Prolonged Fecal Shedding of SARS-CoV-2 in Pediatric Patients. A Quantitative Evidence Synthesis

Objective: To investigate differences in viral shedding in respiratory and fecal samples from children with COVID-19. Methods: We searched PubMed, SCOPUS, Embase and Web of Science databases to identify pediatric studies comparing the pattern of fecal and respiratory shedding of SARS-CoV-2 RNA. Summary estimates were calculated using random-effects models. Results: Four studies reporting data from 36 children were included. A higher proportion of children had viral shedding in stools after 14 days of symptoms onset compared to respiratory samples (RR= 3.2, 95%CI 1.2 to 8.9, I2 = 51%). Viral RNA shedding was longer in fecal samples with a mean difference of approximately 9 days (Mean Difference = 8.6, 95%CI 1.7 to 15.4, I2 = 77%) compared with respiratory samples. Conclusion: SARS-CoV-2 shedding seems to be present in feces for a longer time than in the respiratory tract of children. Although fecal SARS-CoV-2 presence in feces do not confirm its transmissibility, the high and fast spread of the COVID-19 disease worldwide indicate other transmission routes are also plausible

The need to strengthen Primary Health Care in Brazil in the context of the COVID-19 pandemic

The emergence of severe acute respiratory coronavirus 2 (SARS-CoV-2) and its association with severe pneumonia and deaths has exposed gaps in the health systems of several countries worldwide. Although the necessary focus has been to care for hospitalized patients, the strengthening of Primary Health Care (PHC) actions is necessary. PHC is the gateway to the health system in several countries, including Brazil and it plays a role in preventing, protecting, promoting, and treating individuals and communities. Brazil, like other countries, has faced the SARS-CoV-2 pandemic. As Brazil has a universal and decentralized health system, in which PHC has been the model of health re-organizing the health system; here we reflected the importance of strengthening PHC in Brazil in the times of coronavirus disease 2019 pandemic

Tumores de células granulares na língua: relato de 2 casos

ResumoO tumor de células granulares é uma neoplasia benigna incomum com forte predileção pela cavidade oral, com um maior número de casos afetando a região da língua. Apresenta-se geralmente como um nódulo solitário, assintomático, de base séssil, com crescimento lento (meses ou anos) e coloração variável. Apesar da sua etiologia incerta, há estudos que apontam para uma origem neural para a lesão. O presente artigo tem como objetivo apresentar 2 casos clínicos cuja queixa principal era um nódulo submucoso no dorso da língua, com evolução lenta e superfície epitelial hígida. Em ambos os casos, o diagnóstico definitivo foi realizado após a análise histológica e imuno-histoquímica e o tratamento realizado através de excisão cirúrgica conservadora. Também são discutidos os aspetos clínicos, histológicos e imuno-histoquímicos do tumor de células granulares.AbstractThe granular cell tumor is an uncommon benign neoplasm with a strong predilection for the oral cavity, with a greater number of cases affecting the tongue. It typically presents as a solitary nodule, asymptomatic, sessile base, with slow growth (months or years) and variable color. Despite its uncertain etiology, studies suggest a neural origin for the lesion. The aim of this article is to present two clinical cases whose main complaint was a submucosal nodules in the dorsum of the tongue, with slow evolution and healthy surface. In both cases, definitive diagnosis was made after histological and immunohistochemical analysis and the treatment was made with conservative surgical excision. It is also discussed clinical, histological and immunohistochemical features of granular cell tumor

Vitamin D Food Fortification and Nutritional Status in Children: A Systematic Review of Randomized Controlled Trials

Children are in the risk group for developing hypovitaminosis D. Several strategies are used to reduce this risk. Among these, fortification of foods with vitamin D (25(OH)D) has contributed to the achievement of nutritional needs. This systematic review aims to discuss food fortification as a strategy for maintenance or recovery of nutritional status related to vitamin D in children. The work was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International prospective register of systematic reviews (PROSPERO) database (CRD42018052974). Randomized clinical trials with children up to 11 years old, who were offered vitamin D-fortified foods, and who presented 25(OH)D concentrations were used as eligibility criteria. After the selection stages, five studies were included, totaling 792 children of both sexes and aged between two and 11 years. Interventions offered 300–880 IU of vitamin D per day, for a period of 1.6–9 months, using fortified dairy products. In four of the five studies, there was an increase in the serum concentrations of 25(OH)D with the consumption of these foods; additionally, most children reached or maintained su ciency status. Moreover, the consumption of vitamin D-fortified foods proved to be safe, with no concentrations of 25(OH)D > 250 nmol/L. Based on the above, the fortification of foods with vitamin D can help maintain or recover the nutritional status of this vitamin in children aged 2–11 years. However, it is necessary to perform additional randomized clinical trials in order to establish optimal doses of fortification, according to the peculiarities of each region.This research was funded by the National Council for Scientific and Technological Development (CNPq/MS/SCTIE/DECIT/DAB/CGAN), grant number 440809/2017-7. In part by the Coordination of Improvement of Higher Education Personnel—Brazil (CAPES)—Finance Code 001. And by Unidad Científica de Excelencia Ejercicio y Salud (UCEES), University of Granada, Spain

