Virologia ambiental e saneamento no Brasil: uma revisão narrativa

Os serviços de saneamento básico têm papel fundamental no controle da transmissão de diversos agentes patogênicos de veiculação hídrica, especialmente vírus responsáveis por causar gastroenterites agudas e hepatites. Entre os agentes virais de maior impacto para a saúde pública, podem ser destacados os vírus das hepatites A, os rotavírus e norovírus, adenovírus e enterovírus, os quais são responsáveis pela contaminação de diversos ecossistemas aquáticos brasileiros. A alta circulação de vírus no ambiente vem sendo relacionada às condições sanitárias inadequadas das comunidades, incluindo a falta na cobertura de serviços ou ineficácia de tecnologias convencionais na eliminação ou redução da carga viral presente na água ou no esgoto. Este estudo aborda uma revisão das relações entre virologia, saúde e saneamento, enfatizando a epidemiologia das infecções virais de transmissão hídrica e o impacto na saúde pública

Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors /

Anastomotic leak rates after colorectal surgery remain high. In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis. However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists

A highly virulent variant of HIV-1 circulating in the Netherlands.

We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log <sub>10</sub> increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence