Efeito de temperatura e molhamento foliar em Phoma tarda e mancha de phoma em mudas de cafeeiro

Phoma leaf spot is a major disease of coffee plants in regions with specific conditions of temperature and humidity. Despite the importance of environmental variables for disease progression, so far they have been poorly understood. Thus, we assessed the effect of different temperatures (15, 20, 25 and 30 oC) on mycelial growth, production and germination of conidia of Phoma tarda; and the same effect of temperature (15, 20, 25 and 30 oC) and leaf wetness duration (6, 12, 24, 36 and 48 hours) on fungal infection and severity of disease over time in coffee plants. Disease assessment was integrated in the area using the disease progress curve (AUDPC) and the infection processes were observed by scanning electron microscopy (SEM). The optimal temperatures for fungus growth, conidial production and germination in vitro were 22.9, 29.8, and 25.1 °C, respectively. Temperatures ranging from 15-20 °C significantly increased germ tube length and provided favorable conditions for pathogen infection through observation of early events such as cuticle separation from leaf tissue. The same temperature range combined with increasing leaf wetness periods, reached the highest value of the AUDPC of phoma leaf spot. Thus, it was found that both temperature and leaf wetness duration in the variables assessed and the difference in relation to temperature for in vitro growth and sporulation for in vivo tests were important.Mancha de Phoma é uma das principais doenças do cafeeiro em zonas com condições específicas de temperatura e umidade. Apesar da importância das variáveis ambientais para o progresso da doença, até agora essas têm sido mal compreendidas. Avaliou-neste estudo, o efeito de diferentes temperaturas (15, 20, 25 e 30 ºC) sobre o crescimento micelial, produção e germinação de conídios de Phoma tarda, e o efeito da temperatura (15, 20, 25 e 30 ºC) e da duração do período de molhamento (6, 12, 24, 36 e 48 horas) sobre a infecção fúngica e severidade da doença, ao longo do tempo em plantas de café. A avaliação da doença realizada através da área abaixo da curva de progresso da doença (AACPD) e os processos de infecção foram observados por microscopia eletrônica de varredura (MEV). As temperaturas ótimas para o crescimento de fungos, produção de conídios e germinação foram de 22,9, 29,8, 25,1 °C, respectivamente. Temperaturas variando entre 15-20 °C aumentaram, significativamente, o comprimento do tubo germinativo e proporcionaram condições favoráveis para a infecção pelo patógeno através da observação dos primeiros eventos, tais como a separação da cutícula do tecido foliar. A mesma faixa de temperatura combinada com períodos crescentes de molhamento foliar, no máximo, 48 horas, atingiu os maiores valores da AACPD da Mancha Phoma. Assim, verificou-se que, tanto a temperatura quanto a duração do molhamento para testes in vivo e a influência da temperatura para o crescimento e esporulação in vitro foram importantes

COMMUNITY OF CULTIVABLE ENDOPHYTIC FUNGI OF CASSAVA Manihot esculenta CRANTZ

The objective of this work was to characterize the community of endophytic fungi of cassava Manihot esculenta cultivated in the state of Acre, Brazil. For that, M. esculenta root, stem and leaf were collected, washed and disinfected by immersion in 70% ethanol (1 min), sodium hypochlorite 2% (5 min), 70% alcohol (30 sec) and washing in water sterile distilled (1 min) three times. The samples were fragmented and inoculated in BDA and Oat culture media and incubated at 28 º C for 30 days. The isolated fungi were characterized by morphology and grouped into morphospecies. There was isolated a total of 39 endophytic fungi M. esculenta, 19 (48.7%) of stem 13 (33.3%) of leaf and 7 (18%) root. On culture medium, 23 (59%) fungi were isolated in BDA medium and 16 (41%) in Oat medium. Eight fungal genera were identified, Penicillium and Phomopsis the most frequent, with 30.8% relative frequency each, and Fusarium (10.2%) Aspergillus (5.1%), Guignardia (5.1%), Acremonium (2.6%), Colletotrichum (2.6%), Phoma (2.63%), and unidentified (10.2%). M. esculenta showed dominance by fungi of the genera Penicillium and Phomopsis. This is the first study report of the endophytic fungi community of Manihot esculenta

Planejamento reprodutivo no pós-parto entre mulheres atendidas na atenção básica: Reproductive planning in the postpartum period among women assisted in primary care

