ESTUDO DO PANORAMA EPIDEMIOLÓGICO DOS BEBÊS NASCIDOS COM FENDAS EM GÓIAS DURANTE O PERÍODO DE 2010 A 2022

Cleft lip and palate often occur as congenitais deformities in the craniofacial region, resulting from multiple etiological factors, including genetic, environmental, syndromic, or isolated factors. The article aims to analyze the epidemiological landscape of newborns with various types of cleft lip or palate in the state of Goiás from 2010 to 2022. A retrospective descriptive epidemiographic study was conducted using data from the TABNET (DATASUS) application, focusing on live births in Goiás with cleft lip and/or palate during this period. A total of 768 births with orofacial clefts were recorded, predominantly in Goiânia. Among the observed characteristics, there is a notable incidence of singleton pregnancies, often followed by cesarean deliveries, especially among mothers of mixed race, and a prevalence of cleft palate. Understanding the epidemiological panorama of newborns with clefts is crucial for effectively planning preventive and health promotion measures aimed at improving the quality of life of this population.Fendas labiopalatinas frequentemente ocorrem como deformações congênitas na área da região craniofacial, resultantes de múltiplos fatores etiológicos, incluindo genéticos, ambientais, sindrômicos ou isolados. O artigo tem como propósito analisar o panorama epidemiológico dos recém-nascidos com variados tipos de fissuras labiais ou palatinas no estado de Goiás, no período de 2010 a 2022. Foi conduzido um estudo epidemiográfico descritivo retrospectivo utilizando dados do aplicativo TABNET (DATASUS), referente aos nascidos vivos em Goiás com fissuras labiais e/ou palatinas durante esse período. Foram registrados 768 nascimentos com fissuras orofaciais, predominando em Goiânia. Entre as características observadas, destacam-se a incidência de gestações únicas, frequentemente seguidas de partos por cesárea, especialmente entre mães de etnia parda e prevalência de fenda palatina. Entender o panorama epidemiológico dos recém-nascidos com fissuras é fundamental para planejar medidas de prevenção e de promoção a saúde de maneira eficaz, com o objetivo de melhorar a qualidade de vida dessa população. &nbsp

HANSENÍASE EM 2023: PANORAMA NACIONAL E DESAFIOS REGIONAIS NO BRASIL

Leprosy is a serious public health issue in Brazil, causing disabilities and stigma. The country ranks second in the world for the absolute number of cases. Caused by Mycobacterium leprae, the disease is associated with unfavorable socioeconomic conditions and can lead to symptoms affecting the skin, nerves, oral cavity, physical deformities, and disability. To analyze the prevalence and epidemiological profile of leprosy across different regions of Brazil in 2023. An ecological, retrospective, quantitative, and qualitative study using data from the Sistema de Informações de Agravos de Notificação (SINAN) of DATASUS, collected in July 2024. Public secondary data were analyzed in accordance with ethical principles. In 2023, 7,734 new cases were recorded. The prevalence was highest in the Northeast and North regions. Most cases (96.02%) occurred in individuals aged 15 years or older. There was a higher incidence in men (57.81%) and among people of mixed race (60.72%). The most common clinical form was the dimorphic type (51.25%). Leprosy remains a serious problem in Brazil, with significant geographic and demographic disparities. It is crucial to implement effective control strategies, focus on specific populations and the dimorphic clinical form, and continue technological advancements and treatment and rehabilitation strategies.A hanseníase é um sério problema de saúde pública no Brasil, causador de incapacidades e estigma. O país é o segundo em número absoluto de casos. Causada pelo Mycobacterium leprae, a doença está associada a condições socioeconômicas desfavoráveis e pode levar a sintomatologia na pele, nervos, cavidade oral, deformidades físicas e invalidez. Analisar a prevalência e o perfil epidemiológico da hanseníase nas regiões do Brasil em 2023. Estudo ecológico, retrospectivo, quantitativo e qualitativo com dados do Sistema de Informações de Agravos de Notificação (SINAN) do DATASUS, coletados em julho de 2024. Dados secundários públicos foram analisados conforme princípios éticos. Em 2023, foram registrados 7.734 novos casos. A prevalência foi maior nas regiões Nordeste e Norte. A maioria dos casos (96,02%) ocorreu em pessoas com 15 anos ou mais. Houve maior incidência em homens (57,81%) e entre pessoas de cor parda (60,72%). A forma clínica mais comum foi a dimorfa (51,25%). A hanseníase ainda é um grave problema no Brasil, com desigualdades na distribuição geográfica e demográfica. É crucial implementar estratégias de controle eficazes, focar em populações específicas e na forma clínica dimorfa, além de continuar com avanços tecnológicos e estratégias de tratamento e reabilitação

