Hepatitis E Virus Genotype 1 Cases Imported to Portugal from India, 2016

Hepatitis E in industrialized countries is mainly associated with genotype 3 hepatitis E virus (HEV) and normally causes a sporadic self-limiting disease in immunocompetent individuals. Unlike genotype 3, genotypes 1 and 2 circulate in developing countries, produce severe disease and occur in the epidemic form. Hepatitis E occurring in travellers returning from endemic areas in developing countries is not a novel epidemiological occurrence, however the vast majority of cases remain to be genetically studied. The present study describes two cases of severe acute hepatitis E that required hospitalization for 6 and 9 days in two individuals of Indian nationality that had recently migrated to Portugal to work. The retrieved HEV sequences both belonged to genotype 1 and had a high degree of nucleotide sequence identity, clustering with strains isolated in India and Nepal, in 2013 and 2014. Confirmed HEV genotypes of increased pathogenicity like genotype 1 are being introduced into otherwise naïve populations of industrialized countries such as European countries with consequences difficult to predict. As far as we know the present study is the first in Portugal to describe and genetically characterize imported cases of hepatitis E infection caused by HEV genotype 1

Nine karyomorphs for spiny rats of the genus Proechimys (Echimyidae, Rodentia) from North and Central Brazil

Spiny rats of the genus Proechimys are morphologically diverse, widely distributed and have diploid numbers ranging from 2n = 14-16 to 2n = 62. In this paper we present cytogenetical data and brief comments on morphological and biogeographical issues related to spiny rats. In our sample of 42 spiny rats collected from 12 Brazilian Amazonian tropical rainforest and the Cerrado (Brazilian savanna) sites we detected nine karyological entities: four different karyomorphs with 2n = 30, three with 2n = 28, one with 2n = 15 and one with 2n = 44. Based on qualitative morphological characters these karyomorphs can be allocated to five species within the goeldii, guyannensis and longicaudatus species groups

O processo de regionalização do SUS: revisão sistemática

This review focuses only on specific studies into the SUS regionalization process, which were based on empirical results and published since 2006, when the SUS was already under the aegis of the Pact for Health framework. It was found that the regionalization process is now underway in all spheres of government, subject to a set of challenges common to the different realities of the country. These include, primarily, that committee-structured entities are valued as spaces for innovation, yet also strive to overcome the bureaucratic and clientelist political culture. Regional governance is further hampered by the fragmentation of the system and, in particular, by the historical deficiency in planning, from the local level to the strategic policies for technology incorporation. The analyses enabled the identification of a culture of broad privilege for political negotiation, to the detriment of planning, as one of the main factors responsible for a vicious circle that sustains technical deficiency in management.Univ Fed Sao Paulo, Escola Paulista Med, Dept Med Prevent, R Botucatu 740-4, BR-04023062 Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Dept Med Prevent, Sao Paulo, SP, BrazilEscola Nacl Saude Publica, Rio De Janeiro, RJ, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Med Prevent, R Botucatu 740-4, BR-04023062 Sao Paulo, SP, BrazilWeb of Scienc