As implicações da COVID-19 no sistema cardiovascular: prognóstico e intercorrências / Implications of COVID-19 on the cardiovascular system: prognosis and intercurrences

Objetivo: descrever as implicações da COVID-19 no sistema cardiovascular: prognósticos e intercorrências. Método: trata-se de uma revisão integrativa da literatura, realizada nas bases de dados, Science Direct, National Library of Medicine National Institutes of Health dos EUA (PUBMED), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Collaboration e Medical Literature Analysis and Retrieval System Online (MEDLINE) com os descritores, Cardiovascular System; Cardiovascular Diseases; Coronary Disease, e a palavra-chave Covid-19. Incluíram-se estudos originais, relatos de casos, revisões sistemáticas na série temporal 2019-2020. Resultados: a busca resultou em 13 artigos, todos na língua inglesa, emergindo os pontos-chave: potencialização das complicações cardiovasculares pela infecção por COVID-19; aumento da mortalidade de origens cardiovasculares influenciadas pela infecção por COVID-19. Conclusão: o envolvimento do sistema cardiovascular no COVID-19 pode determinar a gravidade da doença, potencializado na presença de fatores de riscos cardiovasculares, repercutindo em complicações que necessitam de tratamento intensivo e morte. De maneira geral, todos os pacientes com COVID-19 são passíveis de ter comprometimento cardiológico, fato que pode depender de antecedentes mórbidos pessoais, resposta inflamatória e liberadores bioquímicos.

Objective: to describe the implications of COVID-19 in the cardiovascular system: prognosis and intercurrences. Method: This is an Integrative Literature Review, performed in the databases, Science direct, National Library of Medicine National Institutes of Health (PUBMED), Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Collaboration and Medical Literature Analysis and Retrieval System Online (MEDLINE) with the descriptors, Cardiovascular system; Cardiovascular Diseases; Coronary Disease, and the keyword Covid-19. It included original studies, case reports, systematic reviews in the time series 2019-2020. Results: The search resulted in 13 articles, all in English language, emerging the key points, Potentiation of cardiovascular complications by COVID-19 infection; Increased mortality of cardiovascular origin influenced by COVID-19 infection. Conclusion: The involvement of the cardiovascular system in COVID-19 may determine the severity of the disease, potentiated in the presence of cardiovascular risk factors, resulting in complications that require intensive treatment and death. In general, all patients with COVID-19 are likely to have cardiological impairment, which may depend on personal morbid antecedents, inflammatory response and biochemical liberators.

As descobertas genômicas do SARS-CoV-2 e suas implicações na pandemia de COVID-19 / The genomic discoveries of SARS-CoV-2 and their implications for the COVID-19 pandemic

Objetivo: Auxiliar no entendimento da COVID-19 em relação à origem do SARS-CoV-2, suas descobertas genômicas, patogenia, possíveis hospedeiros primários e intermediários, além da comparação com outros coronavírus. Metodos: foram utilizadas as bases de dados Scientific Eletronic Library Online e PubMed, com artigos de revisão e originais, em língua portuguesa e inglesa, pesquisados no período de 05 de março a 10 de abril de 2020, adotando os seguintes descritores: SARS-CoV, COVID-19, coronavirus, Wuhan, genome, structure, origin, transmission, evolution, zoonotic. Os artigos originais identificados foram incluídos nesta revisão, juntamente com artigos de suporte referenciados por estes. Resultados: As características genômicas descritas até o momento podem explicar, em parte, a infectividade e a transmissibilidade do SARS-CoV-2 em humanos. Devido aos notáveis recursos de SARS-CoV-2, incluindo o local otimizado do domínio de ligação ao receptor (RBD) e de clivagem polibásica, é pouco provável um cenário laboratorial para a origem do SARS-CoV-2. Conclusão: Para o presente, é de extrema importância obter mais dados genéticos e funcionais sobre o SARS-CoV-2, incluindo estudos em animais, sequenciamento do vírus em casos muito precoces e identificação dos parentes virais mais próximos do SARS-CoV-2 que circulam em animais.(AU)