Introduction: The high frequency of unplanned pregnancies is still a public health problem in Brazil. Unplanned pregnancy can also happen among puerperal women, and the interpartum interval of less than two years greatly increases the risk of morbidity and mortality in these women. Objective: To verify the prevalence and aspects related to the use of contraceptive methods in the postpartum period. Materials and Methods: Quantitative, descriptive, cross-sectional research, carried out in the municipality of Senhor do Bonfim, Bahia. Data collection took place between June/2019 and January/2020, through face-to-face interviews carried out during home visits. Ninety-seven puerperal women participated between the third and sixth postpartum month. Results: The express majority (92.78%) of the interviewees were using some contraceptive method, of these, 37.08% used oral contraceptives and only 4.49% were using the intrauterine device. Among the mothers surveyed, 67.01% attended a postpartum consultation and 35.38% stated that they did not receive any information about contraception during the puerperium. It was observed that 47.78% of the interviewees started contraception only in the 6th postpartum month. Regarding the intended method, 35.56% were not using the desired contraceptive method. Conclusions: There was a high prevalence of contraceptive use in the postpartum period. Some aspects indicate the need to improve the quality of reproductive planning carried out in the municipality.Introducción: La alta frecuencia de embarazos no planificados sigue siendo un problema de salud pública en Brasil. Los embarazos no planificados también pueden ocurrir entre las mujeres puérperas, y el intervalo entre partos de menos de dos años aumenta considerablemente el riesgo de morbilidad y mortalidad en estas mujeres. Objetivo: Verificar la prevalencia y aspectos relacionados con el uso de métodos anticonceptivos en el puerperio. Materiales y Métodos: Investigación cuantitativa, descriptiva, transversal, realizada en el municipio de Senhor do Bonfim, Bahía. La recolección de datos ocurrió entre junio/2019 y enero/2020, a través de entrevistas presenciales realizadas durante visitas domiciliarias. Participaron 97 puérperas entre el tercer y sexto mes posparto. Resultados: La expresa mayoría (92,78%) de las entrevistadas utilizaba algún método anticonceptivo, de estas el 37,08% utilizaba anticonceptivos orales y solo el 4,49% utilizaba el dispositivo intrauterino. De las madres encuestadas, el 67,01% acudió a consulta posparto y el 35,38% manifestó no haber recibido ninguna información sobre anticoncepción durante el puerperio. Se observó que 47,78% de las entrevistadas iniciaron la anticoncepción recién en el 6º mes posparto. En cuanto al método pretendido, el 35,56% no estaba utilizando el método anticonceptivo deseado. Conclusiones: Hubo una alta prevalencia de uso de anticonceptivos en el puerperio. Algunos aspectos indican la necesidad de mejorar la calidad de la planificación reproductiva que se realiza en el municipio.Introdução: A elevada frequência de gestações não planejadas ainda é um problema de saúde publica no Brasil. A gravidez não planejada também pode acontecer entre as puérperas, e o intervalo interpartal menor que dois anos eleva sobremaneira o risco de morbimortalidade dessas mulheres. Objetivo: Verificar a prevalência e aspectos referentes ao uso dos métodos contraceptivos no pós-parto. Materiais e Métodos: Pesquisa quantitativa, descritiva, do tipo transversal, realizada no município de Senhor do Bonfim, Bahia. A coleta de dados ocorreu entre os meses de junho/2019 a janeiro/2020, através de entrevistas presenciais realizadas durante visitas domiciliares. Participaram 97 puérperas entre o terceiro e o sexto mês de pós-parto. Resultados: A expressa maioria (92,78%) das entrevistadas estava em uso de algum método anticoncepcional, dessas, 37,08% utilizavam o contraceptivo oral e apenas 4,49% estavam em uso do dispositivo intrauterino. Das puérperas pesquisadas, 67,01% realizaram consulta de pós-parto e 35,38% afirmaram que não receberam nenhuma informação sobre contracepção no puerpério. Observou-se que 47,78% das entrevistadas iniciaram a contracepção apenas no 6º mês de pós-parto. Em relação ao método pretendido, 35,56% não estavam usando o método contraceptivo desejado. Conclusões: Observou-se elevada prevalência do uso de contraceptivo no puerpério. Alguns aspectos sinalizam a necessidade da melhoria da qualidade do planejamento reprodutivo realizado no município

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Genotype and phenotype landscape of MEN2 in 554 medullary thyroid cancer patients: the BrasMEN study

Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant genetic disease caused by RET gene germline mutations that is characterized by medullary thyroid carcinoma (MTC) associated with other endocrine tumors. Several reports have demonstrated that the RET mutation profile may vary according to the geographical area. In this study, we collected clinical and molecular data from 554 patients with surgically confirmed MTC from 176 families with MEN2 in 18 different Brazili an centers to compare the type and prevalence of RET mutations with those from other countries. The most frequent mutations, classified by the number of families affected, occur in codon 634, exon 11 (76 families), followed by codon 918, exon 16 (34 families: 26 with M918T and 8 with M918V) and codon 804, exon 14 (22 families: 15 with V804M and 7 with V804L). When compared with other major published series from Europe, there are several similarities and some differences. While the mutations in codons C618, C620, C630, E768 and S891 present a similar prevalence, some mutations have a lower prevalence in Brazil, and others are found mainly in Brazil (G533C and M918V). These results reflect the singular proportion of European, Amerindian and African ancestries in the Brazilian mosaic genome83289298CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DO RIO GRANDE DO SUL - FAPERGSSem informaçãoSem informação2006/60402-1; 2010/51547-1; 2013/01476-9; 2014/06570-6; 2009/50575-4; 2010/51546-5; 2012/21942-116/2551-0000482-

Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series

Background: Previous reported neurologic sequelae associated with SARS-CoV-2 infection have mainly been confined to hospital-based patients in which viral detection was restricted to nasal/throat swabs or to IgM/IgG peripheral blood serology. Here we describe seven cases from Brazil of outpatients with previous mild or moderate COVID-19 who developed subacute cognitive disturbances. Methods: From June 1 to August 15, 2020, seven individuals 18 to 60 years old, with confirmed mild/moderate COVID-19 and findings consistent with encephalopathy who were observed >7 days after respiratory symptom initiation, were screened for cognitive dysfunction. Paired sera and CSF were tested for SARS-CoV-2 (IgA, IgG ELISA, and RT-PCR). Serum and intrathecal antibody dynamics were evaluated with oligoclonal bands and IgG index. Cognitive dysfunction was assessed by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Clock Drawing Test (CDT). Results: All but one of our patients were female, and the mean age was 42.6 years. Neurologic symptoms were first reported a median of 16 days (IQR 15–33) after initial COVID-19 symptoms. All patients had headache and altered behavior. Cognitive dysfunction was observed mainly in phonemic verbal fluency (MoCA) with a median of six words/min (IQR 5.25–10.75) and altered visuospatial construction with a median of four points (IQR 4–9) (CDT). CSF pleocytosis was not detected, and only one patient was positive for SARS-Co Conclusions: A subacute cognitive syndrome suggestive of SARS-CoV-2-initiated damage to cortico-subcortical associative pathways that could not be attributed solely to inflammation and hypoxia was present in seven individuals with mild/moderate COVID-19

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.World Health OrganizationRevisión por pare

Skin color and severe maternal outcomes: evidence from the brazilian network for surveillance of severe maternal morbidity

Taking into account the probable role that race/skin color may have for determining outcomes in maternal health, the objective of this study was to assess whether maternal race/skin color is a predictor of severe maternal morbidity. This is a secondary analysis of the Brazilian Network for Surveillance of Severe Maternal Morbidity, a national multicenter cross-sectional study of 27 Brazilian referral maternity hospitals. A prospective surveillance was performed to identify cases of maternal death (MD), maternal near miss (MNM) events, and potentially life-threatening conditions (PLTC), according to standard WHO definition and criteria. Among 9,555 women with severe maternal morbidity, data on race/skin color was available for 7,139 women, who were further divided into two groups: 4,108 nonwhite women (2,253 black and 1,855 from other races/skin color) and 3,031 white women. Indicators of severe maternal morbidity according to WHO definition are shown by skin color group. Adjusted Prevalence Ratios (PRadj - 95%CI) for Severe Maternal Outcome (SMO=MNM+MD) were estimated according to sociodemographic/obstetric characteristics, pregnancy outcomes, and perinatal results considering race. Results. Among 7,139 women with severe maternal morbidity evaluated, 90.5% were classified as PLTC, 8.5% as MNM, and 1.6% as MD. There was a significantly higher prevalence of MNM and MD among white women. MNMR (maternal near miss ratio) was 9.37 per thousand live births (LB). SMOR (severe maternal outcome ratio) was 11.08 per 1000 LB, and MMR (maternal mortality ratio) was 170.4 per 100,000 LB. Maternal mortality to maternal near miss ratio was 1 to 5.2, irrespective of maternal skin color. Hypertension, the main cause of maternal complications, affected mostly nonwhite women. Hemorrhage, the second more common cause of maternal complication, predominated among white women. Nonwhite skin color was associated with a reduced risk of SMO in multivariate analysis. Nonwhite skin color was associated with a lower risk for severe maternal outcomes. This result could be due to confounding factors linked to a high rate of Brazilian miscegenation.2019CNPQ - Conselho Nacional de Desenvolvimento Científico e Tecnológico402702/2008-