14.06 % were positive for Babesia bovis. For spleen samples, Babesia bovis was detected in 17.19 % of the samples, while 29.69 % tested positive for B. bigemina and 37.50 % for Anaplasma marginale. Regarding Trypanosoma vivax, none of the analyzed samples resulted in a positive diagnosis in both tissues. Thus, the findings highlighted that B. bovis, B. bigemina and A. marginale are present in the dairy cattle herd of the northwestern regions of Rio Grande do Sul, with a higher percentage of A. marginale; on the other hand, T. vivax was not diagnosed in the present study

Cloning and expression of a chimera containing ROP2 of Neospora caninum fused with OprI lipoprotein from Pseudomonas aeruginosa / Clonagem e expressão de quimera contendo a proteína ROP2 de Neospora caninum fusionada a lipoproteína OprI de Pseudomonas aeruginosa

Neospora caninum is the etiologic agent of neosporosis, is one of the main responsible for abortion in cattle herds, causing economic losses to Cattle-raising. Vaccination of cattle would be an important alternative; however, the lack of effective vaccines prevents the application of this control method. The proteins present in rhoptries (ROPs), due to their importance in cell infection and their antigenic and immunogenic characteristics, became excellent candidates for vaccine antigens. The bacterial lipoproteins as an Oprl from Pseudomonas aeruginosa have received particular attention as an adjuvant carrier molecule. The aims of this study were to clone and expressing a chimera containing NcROP2 fused with OprI lipoprotein from P. aeruginosa for the future development of a recombinant vaccine against N. caninum. We cloned and expressed, in Escherichia coli Rosetta (DE3) pLysS, the region of NcROP2 described between amino acids 191 and 359, fused OprI producing the chimera rROP2/OprI, showed an expected size of ~50 kDa. and characterized its antigenicity. The protein was purified and characterized by Western blot with anti-histidine monoclonal antibodies and their antigenicity recognized by sera from animals naturally infected by N. caninum. The chimera rROP2/OprI was recognized by antibodies anti-N. caninum reviling common antigenic determinants of the recombinant protein and its native form, suggesting its use for developing a recombinant vaccine

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030