Infecções cutâneas associadas à soropositividade ao HIV: uma abordagem completa

A infecção pelo vírus da imunodeficiência humana (human immunodeficiency vírus – HIV) é responsável pela síndrome da imunodeficiência adquirida, que cursa com a deterioração progressiva do sistema imune devido o acometimento de células linfocitárias, macrófagos e células dendríticas. Ademais, essa patologia se configura como um problema de saúde pública tendo em vista o potencial de complicação associado quando não tratada. Diante da grande quantidade de manifestações dermatológicas associadas à soropositividade do HIV, o presente trabalho tem como objetivo elucidar a etiologia, quadro clínico, diagnóstico, tratamento e complicação das infecções cutâneas, ou seja, decorrentes de algum agente etiológico, relacionadas ao HIV. Foi realizada uma busca nas bases de dados: Biblioteca Virtual de Saúde (BVS), Scientific Eletronic Online (Scielo) e PubMed, por meio dos descritores: “HIV” “Manifestações dermatológicas” “Infecções cutâneas”, e 10 artigos foram utilizados para o desenvolvimento do estudo. Os resultados evidenciaram que as infecções cutâneas se dividem de acordo com o grupo etiológico (viral, bacteriano, fúngico, parasitário e ectoparasitário) e sua gravidade varia a partir do acometimento do sistema imune do paciente. Ademais, foi visto que o tratamento é individualizado para cada agente etiológico, mas, o tratamento da imunossupressão decorrente do HIV sempre deve estar associado. Por fim, é necessário estar atento às interações medicamentosas envolvendo antifúngicos, anti-histamínicos e antirretrovirais e às possíveis complicações decorrentes das infecções não tratadas

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

Anal fistula: results of surgical treatment in a consecutive series of patients

OBJECTIVES: To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. METHODS: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. RESULTS: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. CONCLUSIONS: There was male prevalence (2.2/1), and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.OBJETIVOS: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. MÉTODOS: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. RESULTADOS: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto fistuloso, em 84,2% dos casos. A cicatrização completa ocorreu em todos os pacientes entre 2 e 16 semanas. Cento e setenta e oito pacientes, 84,8% dos pacientes operados, foram avaliados com, pelo menos, um ano de pós-operatório e a recidiva ocorreu em 6,4% dos casos. CONCLUSÕES: Houve prevalência do gênero masculino (2,2/1) com a maioria das fístulas transesfincterianas. A fistulotomia com marsupialização foi o tratamento operatório mais empregado e apresentou baixos índices de morbidade, com recidiva de 6,4%

Estácio de Sá e a fundação do Rio de Janeiro Estácio de Sa and the founding of Rio de Janeiro

O artigo aborda a presença de Estácio de Sá no Rio de Janeiro, bem como a sua fundação e a expulsão dos franceses, que chegaram aqui sob o comando de Villegagnon, em 1555, formando a França Antártica. Discute a participação da armada de Estácio de Sá na guerra contra os tamoios e tupiniquins em São Vicente, a fim de conseguir recursos humanos e mantimentos para retornar à luta na Guanabara. Por fim, questiona se Estácio de Sá teria sido governador ou somente capitão da cidade de São Sebastião do Rio de Janeiro.<br>The article deals with Estacio de Sa's presence in Rio de Janeiro as well as its foundation and the expulsion of the French that arrived here under the command of Villegagnon in 1555 having established the French Antarctic. It argues the participation of the Estacio de Sa armada in the war against the tamoios and tupiniquins in Sao Vicente, which had the purpose of obtaining human resources and supplies to return to the struggle in Guanabara. In the end, it questions as to whether Estacio de Sa had been governor or only captain of the city of Sao Sebastiao in Rio de Janeiro

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora