2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Prevalence and risk factors for intestinal protozoa infection in elderly residents at Long Term Residency Institutions in Southeastern Brazil

This study determined the prevalence of intestinal protozoa in Long Term Residency Institutions for the Elderly (ILPI) in elders, nurses and food handlers, identifying the risk factors associated with the infections. Stool samples taken from the elderly (n = 293), nurses (63) and food handlers (19) were studied. Questionnaires were used with questions related to sociodemographic variables, health, behavior and health characteristics. Stool samples were examined using the techniques of Faust and Ziehl Neelsen, and the prevalence of G. duodenalis, Cryptosporidium spp., E. histolytica/dispar in the elderly was 4.0%, 1.0% and 0.3% respectively. Nurses and food handlers showed 4.8% and 5.2% positivity only for G. duodenalis, respectively. The origin of the individuals and contact with domestic animals has been associated with infection by G. duodenalis in the elderly, and contact with domestic animals was considered a risk factor for infection. The last stool examinations were related to Cryptosporidium spp.. None of the variables were associated with E. histolytica/dispar. The frequency of hand washing was significantly associated with G. duodenalis among nurses. The frequency of positive samples of G. duodenalis, Cryptosporidium spp., E. histolytica/dispar showed that ILPIs environments are conducive to this occurring due to contact between the elderly, nurses and food handlers, which are often poorly trained in hygiene procedures and food handling

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Environmental aspects related to tuberculosis and intestinal parasites in a low-income community of the Brazilian Amazon

We carried out a cross-sectional study from January to December 2015 on 1,425 inhabitants from a floating population in the Brazilian Amazon (Murinin district, Pará State) to describe the population-based prevalence of tuberculosis (TB) from 2011 to 2014, recent TB contacts (rCts) latently infected with Mycobacterium tuberculosis (LTBI) , the coverage of the local health network, socio-environmental factors, and frequency of intestinal parasitic infection (IPI). We found that the sanitary structure was inadequate, with latrines being shared with other rooms within the same accommodation; well water was the main source of water, and 48% of families had low incomes. The average rate of TB was 105/100, 000 inhabitants per year; one third of TB patients had been household contacts of infected individuals in the past, and 23% of rCts were LTBI. More than half (65%) of 44% of the stools examined (representing 76% of the housing) had IPIs; the highest prevalence was of fecal-oral transmitted protozoa (40%, Giardia intestinalis ), followed by soil-transmitted helminths (23%). TB transmission may be related to insufficient disease control of rCts, frequent relocation, and underreporting. Education, adopting hygienic habits, improving sanitation, provision of a treated water supply and efficient sewage system, further comprehensive epidemiological surveillance of those who enter and leave the community and resources for basic treatment of IPIs are crucial in combating the transmission of these neglected diseases

Desordens musculoesqueléticas em violinistas e violistas profissionais: revisão sistemática Musculoskeletal disorders in professional violinists and violists: systematic review

Devido à alta demanda física e psicológica de trabalho, os músicos possuem grande risco de desenvolver uma variedade de problemas de saúde. As maiores causas de desordens musculoesqueléticas observadas em instrumentistas são excesso de uso, compressão nervosa e distonia focal. O objetivo deste artigo é identificar as desordens musculoesqueléticas que acometem com maior freqüência os violinistas e violistas profissionais. Foram lidos 50 artigos, desses, 24 foram utilizados. A escala PEDro foi utilizada para atestar a qualidade dos artigos. A definição dos fatores de risco pode ajudar na elaboração de programas de prevenção. Tocar instrumentos musicais envolve combinação de ações, incluindo movimentos rápidos, repetitivos e complicados das mãos e dedos. As cadeiras não oferecem outra opção senão a adaptação do corpo frente às exigências posturais. Para atingir destreza necessária para se tornar um músico de alto nível, são necessárias muitas horas de treinamento e aperfeiçoamento. O pescoço, ombro e a articulação temporomandibular são os mais afetados devido à posição prolongada de flexão da cabeça e ombro para segurar o violino, cotovelo e dedos também são alvos de desordens. É necessário alertar aos músicos de como são os sintomas iniciais para evitar que o distúrbio se agrave. Nível de Evidência I, Centro de Medicina baseada em Evidência, Oxford, Reino Unido.<br>Due to the high physical and psychological demands of their work, musicians have a high risk of developing a range of health problems. The main causes of musculoskeletal disorders seen in instrumentalists are overuse, nerve compression and focal dystonia. The aim of this paper is to identify the musculoskeletal disorders that most frequently affect professional violinists and violists. 50 articles were read, of which 24 were used. The PEDro scale was used to determine the quality of the articles. The definition of risk factors can help in the development of prevention programs. Playing a musical instrument involves a combination of actions, including rapid, repetitive and complicated movements of the hands and fingers. The chairs used offer no other option than to adapt to the demands of body posture. To achieve the necessary skills to become a musician of a high standard, many hours of training and perfection are required. The neck, shoulder and temporomandibular joints are the most commonly affected areas, due to prolonged flexion of the head and shoulder required to hold the violin. The elbow and fingers are also common sites of disorders. It is necessary to warn musicians of the initial symptoms, and how they can prevent the disorder from worsening. Level I Evidence (Centre for Evidence-Based Medicine, Oxford, UK)

Biological control of invasive stink bugs: review of global state and future prospects

Invasive stink bugs (Hemiptera: Pentatomidae) are responsible for high economic losses to agriculture on a global scale. The most important species, dating from recent to old invasions, include Bagrada hilaris (Burmeister), Halyomorpha halys (Stål), Piezodorus guildinii (Westwood), Nezara viridula (L.), and Murgantia histrionica (Hahn). Bagrada hilaris, H. halys, and N. viridula are now almost globally distributed. Biological control of these pests faces a complex set of challenges that must be addressed to maintain pest populations below the economic injury level. Several case studies of classical and conservation biological control of invasive stink bugs are reported here. The most common parasitoids in their geographical area of origin are egg parasitoids (Hymenoptera: Scelionidae, Encyrtidae, and Eupelmidae). Additionally, native parasitoids of adult stink bugs (Diptera: Tachinidae) have in some cases adapted to the novel hosts in the invaded area and native predators are known to prey on the various instars. Improving the efficacy of biocontrol agents is possible through conservation biological control techniques and exploitation of their chemical ecology. Moreover, integration of biological control with other techniques, such as behavioural manipulation of adult stink bugs and plant resistance, may be a sustainable pest control method within organic farming and integrated pest management (IPM) programs. However, additional field studies are needed to verify the efficacy of these novel methods and transfer them from research to application