Risk of adverse outcomes in offspring with RT-PCR confirmed prenatal Zika virus exposure: an individual participant data meta-analysis of 13 cohorts in the Zika Brazilian Cohorts ConsortiumResearch in context

Summary: Background: Knowledge regarding the risks associated with Zika virus (ZIKV) infections in pregnancy has relied on individual studies with relatively small sample sizes and variable risk estimates of adverse outcomes, or on surveillance or routinely collected data. Using data from the Zika Brazilian Cohorts Consortium, this study aims, to estimate the risk of adverse outcomes among offspring of women with RT-PCR-confirmed ZIKV infection during pregnancy and to explore heterogeneity between studies. Methods: We performed an individual participant data meta-analysis of the offspring of 1548 pregnant women from 13 studies, using one and two-stage meta-analyses to estimate the absolute risks. Findings: Of the 1548 ZIKV-exposed pregnancies, the risk of miscarriage was 0.9%, while the risk of stillbirth was 0.3%. Among the pregnancies with liveborn children, the risk of prematurity was 10,5%, the risk of low birth weight was 7.7, and the risk of small for gestational age (SGA) was 16.2%. For other abnormalities, the absolute risks were: 2.6% for microcephaly at birth or first evaluation, 4.0% for microcephaly at any time during follow-up, 7.9% for neuroimaging abnormalities, 18.7% for functional neurological abnormalities, 4.0% for ophthalmic abnormalities, 6.4% for auditory abnormalities, 0.6% for arthrogryposis, and 1.5% for dysphagia. This risk was similar in all sites studied and in different socioeconomic conditions, indicating that there are not likely to be other factors modifying this association. Interpretation: This study based on prospectively collected data generates the most robust evidence to date on the risks of congenital ZIKV infections over the early life course. Overall, approximately one-third of liveborn children with prenatal ZIKV exposure presented with at least one abnormality compatible with congenital infection, while the risk to present with at least two abnormalities in combination was less than 1.0%. Funding: National Council for Scientific and Technological Development - Brazil (Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq); Wellcome Trust and the United Kingdom's Department for International Development; European Union's Horizon 2020 research and innovation program; Medical Research Council on behalf of the Newton Fund and Wellcome Trust; National Institutes of Health/National Institute of Allergy and Infectious Diseases; Foundation Christophe et Rodolphe Mérieux; Coordination for the improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Capes); Ministry of Health of Brazil; Brazilian Department of Science and Technology; Foundation of Research Support of the State of São Paulo (Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP); Foundation of Research Support of the State of Rio de Janeiro (Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro – FAPERJ); Foundation of Support for Research and Scientific and Technological Development of Maranhão; Evandro Chagas Institute/Brazilian Ministry of Health (Instituto Evandro Chagas/Ministério da Saúde); Foundation of Research Support of the State of Goiás (Fundação de Amparo à Pesquisa do Estado de Goiás – FAPEG); Foundation of Research Support of the State of Rio Grande do Sul (Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul – FAPERGS); Foundation to Support Teaching, Research and Assistance at Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto (Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto); São Paulo State Department of Health (Secretaria de Saúde do Estado de São Paulo); Support Foundation of Pernambuco Science and Technology (Fundação de Amparo à Ciência e Tecnologia de Pernambuco – FACEPE)

Guidance on mucositis assessment from the MASCC Mucositis Study Group and ISOO: an international Delphi studyResearch in context

Summary: Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022–July 2023). The first phase involved a survey to MASCC-MSG members (January 2022–May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023–May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved