Immunogenicity and Reactogenicity of 2009 Influenza A (H1N1) Inactivated Monovalent Non-Adjuvanted Vaccine in Elderly and Immunocompromised Patients

Background\ud \ud Immunosuppressed individuals present serious morbidity and mortality from influenza, therefore it is important to understand the safety and immunogenicity of influenza vaccination among them.\ud Methods\ud \ud This multicenter cohort study evaluated the immunogenicity and reactogenicity of an inactivated, monovalent, non-adjuvanted pandemic (H1N1) 2009 vaccine among the elderly, HIV-infected, rheumatoid arthritis (RA), cancer, kidney transplant, and juvenile idiopathic arthritis (JIA) patients. Participants were included during routine clinical visits, and vaccinated according to conventional influenza vaccination schedules. Antibody response was measured by the hemagglutination-inhibition assay, before and 21 days after vaccination.\ud Results\ud \ud 319 patients with cancer, 260 with RA, 256 HIV-infected, 149 elderly individuals, 85 kidney transplant recipients, and 83 with JIA were included.\ud \ud The proportions of seroprotection, seroconversion, and the geometric mean titer ratios postvaccination were, respectively: 37.6%, 31.8%, and 3.2 among kidney transplant recipients, 61.5%, 53.1%, and 7.5 among RA patients, 63.1%, 55.7%, and 5.7 among the elderly, 59.0%, 54.7%, and 5.9 among HIV-infected patients, 52.4%, 49.2%, and 5.3 among cancer patients, 85.5%, 78.3%, and 16.5 among JIA patients. The vaccine was well tolerated, with no reported severe adverse events.\ud Conclusions\ud \ud The vaccine was safe among all groups, with an acceptable immunogenicity among the elderly and JIA patients, however new vaccination strategies should be explored to improve the immune response of immunocompromised adult patients. (ClinicalTrials.gov, NCT01218685)Fundação Butantan funded the study, and employed several of the authors. The funder had a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Longer-term effectiveness of a heterologous coronavirus disease 2019 (COVID-19) vaccine booster in healthcare workers in Brazil

Abstract Objective: To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs). Methods: We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time. Results: Of 14,532 HCWs, coronavirus disease 2019 (COVID-19) was confirmed in 56.3% of HCWs receiving 2 doses of CoronaVac vaccine versus 23.2% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P < .001), and 37.1% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 22.7% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P < .001). The highest vaccine effectiveness with mRNA booster was observed 30 days after vaccination: 91% for the CoronaVac vaccine group and 97% for the ChAdOx1 vaccine group. Vacine effectiveness declined to 55% and 67%, respectively, at 180 days. Of 430 samples screened for mutations, 49.5% were SARS-CoV-2 delta variants and 34.2% were SARS-CoV-2 omicron variants. Conclusions: Heterologous COVID-19 vaccines were effective for up to 180 days in preventing COVID-19 in the SARS-CoV-2 delta and omicron variant eras, which suggests the need for a second booster

Pelvic floor muscle strength evaluation in different body positions in nulliparous healthy women and its correlation with sexual activity

Objective: The aim of this study was to assess pelvic floor muscle (PFM) strength in different body positions in nulliparous healthy women and its correlation with sexual activity.Materials and Methods: Fifty healthy nulliparous women with mean age of 23 years were prospectively studied. Subjective evaluation of PFM was assessed by transvaginal digital palpation (TDP) of anterior and posterior areas regarding the vaginal introitus. A perineometer with inflatable vaginal probe was used to assess the PFM strength in four different positions: supine with extended lower limbs (P1); bent-knee supine (P2); sitting (P3); standing (P4).Results: Physical activity, 3 times per week, was reported by 58% of volunteers. Sexual activity was observed in 80% of women and 82% of them presented orgasm. The average body mass index (BMI) was 21.76 kg/m(2), considered as normal according World Health Organization (WHO). We observed that 68% of volunteers were conscious about the PFM contraction. TDP showed concordance of 76% when anterior and posterior areas were compared (p = 0.00014). There was not correlation between PFM strength and orgasm in subjective evaluation. The PFM strength was significantly higher in standing position when compared with the other positions (p < 0.000). No statistical difference was observed between orgasm and PFM strength when objective evaluations were performed.Conclusions: There was concordance between anterior and posterior areas in 76% of cases when subjective PFM strength was assessed. In objective evaluation, higher PFM strength was observed when volunteers were standing. No statistical correlation was observed between PFM strength and orgasm in nulliparous healthy women

The variation of the burden of hypertension and diabetes in two large districts of the city of São Paulo, Brazil, based on primary health care routinely-collected data.

BackgroundNoncommunicable diseases (NCDs) were responsible for 72.3% of global deaths in 2016, with cardiovascular diseases accounting for almost half of those deaths and low- and middle-income countries carrying the biggest burden. As a result, the prevention and control of NCDs is recognized as urgent, while better surveillance at the country level could result in more effective policies. Hence, the objective of this study was to obtain more detailed information on the distribution of the prevalence of hypertension and diabetes among the population of two large districts of the city of São Paulo in Brazil, and to compare these findings to the results of a citywide health survey.Methods and findingsThis cross-sectional study used primary health care (PHC) routinely-collected data. The study population included 187,110 individuals 20 years of age or older registered in 13 public PHC facilities at two districts of the city of São Paulo in 2015. Data extracted from SIAB, a primary care database, was used to calculate age and sex directly standardized prevalences for diabetes and hypertension for each PHC facility. The prevalence of hypertension among women was significantly higher than the prevalence among men in the entire study population, and in every PHC facility. There was great variation among PHC facilities that was more pronounced among women. The prevalence of diabetes among women was significantly higher than the prevalence among men in the entire study population, and in every PHC facility, but there was little variation among PHC facilities.ConclusionsThis study provided information that could help with policy planning and allocation of resources, and demonstrated the use of PHC routinely-collected data to generate important insights that if replicated could have a substantial impact given the broad coverage of the national public PHC program in Brazil

Molecular detection of hemotrophic mycoplasmas among domiciled and free-roaming cats in Campo Grande, state of Mato Grosso do Sul, Brazil

Hemoplasmas are bacteria living in feline red blood cells. Feline hemoplasmosis is frequently associated with old male cats that have access to the streets. This study aimed to detect the presence of hemoplasma speciess in domiciled and free-roaming cats in Campo Grande, state of Mato Grosso do Sul (MS), Brazil, using molecular techniques. Between January 2013 and April 2013, EDTA-whole blood samples were collected from 151 domestic cats (65 free-roaming and 86 domiciled cats). Samples were subjected to PCR assays targeting hemoplasmas 16S rRNA, followed by sequencing, BLAST analysis and phylogenetic analysis. Results show an occurrence of 36.4% for hemoplasmas. Twenty-three cats (15.2%) were positive for &apos;Candidatus Mycoplasma haemominutum&apos;, 17 (11.2%) for M. haemofelis and 15 (9.9%) for &apos;Candidatus M. turicensis&apos;, from PCR. Coinfection by two or three hemoplasmas was found in 25 cats (16.6%). No statistically significant difference between genders or between lifestyles was observed for the presence of hemoplasmas among the cats. Results show different hemoplasma species are present in cat population (Campo Grande, MS, Brazil). It is suggested that a differential diagnosis for feline hemoplasmosis should be made when cats show nonspecific clinical signs of disease with systemic manifestation.Hemoplasmas são bactérias encontradas aderidas aos eritrócitos de felinos. A hemoplasmose felina está frequentemente associada a gatos velhos machos, sem raça definida e com acesso à rua. O presente estudo objetivou realizar a detecção molecular de espécies de hemoplasmas em gatos domiciliados e errantes em Campo Grande, estado do Mato Grosso do Sul (MS), Brasil. Entre janeiro/2013 e abril/2013, amostras de sangue foram colhidas de 151 gatos domésticos (65 errantes e 86 domiciliados) e avaliadas por PCR frente à presença de sequências do gene do 16S rRNA de hemoplasmas, seguidas de sequenciamento, análise pelo BLAST e análise filogenética. Os resultados deste estudo mostraram uma ocorrência de 36,4%. Vinte e três (15,2%) gatos mostraram-se positivos na PCR para ‘Candidatus Mycoplasma haemominutum’, 17 (11,2%) para Mycoplasma haemofelis, e 15 (9,9%) para ‘Candidatus Mycoplasma turicensis’. A co-infecção por dois ou três hemoplasmas ocorreu em 25 gatos (16,6%). Não foi observada diferença estatística significativa entre sexo e estilo de vida dos gatos amostrados e a presença de hemoplasmas. O estudo mostrou que diferentes espécies de hemoplasmas circulam na população de gatos (domiciliados e errantes) na cidade de Campo Grande, MS, Brasil. Sugere-se o diagnóstico diferencial para hemoplasmose felina em gatos que apresentam sinais clínicos inespecíficos de doença com manifestação sistêmica.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Characteristics and comparisson of the population from Group 1, according to their GBV-C status at baseline, N = 233.

<p>*Pearson's chi-squared test.</p><p>**Wilcoxon rank-sum test adjusted for ties.</p

Characteristics of the GBV-C positive population, according to their genotypic distribution, N = 45.

<p>*Two-sided Fisher's exact test.</p><p>**Kruskal-Wallis test (chi-square approximation).</p

Characteristics of the population from Group 2, according to their E2 Antibody status at baseline, N = 131.

<p>*Pearson's chi-squared test.</p><p>**Kruskal-Wallis test (chi-square approximation) adjusted for tiés.</p

Phylogenetic tree of GB virus C (GBV-C) isolates.

<p>Phylogenetic tree of Brazilian GB virus C (GBV-C) clinical isolates based on the nucleotide sequences. Tree was constructed by the Neighbor-Joining (NJ) program, and the pair wise distances between sequences were calculated by the DNADIST program. Values near branches indicate bootstrap support based on 1000 replicates. Relevant bootstrap values >60 (out of 100) are shown.</p