American Tegumentary Leishmaniasis in an endemic municipality in the North of Minas Gerais State: spatial analysis and socio-environmental factors

American Tegumentary Leishmaniasis (ATL) is endemic in the municipality of Montes Claros, Minas Gerais State. The use of geotechnology such as spatial statistics and remote sensing has contributed to a better understanding of the eco-epidemiology of diseases, and consequently a better definition of control strategies. This study aimed to analyze the spatial distribution of probable sites of cases of ATL infection (2007-2011) in the municipality of Montes Claros and to identify related socio-environmental factors. Data on ATL cases notification were obtained from the Municipal Health Department of Montes Claros. The annual incidence of ATL in the municipality was calculated and the probable sites of infection were georeferenced. Crude Rate and the Local Empirical Bayesian Rate were calculated with census sectors considered as the unit of analysis. The Normalized Difference Vegetation Index (NDVI) was calculated from LANDSAT 5 TM images. The spatial association between the crude rate of ATL and the NDVI of the census tracts was evaluated using the Local Bivariate of Moran I. The socio-environmental aspects of household structures were assessed based on a structured questionnaire. The incidence of ATL in the evaluated period ranged from 6.2 to 16.6 cases/100,000 inhabitants. The highest rates of ATL occurrence were found in the census sectors located in the rural area and in the peripheral census sectors in the city. Through the Empirical Bayes Smoothed Rate map, it was found that in the peripheral areas of the city, the rates of ATL occurrence were lower than in the rural area and their values decreased as they approach the city center. Local Bivariate of Moran I showed a positive correlation between NDVI and crude ATL rates, with significant high-high clusters observed in the rural area and in the census sectors in the Western peripheral area of the city that have experienced an urban expansion concomitant to the period investigated. In most homes of people affected by the disease, there were domestic animals and organic matter in the peridomicile. In addition, a high percentage of individuals affected by ATL reported the presence of rodents circulating near their homes. In conclusion, it is possible that the disorderly expansion process in the city of Montes Claros favored the establishment of the ATL periurban and urban transmission cycle. These regions deserve special attention from health surveillance to combat this zoonosis

Implicações do diagnóstico genético pré-implantação na análise dos erros inatos do metabolismo na prática clínica

Os erros inatos do metabolismo (EIMs) são doenças hereditárias caracterizadas por alterações metabólicas que impedem a homeostase do organismo saudável, sobretudo em recém-nascidos e crianças. O desenvolvimento de tecnologias de genética associadas a reprodução assistida garante que hoje seja possível o diagnóstico de características genéticas de um embrião com intuito de verificar o risco de transferência de mutações que causam os EIMs. O objetivo desta revisão é avaliar o valor do diagnóstico genético pré-implantacional (PGD - Preimplantation Genetic Diagnosis) e seu uso para identificar mutações de EIMs em embriões, além de sua efetividade para a aplicação na prática clínica. As análises dos estudos permitiram compreender que o PGD é um teste genético para diagnóstico eficaz dos EIMs e outras doenças genéticas. Entretanto, ainda são necessários outros estudos com maior enfoque nos EIMs para se possa confirmar o PGD como técnica totalmente eficaz na prática clínica

Levantamento dos impactos ambientais de um trecho de mata ciliar em região de Caatinga no Sertão Paraíbano / Survey of the environmental impacts of a ciliary forest stretch in the Caatinga region in the Paraíbano hinterland

O presente estudo teve como objetivo realizar o levantamento florístico e determinar os impactos ambientais da mata ciliar do Rio Espinharas e seus afluentes na área urbana da cidade de Patos-PB. Foram realizadas oito coletas de forma aleatória, nas respectivas margens dos rios em um percurso de aproximadamente 08 quilômetros. As coletas foram realizadas entre os meses de março de 2015 a setembro de 2015. Os procedimentos seguidos foram: (a) Caracterização breve da cobertura vegetal; (b) Listagem das espécies coletadas em cada fitofisionomia e (c) Elaboração de tabelas e listas de táxons. Foram registradas 107 espécies, distribuídas em 37 famílias botânicas e 84 gêneros. Fabaceae foi a família mais expressiva apresentando 24 espécies, seguida pela família Malvaceae, Euphorbiaceae, Poaceae, Convolvulaceae e as demais famílias, que apresentaram a ocorrência de 1 a 4 espécies por família. A composição florística das margens do Rio Espinharas, Rio Farinha e Rio da Cruz não apresentaram diversidade significativa de extrato arbóreo, sendo as mais encontradas: Prosopis juliflora (SW.) DC e Parkinsonia aculeata L. de origem exótica; a Pithecellobium diversifolium Benth. e a Mimosa tenuiflora (Willd.), ambas não endêmicas de matas ciliares, Licania rigida Benth e Vitex gardneriana Schauer características da vegetação ripária. As margens dos rios estão altamente poluídas e degradadas. As principais práticas que degradam os rios são a criação de animais, a cultura de espécies de ciclo curto, o despejo de resíduos sólido/líquidos no leito e nas margens do rio, exploração de lenha e fabricação de tijolos

A epidemiologia da cardiomiopatia de Takotsubo no Brasil e os principais fatores de risco da cardiomiopatia de Takotsubo: The epidemiology of Takotsubo cardiomyopathy in Brazil and the main risk factors for takotsubo cardiomyopathy

A Cardiomiopatia de Takotsubo (CTT) é uma disfunção cardíaca reversível, a qual está relacionada, diretamente, ao estresse físico ou emocional. Objetiva-se através dessa pesquisa evidenciar os principais fatores de risco da CT. Trata-se de uma revisão sistemática realizada no motor de busca Biblioteca Virtual em Saúde (BVS) na base de dados das “Ciências em Saúde em Geral” (Scielo, Medline, Lilacs). Percebeu-se que que a CT apresenta uma ocorrência maior em mulheres na fase de pós-menopausa, onde são atingidas pelo estresse emocional, bem como a inserção de marcapasso também pode desencadear a doença. Entretanto, a etiologia da CT ainda é marcada por controvérsias, mas há concordância acerca do surgimento da CT estar relacionado com a abundância de catecolaminas circulantes

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030