Objective: To assist in the understanding of COVID-19 in relation to the origin of SARS-CoV-2, its genomic discoveries, pathogenesis, possible primary and intermediate hosts, in addition to comparison with other coronaviruses. Methods: the Scientific Electronic Library Online and PubMed databases were used, with review articles and originals, in Portuguese and English, researched from March 5 to April 10, 2020, adopting the following descriptors: SARS-CoV , COVID-19, coronavirus, Wuhan, genome, structure, origin, transmission, evolution, zoonotic. The original articles identified were included in this review, along with supporting articles referenced by them. Results: The genomic characteristics described so far may partly explain the infectivity and transmissibility of SARS-CoV-2 in humans. Due to the remarkable resources of SARS-CoV-2, including the optimized site of the receptor binding domain (RBD) and polybasic cleavage, a laboratory scenario for the origin of SARS-CoV-2 is unlikely. Conclusion: For the present, it is extremely important to obtain more genetic and functional data on SARS-CoV-2, including studies on animals, sequencing of the virus in very early cases and identification of the closest viral relatives of SARS-CoV-2 that circulate in animals.(AU)

Discrimination based on sexual orientation against MSM in Brazil: a latent class analysis / Discriminação por orientação sexual entre HSH no Brasil: uma análise de classes latentes

ABSTRACT Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile's Successive Sampling estimator. Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), more than a third said they had felt afraid of walking in public places during the past 12 months, and about one-fifth of participants reported having been victims of physical or sexual assault due to DSO. DSO was classified into four latent classes: "very high", "high", "moderate" and "low", with estimates of 2.2%, 16.4%, 35.1%, and 46.19%, respectively. Conclusion: We observed a high proportion of discrimination against MSM in this study. The use of LCA differentiated parsimoniously classes of discrimination.

RESUMO Introdução: A discriminação por orientação sexual (DPOS) pode influenciar a vulnerabilidade ao HIV aumentando a exposição a comportamentos sexuais de risco entre homens que fazem sexo com homens (HSH). Objetivos: Examinar dados utilizando a análise de classes latentes (ACL) para identificar grupos de indivíduos com padrões específicos de DPOS. Métodos: Estudo transversal com entrevistados recrutados pelo processo amostral respondent driven sampling em 12 cidades brasileiras em 2016. A ACL foi usada para caracterizar o DPOS entre HSH com base em 13 variáveis do bloco de discriminação do questionário da pesquisa. As proporções de DPOS e das variáveis de interesse, bem como seus intervalos de confiança (95%) foram ponderados usando o estimador de Gile. Resultados: A maioria era de jovens, solteiros, com alguma religião, escolaridade média ou superior, cor da pele preta ou parda e com nível socioeconômico médio. Mais da metade referiu ter sido discriminado nos últimos 12 meses por sua orientação sexual (65%), mais de um terço referiu ter tido medo de andar em lugares públicos nos últimos 12 meses e em torno de um quinto dos participantes reportaram ter sofrido agressão física ou sexual na vida. A DPOS foi classificada em 4 classes latentes, "muito alta", "alta", "média" e "baixa", com estimativas de 2,2%, 16,4%, 35,1% e 46,19%, respectivamente. Conclusão: Observou-se alta proporção de discriminação entre os HSH participantes deste estudo. A utilização da ACL discriminou de maneira parcimoniosa as classes de DPOS.

Association of breast cancer with human papillomavirus (HPV) infection in Northeast Brazil: molecular evidence

OBJECTIVE: The aim of this study is to investigate the presence of human papillomavirus DNA and genotypes in breast cancer and normal breast tissue samples obtained from women from the northeast region of Brazil. METHOD: One hundred three breast cancer samples and 95 normal breast samples, as the non-malignant controls, were studied. DNA extraction was verified by human beta-globin gene amplification, and polymerase chain reaction was conducted based on HPV L1-specific consensus primers MY09/MY11 and GP5+/GP6+, followed by nested multiplex polymerase chain reaction with type-specific primers for the E6/E7 consensus region. RESULTS: Human papillomavirus DNA was detected in 51 (49.5%) breast carcinoma samples and 15 (15.8%) normal breast samples (p<0.0001). Human papillomavirus genotypes 6 and 11 were identified in 15.2% of all samples. CONCLUSIONS: The high frequency of human papillomavirus infection in breast cancer samples indicates a potential role of this virus in breast carcinogenesis in the studied participants.

Natural environmental water sources in endemic regions of northeastern Brazil are potential reservoirs of viable Mycobacterium leprae

BACKGROUND The detection of live Mycobacterium leprae in soil and animals other than humans suggests that the environment plays a role in the transmission of leprosy. OBJECTIVE The objective of this study was to investigate the presence of viable M. leprae in natural water sources used by the local population in five municipalities in the state of Ceará, northeastern Brazil. METHODS Samples were collected from 30 different sources. Viable bacilli were identified by reverse transcriptase polymerase chain reaction (PCR) of the M. leprae gyrA gene and sequencing of the PCR products. Physicochemical properties of each water source were also assessed. FINDINGS M. leprae gyrA mRNA was found in 23 (76.7%) of the water sources. No association was found between depth of the water and sample positivity, nor was there any association between the type of water used by the population and sample positivity. An association between viable M. leprae and temperature and pH was found. Georeferencing showed a relation between the residences of leprosy cases and water source containing the bacterium. MAIN CONCLUSIONS The finding of viable M. leprae in natural water sources associated with human contact suggests that the environment plays an important role in maintaining endemic leprosy in the study region.

Widespread nasal carriage of Mycobacterium lepraeamong a healthy population in a hyperendemic region of northeastern Brazil

A case-control study was conducted to determine the presence ofMycobacterium lepraeDNA in nasal secretions of leprosy cases and nonleprosy individuals in Fortaleza, Brazil. It included 185 cases identified by physicians at the Dona Libânia National Reference Centre for Sanitary Dermatology (CDERM). A control group (Co) (n = 136) was identified among individuals from CDERM not diagnosed as leprosy cases. To augment the spatial analysis of M. leprae specific repetitive element (RLEP) positive prevalence, an external group (EG) (n = 121), a convenience sample of healthy students, were included. Polymerase chain reaction for the RLEP sequence was conducted for all participants. Prevalence of RLEP positivity for cases and Co were 69.2% and 66.9%, respectively, significantly higher than for EG (28.1%), and reported elsewhere. Male sex, belonging to a lower socioeconomic status (D/E), history of a previous contact with a case and being older, were associated with being a leprosy case. Our geographical analysis demonstrated that the bacillus is widespread among the healthy population, with clusters of RLEP positive multibacillary cases concentrated in distinct areas of the city. Our results suggest that in endemic areas, as in Fortaleza, surveillance for both nonhousehold leprosy contacts and members of the general population living in cluster areas should be implemented.

Cytokine polymorphisms and susceptibility to leprosy / Polimorfismos de citocinas e susceptibilidade à hanseníase

Cytokines play a key role in the regulation of the immune response against infectious diseases. In leprosy, the polymorphisms of pro-inflammatory cytokine genes may contribute to host susceptibility to Mycobacterium leprae. The objective of this study was to investigate the association between cytokine gene polymorphisms and BCG protection against leprosy in Brazilian leprosy cases and controls. DNA samples were obtained from 46 patients with leprosy and 83 healthy controls (not leprosy contacts). All genotyping (TNF alpha, IFN gamma, IL-6, IL-10 and TGF beta) measurements were taken using sequence-specific primers (SSP) - PCR. When compared to the healthy controls, no significant associations were observed between the cytokine gene polymorphisms studied and their susceptibility to leprosy. The most frequent genotypes in this population were TNF alpha ?G? allele and G/G genotype at position -308, ?A? allele of IFN gamma at position +874, G allele in the IL-6 at position -174, G allele (codon 25) and T/C-G/G genotype in TGF beta, and ?A? allele in IL-10 at position -1082. For those individuals that had a BCG scar, the TGF beta and IFN gamma genotype polymorphisms did not show difference among leprosy patients compared to healthy controls. Polymorphisms of the cytokine genes studied were not associated with an increased occurrence of leprosy.