A DISTRIBUIÇÃO DA RENDA E O PROCESSO DE DESENVOLVIMENTO DOS SISTEMAS PRODUTIVOS DAS ECONOMIAS DESENVOLVIDAS E SUBDESENVOLVIDAS A PARTIR DE CELSO FURTADO

Compreendendo a importância de Celso Furtado para o entendimento da formação das economias latino-americanas, o presente artigo tem por objetivo trazer os argumentos do autor que mostram as diferenças da formação dos sistemas produtivos nos países desenvolvidos e subdesenvolvidos, e como a questão da distribuição/concentração da renda se coloca nesses processos. Guiados pela vanguarda tecnológica, os países centrais concentraram geograficamente a produção industrial e lograram uma repartição da renda mais igualitária, o que possibilitou a adoção de políticas de proteção social. Já nos países subdesenvolvidos, o processo de industrialização não criou o proletariado clássico, criou, na verdade, uma massa urbana pouco definida cujas aspirações se dão num quadro político incapaz de atender suas necessidades básicas. Desse modo, fica nítido que, diferentemente do otimismo e esperança atribuído à industrialização nos seus trabalhos iniciais, Furtado revela certa desilusão – não só na economia brasileira, mas nas economias subdesenvolvidas como um todo – com relação às possibilidades de transformações estruturais qualitativas em direção a um desenvolvimento nacional autônomo e sustentado. Por fim, a intensificação da acumulação per se não produziu, via de regra, as transformações nas estruturas sociais capazes de converter a distribuição de renda e a destinação do novo excedente num quadro de igualdade

Child deaths caused by Klebsiella pneumoniae in sub-Saharan Africa and south Asia: a secondary analysis of Child Health and Mortality Prevention Surveillance (CHAMPS) data

Background: Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterise child mortality associated with this pathogen in seven high-mortality settings. Methods: We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021. CHAMPS sites conduct active surveillance for deaths in catchment populations and following reporting of an eligible death or stillbirth seek consent for minimally invasive tissue sampling followed by extensive aetiological testing (microbiological, molecular, and pathological); cases are reviewed by expert panels to assign immediate, intermediate, and underlying causes of death. We reported on susceptibility to antibiotics for which at least 30 isolates had been tested, and excluded data on antibiotics for which susceptibility testing is not recommended for Klebsiella spp due to lack of clinical activity (eg, penicillin and ampicillin). Findings: Among 2352 child deaths with cause of death assigned, 497 (21%, 95% CI 20–23) had K pneumoniae in the causal chain of death; 100 (20%, 17–24) had K pneumoniae as the underlying cause. The frequency of K pneumoniae in the causal chain was highest in children aged 1–11 months (30%, 95% CI 26–34; 144 of 485 deaths) and 12–23 months (28%, 22–34; 63 of 225 deaths); frequency by site ranged from 6% (95% CI 3–11; 11 of 184 deaths) in Bangladesh to 52% (44–61; 71 of 136 deaths) in Ethiopia. K pneumoniae was in the causal chain for 450 (22%, 95% CI 20–24) of 2023 deaths that occurred in health facilities and 47 (14%, 11–19) of 329 deaths in the community. The most common clinical syndromes among deaths with K pneumoniae in the causal chain were sepsis (44%, 95% CI 40–49; 221 of 2352 deaths), sepsis in conjunction with pneumonia (19%, 16–23; 94 of 2352 deaths), and pneumonia (16%, 13–20; 80 of 2352 deaths). Among K pneumoniae isolates tested, 121 (84%) of 144 were resistant to ceftriaxone and 80 (75%) of 106 to gentamicin. Interpretation: K pneumoniae substantially contributed to deaths in the first 2 years of life across multiple high-mortality settings, and resistance to antibiotics used for sepsis treatment was common. Improved strategies are needed to rapidly identify and appropriately treat children who might be infected with this pathogen. These data suggest a potential impact of developing and using effective K pneumoniae vaccines in reducing neonatal, infant, and child deaths globally

Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study

BACKGROUND: Low-density Plasmodium falciparum infections prevail in low transmission settings, where immunity is expected to be minimal, suggesting an immune-independent effect on parasite densities. We aimed to describe parasite densities in pregnancy, and determine how gravidity and antibody-mediated immunity affect these, during a period of declining malaria transmission in southern Mozambique. METHODS: We documented P. falciparum infections at first antenatal care visits (n = 6471) between November 2016 and October 2019 in Ilha Josina (high-to-moderate transmission area), Manhiça (low transmission area), and Magude (pre-elimination area). Two-way interactions in mixed-effects regression models were used to assess gravidity-dependent differences in quantitative PCR-determined P. falciparum positivity rates (PfPRqPCR) and densities, in the relative proportion of detectable infections (pDi) with current diagnostic tests (≥ 100 parasites/μL) and in antimalarial antibodies. RESULTS: PfPRqPCR declined from 28 to 13% in Ilha Josina and from 5-7 to 2% in Magude and Manhiça. In primigravidae, pDi was highest in Ilha Josina at the first study year (p = 0.048), which declined with falling PfPRqPCR (relative change/year: 0.41, 95% CI [0.08; 0.73], p = 0.029), with no differences in antibody levels. Higher parasite densities in primigravidae from Ilha Josina during the first year were accompanied by a larger reduction of maternal hemoglobin levels (- 1.60, 95% CI [- 2.49; - 0.72; p < 0.001), than in Magude (- 0.76, 95% CI [- 1.51; - 0.01]; p = 0.047) and Manhiça (- 0.44, 95% CI [- 0.99; 0.10; p = 0.112). In contrast, multigravidae during the transmission peak in Ilha Josina carried the lowest pDi (p = 0.049). As PfPRqPCR declined, geometric mean of parasite densities increased (4.63, 95% CI [1.28; 16.82], p = 0.020), and antibody levels declined among secundigravidae from Ilha Josina. CONCLUSIONS: The proportion of detectable and clinically relevant infections is the highest in primigravid women from high-to-moderate transmission settings and decreases with declining malaria. In contrast, the falling malaria trends are accompanied by increased parasite densities and reduced humoral immunity among secundigravidae. Factors other than acquired immunity thus emerge as potentially important for producing less detectable infections among primigravidae during marked declines in malaria transmission

In Vitro and In Vivo Activity of a Palladacycle Complex on Leishmania (Leishmania) amazonensis

Leishmaniasis is an important public health problem with an estimated annual incidence of 1.5 million of new human cases of cutaneous leishmaniasis and 500,000 of visceral leishmaniasis. Treatment of the diseases is limited by toxicity and parasite resistance to the drugs currently in use, validating the need to develop new leishmanicidal compounds. We evaluated the killing by the palladacycle complex DPPE 1.2 of Leishmania (Leishmania) amazonensis, an agent of human cutaneous leishmaniasis in the Amazon region, Brazil. DPPE 1.2 destroyed promastigotes of L. (L.) amazonensis in vitro at nanomolar concentrations, whereas intracellular amastigotes were killed at drug concentrations 10-fold less toxic than those displayed to macrophages. L. (L.) amazonensis-infected BALB/c mice treated by intralesional injection of DPPE 1.2 exhibited a significant decrease of foot lesion sizes and a 97% reduction of parasite burdens when compared to untreated controls. Additional experiments indicated the inhibition of the cathepsin B activity of L. (L.) amazonensis amastigotes by DPPE 1.2. Further studies are needed to explore the potential of DPPE 1.2 as an additional option for the chemotherapy of leishmaniasis

