Alta ocorrência de Entamoeba histolytica nos municípios de Ariquemes e Monte Negro, estado de Rondônia, Amazônia Ocidental, Brasil

Introdução: Infecções por Entamoeba histolytica foram investigadas em moradores dos municípios de Ariquemes e Monte Negro, Rondônia, Brasil. Métodos: Amostras de fezes de 216 indivíduos foram processadas por microscopia óptica para detecção de cistos do complexo E. histolytica/E. dispar, seguido pelo método de imunoensaio utilizando kit de ensaio imunoenzimático para detecção específica de antígeno de E. histolytica. Resultados: Cistos de E. histolytica/E. dispar estavam presentes em 61% e 44% das amostras de Ariquemes e Monte Negro, respectivamente com diferença significativa na ocorrência da infecção entre as duas populações [p < 0,05; χ2 = 5,2; Odds relativa = 2,0 (1,1 - 3,6)]. A taxa de detecção de antígenos de E. histolytica nas amostras provenientes de Ariquemes foi de 36,6% e de 19,41% nas amostras de Monte Negro, sendo a ocorrência de amebíase significativamente maior na população de Ariquemes [p < 0,05; χ2 = 7,8; Odds relativa = 2,4 (1,2 - 4,7)]. Discussão: A elevada frequência da infecção por E. histolytica em residentes na região, bem como a indisponibilidade de avaliação clínica por testes específicos para distinção entre as duas espécies de Entamoeba, deve promover uma reflexão sobre o tratamento de infecções pelo complexo E. histolytica/E. dispar. Conclusão: Nas populações avaliadas foram detectadas elevadas ocorrências de E. histolytica.Introduction: Entamoeba histolytica infections were investigated in residents of the Ariquemes and Monte Negro municipalities in Rondônia State, Brazil. Methods: Stool samples of 216 individuals were processed by the spontaneous sedimentation method and analyzed by microscopy for detection of the E. histolytica/E. dispar complex, followed by the immunoassay method using an enzyme-linked immunosorbent assay-based kit for the E. histolytica stool antigen. Results: E. histolytica/E. dispar cysts were present in 61% (50/82) and 44% (59/134) of the samples from Ariquemes and Monte Negro respectively, with a significant difference in the occurrence of infection between the two populations [p < 0.05; χ2 = 5.2; odds ratio = 2.0 (1.1 - 3.6)]. The E. histolytica antigen detection rate was 36.6% (30/82) for stool samples from Ariquemes, and 19.4% (26/134) for stool taken from the residents of Monte Negro. The rate of the occurrence of amoebiasis was significantly higher in the population from Ariquemes [p < 0.05; χ2 = 7.8; odds ratio = 2.4 (1.2 - 4.7)]. Discussion: Due to the high occurrence of E. histolytica infected residents diagnosed in the region and the unavailability in local clinics of a test to distinguish between the two Entamoeba species, physicians should consider treating E. histolytica/E.dispar infections. Conclusion: The results indicate that E. histolytica infection is highly endemic in the studied areas

Survey of Bancroftian filariasis infection in humans and Culex mosquitoes in the western Brazilian Amazon region: implications for transmission and control

Introduction: The aim of this work was to identify possible lymphatic filariasis foci in the western Brazilian Amazonian that could be established from the reports of Rachou in the 1950s. The study was conducted in three cities of the western Brazilian Amazon region - Porto Velho and Guajará-Mirim (State of Rondônia) and Humaitá (State of Amazonas). Methods: For human infection evaluation thick blood smear stained with Giemsa was used to analyze samples collected from 10pm to 1am. Polymerase chain reaction (PCR) was used to examine mosquito vectors for the presence of Wuchereria bancrofti DNA. Humans were randomly sampled from night schools students and from inhabitants in neighborhoods lacking sanitation. Mosquitoes were collected from residences only. Results: A total 2,709 night students enrolled in the Program for Education of Young Adults (EJA), and 935 people registered in the residences near the schools were examined, being 641 from Porto Velho, 214 from Guajará-Mirim and 80 from Humaitá. No individual examined was positive for the presence of microfilariae in the blood stream. A total of 7,860 female Culex quinquefasciatus specimens examined were negative by PCR. Conclusions: This survey including human and mosquito examinations indicates that the western Amazon region of Brazil is not a focus of Bancroftian filariasis infection or transmission. Therefore, there is no need to be included in the Brazilian lymphatic filariasis control program.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Proj no. 2007/00848-

Análise da produção científica acerca das vacinas contra Covid-19

The World Health Organization has publicly affirmed the existence of a global emergency caused by the SARS-CoV-2 virus causing high rates of death and morbidity. Strategies for controlling the infection began to be developed, including vaccines manufactured by different nations worldwide. This work aimed to carry out an updated literature review on the vaccines available against Covid-19, their mechanisms and effectiveness. A bibliographic survey was carried out in the PubMed, LILACS and SciELO databases, using the following descriptors: Vaccines; COVID-19; Pandemic. The most used immunizers in Brazil were ChAdOx1-S/nCoV-19 [recombinant] (AstraZeneca), CoronaVac (Butantan), Bnt162b2 (BioNTech/Pfizer) and Ad.26.COV2.S (Janssen Pharma). The studies concluded that different mechanisms of action were used to manufacture the vaccines and all were effective, including the new variants, despite the existence of some adverse reactions and contraindications, the benefits of the vaccines outweigh their risks.A Organização Mundial da Saúde afirmou publicamente a existência de uma emergência global causada pelo vírus SARS-CoV-2 provocando elevados índices de morte e morbidade. Estratégias para o controle da infecção passaram a ser desenvolvidas, entre elas, as vacinas fabricadas por diferentes nações mundiais. Este trabalho teve como objetivo realizar uma revisão de literatura atualizada sobre as vacinas disponíveis contra a Covid-19, seus mecanismos e eficácia. Realizou-se um levantamento bibliográfico nas bases de dados PubMed, LILACS e SciELO, utilizando os seguintes descritores: Vacinas; COVID-19; Pandemia. Os imunizantes mais utilizados no Brasil foram ChAdOx1-S/nCoV-19 [recombinante] (AstraZeneca), CoronaVac (Butantan), Bnt162b2 (BioNTech/Pfizer) e Ad.26.COV2.S (Janssen Pharma). Os estudos concluíram que diferentes mecanismos de ação foram utilizados para fabricação das vacinas e todas foram eficazes, inclusive para as novas variantes, apesar da existência de algumas reações adversas e contra-indicações os benefícios das vacinas superam seus riscos

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

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension