Mulheres embarcadas: Formação e vida profissional de oficiais / Embarked women: Official training and professional life

A Formação e a vida profissional de oficiais da marinha mercante do Brasil são os temas apresentados nesse estudo. A partir de perspectiva das relações sociais de gênero, essa investigação aborda os desafios enfrentados pelas mulheres nas escolas de formação e no trabalho nas embarcações. Suas motivações, suas expectativas como estudantes e como oficiais, suas dificuldades e facilidades na inserção em espaço eminentemente masculino são analisadas a partir da pesquisa documental e pesquisa bibliográfica. A pesquisa etnográfica deu-se ente as escolas de formação e navio mercante. Verificou-se que apesar de avanços em termos de formação e na prática de oficiais, há muito ainda a ser conquistado em termos superação de preconceitos e de conquistas de condições trabalhistas favoráveis à presença da mulher nesse ramo profissional

Would Ancylostoma caninum be one of the agents of diffuse unilateral subacute neuroretinitis (D.U.S.N) in Brazil?

The autors present a confirmed case of diffuse unilateral subacute neuroretinitis (D.U.S.N.) with identification of the worm in a 6-year-old child with symptoms of cutaneous larva migrans, as well as analysis of 7 other cases of D.U.S.N. and association with cutaneous larva migrans or positive sorology for Toxocara canis. This is the first described case in the literature of the association between D.U.S.N. and cutaneous larva migrans in its active form.Os autores apresentam um caso de neurorretinite subaguda difusa unilateral (D.U.S.N) confirmada com a identificação da larva em uma criança de 6 anos associada a quadro de larva migrans cutânea, bem como a análise de outros sete casos de D.U.S.N. e sua associação sorológica à toxocaríase e antecedentes de larva migrans cutânea. Este é o primeiro caso descrito na literatura de D.U.S.N. concomitante a larva migrans cutânea na fase ativa.Universidade Estadual de Londrina Setor de OftalmologiaUNIFESP-EPM Departamento de OftalmologiaUNIFESP, EPM, Depto. de OftalmologiaSciEL

Fontes de acesso e utilização de medicamentos na zona rural de Pelotas, Rio Grande do Sul, em 2016: estudo transversal de base populacional

Objective. To analyze the prevalence of medication use, sources of access, and associated factors among rural residents in Pelotas, RS, Brazil. Methods. Cross-sectional study with adults ≥18 years, in 2016. Participants reported on the use and sources of access to medication used in the month prior to the interview. Poisson regression was used. Results. Among the 1,519 respondents, 54.7% (95%CI 48.7;60.5) used some medication and 3.3% (95%CI 2.4;4.5) didn’t use some necessary medication. Higher prevalence of use occurred in: women (PR=1.23 – 95%CI 1.12;1.34), the elderly (PR=2.36 – 95%CI 2.05;2.73), worse self-perception of health (PR=1.29 – 95%CI 1.14;1.46) and higher number of diseases (PR=2.37 – 95%CI 2.03;2.77). A total of 14.0% (95%CI 11.2;17.4) obtained medications exclusively from Health System and the prevalence was higher among those who self-declared non-white and from lower economic classes. Conclusion. A small portion indicated that they didn’t use necessary medications. Free obtaining was higher in groups with lower income.Objetivo. Analisar a prevalência do uso de medicamentos, fontes de acesso e fatores associados, em residentes da zona rural de Pelotas, RS, Brasil. Métodos. Estudo transversal com adultos ≥18 anos, realizado em 2016. Questionou-se o uso e fontes de acesso aos medicamentos no mês anterior à entrevista. Empregou-se regressão de Poisson. Resultados. Dos 1.519 entrevistados, 54,7% (IC95% 48,7;60,5) utilizaram algum medicamento e 3,3% (IC95% 2,4;4,5) deixaram de utilizar medicamento necessário. Exibiram maiores prevalências de utilização: mulheres (RP=1,23 – IC95% 1,12;1,34), idosos (RP=2,36 – IC95% 2,05;2,73), pessoas com pior autopercepção de saúde (RP=1,29 – IC95% 1,14;1,46), com maior número de doenças (RP=2,37 – IC95% 2,03;2,77). Obtiveram medicamentos exclusivamente pelo Sistema Único de Saúde (SUS) 14,0% (IC95% 11,2;17,4), com prevalências maiores entre pessoas de cor da pele autodeclarada não branca e classe econômica inferior. Conclusão. Pequena parcela deixou de usar medicamentos que necessitava. A obtenção gratuita de medicamentos foi maior nos grupos de menor poder aquisitivo

Association of TLR variants with susceptibility to Plasmodium vivax malaria and parasitemia in the Amazon region of Brazil

BACKGROUND: Plasmodium vivax malaria (Pv-malaria) is still considered a neglected disease despite an alarming number of individuals being infected annually. Malaria pathogenesis occurs with the onset of the vector-parasite-host interaction through the binding of pathogen-associated molecular patterns (PAMPs) and receptors of innate immunity, such as toll-like receptors (TLRs). The triggering of the signaling cascade produces an elevated inflammatory response. Genetic polymorphisms in TLRs are involved in susceptibility or resistance to infection, and the identification of genes involved with Pv-malaria response is important to elucidate the pathogenesis of the disease and may contribute to the formulation of control and elimination tools. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective case-control study was conducted in an intense transmission area of Pv-malaria in the state of Amazonas, Brazil. Genetic polymorphisms (SNPs) in different TLRs, TIRAP, and CD14 were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis in 325 patients infected with P. vivax and 274 healthy individuals without malaria history in the prior 12 months from the same endemic area. Parasite load was determined by qPCR. Simple and multiple logistic/linear regressions were performed to investigate association between the polymorphisms and the occurrence of Pv-malaria and parasitemia. The C/T (TLR5 R392StopCodon) and T/T (TLR9 -1486C/T) genotypes appear to be risk factors for infection by P. vivax (TLR5: C/C vs. C/T [OR: 2.116, 95% CI: 1.054-4.452, p = 0.031]; TLR9: C/C vs. T/T [OR: 1.919, 95% CI: 1.159-3.177, p = 0.010]; respectively). Fever (COEF = 7599.46, 95% CI = 3063.80-12135.12, p = 0.001) and the C/C genotype of TLR9 -1237C/T (COEF = 17006.63, 95% CI = 3472.83-30540.44, p = 0.014) were independently associated with increased parasitemia in patients with Pv-malaria. CONCLUSIONS: Variants of TLRs may predispose individuals to infection by P. vivax. The TLR5 R392StopCodon and TLR9 -1486C/T variants are associated with susceptibility to Pv-malaria. Furthermore, the TLR9 variant -1237C/C correlates with high parasitemia

Bloqueio Atrioventricular Total por Lúpus Eritematoso Neonatal

Os autores relatam o caso de uma criança, cuja mae era portadora de Lupus Eritematoso Sistêmico. Já no oitavo mês de gestaçao, o obstetra detectou uma importante bradicardia fetal. No nono mês, a criança nasceu com bloqueio atrioventricular total (BAV) e baixo débito, tendo sido necessário o implante de marcapasso definitivo endocárdico, no mesmo dia do nascimento. Em decorrência do surgimento de endocardite, aquele marcapasso foi substituído por um epimiocárdico. Os autores chamam a atençao para os casos de bloqueio atrioventricular total (BAV) congênito associado à miocardite por Lúpus Eritematoso Neonatal, os quais, se nao tratados precocemente, sao fatores causais de alta mortalidade perinatal

Bloqueio Atrioventricular Total por Lúpus Eritematoso Neonatal

Os autores relatam o caso de uma criança, cuja mae era portadora de Lupus Eritematoso Sistêmico. Já no oitavo mês de gestaçao, o obstetra detectou uma importante bradicardia fetal. No nono mês, a criança nasceu com bloqueio atrioventricular total (BAV) e baixo débito, tendo sido necessário o implante de marcapasso definitivo endocárdico, no mesmo dia do nascimento. Em decorrência do surgimento de endocardite, aquele marcapasso foi substituído por um epimiocárdico. Os autores chamam a atençao para os casos de bloqueio atrioventricular total (BAV) congênito associado à miocardite por Lúpus Eritematoso Neonatal, os quais, se nao tratados precocemente, sao fatores causais de alta mortalidade perinatal

Outcomes of the first 54 pediatric patients on long-term home parenteral nutrition from a single Brazilian center

Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0–18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7–19) versus 34.7 (20.4–53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheterrelated bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients’ family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion: The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system

Coinfection with Different Trypanosoma cruzi Strains Interferes with the Host Immune Response to Infection

A century after the discovery of Trypanosoma cruzi in a child living in Lassance, Minas Gerais, Brazil in 1909, many uncertainties remain with respect to factors determining the pathogenesis of Chagas disease (CD). Herein, we simultaneously investigate the contribution of both host and parasite factors during acute phase of infection in BALB/c mice infected with the JG and/or CL Brener T. cruzi strains. JG single infected mice presented reduced parasitemia and heart parasitism, no mortality, levels of pro-inflammatory mediators (TNF-α, CCL2, IL-6 and IFN-γ) similar to those found among naïve animals and no clinical manifestations of disease. On the other hand, CL Brener single infected mice presented higher parasitemia and heart parasitism, as well as an increased systemic release of pro-inflammatory mediators and higher mortality probably due to a toxic shock-like systemic inflammatory response. Interestingly, coinfection with JG and CL Brener strains resulted in intermediate parasitemia, heart parasitism and mortality. This was accompanied by an increase in the systemic release of IL-10 with a parallel increase in the number of MAC-3+ and CD4+ T spleen cells expressing IL-10. Therefore, the endogenous production of IL-10 elicited by coinfection seems to be crucial to counterregulate the potentially lethal effects triggered by systemic release of pro-inflammatory mediators induced by CL Brener single infection. In conclusion, our results suggest that the composition of the infecting parasite population plays a role in the host response to T. cruzi in determining the severity of the disease in experimentally infected BALB/c mice. The combination of JG and CL Brener was able to trigger both protective inflammatory immunity and regulatory immune mechanisms that attenuate damage caused by inflammation and disease severity in BALB/c mice