Differences in ballistic findings between autopsy and post-mortem computed tomography in the head and neck region of gunshot victims: a comprehensive synthesis for forensic decision-making

info:eu-repo/semantics/publishedVersio

Anthropometry and lifestyle of children and adolescent in inland of Northeastern Brazil

Introduction: Brazil is going through a nutritional transition, which is observed decrease in malnutrition and increased excess weight.Objective: To evaluate the nutritional status and lifestyle of school children and adolescents from 4 to 17 years old resident in the interior of the Brazilian Northeast.Methods: This is a longitudinal study performed in two stages. The first stage took place during the School Health Program and anthropometric data were collected from 975 schoolchildren. In the second stage, it was used a questionnaire to assess lifestyle and diet. Participants were classified into “not overweight” and “overweight”. The significant level for the statistical tests was set at 5%.Results: In the first stage, less than 2% of students had low height for age. The prevalence of overweight and malnutrition was 22.15% and 5.23%, respectively.  Of the 134 participants of the second stage, 47.76% were not overweight and 52.24% overweight. Regarding the lifestyle, the not overweight group had a higher percentage of insufficiently active members (p = 0.017) and a lower intake of vegetables and salads (p=0.015).Conclusions: The results revealed low short stature in the population studied and overweight was more prevalent than malnutrition. Children and adolescents had sedentary habits that associated with inappropriate dietary practices favor the occurrence of overweight.

Efficiency of entomopathogenic nematodes and chemical insecticides against Sphenophorus levis and Leucothyreus sp. on sugarcane

The sugarcane billbug, Sphenophorus levis (Coleoptera: Dryophthoridae), is an important pest of sugarcane crops in the São Paulo State, Brazil. Their larvae damage plants rhizome, causing losses of up to 30 t ha-1 year-1 of sugarcane. In order to evaluate the effectiveness of entomopathogenic nematodes and chemical insecticides against the sugarcane billbug and the scarab beetle Leucothyreus sp., three field trials were carried out in Brazil. For the first one, 10 treatments were considered: 1) thiametoxan (Actara 250WG) 500 g ha-1 of commercial product (c.p.); 2) thiametoxan 1.0 kg ha-1 c.p.; 3) thiametoxan 1.5 kg ha-1 c.p.; 4) Steinernema brazilense 108 infective juveniles (IJ) ha-1 + thiametoxan 250 g ha-1 c.p.; 5) S. brazilense (108 IJ ha-1) + thiametoxan 500 g ha-1 c.p.; 6) Heterorhabditis indica (108 IJ ha-1) + thiametoxan 250 g ha-1 c.p; 7) H. indica (108 IJ ha-1) + thiametoxan 500 g ha-1 c.p.; 8) S. brazilense (108 IJ ha-1); 9) H. indica (108 IJ ha-1); and 10) Control. The second one consisted of five treatments: 1) thiametoxan (Actara 250WG) 800 g ha-1 c.p.; 2) fipronil (Regente 800WG) 250 g ha-1 c.p.; 3) S. brazilense (108 IJ ha-1); 4) S. brazilense (108 IJ ha-1) + thiametoxan 200 g ha-1 c.p.; and 5) Control. In the third one, all treatments already mentioned for the second trial plus the mixture S. brazilense (108 IJ ha-1) + fipronil (Regente 800WG) 62.5 g ha-1 c.p. were considered. All treatments with the insecticides and nematodes provided higher sugarcane yield, when compared to their respective controls, which were most damaged by S. levis, but without statistical significance. S. brazilense was more efficient on controlling this pest, if compared to H. indica, but without statistical significance. S. brazilense provided a 50% control of Leucothyreus sp. larvae, meanwhile the best treatments against this scarab were the mixtures of this nematode with fipronil (78%) and thiametoxan (83%)

Levothyroxine Replacement Improves Oxidative Status in Primary Hypothyroidism

Objective: Although hypothyroidism has been linked to oxidative stress, data regarding the relationship between thyroid hormone levels and oxidative stress is still inconsistent. This study was designed to evaluate the effect of levothyroxine replacement on oxidative stress in women with primary hypothyroidism.Design: A total of 25 female patients with primary hypothyroidism were included. Oxidative stress markers were measured before and after levothyroxine replacement treatment in all patients.Methods: Oxidative stress was evaluated through the measurement of oxidants (thiobarbituric acid reactive substances [TBARS] and nitrite/nitrate levels), and antioxidants (superoxide dismutase and catalase activity).Results: Antioxidant catalase activity (63.77 ± 23.8 vs. 50.12 ±12.75 atv/min; p = 0.03) was significantly increased and the levels of TBARS (3.02 ± 0.86 vs. 3.55 ± 0.87 μM; p = 0.03) were significantly decreased in the state of euthyroidism after levothyroxine replacement compared to the hypothyroidism before levothyroxine treatment. No significant change in neither nitrite/nitrate concentration (p = 0.18) nor in superoxide dismutase activity (p = 0.93) after L-T4 adjustment was found.Conclusions: Our data demonstrate that levothyroxine replacement improved oxidative status in patients with primary hypothyroidism, indexed by the significantly decreased levels of malonaldehyde (MDA) and increased catalase (CAT) activity