Epidemiological study in Brazilian women highlights that syphilis remains a public health problem

yphilis, an infectious disease considered a global public health concern, can cause stillbirths and neonatal deaths. This highlights the importance of continuous surveillance studies among women of reproductive age. A cross-sectional study was carried out to analyze the prevalence and risk factors associated with Treponema pallidum infection in women assisted by primary health care units in Dourados, a city located in Mato Grosso do Sul State, Brazil, which borders Paraguay. A questionnaire was applied to a population-based sample, blood samples were collected for syphilis testing and multivariable analyses were performed to screen associations with T. pallidum infection. The prevalence of T. pallidum infection was 6.04%. Bivariate analysis showed that women referring multiple sexual partners (c2: 6.97 [p=0.014]), income less 2 minimal wages (c2: 15.93 [p=0.003]), who did not have high school (c2: 12.64 [p=0.005]), and reporting history of STIs (c2: 7.30 [p=0.018]) are more likely to have syphilis. In the multivariate analysis, a highest prevalence ratio was observed in women with income less than 2 minimal wages (PR: 0.96 [95% CI: 0.85 - 0.97]), and who did not have high school (PR: 0.94 [95% CI: 0.90 - 0.98]). In addition, 80% of the women reported irregular use of condoms and 63.89% declared having sexual intercourses with multiple partners, which creates more opportunities for the transmission of the infection. These results highlight the need for healthcare systems to implement initiatives to monitor syphilis screening and the commitment of patients and their sexual partners to the treatment in order to achieve a decrease of new cases

Identificação de um peptideo antifúngico em sementes de Passiflora alata Curtis com similaridade à albumina 2S

Diseases caused by pathogens, including bacteria and fungi can generate many problems to human health and agriculture. In important economically cultivars, such pathogens may contribute to significant losses in yield of agricultural production. The aggravating factor for these two scenarios is the intensive use of conventional compounds to combat these pathogens, leading to selection of highly resistant microorganisms. Furthermore, these compounds can bring severe consequences to the environment, human and animal health. Thus the search for new compounds capable of effectively controlling bacteria and fungi resistant has been a priority. In this report a heterodimeric antifungal protein named Pa-AFP1, showing higher identity with the 2S albumin family, was purified by using 70-100% ammonium sulfate saturation and further purification steps such as anionic exchange Q-Sepharose chromatography associated with HPLC reversed-phase C4 chromatography. Analysis by Tricine-SDS-PAGE revealed two peptide molecular masses of approximately 4,500 Da and 7,000 Da, in the presence of β-mercapthoetanol, while by removing the reducing agent, a single protein with molecular mass of about 11,500 Da was obtained. Moreover, dimeric mass was confirmed by MALDI-TOF analyses (11,569.76 Da). The antifungal protein, named Pa-AFP1, efficiently inhibited the growth of filamentous fungi Colletotrichum gloeosporiodes, and was added to a short list of 2S albumins with antimicrobial properties. Otherwise, this same peptide showed no activity toward bacteria and yeasts. In summary, this compound could be used in the future to develop biotechnological products for the control of phytopathogenic fungi.Doenças causadas por patógenos, incluindo bactérias e fungos podem gerar muitos problemas à saúde humana e à agricultura. Em cultivares economicamente importantes, tais patógenos podem contribuir para perdas significativas no rendimento da produção agrícola. Um fator agravante para esses dois cenários é o uso intensivo de compostos convencionais para combater esses patógenos, levando à seleção de microrganismos extremamente resistentes. Além disso, tais compostos podem trazer severas conseqüências ao meio ambiente bem como à saúde humana e animal. Desta forma, a busca por novos compostos capazes de controlar efetivamente bactérias e fungos patogênicos resistentes, têm sido prioritária. Por estas razões, este trabalho reporta o isolamento de uma nova proteína heterodimérica (Pa-AFP1) de sementes de Passiflora alata com propriedades antifúngicas. Pa-AFP1 foi purificada utilizando precipitação com sulfato de amônio 70-100%, subseqüente cromatografia de troca aniônica em Q-Sepharose e cromatografia de HPLC fase reversa em coluna C4. Análise da massa molecular por meio de gel Tricina-SDS-PAGE revelou uma massa molecular de aproximadamente 4.500 Da para a cadeia menor e cerca de 7.000 Da para cadeia maior totalizando um heterodímero com cerca de 11.500 Da. A massa da forma oligomérica também foi obtida por espectrometria de massa (11569. 63 Da). Análise da seqüência N-terminal mostrou alta identidade entre Pa-AFP1 e albuminas 2S, adicionando assim uma nova proteína à pequena lista de albuminas 2S com atividade antimicrobiana. Além disso, Pa-AFP1 foi capaz de inibir eficientemente o fungo filamentoso Colletotrichum gloeosporiodes, mas foi incapaz de inibir bactérias e fungos leveduriformes. Em suma, Pa-AFP1 poderá futuramente contribuir para o desenvolvimento de produtos biotecnológicos contra fungos fitopatogênicos

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status