Safety of the yellow fever vaccine in people living with HIV: a longitudinal study exploring post-vaccination viremia and hematological and liver kinetics

ABSTRACT Background: Safety data on the yellow fever vaccine 17DD in People Living with HIV (PLWH) are limited. This study explored the occurrence of post-vaccination 17DD viremia and the kinetics of hematological and liver laboratorial parameters in PLWH and HIV-uninfected participants [HIV(-) controls]. Methods: We conducted a secondary analysis of a longitudinal interventional trial (NCT03132311) study that enrolled PLWH and HIV(-) controls to receive a single 17DD dose and were followed at 5, 30 and 365 days after vaccination in Rio de Janeiro, Brazil. 17DD viremia (obtained throughreal-time PCR and plaque forming units' assays), hematological (neutrophils, lymphocytes and platelets counts) and liver enzymes (ALT and AST) results were assessed at baseline and Days 5 and 30 post-vaccination. Logistic regression models explored factors associated with the odds of having positive 17DD viremia. Linear regression models explored variables associated with hematological and liver enzymes results at Day 5. Results: A total of 202 PLWH with CD4 > 200 cells/μL and 68 HIV(-) controls were included in the analyses. 17DD viremia was found in 20.0 % of the participants and was twice more frequent in PLWH than in HIV(-) controls (22.8% vs. 11.8 %, p-value < 0.001). Neutrophils, lymphocytes and platelets counts dropped at Day 5 and returned to baseline values at Day 30. 17DD viremia was associated with lower nadir of lymphocytes and platelets at Day 5. ALT levels did not increase post-vaccination and were not associated with 17DD viremia. Conclusions: 17DD was safe and well-tolerated in PLWH with CD4 > 200 cells/μL. Post-vaccination viremia was more frequent in PLWH than in controls. Transient and self-limited decreases in lymphocytes and neutrophils occurred early after vaccination. 17DD viremia was associated with lower lymphocytes and platelets nadir after vaccination. We did not observe elevations in ALT after 17DD vaccination.

Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil

ABSTRACT Syndemic psychosocial and reproductive factors affecting women's retention in HIV care remain understudied. We analyzed correlates of non-retention in a cohort of women with HIV in Brazil from 2000-2015. Participants self-reported exposure to physical/sexual violence, illicit drug use, adolescent pregnancy, or induced abortion. Lifetime history of these psychosocial stressors were used to create a syndemic score based on the presence or absence of these conditions. All dichotomous variables were summed (range 0 to 4), with greater scores indicating more syndemic factors experienced. Logistic regression models identified predictors of non-retention, defined as < 2 HIV viral load or CD4 results within the first year of enrollment. Of 915 women, non-retention was observed for 18%. Prevalence of syndemic factors was adolescent pregnancy (53.2%), physical/sexual violence (38.3%), induced abortion (27.3%), and illicit drug use (17.2%); 41.2% experienced > 2 syndemic conditions. Syndemic scores of 2 and 3 were associated with non-retention, as well as low education, years with HIV and seroprevalent syphilis. Psychosocial and reproductive syndemics can limit women's retention in HIV care. Syphilis infection predicted non-retention and could be explored as a syndemic factor in future studies.

Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil

Abstract Introduction Oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir (FTC/TDF) is highly effective in preventing HIV infection. This study aimed to identify factors associated with PrEP early loss to follow-up (ELFU) among gay, bisexual and other men who have sex with men (MSM), travestis and transgender women (TGW). Methodology This was a prospective cohort study evaluating TGW and MSM who initiated PrEP at the Evandro Chagas National Institute of Infectious Diseases (INI-Fiocruz) from 2014 to 2020. ELFU was defined as not returning for a PrEP visit within 180 days after first dispensation. Exposure variables included age, gender, race, education, transactional sex, condomless anal intercourse [CAI] (both in the past six months), binge drinking and substance use (both in past three months) and syphilis diagnosis at baseline. Multilevel logistic regression models with random intercepts and fixed slopes were used to identify factors associated with ELFU accounting for clustering of participants according to their PrEP initiation study/context (PrEP Brasil, PrEParadas, ImPrEP and PrEP SUS). Results Among 1,463 participants, the median age was 29 years (interquartile range 24-36), 83% self-identified as MSM, 17% as TGW, 24% were black, 37% mixed-black/pardo and 30% had < 12 years of education. Fifteen percent reported transactional sex, 59% reported CAI, 67% binge drinking, 33% substance use, and 15% had a syphilis diagnosis. Overall, 137 participants (9.7%) had ELFU. Younger age (18-24 years) (adjusted odds ratio [aOR] 1.9, 95%CI:1.2-3.2), TGW (aOR 2.8, 95%CI:1.6-4.8) and education < 12 years (aOR 1.9, 95%CI:1.2-2.9) were associated with greater odds of ELFU. Conclusion TGW, young individuals and those with lower education were at higher risk of PrEP ELFU. Our results suggest that the development of specific strategies targeting these populations should be a priority, through policies that aim to reduce the incidence of HIV infection.

Mortality rates by gender and sexual orientation reveal a disproportionally high mortality among cisgender men of unknown sexual orientation and men who have sex with women in a cohort of people living with HIV in Rio de Janeiro, Brazil

ABSTRACT Background: Antiretroviral therapy use has led to a decline in HIV-related mortality yet disparities by gender and/or sexual orientation may exist. In this study, we estimated hazards of death in people living with HIV (PLWH) according to gender and sexual orientation. Methods: We included PLWH ≥ 18 years enrolled between 2000 and 2018 at INI/Fiocruz, Rio de Janeiro, Brazil. Participants were grouped as cisgender or transgender women, cisgender men who have sex with men (MSM) or men who have sex with women, or cisgender men with unknown sexual orientation. We assessed disparities in the hazard of death using Cox proportional hazards models. Results: Among 5,576 PLWH, median age at enrollment was 35 years, 39% were MSM, 28% cisgender women, 23% men who have sex with women, 5% transgender women, and 5% men with unknown sexual orientation. A total of 795 deaths occurred in 39,141 person-years of follow-up. Mortality rates per 1,000 person-years were: 82.4 for men with unknown sexual orientation, 24.5 for men who have sex with women, 18.3 for cisgender, 16.6 for transgender women, and 15.1 for MSM. Compared to MSM, men with unknown sexual orientation had the highest death hazard ratio (adjusted hazard ratio [aHR] 2.93, 95% confidence interval [CI] 2.35-3.81), followed by men who have sex with women (aHR 1.17, 95%CI 0.96, 1.43); death hazard ratios for cisgender and transgender women were not statistically different. Conclusion: We observed disparities in the hazard of death for men with unknown sexual orientation and men who have sex with women despite universal access to antiretroviral therapy in Brazil. Future work should characterize and assist men with unknown sexual orientation with tailored policies and interventions. Increased hazard of death was not observed for transgender women, which probably results from interventions implemented in our service to reach, engage, retain, and support this population.

Low- and high-viscosity bulk-fill resin composites / Resinas compostas bulk-fill de baixa e alta viscosidade

ABSTRACT The aim of this study was to compare low- and high-viscosity bulk-fill composites for Knoop microhardness (KHN), microtensile bond strength (MTBS) to dentin in occlusal cavities, and fracture strength (FS) in molars with mesialocclusal- distal restoration. Disk-shaped samples with different thicknesses (2 or 4 mm) of low-viscosity (SDR Flow, Dentsply) and high-viscosity bulk-fill composites (Filtek BulkFill, 3M ESPE; and Tetric-N Ceram Bulk Fill, Ivoclar Vivadent) were prepared for top and bottom KHN analysis (n=10). MTBS to dentin and fracture pattern was evaluated in human molars with occlusal cavities restored with (n=10): conventional nanocomposite (Z350XT, 3M ESPE), low-viscosity (Filtek Bulk-fill Flow, 3M ESPE) or high-viscosity bulk-fill composites (Filtek BulkFill). The FS and fracture pattern of human molar with mesial-occlusal-distal restorations submitted or not to thermomechanical cycling were investigated (n=10) using: intact tooth (control), and restoration based on conventional microhybrid composite (Z250, 3M ESPE), low-viscosity (SDR Flow) or high-viscosity bulk-fill composites (Filtek BulkFill). The data were submitted to split-plot ANOVA (KHN), one-way ANOVA (MTBS), two-way ANOVA (FS) followed by Tukey's test (α=0.05). For KHN, there was no significant difference for the resin composites between the top and bottom. For MTBS, no significant differences among the materials were detected; however, the low-viscosity composite presented lower frequency of adhesive failures. For FS, there was no significant difference between composites and intact tooth regardless of thermomechanical cycling. Low- and high-viscosity bulk-fill composites have comparable microhardness and microtensile bond strength when used in occlusal restorations. Likewise, the bulk-fill composites present similar fracture strength in molars with mesio-occlusal-distal restorations.

RESUMO O objetivo deste estudo foi comparar resinas compostas bulk- -fill de baixa e alta viscosidade quanto à microdureza Knoop (KHN), resistência de união a microtração (MTBS) em cavidades oclusais e carga à fratura (FS) em molares com restauração mesio-oclusal-distal. Amostras em forma de disco com diferentes espessuras (2 ou 4 mm) de resinas bulk-fill de baixa viscosidade (SDR Flow, Dentsply) e alta viscosidade (Filtek BulkFill, 3M ESPE; e Tetric-N Ceram Bulk Fill, Ivoclar Vivadent) foram obtidas para análise de KHN no topo e na base (n = 10). A MTBS em dentina e o padrão de fratura foram avaliados em molares humanos com cavidades oclusais restauradas com (n = 10): resina composta nanoparticulada convencional (Z350XT, 3M ESPE), resinas bulk-fill de baixa viscosidade (Filtek Bulk-fill Flow, 3M ESPE) ou alta viscosidade (Filtek BulkFill). Foram investigados a FS e o padrão de fratura de molares humanos em restaurações mesial-ocluso-distais sub metidas ou não à ciclagem termomecânica (n = 10), sendo: dente íntegro (controle), e restaurações baseadas em resina composta microhíbrida convencional (Z250, 3M ESPE); resinas bulk-fill de baixa viscosidade (SDR Flow) ou alta viscosidade (Filtek BulkFill). Os dados foram submetidos a split-plot ANOVA (KHN), one-way ANOVA (MTBS), two-way ANOVA (FS) seguidos do teste de Tukey (α = 0,05). Para KHN, não houve diferença significativa entre o topo e a base para as resinas compostas. Para MTBS, não foram detectadas diferenças significativas entre os materiais; entretanto, a resina bulk-fill de baixa viscosidade apresentou menor frequência de falhas adesivas. Para FS, não houve diferença significativa entre os materiais e o dente íntegro, independentemente da ciclagem termomecânica. As resinas bulk-fill de baixa e alta viscosidade têm microdureza e resistência à microtração comparáveis quando usados em restaurações oclusais. Da mesma forma, as resinas bulk-fill apresentam resistência à fratura semelhante em molares com restaurações mesio-oclusal-distais.

Experiencias docentes en el cambio curricular vivido en la carrera de enfermería de la FES, Iztacala / Teaching experiences in the curricular change experienced in the nursing career of the FES Iztacala

Introducción: la calidad educativa en las IES (Instituciones de Educación Superior) ha sido avalada por procesos de evaluación y acreditación a nivel institucional y curricular, llevando a cabo un proceso de mejora continua, mediante recomendaciones sugeridas por los evaluadores, lo anterior garantizará la calidad institucional ante la formación de futuros profesionales. Objetivo: analizar las experiencias del profesorado de la carrera de enfermería de la Facultad de Estudios Superiores Iztacala, sobre el cambio curricular vivido. Material y métodos: estudio cualitativo con enfoque fenomenológico, mediante entrevista a profundidad a doce profesores de enfermería. Muestreo por conveniencia de acuerdo a la saturación de datos. En aspectos éticos y legales, se realizó carta de consentimiento informado. El análisis de datos fue basado en Miles y Huberman, con abordaje teórico según Van Manen. Resultados: surgieron dos categorías: 1. Sentimientos y afectaciones emocionales respecto al cambio curricular y laborales; 2. impacto del cambio curricular en los aprendizajes de los estudiantes, las cuales evidenciaron cómo el profesorado ha vivido los cambios curriculares en los 17 años desde que fue implementada la licenciatura. Conclusiones: los informantes narraron que en cada cambio curricular surgen emociones diferentes, entre incertidumbre, compromiso, responsabilidad y asumir empoderamiento para implementar la curricula, con ello, lograr los objetivos esperados por la misma, considerando perfil de egreso y rendimiento académico de los estudiantes.

Introduction: the educational quality at the higher level in schools and faculties has been endorsed by evaluation and accreditation processes at the institutional and curricular level, carrying out an improvement process, through the recommendations suggested by the evaluators, thus covering them in a certain time. The foregoing will guarantee the institutional quality before the training of future professionals. Objective: to analyze experiences of the teaching staff of the nursing career of the Iztacala Faculty of Higher Studies, on the curricular change experienced. Material and methods: Qualitative study with a phenomenological approach, through an in-depth interview with twelve nursing professors. Convenience sampling according to data saturation. In ethical and legal aspects, an informed consent letter was drawn up. The data analysis was through Miles and Huberman, with a theoretical approach based on Van Manen. Results: two categories emerged: 1. Feelings and emotional affectations regarding the curricular and work change; 2. impact of curricular change on student learning, which showed how teachers have experienced curricular changes in the 17 years since the degree was implemented. Conclusions: the informants narrated that in each curricular change different emotions arise, between uncertainty, commitment, responsibility and assuming empowerment to implement the curriculum, thereby achieving the objectives expected by it, considering the graduation profile and the academic performance of the students.

Sofrimento e trabalho em tempos de pandemia: uma intervenção clínica com educadores / Sufrimiento y trabajo en tiempos de pandemia: una intervención clínica con educadores / Suffering and work in times of pandemic: an enlarged clinical intervention with educators / Souffrance et travail en temps de pandémie: une intervention clinique élargiee auprès des educateurs

Com base em um projeto de intervenção social clínica, fundamentado na psicanálise e dirigido ao atendimento de professores do ensino básico da rede municipal do Rio de Janeiro, são analisados neste artigo aspectos envolvidos em sua experiência subjetiva. É priorizada a questão de sua relação com a esfera do trabalho, tendo como foco central as ressonâncias psíquicas do confronto sofrido por eles com a situação da pandemia da Covid-19. Trata-se de abordar seu impacto na rotina das atividades de trabalho desses sujeitos, na área da Educação, já marcadas pela precariedade social, fonte de vulnerabilidade psíquica. O isolamento social imposto pela pandemia, aliado a outras consequências, evidenciou, e mesmo acentuou esse quadro, objeto de especial atenção na proposta clínica, cujas linhas mestras são brevemente trazidas no texto.

Basado en un proyecto de intervención social clínica, apoyado en la psicoanálisis y dirigido a la asistencia a profesores de la enseñanza de la red municipal en Rio de Janeiro, analizamos aspectos envueltos en su experiencia subjetiva. La cuestión de su relación con la esfera del trabajo es priorizada, habiendo como foco central las resonancias psíquicas del confronto que ellos sufren con la situación de la pandemia de Covid-19. Es cuestión de abordar su impacto en la rutina de las actividades de trabajo de esos sujetos, en el área de la Educación, ya marcadas por la precariedad social, fuente de vulnerabilidad psíquica. El aislamiento social impuesto por la pandemia ha evidenciado tal cuadro, objeto de atención en la propuesta clínica, cuyas líneas maestras están brevemente expuestas en el texto.

Based on a project of social clinical intervention, founded on psychoanalysis and addressed to the assistance of teachers of basic education in the local network in Rio de Janeiro, we examine in this article some features involved in their subjective experience. The issue of their relation to the sphere of work is prioritized, having as a central focus the psychic resonances of the confrontation they endured in the situation of Covid-19 pandemic. It's a matter of approaching its impact on the routine of work of these individuals in the area of education, already marked by social precariousness, source of psychic vulnerability.The social isolation imposed by the pandemic highlighted and even reinforced such picture, object of attention in the clinical proposition whose guidelines are briefly developed in the text.

En tenant comme base un projet d'intervention social clinique, en ayant comme fondement la psychanalyse, projet consacré au soin de professeurs de l'enseignement assuré par le reseau municipal de Rio de Janeiro, dans cet article des aspects liés à leur expérience subjective seront analysés. La question de leur relation avec le champs du travail sera privilegiée dont l'axe central sont les ressonances psychiques de la confrontation de ces sujets avec la pandémie du Covid 19. Il s'agit d'aborder son impact sur leur quotidien de travail, dans le champs de l'Education, déjà marqué par la precarité social, source de vulnérabilité psychique. L'isolement social, imposé par la pandémie a evidentié et a aussi acentué ce cadre, objet d'attention dans la proposition clinique dont les grandes lignes sont syntétiquementpresentées dans ce texte.

SARS-CoV-2 testing disparities across geographical regions from a large metropolitan area in Brazil: Results from a web-based survey among individuals interested in clinical trials for COVID-19 vaccines

ABSTRACT After more than a year since the novel coronavirus (SARS-CoV-2) disease 2019 or COVID-19 has reached the status of a global pandemic, the number of COVID-19 cases continues to rise in Brazil. As no effective treatment been approved yet, only mass vaccination can stop the spread of SARS-CoV-2 and end the COVID-19 pandemic. Multiple COVID-19 vaccine candidates are under development and some are currently in use. This study aims to describe the characteristics of individuals who have registered in an online platform to participate in clinical trials for COVID-19 vaccines. Additionally, participants' characteristics according to age and presence of comorbidities associated with severe COVID-19 and differences of SARS-CoV-2 testing across different geographical areas/neighborhoods are provided. This was a cross-sectional web-based study conducted between September and December/2020, aiming to reach individuals aged ≥18 years who live in Rio de Janeiro metropolitan area, Brazil. Among 21,210 individuals who completed the survey, 20,587 (97.1%) were willing to participate in clinical trials for COVID-19 vaccines. Among those willing to participate, 57.8% individuals were aged 18-59 years and had no comorbidity, 33.7% were aged 18-59 years and had at least one comorbidity, and 8.6% were aged ≥ 60 years regardless the presence of any comorbidity. Almost half (42.6%) reported ever testing for COVID-19, and this proportion was lower among those aged ≥ 60 years (p < 0.001). Prevalence of positive PCR results was 16.0%, higher among those aged 18-59 years (p < 0.009). Prevalence of positive antibody result was 10.0%, with no difference across age and comorbidity groups. Participants from areas/neighborhoods with higher Human Development Index (HDI) reported ever testing for SARS-CoV-2 more frequently than those from lower HDI areas. Interest to participate in clinical trials for COVID-19 vaccines candidates in Rio de Janeiro was significantly high. The online registry successfully reached out a large number of individuals with diverse sociodemographic, economic and clinical backgrounds.

Acute lymphocytic leukemia associated with toxoplasmosis: case report / Leucemia linfoblástica aguda associada à toxoplasmose: relato de caso

ABSTRACT Rare clinical case of acute lymphocytic leukemia (ALL) associated with toxoplasmosis affecting a 23-year-old male patient with progressive dyspnea. Chest computed tomography revealed expansive lesions indicating right supraclavicular fossa lymph node enlargement and right pleural effusion. Toxoplasmosis serology was performed: positive for immunoglobulin G [(IgG) 180.6] and positive for immunoglobulin M [(IgM) 0.98]. Therefore, treatment for the infection was initiated and immunohistochemistry of left cervical lymph node revealed ALL. Consequently, chemotherapy treatment was introduced at an oncology center. The diagnosis of toxoplasmosis allowed treatment to be administered, preventing the worsening of the condition caused by chemotherapy-induced immunosuppression.

RESUMEN Reportamos un caso clínico raro de leucemia linfocítica aguda (LLA) asociada a toxoplasmosis en un paciente masculino de 23 años con cuadro de disnea progresiva. La tomografía de tórax reveló lesiones expansivas, indicando agrandamiento de los ganglios linfáticos en fosa supraclavicular derecha y derrame pleural a la derecha. Examen serológico para toxoplasmosis: inmunoglobulinas G (IgG) e inmunoglobulinas M (IgM) positivas - 180,6 y 0,98, respectivamente. Se inició el tratamiento de la infección; la inmunohistoquímica de ganglio linfático cervical izquierdo reveló LLA. Se llevó a cabo la quimioterapia en un hospital oncológico. El diagnóstico de toxoplasmosis permitió hacer el tratamiento, impidiendo que la inmunosupresión inducida por la quimioterapia agravara el cuadro clínico.

RESUMO Relatamos um caso clínico raro de leucemia linfoblástica aguda (LLA) associada à toxoplasmose em um paciente do sexo masculino, 23 anos, com quadro de dispneia progressiva. A tomografia de tórax revelou lesões expansivas, indicando linfonodomegalias em fossa supraclavicular direita e derrame pleural à direita. Sorologia realizada para toxoplasmose: imunoglobulinas da classe G (IgG) e da classe M (IgM) positivas - 180,6 e 0,98, respectivamente. Tratamento para a infecção foi iniciado; estudo imuno-histoquímico de linfonodo cervical esquerdo foi realizado, revelando LLA. Institui-se tratamento quimioterápico em centro oncológico. O diagnóstico de toxoplasmose permitiu que o tratamento fosse feito, impedindo que a imunossupressão induzida pela quimioterapia agravasse o quadro clínico.

Different gene expression profiles in subcutaneous & visceral adipose tissues from Mexican patients with obesity

Background & objectives: Obesity is a health problem that requires substantial efforts to understand the physiopathology of its various types and to determine therapeutic strategies for its treatment. The objective of this study was to characterize differences in the global gene expression profiles of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) between control patients (normal weight) and patients with obesity (IMC?30) using microarrays. Methods: Employing RNA isolated from SAT and VAT samples obtained from eight control and eight class I, II and III patients with obesity, the gene expression profiles were compared between SAT and VAT using microarrays and the findings were validated via real-time quantitative polymerase chain reaction. Results: A total of 327 and 488 genes were found to be differentially expressed in SAT and VAT, respectively (P?0.05). Upregulation of PPAP2C, CYP4A11 and CYP17A1 genes was seen in the VAT of obese individuals. Interpretation & conclusions: SAT and VAT exhibited significant differences in terms of the expression of specific genes. These genes might be related to obesity. These findings may be used to improve the clinical diagnosis of obesity and could be a tool leading to the proposal of new therapeutic strategies for the treatment of obesity.

Ecology of phlebotomine sand flies in an area of leishmaniasis occurrence in the Xakriabá Indigenous reserve, Minas Gerais, Brazil

Abstract INTRODUCTION: Leishmaniasis is a complex vector-borne infectious diseases caused by protozoan parasites in the genus Leishmania and spread by hematophagous phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae). The aim of this study was to investigate the phlebotomine fauna, endophily and exophily of the species found, and possible influence of climatic factors on their populations. METHODS: The study was conducted in the Xakriabá Indigenous Reserve (XIR) in the municipality of São João das Missões in northern Minas Gerais state, Brazil. Insects were collected over three consecutive nights in the last week of each month for 12 months from July 2015 to May 2016 from four houses in four different villages. Two traps were set up in each house: one in the intra-domicile and another in the peri-domicile. RESULTS: A total of 2,012 phlebotomine sand fly specimens representing 23 species and belonging to 10 different genera were captured and identified. Among the studied villages, Riacho do Brejo showed the highest density and diversity of phlebotomine sand flies. The species Lutzomyia longipalpis (80.3%) and Nyssomyia intermedia (7.3%), which are major vectors of visceral and cutaneous leishmaniasis, respectively, had the highest population densities, both in the intra- and peri-domicile. No correlation was observed between climatic factors and the density of phlebotomine sand flies. CONCLUSIONS: The results of the present study may contribute to a better understanding and targeting of the measures for preventing and controlling leishmaniasis by the authorities responsible for indigenous health.

Uso de la matriz hemostática Floseal® en el control de la hemorragia obstétrica: estudio de seguimiento y costos asociados con el tratamiento / Use of Floseal® hemostatic matrix in the management of obstetric hemorrhage: A follow-up and costs related to treatment

Resumen OBJETIVO Evaluar cómo se atendieron las pacientes con hemorragia obstétrica, qué recursos se utilizaron y los costos directos relacionados con el tratamiento de pacientes con placenta previa, con o sin placenta acreta, en quienes se indicó Floseal® como parte de las medidas de control e inhibición de la hemorragia en comparación con quienes solo recibieron los cuidados convencionales. MATERIALES Y MÉTODOS Estudio retrospectivo, observacional y comparativo de los expedientes clínicos de pacientes adultas con más de 20 semanas de gestación y placenta previa tratadas entre septiembre y noviembre del 2012 en la Unidad Médica de Alta Especialidad 23 en Monterrey, México. Los resultados clínicos y costos se compararon con pruebas paramétricas y no paramétricas. RESULTADOS Se analizaron 29 expedientes (15: Floseal® coadyuvante, 14: solo con tratamiento convencional). El grupo tratado con Floseal® tuvo menos reintervenciones (0 vs 57.1%, p 0.0010), días de estancia hospitalaria [2(2-4) vs 6(4-11), p 0.0048] y cuidados intensivos (2.4 ± 1.5 vs 4.5 ± 2.1, p 0.0048). El costo promedio por remuestreo fue de 109,172.00 pesos mexicanos (IC95%: 80,153.10-139,073.71 pesos) para Floseal® vs 224,289.00 pesos mexicanos (IC95%: 181,881.48-269,061.23 pesos) para el tratamiento convencional a expensas de un número de piezas mayor de Tisseel®, crioprecipitados, cristaloides y retiro quirúrgico de compresas. CONCLUSIONES El uso coadyuvante de Floseal® se asoció con menor número de reintervenciones, días de estancia hospitalaria y atención en cuidados intensivos. Se registraron menores costos promedio y total asociados con la atención. Para corroborar estos resultados en población mexicana se requieren análisis de largo seguimiento y con muestras más grandes.

Abstract OBJECTIVE To evaluate the clinical outcomes and direct costs related to treatment of placenta previa with Floseal® hemostatic matrix as part of the treatment of obstetric hemorrhage in comparison with conventional management only. METHODS Clinical records of patients with hemorrhagic hemorrhage, with more than 20 weeks of pregnancy and placenta previa were reviewed, all patients were adults and treated within September and November of 2012 in the "Unidad Médica de Alta Especialidad 23" of the Mexican Institute of Social Security, Monterrey, México. Costs where estimated using the Diario Oficial de la Federación 2013) and a resampling was performed. Clinical and costs outcomes where compared with parametric and non-parametric tests. RESULTS 29 clinical records (15: Adjuvant Floseal®, 14: conventional treatment only). Floseal® group resulted in less re-interventions (0% vs 57.1%, p 0.0010), days of hospital stay [2(2-4) vs 6(4-11), p 0.0048] and days in the intensive care unit (2.4 ± 1.5 vs 4.5 ± 2.1, p 0.0048). Average cost by resampling was $109,172.00 [CI95% (80,153.10-139,073.71 mexican pesos)] for Floseal® vs 224,289.00 mexican pesos [IC95% (181,881.48-269,061.23)] for conventional treatment at the expense greater number of pieces of Tisseel®, cryoprecipitate, crystalloids and surgical removal of compresses. CONCLUSIONS The adjuvant use of Floseal® was associated with fewer re-interventions, days of hospital stay and intensive care. Lower average and total costs associated with treatment were also estimated. Future long-term analyzes and larger sample sizes are necessary to corroborate these results in the Mexican population.

Transmitted drug resistance in patients with acute/recent HIV infection in Brazil

Abstract Introduction: The widespread use of antiretroviral therapy increased the transmission of antiretroviral resistant HIV strains. Antiretroviral therapy initiation during acute/recent HIV infection limits HIV reservoirs and improves immune response in HIV infected individuals. Transmitted drug resistance may jeopardize the early goals of early antiretroviral treatment among acute/recent HIV infected patients. Methods: Patients with acute/recent HIV infection who underwent resistance test before antiretroviral treatment initiation were included in this analysis. HIV-1 sequences were obtained using an in house protease/reverse transcriptase genotyping assay. Transmitted drug resistance was identified according to the Stanford HIV Database for Transmitted Drug Resistance Mutations, based on WHO 2009 surveillance list, and HIV-1 subtyping according to Rega HIV-1 subtyping tool. Comparison between patients with and without transmitted drug resistance was made using Kruskal-Wallis and Chi-square tests. Results: Forty-three patients were included, 13 with acute HIV infection and 30 with recent HIV infection. The overall transmitted drug resistance prevalence was 16.3% (95% confidence interval [CI]: 8.1-30.0%). The highest prevalence of resistance (11.6%, 95% CI: 8.1-24.5) was against non-nucleoside reverse transcriptase inhibitors, and K103N was the most frequently identified mutation. Conclusions: The high prevalence of nonnucleoside reverse transcriptase inhibitors resistance indicates that efavirenz-based regimen without prior resistance testing is not ideal for acutely/recently HIV-infected individuals in our setting. In this context, the recent proposal of including integrase inhibitors as a first line regimen in Brazil could be an advantage for the treatment of newly HIV infected individuals. However, it also poses a new challenge, since integrase resistance test is not routinely performed for antiretroviral naive individuals. Further studies on transmitted drug resistance among acutely/recently HIV-infected are needed to inform the predictors of transmitted resistance and the antiretroviral therapy outcomes among these population.

Hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV infected patients from Rio de Janeiro, Brazil

Abstract In this study, we evaluated trends in hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV-infected patients in Rio de Janeiro, Brazil, from 2007 through 2013. Among the 3991 included patients, 1861 hospitalizations occurred (hospitalization rate of 10.44/100 person-years, 95% confidence interval 9.98-10.93/100 person-years). Hospitalization rates decreased annually (per year incidence rate ratio 0.92, 95% confidence interval 0.89-0.95) as well as length of stay (median of 15 days in 2007 vs. 11 days in 2013, p-value for trend < 0.001), and in-hospital mortality (13.4% in 2007 to 8.1% in 2013, p-value for trend = 0.053). Our results show that, in a middle-income setting, hospitalization rates are decreasing over time and non-AIDS hospitalizations are currently more frequent than those related to AIDS. Notwithstanding, compared with high-income settings, our patients had longer length of stay and higher in-hospital mortality. Further studies addressing these outcomes are needed to provide information that may guide protocols and interventions to further reduce health-care costs and in-hospital mortality.

COMPARACIÓN DE DOS TIPOS DE SACRIFICIO Y DIFERENTES TIEMPOS DE MADURACIÓN SOBRE VARIABLES FÍSICO-QUÍMICAS Y MICROBIOLÓGICAS DE LA CARNE DE CUY (Cavia porcellus) / COMPARISON OF TWO TYPES OF SACRIFICE AND DIFFERENT RIPENING TIMES ON PHYSICO-CHEMICAL AND MICROBIOLOGICAL VARIABLES OF GUINEA PIG (Cavia porcellus) MEAT

El objetivo fue determinar el comportamiento de las variables fisicoquímicas y microbiologías durante la maduración de la carne de cuy (Cavia porcellus), utilizando dos métodos de insensibilización (desnucamiento y electronarcosis). La investigación se realizó en los laboratorios de la Universidad de Nariño y se utilizaron 24 animales: 12 para cada método. Los animales ayunaron 12 h antes del sacrificio y las canales se maduraron en refrigeración (2 a 4°C) durante 24 h. Se determinaron las variables pH, acidez, temperatura, capacidad de retención de agua (CRA), conductibilidad eléctrica (CE) y pérdida de agua en refrigeración cada 4 h. Se evaluaron los parámetros microbiológicos coliformes totales y fecales a las 0, 16 y 24 h, además de Listeria sp. y la presencia de antibióticos (sulfamidas) al inicio de la maduración. Para detectar diferencia entre métodos de insensibilización para las variables fisicoquímicas se utilizó un diseño de medidas repetidas en el tiempo; para las demás variables se utilizó estadística descriptiva. Los resultados mostraron que el mejor tiempo de maduración fue a las 16 horas, con un pH promedio de 5,42, acidez de 0,272 % y CRA de 12,73. Además, las variables microbiológicas estuvieron por debajo de la norma vigente garantizando la inocuidad de la carne evaluada. No se observó diferencia estadísticas entre métodos de insensibilización y los resultados de antibióticos fueron negativos. Se concluye que el tiempo adecuado de maduración para la carne de cuy fue de 16 horas sin diferencias en el método de insensibilización.

The objective was to determine the behavior of the physicochemical and microbiological during ripening of meat of guinea pig (Cavia porcellus) variables, using two methods of desensitization (whiplash and electric stun). The research was conducted in the laboratories of the University of Narino and 24 animals were used: 12 for each method. 12h fast animals before slaughter and channels matured under refrigeration (2-4°C) for 24 h. the variables pH, acidity, temperature, water retention capacity (WRC), electrical conductivity (EC) and cooling water loss every 4 hours were determined. Total coliforms and fecal parameters were evaluated at 0, 16 and 24 h, plus Listeria sp. and presence of antibiotics (sulfonamides) at the start of ripening. To detect difference between desensitization methods for physicochemical variables repeated measures design was used in time; whereas for the other variables descriptive statistics were used. The results showed that the best time to maturity was at 16 hours, with an average pH of 5.42, 0.272% acidity and CRA of 12.73. Further, microbiological variables were below the current standard guaranteeing the safety of meat assessed. No statistical difference was observed between desensitization methods and results were negative antibiotics. It is concluded that the proper ripening time for guinea pig meat was 16 hours without differences in the method of desensitization.

Distúrbios da voz: representações sociais por professores em tratamento fonoaudiológico / Voice disorders: social representations by teachers in speech therapy / Trastornos de la voz: representaciones sociales por profesores en el tratamiento fonoaudiológico

A voz é fundamental para o exercício da docência, requerendo intenso e adequado processamento muscular para atender à demanda em sala de aula. Elevadas prevalências de distúrbio vocal e falta ao trabalho por causa da voz entre professores têm sido confirmados. O objetivo deste estudo foi comparar as representações sociais sobre o distúrbio vocal e o enfrentamento do problema, elaboradas por professores em tratamento fonoaudiológico. Realizaram-se dezoito entrevistas semi-estruturadas por meio de grupos focais, as quais foram submetidas à análise temática. De modo geral, as representações sociais sobre os distúrbios da voz e as ações institucionais a ele associadas (gestão e assistência) influenciam a declaração, o reconhecimento e o enfrentamento do problema, visto, ora como disfonia ocupacional, ora como doença individual. Identificou-se um paradoxo entre a vigência tanto de sintomas vocais quanto de incapacidade para o trabalho e a negação de tais problemas. Convergente ao aporte da literatura, a declaração do sintoma não é imediata à sua expressão clínica, ou, apesar de declarados ou assumidos, tais sintomas são relegados a segundo plano pelos próprios professores. O adoecimento e os sintomas influenciam na capacidade do professor em responder às demandas do ensino e às exigências da gestão. A elaboração de programas de prevenção e promoção da saúde vocal será beneficiada se consideradas as representações sociais da disfonia.

The voice is fundamental for teaching, given the intense muscle processing that needs to be properly implemented in order to meet classroom demands. High prevalence of voice disorders and absence from work due to voice problems among teachers have been confirmed. The objective of this study was to compare the social representations regarding voice disorders and coping strategies that teachers undergoing speech therapy describe. Eighteen semi-structured interviews were conducted by means of focus groups, and the content was subjected to thematic analysis. In a general manner, the social representations regarding voice disorders and the institutional actions that are associated with these disorders (management and assistance) influence how the problem is announced, recognized and coped with, seen now as occupational dysphonia or as individual illness. A paradox between on the one hand, surveillance of vocal symptoms and incapacity for work; and on the other, denial of such problems, was identified. Converging to literature contribution, the symptom statement is not immediate to its clinical expression, or in spite of declared or assumed such symptoms are relegated to the background by teachers themselves. The disease and symptoms influence the teacher's ability to respond to the demands of education and the requirements of management. The development of prevention programs and for promotion of voice health will benefit if considered the social representations of dysphonia.

La voz es fundamental para el ejercicio de la docencia, requiriendo un intenso y adecuado procesamiento muscular para atender la demanda de la sala de aula. Se han confirmado entre los profesores elevadas prevalencias de trastorno vocal y faltas al trabajo por problemas en la voz. El objetivo de este estudio es comparar las representaciones sociales sobre los trastornos vocales y la forma como se enfrenta el problema, elaboradas por profesores en tratamiento fonoaudiológico. Se realizaron dieciocho entrevistas semi-estructuradas por medio de grupos focales, las cuales fueron sometidas al análisis temático. De forma general, las representaciones sociales sobre los trastornos de la voz y las acciones institucionales a ellas asociadas (gestión y asistencia) influenciaron la declaración, el reconocimiento y el enfrentamiento del problema, visto a veces como disfonía ocupacional, otras veces como enfermedad individual. Se identificó una incongruencia entre la vigencia sea de síntomas vocales sea de incapacidad para el trabajo, y la negación de estos problemas. Convergiendo con la contribución de la literatura, la declaración de los síntomas no es inmediata para su manifestación clínica, o a pesar de declarados o asumidos, tales síntomas son relegados a un segundo plano por los propios maestros. La enfermedad y los síntomas influyen en la capacidad del profesor para responder a las exigencias de la educación y a los requisitos de gestión. La elaboración de programas de prevención y de promoción de la salud vocal se beneficiará si se consideran las representaciones sociales de la disfonía.

Espiritualidade, depressão e qualidade de vida no enfrentamento do câncer: estudo exploratório / Spirituality, depression, and quality of life in the fight of cancer: an exploratory study / Espiritualidad, depresión y calidad de vida en el enfretamiento del cáncer: estudio esploratorio

Este trabalho teve como objetivo investigar inter-relações entre bem-estar espiritual, depressão e qualidade de vida durante o enfrentamento do câncer por pacientes da Casa de Apoio aos Pacientes com Câncer – Vencer. Quinze pacientes diagnosticados com câncer, independentemente do tipo de neoplasia, foram sorteados e participaram da pesquisa mediante o consentimento livre e esclarecido. Foram aplicados os seguintes instrumentos: escala analógica de avaliação do bem-estar espiritual; inventário Beck para depressão; escala de qualidade de vida da Organização Mundial de Saúde e uma entrevista semi estruturada. Para a análise dos dados, utilizou-se a análise correlacional estatística e a análise de categorias das entrevistas semi estruturadas. A população estudada apresentou bem-estar espiritual e religioso moderados, o que sugere que o câncer favorece a busca pela espiritualidade e religiosidade como mecanismos de enfrentamento do sofrimento. As correlações apontam para uma busca significativa do paciente oncológico por espiritualidade e melhora em sua qualidade de vida. O apoio do cônjuge, demais familiares, amigos e pessoas religiosas constituem uma rede social de apoio ao paciente oncológico.

This exploratory study aimed to investigate the quantitative and qualitative interrelationships between spiritual well-being, depression, and the quality of life of cancer patients from the Support House for Cancer Patients–Vencer. Fifteen patients diagnosed with cancer, regardless of the type of neoplasma, were randomly selected and participated in the study after signing the informed consent form. The Spiritual Well-Being Analog Assessment Scale, Beck Depression Inventory, World Health Organization Quality of Life Instrument, and a semi-structured interview were used for data collection. The data was analyzed using correlations and analysis of the semi-structured interview categories. In this study, the entire population displayed moderate spiritual and religious welfare, suggesting that the onset of cancer suggesting that the onset of cancer stimulate the pursuit of spirituality and religiosity as coping mechanisms. The correlations indicate significant search for spirituality by cancer patients and desire for improvement in their quality of life. Support from spouses, family members, friends, and religious figures represent a social support network for cancer patients. In this context, it is noteworthy that the psychological work is relevant for the therapeutic monitoring of patients, family members, and caregivers.

Este trabajo tuvo como objetivo investigar inter-relaciones entre bienestar espiritual, depresión y calidad de vida durante el enfrentamiento del cáncer por pacientes de la Casa de Apoyo a los Pacientes con Cáncer-Vencer. Quince pacientes diagnosticados con cáncer, independientemente del tipo de neoplasia, fueron sorteados y participaron de la investigación mediante el consentimiento libre y aclarado. Se aplicaron los siguientes instrumentos: escala analógica de evaluación del bienestar espiritual; inventario Beck para depresión; escala de calidad de vida de la Organización Mundial de Salud y una entrevista semi-estructurada. Para el análisis de los datos, se utilizó el análisis de correlación estadístico y el análisis de categorías de las entrevistas semi-estructuradas. La población estudiada presentó bienestar espiritual y religioso moderado, sugiriendo que el cáncer favorece la búsqueda de la espiritualidad y religiosidad como mecanismos de enfrentamiento del sufrimiento. Las correlaciones señalan para una búsqueda significativa del paciente oncológico por espiritualidad y mejoría en su calidad de vida. El apoyo del conyugue, demás familiares, amigos y personas religiosas constituyen una red social de apoyo al paciente oncológico, resaltando la actuación relevante del psicólogo en el acompañamiento terapéutico del paciente, sus familiares y cuidadores.

Ecoepidemiologia e Controle da Leishmaniose Visceral no município de Belo Horizonte (Minas Gerais, Brasil) / Ecoepidemiology and Control of Visceral Leishmaniasis in city of Belo Horizonte (Minas Gerais, Brazil)

Este estudo foi realizado em Belo Horizonte (Minas Gerais, Brasil), área endêmica para Leishmaniose visceral (LV), onde a doença vem se expandindo rapidamente, com 1.612 casos registrados nos últimos 10 anos. Nossa pesquisa avaliou o perfil epidemiológico em duas Áreas de abrangência (AA) dos Centros de Saúde (CS) Miramar e Salgado Filho do município de Belo Horizonte, com transmissão recente de LV, buscando compreender a tríade envolvida na transmissão: parasito-vetor-reservatório. Cada AA foi dividida em três trechos, controle, borrifação e manejo, a fim de avaliar o impacto das medidas de controle no número mensal de Lutzomyia longipalpis, através da curva flebotomínica. Em todos os trechos a captura de flebotomíneos e o inquérito canino censitário foram realizados.Durante 24 meses (setembro/2010 a agosto/2012) foram capturados 5194 flebotomíneos, distribuídos em 6 espécies, sendo Lu. longipalpis, vetora da LV, a espécie predominante (96,54%). Houve uma correlação entre a precipitação pluviométrica e o número de Lu. longipalpis capturados, mostrando que o número de espécimes de flebotomíneos capturados aumentou após o período chuvoso...

Através do uso da Leishmania Nested PCR e sequenciamento, foram analisados 93 “pools” espécie-específicos. Leishmania infantum e Le. braziliensis foram encontradas em 23 e em 2 dos 26 “pools” de Lu. longipalpis, respectivamente. O DNA de Le. infantum foi encontrado em um “pool” de cada uma das espécies Lu. lloydi e complexo cortelezzii. A taxa mínima de infecção natural de flebotomíneos na área foi alta, 18,8% para Lu. Longipalpis, 20% para complexo cortelezzii e 100% para Lu. lloydi. Em relação às medidas de controle, observamos uma redução estatisticamente significativa no número de flebotomíneos no trecho manejo ambiental, enquanto houve apenas uma tendência de queda no número de flebotomíneos no trecho borrifação. Em relação ao reservatório doméstico, um total de 1408 cães foram examinados em 2011 através de testes sorológicos; 3,6% apresentaram-se soropositivos para LV canina (LVC). Biópsias de linfonodo, pele, baço e aspirado de medula óssea destes animais foram obtidos e analisados através do diagnóstico parasitológico e molecular. A positividade tanto para mielocultura como para o técnica de aposição em lâmina foi de 72.5%. Todas as amostras de baço mostraram-se positivas para LnPCR, indicando a presença de Le. infantum nas 51 amostras. O linfonodo foi o tecido menos sensível na PCR (57%) em relação aos demais. Cães sintomáticos demonstraram uma tendência a ter mais testes positivos. Nossos resultados mostram que as interfaces parasito-vetor e parasito-reservatório são ativas em áreas de médio risco para transmissão de LV, e que ações eficazes e rápidas devem ser implementadas para controlar a expansão da doença...

Ecoepidemiologia e Controle da Leishmaniose Visceral no município de Belo Horizonte (Minas Gerais, Brasil)

Este estudo foi realizado em Belo Horizonte (Minas Gerais, Brasil), área endêmica para Leishmaniose visceral (LV), onde a doença vem se expandindo rapidamente, com 1.612 casos registrados nos últimos 10 anos. Nossa pesquisa avaliou o perfil epidemiológico em duas Áreas de abrangência (AA) dos Centros de Saúde (CS) Miramar e Salgado Filho do município de Belo Horizonte, com transmissão recente de LV, buscando compreender a tríade envolvida na transmissão: parasito-vetor-reservatório. Cada AA foi dividida em três trechos, controle, borrifação e manejo, a fim de avaliar o impacto das medidas de controle no número mensal de Lutzomyia longipalpis, através da curva flebotomínica. Em todos os trechos a captura de flebotomíneos e o inquérito canino censitário foram realizados.Durante 24 meses (setembro/2010 a agosto/2012) foram capturados 5194 flebotomíneos, distribuídos em 6 espécies, sendo Lu. longipalpis, vetora da LV, a espécie predominante (96,54%). Houve uma correlação entre a precipitação pluviométrica e o número de Lu. longipalpis capturados, mostrando que o número de espécimes de flebotomíneos capturados aumentou após o período chuvoso.

Através do uso da Leishmania Nested PCR e sequenciamento, foram analisados 93 “pools” espécie-específicos. Leishmania infantum e Le. braziliensis foram encontradas em 23 e em 2 dos 26 “pools” de Lu. longipalpis, respectivamente. O DNA de Le. infantum foi encontrado em um “pool” de cada uma das espécies Lu. lloydi e complexo cortelezzii. A taxa mínima de infecção natural de flebotomíneos na área foi alta, 18,8% para Lu. Longipalpis, 20% para complexo cortelezzii e 100% para Lu. lloydi. Em relação às medidas de controle, observamos uma redução estatisticamente significativa no número de flebotomíneos no trecho manejo ambiental, enquanto houve apenas uma tendência de queda no número de flebotomíneos no trecho borrifação. Em relação ao reservatório doméstico, um total de 1408 cães foram examinados em 2011 através de testes sorológicos; 3,6% apresentaram-se soropositivos para LV canina (LVC). Biópsias de linfonodo, pele, baço e aspirado de medula óssea destes animais foram obtidos e analisados através do diagnóstico parasitológico e molecular. A positividade tanto para mielocultura como para o técnica de aposição em lâmina foi de 72.5%. Todas as amostras de baço mostraram-se positivas para LnPCR, indicando a presença de Le. infantum nas 51 amostras. O linfonodo foi o tecido menos sensível na PCR (57%) em relação aos demais. Cães sintomáticos demonstraram uma tendência a ter mais testes positivos. Nossos resultados mostram que as interfaces parasito-vetor e parasito-reservatório são ativas em áreas de médio risco para transmissão de LV, e que ações eficazes e rápidas devem ser implementadas para controlar a expansão da doença.

Phlebotomine sandflies (Diptera: Psychodidae) in Governador Valadares, a transmission area for American tegumentary leishmaniasis in State of Minas Gerais, Brazil / Flebotomíneos (Diptera: Psychodidae) em Governador Valadares, área de transmissão de leishmaniose tegumentar americana no Estado de Minas Gerais, Brasil

INTRODUCTION: A study on the phlebotomine sandfly fauna was carried out in an endemic area for American tegumentary leishmaniasis in the municipality of Governador Valadares, in the State of Minas Gerais, Brazil. METHODS: Captures were undertaken using HP light traps in four districts, on three nights per month, for one year (from January to December 2008). Correlations between climatic factors (temperature, relative air humidity and rainfall) and the numbers of sandflies collected was observed. RESULTS: 5,413 phlebotomine specimens were caught and were identified as belonging to 12 species. Of these specimens, 2,851 (52 percent) were females and 2,562 (48 percent) were males. CONCLUSIONS: Lutzomyia intermedia predominated (29.9 percent of the species caught), thus suggesting that they were responsible for transmission of American tegumentary leishmaniasis, together with L. whitmani, which was also found in the area (4.3 percent). The presence of L. longipalpis (11.9 percent), the main vector for visceral leishmaniasis in Brazil, is an important finding, which makes rigorous entomological surveillance of the area necessary.

INTRODUÇÃO: Um estudo da fauna de flebotomíneos foi realizado em uma área endêmica para leishmaniose tegumentar americana no município de Governador Valadares, no Estado de Minas Gerais, Brasil. MÉTODOS: Capturas foram feitas com armadilhas luminosas HP em quatro bairros, três noites por mês, durante o período de janeiro a dezembro de 2008. A correlação entre fatores climáticos (temperatura, umidade relativa do ar e pluviosidade) e o número de flebotomíneos coletados foi avaliada. RESULTADOS: Foram capturados 5.413 espécimes de flebotomíneos, distribuídos em 12 espécies, sendo 2.851 (52 por cento) fêmeas e 2.562 (48 por cento) machos. CONCLUSÕES: Lutzomyia intermedia foi predominante com 29,9 por cento das espécies capturadas, sugerindo ser a responsável pela transmissão de LTA, juntamente com L. whitmani, que também foi encontrada na região (4,3 por cento). A presença de L. longipalpis (11,9 por cento), principal vetor de LV no Brasil, é um dado relevante tornando-se necessário uma rigorosa vigilância entomológica na região.