Community pharmacies and pharmacists in Brazil: A missed opportunity

The Brazilian National Health System (BR-NHS) is one of the largest public health systems in the world. In 2019 Brazil had 114,352 community pharmacies (76.8% private owned), that represent the first point of access to healthcare in Brazil due to their wide distribution. Unfortunately, from the government's point of view, the main expected activity of private and public community pharmacies is related to dispensing medicines and other health products. Public community pharmacies can be part of a healthcare center or be in a separate location, sometimes without the presence of a pharmacist. Pharmacists working in these separated locations do not have access to patients’ medical records, and they have difficulty in accessing other members of the patient care team. Pharmacists working in public pharmacies located in healthcare centers may have access to patients’ medical records, but pharmacy activities are frequently under other professional’s supervision (e.g., nurses). Private pharmacies are usually open 24/7 with the presence of a pharmacist for 8 hours on business days. Private community pharmacies have a very limited integration in the BR-NHS and pharmacists are the third largest healthcare workforce in Brazil with more than 221,000 registered in the Brazilian Federal Pharmacist Association [CFF - Conselho Federal de Farmácia]. A University degree in pharmacy is the only requirement to entry into the profession, without any proficiency exam for maintenance or career progression. The Brazilian pharmacist's annual income is ranked as the 2nd better-paid profession with an annual average income of € 5502.37 (in 2020). Description of clinical activities for pharmacies by the CFF increased in the recent years, however there is still a long way to effectively implement them into practice

Consórcio couve-coentro em cultivo orgânico e sua influência nas populações de joaninhas.

O consórcio de culturas é comumente praticado na produção de hortaliças devido a diversos benefícios econômicos. Em alguns casos, podem reduzir infestações de pragas por favorecer a conservação dos inimigos naturais nos agroecossistemas. Avaliou-se a viabilidade agronômica do consórcio de couve e coentro, sob manejo orgânico, com base em parâmetros fitotécnicos, além de sua influência sobre populações de joaninhas (Coleoptera: Coccinellidae), na comparação com os respectivos cultivos solteiros. O coentro, representando a cultura secundária, foi utilizado com a finalidade de fornecer recursos para as joaninhas. O estudo foi realizado em área do Sistema Integrado de Produção Agroecológica em Seropédica-RJ. O experimento consistiu dos consórcios: 1) couve consorciada com coentro, cujas quatro linhas de plantas foram colhidas na fase vegetativa (consórcio I), e 2) couve consorciada com coentro, cujas plantas das duas linhas internas (próximas à linha da couve) foram colhidas na fase vegetativa e as duas linhas externas foram cortadas após floração (consórcio II). Em ambos consórcios foram avaliados os parâmetros fitotécnicos da couve e do coentro na fase vegetativa (padrão comercial), enquanto que no consórcio II, também se avaliou as populações de joaninhas, por meio de coletas semanais de adultos, em comparação com a couve em cultivo solteiro. O delineamento experimental foi em blocos ao acaso com quatro repetições. O coentro não interferiu na produtividade da couve consorciada e sua introdução contribuiu positivamente para a abundância e diversidade de espécies de joaninhas. O índice de equivalência de área para o consórcio I, com referência aos rendimentos de biomassa aérea fresca, foi superior em 92% em relação ao cultivo solteiro. Este resultado demonstra a viabilidade do consórcio I, no manejo orgânico adotado, para plantios de outono nas condições edafoclimáticas da Baixada Fluminense

Molecular Genetic Variability, Population Structure and Mating System in Tropical Forages

Microsatellite (SSR) markers were developed for the following tropical forage species, using accessions available from the plant genetic resources (PGR) collections held by EMBRAPA (Brazilian Agricultural Research Corporation): Brachiaria brizantha, B. humidicola, Panicum maximum, Paspalum spp., Stylosanthes capitata, S. guianensis, S. macrocephala, Calopogonium mucunoides and Centrosema spp. The markers were used to analyse population structure and genetic diversity, evolution and origin of the genetic variability in the centre of origin, mating systems and genetic resources in EMBRAPA’s germplasm bank. The results shed light on the amount of genetic variation within and between populations, revealed the need in some cases for further plant collection to adequately represent the species in PGR collections, allowed us to assemble core collections (subsets of the total collections) that should contain most of the available diversity and (in the case of the legumes) showed the need to avoid unwanted outcrossing when regenerating conserved material. The data will allow plant breeders to better select accessions for hybrid production, discriminate between genotypes and use marker-assisted selection in breeding programs. Our results will also underpin the construction of genetic maps, mapping of genes of agronomic interest and numerous other studies on genetic variability, population structure, gene flow and reproductive systems for the tropical forage species studied in this work

Cohort-profile: Household transmission of SARS-CoV-2 in a low-resource community in Rio de Janeiro, Brazil.

PURPOSE: To better understand the household transmission of SARS-COV-2 in a low-resource community in Rio de Janeiro during the COVID-19 pandemic (2020-2022). PARTICIPANTS: This is an open prospective cohort study of children ≤12 years old and their household contacts. During home visits over 24 months, we collected data on sociodemographic characteristics, behavioural data, clinical manifestations of SARS-CoV-2, vaccination status, SARS-CoV-2 (reverse transcription-polymerase chain reaction) RT-PCR and anti-S antibody tests. Among adults, the majority of participants were women (62%). FINDINGS TO DATE: We enrolled 845 families from May 2020 to May 2022. The median number of residents per household was four. The median household density, defined as the number of persons per room, was 0.95. The risk of SARS-CoV-2 occurrence was higher in households with a high number of persons per room. Children were not the principal source of SARS-CoV-2 infections in their households during the first wave of the pandemic. FUTURE PLANS: Future studies will investigate cellular and humoral immune responses to locally circulating SARS-CoV-2 variants, which is relevant for the design of vaccines, antivirals and monoclonal antibodies. We will also engage in outreach to encourage vaccination as a means of limiting the transmission of novel SARS-CoV-2 variants and other emerging pathogens

Long COVID-19 syndrome associated with Omicron XBB.1.5 infection: a case report.

BACKGROUND: There is interest in lingering non-specific symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, referred to as Long coronavirus disease 2019 (Long COVID-19). It remains unknown whether the risk of Long COVID-19 is associated with pre-existing comorbidities or initial COVID-19 severity, including infections due to new Omicron lineages which predominated in 2023. OBJECTIVES: The aim of this case report was to characterize the clinical features of acute XBB.1.5 infection followed by Long COVID-19. METHODS: We followed a 73-year old female resident of Rio de Janeiro with laboratory-confirmed SARS-CoV-2 during acute infection and subsequent months. The SARS-CoV-2 lineage was determined by genome sequencing. FINDINGS: The participant denied comorbidities and had completed a two-dose vaccination schedule followed by two booster doses eight months prior to SARS-CoV-2 infection. Primary infection by viral lineage XBB.1.5. was clinically mild, but the participant subsequently reported persistent fatigue. MAIN CONCLUSIONS: This case demonstrates that Long COVID-19 may develop even after mild disease due to SARS-CoV-2 in fully vaccinated and boosted individuals without comorbidities. Continued monitoring of new SARS-CoV-2 lineages and associated clinical outcomes is warranted. Measures to prevent infection should continue to be implemented including development of new vaccines and antivirals effective against novel variants