Considerations on extinct species of Brazilian flora

AbstractExtinction risk assessments are important tools for plant conservation. However, misinterpretations can lead to negative consequences for survival of species. Inconsistent categorization as extinction, when the species is still extant, constitutes a Romeo error, and annuls all and any mechanism of existing legal protection. But precisely determining the extinction of a plant species is a challenging task, in that the plants can portray characteristics that permit survival in a state of dormancy. To circumvent this problem, specialists frequently adopt precaution and a comprehensive approach that consider biological, ecological, and geographical parameters as inputs for the assessments. It is also important to include explicit logic arguments, as building-blocks of the rational that will support the assessment. Transparent interpretation of the available data can minimize inconsistent categorization. In Brazil, 23% of the plant species assessed as Extinct or Extinct in the Wild, comprise Romeo errors. The other 77% are cases of Data Deficient. Countries that succeeded in minimizing problems arising from this error developed specific legislation to protect threatened species, including mechanisms to annul an erroneous categorizations. Anyhow, the use of categories Extinct (EX) and Extinct in the Wild (EW) according to IUCN definitions should be avoided when no effort has been made to provide evidence of extinction in the wild

Surgical Treatment of Chronic Giant Left Ventricular Pseudoaneurysm

Left ventricle pseudoaneurysm is usually a severe complication of acute myocardial infarction, caused by rupture of the myocardial wall with pericardium bleeding. Mortality can reach 50 to 80% within a week if not properly treated. Hemodynamic instability, cardiac tamponade, and cardiac arrest are life-threatening presentations that require surgical treatment. We report a case of a man with a left ventricle chronic giant pseudoaneurysm and unspecific symptoms. After critical judgement on a heart team basis, surgical treatment was successfully performed, with a good long-term clinical outcome

Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study

International audienceBackground Low-density Plasmodium falciparum infections prevail in low transmission settings, where immunity is expected to be minimal, suggesting an immune-independent effect on parasite densities. We aimed to describe parasite densities in pregnancy, and determine how gravidity and antibody-mediated immunity affect these, during a period of declining malaria transmission in southern Mozambique. Methods We documented P. falciparum infections at first antenatal care visits ( n = 6471) between November 2016 and October 2019 in Ilha Josina (high-to-moderate transmission area), Manhiça (low transmission area), and Magude (pre-elimination area). Two-way interactions in mixed-effects regression models were used to assess gravidity-dependent differences in quantitative PCR-determined P. falciparum positivity rates ( Pf PR qPCR ) and densities, in the relative proportion of detectable infections (pDi) with current diagnostic tests (≥ 100 parasites/μL) and in antimalarial antibodies. Results Pf PR qPCR declined from 28 to 13% in Ilha Josina and from 5–7 to 2% in Magude and Manhiça. In primigravidae, pDi was highest in Ilha Josina at the first study year ( p = 0.048), which declined with falling Pf PR qPCR (relative change/year: 0.41, 95% CI [0.08; 0.73], p = 0.029), with no differences in antibody levels. Higher parasite densities in primigravidae from Ilha Josina during the first year were accompanied by a larger reduction of maternal hemoglobin levels (− 1.60, 95% CI [− 2.49; − 0.72; p < 0.001), than in Magude (− 0.76, 95% CI [− 1.51; − 0.01]; p = 0.047) and Manhiça (− 0.44, 95% CI [− 0.99; 0.10; p = 0.112). In contrast, multigravidae during the transmission peak in Ilha Josina carried the lowest pDi ( p = 0.049). As Pf PR qPCR declined, geometric mean of parasite densities increased (4.63, 95% CI [1.28; 16.82], p = 0.020), and antibody levels declined among secundigravidae from Ilha Josina. Conclusions The proportion of detectable and clinically relevant infections is the highest in primigravid women from high-to-moderate transmission settings and decreases with declining malaria. In contrast, the falling malaria trends are accompanied by increased parasite densities and reduced humoral immunity among secundigravidae. Factors other than acquired immunity thus emerge as potentially important for producing less detectable infections among primigravidae during marked declines in malaria transmission