Objeto de aprendizagem sobre calendário de vacinação para pessoas vivendo com HIV/AIDS

Este artigo tem o objetivo de apresentar os resultados de um estudo que concebeu e avaliou um Objeto de Aprendizagem (OA) sobre o Calendário Vacinal das Pessoas Vivendo com HIV/AIDS para profissionais que atuam na atenção primária à saúde. As etapas do estudo consistiram em: identificação das necessidades dos profissionais; planejamento da arquitetura do OA; construção do plano de ação pedagógica e storyboard; desenvolvimento e avaliação do OA. A partir da identificação de demandas, foi concebido um recurso educacional, que contemplou o Calendário de Vacinação preconizado para PVHA. Referente à avaliação, observou-se que todos os participantes concordaram que o conteúdo apresentado, as atividades e/ou avaliações incluídas no objeto de aprendizagem são suficientes para permitir que o público-alvo atinja os objetivos propostos. Por fim, obteve-se um curso autoinstrucional voltado a profissionais de saúde, destinado à educação continuada e ofertado na modalidade à distância

Prevalence of Microorganisms and Immunoglobulins in Children with Tonsillar Hypertrophy and Adenoiditis

Introduction: Benign idiopathic tonsillar hypertrophy (HBI) may affect a child's quality of life and sleep. Several studies have sought to relate the clinical features of HBI with the infectious and/or immunologic changes that occur. Objective: To increase the knowledge of the etiology of HBI. Data Synthesis: From 2012 to 2013 we conducted a retrospective observational study of 101 children with HBI who underwent tonsillectomies at Ambulatory ENT General Hospital of the East Zone of São Paulo City, a region with a poor socioeconomic population. Preoperative serologic results were available to confirm mononucleosis, cytomegalovirus, anti-streptolysin O (ASLO) and immunoglobulins. The mean patient age was 5.8 years (55% male, 45% female). Using the Mann-Whitney U test, we identified significant gender differences in the parameters of immunoglobulins (Ig) M (IgM), IgA, and IgE. Forty-seven percent of the patients had increased ASLO levels, and 37% had increased IgE levels. Conclusion: An evaluation of a patient's serologic parameters and laboratory results may be relevant to the etiology and prevention of HBI. Based on the results obtained from the study sample, the identification of etiologic agents and causative factors remain a public health challenge that affects the quality of life of children.Universidade Anhembi MorumbiUniversidade Federal de São Paulo (UNIFESP)Universdidade Cidade de São PauloUNIFESP, EPMSciEL

Modelling the impact of school reopening and contact tracing strategies on Covid-19 dynamics in different epidemiologic settings in Brazil

We simulate the impact of school reopening during the COVID-19 pandemic in three major urban centers in Brazil to identify the epidemiological indicators and the best timing for the return of in-school activities and the effect of contact tracing as a mitigation measure. Our goal is to offer guidelines for evidence-based policymaking. We implement an extended SEIR model stratified by age and considering contact networks in different settings – school, home, work, and community, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening, and also estimate the number of hospitalization and deaths averted by the implementation of contact tracing. Reopening schools results in a non-linear increase in reported COVID-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects in reducing the total number of hospitalizations and deaths. Policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. While contact tracing strategies prevent new infections within school en- vironments, they alone are not sufficient to avoid significant impacts on community transmission

Detecção de genes toxigênicos, susceptibilidade antimicrobiana e antagonismo in vitro de Staphylococcus spp. isolados de queijos artesanais

Staphylococcus spp. isolated from samples of Minas cheese traditionally manufactured following artisan procedures were identified using molecular techniques and further analyzed using PCR and specific primers for the detection of classic enterotoxins (SEA, SEB, SEC, SED, and SEE) and toxic shock syndrome toxin-1 (TSST-1). Specific sea, sec, sed, and see genes were identified using multiplex PCR, whereas seb and tst genes were detected by uniplex PCR. In vitro antagonism with Lactobacillus spp. was evaluated to assess antimicrobial susceptibility. Classic enterotoxins and TSST-1 genes were not detected. The antimicrobials sulfonamide, penicillin, ceftzadime, and oxacillin showed higher resistance rates in the antibiogram (100%, 80%, 60%, and 40%, respectively), whereas other antimicrobials were effective in percentages above 70%. Lactobacillus spp. were able to inhibit Staphylococcus spp. in vitro. Thus, our results indicated that the isolated Staphylococcus spp. were sensitive to the most common antimicrobials tested and were inhibited by Lactobacillus spp.Cepas de Staphylococcus spp. molecularmente identificadas foram submetidas à Reação em Cadeia da Polimerase (PCR), utilizando-se iniciadores específicos para a detecção de genes codificadores de enterotoxinas clássicas (SEA, SEB, SEC, SED, SEE) e da Toxina-1 da Síndrome do Choque Tóxico (TSST-1). Foi realizada PCR-Multiplex para detecção dos genes sea, sec, sed e see. Para seb e tst, foram realizadas PCR-Uniplex. Além disso, foi analisado o perfil de susceptibilidade das cepas a antimicrobianos de diferentes classes e foi verificado antagonismo in vitro entre Lactobacillus spp. e as cepas estudadas. Genes codificadores de enteroxinas clássicas, assim como de TSST-1, não foram encontrados. Em relação ao antibiograma, Sulfonamida, Penicilina, Ceftazidima e Oxacilina apresentaram os maiores percentuais de resistência (100, 80, 60 e 40%, respectivamente). Os demais antimicrobianos foram eficientes em percentuais acima de 70%. Lactobacillus spp. foram capazes de inibir o desenvolvimento in vitro de Staphylococcus spp. Conclui-se que as cepas estudadas não possuem genes codificadores da produção de enterotoxinas clássicas e TSST-1, são sensíveis à maioria dos antimicrobianos e são inibidos por bactérias do gênero Lactobacillus

Influence of the expression of inflammatory markers on kidney after fetal programming in an experimental model of renal failure

Objective. To evaluate the expression of inflammatory markers in experimental renal failure after fetal programming. Methods. The offspring aged two and fivemonths were divided into four groups: CC (control dams, control offspring)DC (diabetic dams, control offspring)CFA (control dams, folic acid offspring, 250 mg/Kg)and DFA (diabetic dams, folic acid offspring). Gene expression of inflammatory markersMCP-1, IL-1, NOS3, TGF-beta, TNF-alpha, and VEGF was evaluated by RT-PCR. Results. MCP-1 was increased in the CFA and DFA groups at two and fivemonths of age, as well as in DC5 when compared to CC5. There was a higher expression of IL-1 in the CFA2, DFA2, and DC2 groups. There was a decrease in NOS3 and an increase in TNF-alpha in DFA5 in relation to CFA5. The gene expression of TGF-beta increased in cases that had received folic acid at two and five months, and VEGF decreased in the CFA5 and DFA5 groups. DC5 showed increased VEGF expression in comparison with CC5. Conclusions. Gestational diabetes mellitus and folic acid both change the expression of inflammatory markers, thus demonstrating that the exposure to harmful agents in adulthood has a more severe impact in cases which underwent fetal reprogramming.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG)Fundacao de Ensino e Pesquisa de Uberaba (FUNEPU)Discipline of General Pathology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, BrazilDepartment of Health Sciences, Lavras Federal University, Lavras, MG, BrazilDiscipline of Physiology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, BrazilNephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, BrazilDepartment of Immunology, Institute of Biomedical Sciences IV, University of São Paulo (USP), São Paulo, SP, BrazilDepartment of General Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, BrazilNephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, BrazilWeb of Scienc

Modeling the impact of school reopening and contact tracing strategies on COVID-19 dynamics in different epidemiologic settings in Brazil

This study was funded by the Brazilian National Council for Scientific and Technological Development (CNPq) - Process # 402834/2020-8 (request for proposals MCTIC/CNPq/FNDCT/MS/SCTIE/Decit Number 07/2020). The funding sources played no role in the study design; collection, analysis, or interpretation of the data; writing the report, or decision to submit the paper for publication. MEB received a technological and industrial scholarship from CNPq (grant number 315854/2020-0). LSF received a masters scholarship from Coordination of Superior Level Staff Improvement (CAPES) (finance code 001). SP was supported by Sao Paulo State Research Support Foundation (FAPESP) (grant number: 2018/24037-4). CF was supported by FAPESP (grant number: 2019/26310-2 and 2017/26770-8). RAK has been supported by CNPq (grant number: 311832/2017-2) and FAPESP (contract number: 2016/01343-7). PIP has been supported by CNPq (grant number: 313055/2020-3). RSK has been supported by CNPq (proc. 312378/2019-0). MQMR received a postdoctoral scholarship from CAPES (grant number 305269/2020-8). CMT has been supported by CNPq productivity fellowship and the National Institute of Science and Technology for Health Technology Assessment (IATS) (proc: 465518/2014-1). AMB received a technological and industrial scholarship from CNPq (grant number 402834/2020-8). LMS received a technological and industrial scholarship from CNPq (grant number 315866/2020-9). JAFD-F has been supported by CNPq productivity fellowship and the National Institutes for Science and Technology in Ecology, Evolution and Biodiversity Conservation (INCT-EEC), supported by MCTIC/CNPq (proc. 465610/2014-5) and FAPEG (proc. 201810267000023).Preprin

Modeling the impact of child vaccination (5–11 y) on overall COVID-19 related hospitalizations and mortality in a context of omicron variant predominance and different vaccination coverage paces in Brazil

Background Developing countries have experienced significant COVID-19 disease burden. With the emergence of new variants, particularly omicron, the disease burden in children has increased. When the first COVID-19 vaccine was approved for use in children aged 5–11 years of age, very few countries recommended vaccination due to limited risk-benefit evidence for vaccination of this population. In Brazil, ranking second in the global COVID-19 death toll, the childhood COVID-19 disease burden increased significantly in early 2022. This prompted a risk-benefit assessment of the introduction and scaling-up of COVID-19 vaccination of children. Methods To estimate the potential impact of vaccinating children aged 5–11 years with mRNA-based COVID-19 vaccine in the context of omicron dominance, we developed a discrete-time SEIR-like model stratified in age groups, considering a three-month time horizon. We considered three scenarios: No vaccination, slow, and maximum vaccination paces. In each scenario, we estimated the potential reduction in total COVID-19 cases, hospitalizations, deaths, hospitalization costs, and potential years of life lost, considering the absence of vaccination as the base-case scenario. Findings We estimated that vaccinating at a maximum pace could prevent, between mid-January and April 2022, about 26,000 COVID-19 hospitalizations, and 4200 deaths in all age groups; of which 5400 hospitalizations and 410 deaths in children aged 5–11 years. Continuing vaccination at a slow/current pace would prevent 1450 deaths and 9700 COVID-19 hospitalizations in all age groups in this same time period; of which 180 deaths and 2390 hospitalizations in children only. Interpretation Maximum vaccination of children results in a significant reduction of COVID-19 hospitalizations and deaths and should be enforced in developing countries with significant disease incidence in children