Homologous equivalence study of immunogenicity after third dose of Covid-19 vaccine (recombinant) with an interval of six months after the second dose, comparing the interval of eight and 12 weeks between the first two doses.

BACKGROUND: In response to the coronavirus disease 2019 (Covid-19) pandemic, Brazil authorised the Astra Zeneca/Fiocruz vaccine in January 2021. As the Delta variant emerged in May 2021, interval between vaccine doses was adjusted. By September 2021, the Brazilian National Immunisation Program recommended a booster dose for individuals over 70, and later expanded the recommendation to all adults. OBJECTIVES: Assess the equivalence of IgG antibody response against the Covid-19 S protein before and approximately 28 days after the third dose of a Covid-19 recombinant vaccine. Two groups received initial two doses with intervals of eight and 12 weeks. METHODS: This is a phase IV clinical study, uncontrolled, non-randomised. The study proposes calculating the ratio of geometric means titres (GMT) 28 days after the third dose, with a target ratio of confidence interval (CI) between 0.77 and 1.3. FINDINGS: In the primary endpoint, there was no equivalence between the eight- and 12-week intervals with a slight variation favouring the eight-week group. Post-third dose, both groups showed increases titres at 28 days, three months, six months and 12 months. Both groups responded similarly to Delta and Omicron BA.1, with a more significant increase for Delta. MAIN CONCLUSIONS: The study showed strong and consistent immune response in all age groups receiving the Covid-19 recombinant vaccine. Third dose elicited an increase in GMT by at least three times aligned with Ministry of Health strategies emphasising Bio-Manguinhos crucial role in pandemic control in the country.

miRNAs and NFKB1 and TRAF6 target genes: The initial functional study in CD14+ monocytes in rheumatoid arthritis patients.

We predicted miRNAs with regulatory impact on NFKB1 and TRAF6 gene expression and selected the miR-194-5p, miR-124-3p, miR-9-5p, and miR-340-5p and their target genes for expression analyses on CD14+ monocytes from rheumatoid arthritis (RA) patients and healthy controls. Additionally, we evaluated the influence of genes and miRNA expression on RA patients' cytokine levels. No difference was observed in genes or miRNAs expression when compared to healthy controls and RA patients or clinical parameters. However, we found a significant difference between miR-194-5p and miR-9-5p levels (FC=-2.31; p=0.031; FC=-3.05;p=0.031, respectively) and non-prednisone users as compared to prednisone using patients. We conducted correlation analyses to identify the strength of the relationship between expression data and cytokine plasma levels. We observed a moderate positive correlation between miR-124-3p expression and IL-6 plasma levels (r=0.46; p=0.033). In addition, overexpression of miRNAs was concomitant to TRAF6 and NFKB1 genes as indicated by correlation analyses: TRAF6 and miR-194-5p (r=0.60;p<0.001) and miR-9-5p (r=0.63;p<0.001) and NFKB1 and miR-194-5p (r=0.72;p<0.001), miR-9-5p (r=0.72;p<0.001) and miR-340-5p (r=0.61;p<0.001). NFKB1 and TRAF6 genes and miRNAs monocyte expression do not appear to be related to RA but showed a significant difference in different groups of RA therapy. In addition, increased levels of miRNAs can be linked to concomitant overexpression of TRAF6 and NFKB1 in monocytes and act as its regulators.

Lexical repertoire of 24 and 30-month-old children speaking Brazilian portuguese: preliminary results. / Repertório lexical de crianças de 24 e 30 meses falantes do português brasileiro: resultados preliminares.

PURPOSE: To check the lexical repertoire of Brazilian Portuguese-speaking children at 24 and 30 months of age and the association between the number of words spoken and the following variables: socioeconomic status, parents' education, presence of siblings in the family, whether or not they attend school, and excessive use of tablets and cell phones. METHODS: 30 parents of children aged 24 months living in the state of São Paulo participated in the study. Using videoconferencing platforms, they underwent a speech-language pathology anamnesis, an interview with social services, and then they completed the "MacArthur Communicative Development Inventory - First Words and Gestures" as soon as their children were 24 and 30 months old. Quantitative and qualitative inferential inductive statistics were applied. RESULTS: the median number of words produced was 283 at 24 months and 401 at 30 months, indicating an increase of around 118 words after six months. The child attending a school environment had a significant relationship with increased vocabulary. CONCLUSION: The study reinforces the fact that vocabulary grows with age and corroborates the fact that children aged 24 months already have a repertoire greater than 50 words. Those who attend school every day produce at least 70 more words than those who do not.

OBJETIVO: Verificar o repertório lexical de crianças falantes do português brasileiro aos 24 e 30 meses e a associação entre a quantidade de palavras faladas e as variáveis: nível socioeconômico, escolaridade dos pais, presença de irmãos no convívio familiar, frequentar ou não escola e uso exacerbado de tablets e celulares pelas crianças. MÉTODO: 30 pais de crianças com 24 meses, residentes no estado de São Paulo participaram do estudo. Por meio de plataformas de videoconferência eles foram submetidos à anamnese fonoaudiológica, entrevista com o serviço social e preencheram o "Inventário MacArthur de Desenvolvimento Comunicativo - Primeiras Palavras e Gestos", quando seus filhos tinham 24 e 30 meses. Foi aplicada estatística indutiva inferencial, quantitativa e qualitativa. RESULTADOS: A mediana das palavras emitidas foi de 283 aos 24 meses e 401 aos 30 meses, indicando aumento em torno de 118 palavras após seis meses. A criança estar frequentando ambiente escolar apresentou relação significativa com o aumento do vocabulário. CONCLUSÃO: O estudo reforça o crescimento do vocabulário conforme o avanço da idade e corrobora o fato de as crianças com 24 meses já possuírem um repertório maior que 50 palavras. Aqueles que frequentam escola diariamente produzem pelo menos 70 palavras a mais dos que não frequentam.

Comprehensive landscape of neutralizing antibody and cell-mediated response elicited by the 1/5 fractional dose of 17DD-YF primary vaccination in adults.

The present study aimed at evaluating the YF-specific neutralizing antibody profile besides a multiparametric analysis of phenotypic/functional features of cell-mediated response elicited by the 1/5 fractional dose of 17DD-YF vaccine, administered as a single subcutaneous injection. The immunological parameters of each volunteer was monitored at two time points, referred as: before (Day 0) [Non-Vaccinated, NV(D0)] and after vaccination (Day 30-45) [Primary Vaccinees, PV(D30-45)]. Data demonstrated high levels of neutralizing antibodies for PV(D30-45) leading to a seropositivity rate of 93%. A broad increase of systemic soluble mediators with a mixed profile was also observed for PV(D30-45), with IFN-γ and TNF-α presenting the highest baseline fold changes. Integrative network mapping of soluble mediators showed increased correlation numbers in PV(D30-45) as compared to NV(D0) (532vs398). Moreover, PV(D30-45) exhibited increased levels of Terminal Effector (CD45RA+CCR7-) CD4+ and CD8+ T-cells and Non-Classical memory B-cells (IgD+CD27+). Dimensionality reduction of Mass Cytometry data further support these findings. A polyfunctional cytokine profile (TNF-α/IFN-γ/IL-10/IL-17/IL-2) of T and B-cells was observed upon in vitro antigen recall. Mapping and kinetics timeline of soluble mediator signatures for PV(D30-45) further confirmed the polyfunctional profile upon long-term in vitro culture, mediated by increased levels of IFN-γ and TNF-α along with decreased production of IL-10. These findings suggest novel insights of correlates of protection elicited by the 1/5 fractional dose of 17DD-YF vaccine.

Immune response induced by standard and fractional doses of 17DD yellow fever vaccine.

The re-emergence of yellow fever (YF) urged new mass vaccination campaigns and, in 2017, the World Health Organization approved the use of the fractional dose (FD) of the YF vaccine due to stock shortage. In an observational cross-sectional investigation, we have assessed viremia, antibodies, soluble mediators and effector and memory T and B-cells induced by primary vaccination of volunteers with FD and standard dose (SD). Similar viremia and levels of antibodies and soluble markers were induced early after immunization. However, a faster decrease in the latter was observed after SD. The FD led to a sustained expansion of helper T-cells and an increased expression of activation markers on T-cells early after vaccination. Although with different kinetics, expansion of plasma cells was induced upon SD and FD immunization. Integrative analysis reveals that FD induces a more complex network involving follicular helper T cells and B-cells than SD. Our findings substantiate that FD can replace SD inducing robust correlates of protective immune response against YF.

Neutralizing antibody titers against D8 genotype and persistence of measles humoral and cell-mediated immunity eight years after the first dose of measles, mumps, and rubella vaccine in Brazilian children.

OBJECTIVE: Assess the level of measles vaccine-induced neutralizing antibodies against the D8 genotype and the persistence of humoral and cell-mediated immunity in children who received their first dose of the measles, mumps, and rubella vaccine eight years previously. METHODS: Measles-specific IgG and neutralizing antibodies were determined in serum using ELISA and plaque reduction neutralization test, respectively. Cellular response was evaluated from peripheral blood mononuclear cells (PBMC). IFN-γ-secreting cells, memory B and T cells, and immunological mediators were assayed by ELISpot, flow cytometry, and multiplex liquid microarray assay, respectively. RESULTS: Antibody concentrations declined over time; however, the vaccine-induced neutralizing antibodies' effect against D8 and vaccinal genotypes persisted. PBMC stimulated with the vaccine virus exhibited specific IFN- γ-measles-secreting responses in most participants. Participants with high levels of neutralizing antibodies showed a higher proportion of activated B cells compared to participants with low levels of neutralizing antibodies, while proportions of memory CD4+ and CD8+ T cells were similar between these groups. PBMC supernatant cytokine levels showed a significant difference between stimulated and non-stimulated conditions for IL-2, TNF-α, IL-10, and CXCL10. CONCLUSION: Despite the decline in antibody concentrations over time, the participants still demonstrated neutralizing capacity against the measles D8 genotype five to eight years after the second dose of the measles, mumps, and rubella vaccine. Additionally, most of the enrolled children exhibited cell-mediated immunity responses to measles virus stimulation.

2,4-D Herbicide-Induced Hepatotoxicity: Unveiling Disrupted Liver Functions and Associated Biomarkers.

2,4-dichlorophenoxyacetic acid (2,4-D) is a widely used herbicide worldwide and is frequently found in water samples. This knowledge has prompted studies on its effects on non-target organisms, revealing significant alterations to liver structure and function. In this review, we evaluated the literature on the hepatotoxicity of 2,4-D, focusing on morphological damages, toxicity biomarkers and affected liver functions. Searches were conducted on PubMed, Web of Science and Scopus and 83 articles were selected after curation. Among these studies, 72% used in vivo models and 30% used in vitro models. Additionally, 48% used the active ingredient, and 35% used commercial formulations in exposure experiments. The most affected biomarkers were related to a decrease in antioxidant capacity through alterations in the activities of catalase, superoxide dismutase and the levels of malondialdehyde. Changes in energy metabolism, lipids, liver function, and xenobiotic metabolism were also identified. Furthermore, studies about the effects of 2,4-D in mixtures with other pesticides were found, as well as hepatoprotection trials. The reviewed data indicate the essential role of reduction in antioxidant capacity and oxidative stress in 2,4-D-induced hepatotoxicity. However, the mechanism of action of the herbicide is still not fully understood and further research in this area is necessary.

Biochemical Markers for Liver Injury in Zebrafish Larvae.

Liver plays a crucial role in detoxification processes and metabolism of xenobiotics, and therefore, it is a target organ of toxicity of different classes of chemicals. In this context, some key enzymes present in liver are considered to be good biochemical markers of hepatic damage and can have their activities determined via spectrophotometry. Aspartate and alanine aminotransferases, alkaline phosphatase, lactate dehydrogenase, and glutathione peroxidase are enzymes that have activities often changed in response to hepatotoxic compounds and can be accessed through the larval period of zebrafish (Danio rerio). In this chapter, we described methodologies for analyses of these five biomarkers in pooled zebrafish larvae through spectrophotometry.

Homologous equivalence study of immunogenicity after third dose of Covid-19 vaccine (recombinant) with an interval of six months after the second dose, comparing the interval of eight and 12 weeks between the first two doses

BACKGROUND In response to the coronavirus disease 2019 (Covid-19) pandemic, Brazil authorised the Astra Zeneca/Fiocruz vaccine in January 2021. As the Delta variant emerged in May 2021, interval between vaccine doses was adjusted. By September 2021, the Brazilian National Immunisation Program recommended a booster dose for individuals over 70, and later expanded the recommendation to all adults. OBJECTIVES Assess the equivalence of IgG antibody response against the Covid-19 S protein before and approximately 28 days after the third dose of a Covid-19 recombinant vaccine. Two groups received initial two doses with intervals of eight and 12 weeks. METHODS This is a phase IV clinical study, uncontrolled, non-randomised. The study proposes calculating the ratio of geometric means titres (GMT) 28 days after the third dose, with a target ratio of confidence interval (CI) between 0.77 and 1.3. FINDINGS In the primary endpoint, there was no equivalence between the eight- and 12-week intervals with a slight variation favouring the eight-week group. Post-third dose, both groups showed increases titres at 28 days, three months, six months and 12 months. Both groups responded similarly to Delta and Omicron BA.1, with a more significant increase for Delta. MAIN CONCLUSIONS The study showed strong and consistent immune response in all age groups receiving the Covid-19 recombinant vaccine. Third dose elicited an increase in GMT by at least three times aligned with Ministry of Health strategies emphasising Bio-Manguinhos crucial role in pandemic control in the country.

Repertório lexical de crianças de 24 e 30 meses falantes do português brasileiro: resultados preliminares / Lexical repertoire of 24 and 30-month-old children speaking Brazilian portuguese: preliminary results

RESUMO Objetivo Verificar o repertório lexical de crianças falantes do português brasileiro aos 24 e 30 meses e a associação entre a quantidade de palavras faladas e as variáveis: nível socioeconômico, escolaridade dos pais, presença de irmãos no convívio familiar, frequentar ou não escola e uso exacerbado de tablets e celulares pelas crianças. Método 30 pais de crianças com 24 meses, residentes no estado de São Paulo participaram do estudo. Por meio de plataformas de videoconferência eles foram submetidos à anamnese fonoaudiológica, entrevista com o serviço social e preencheram o "Inventário MacArthur de Desenvolvimento Comunicativo - Primeiras Palavras e Gestos", quando seus filhos tinham 24 e 30 meses. Foi aplicada estatística indutiva inferencial, quantitativa e qualitativa. Resultados A mediana das palavras emitidas foi de 283 aos 24 meses e 401 aos 30 meses, indicando aumento em torno de 118 palavras após seis meses. A criança estar frequentando ambiente escolar apresentou relação significativa com o aumento do vocabulário. Conclusão O estudo reforça o crescimento do vocabulário conforme o avanço da idade e corrobora o fato de as crianças com 24 meses já possuírem um repertório maior que 50 palavras. Aqueles que frequentam escola diariamente produzem pelo menos 70 palavras a mais dos que não frequentam.

ABSTRACT Purpose To check the lexical repertoire of Brazilian Portuguese-speaking children at 24 and 30 months of age and the association between the number of words spoken and the following variables: socioeconomic status, parents' education, presence of siblings in the family, whether or not they attend school, and excessive use of tablets and cell phones. Methods 30 parents of children aged 24 months living in the state of São Paulo participated in the study. Using videoconferencing platforms, they underwent a speech-language pathology anamnesis, an interview with social services, and then they completed the "MacArthur Communicative Development Inventory - First Words and Gestures" as soon as their children were 24 and 30 months old. Quantitative and qualitative inferential inductive statistics were applied. Results the median number of words produced was 283 at 24 months and 401 at 30 months, indicating an increase of around 118 words after six months. The child attending a school environment had a significant relationship with increased vocabulary. Conclusion The study reinforces the fact that vocabulary grows with age and corroborates the fact that children aged 24 months already have a repertoire greater than 50 words. Those who attend school every day produce at least 70 more words than those who do not.

Conhecimento, desejo e atitude de estudantes de Medicina e Enfermagem sobre a doação de órgãos / Knowledge, attitudes and willingness to donate organs among Medical and Nursing students

Resumo Introdução: A necessidade crescente de doadores de órgãos e de profissionais capacitados impulsiona novos estudos que esclareçam o entendimento e comportamento da sociedade perante a doação de órgãos. Estudantes de saúde vêm sendo alvo de estudos por seu influente papel social e, além disso, quando formados, farão parte de etapas fundamentais da doação. Contudo, evidencia-se conhecimento insuficiente dos estudantes apesar de possuírem atitude positiva. Objetivo: Este estudo teve como objetivo avaliar o grau de conhecimento, desejo e atitude perante as doações de órgãos entre os acadêmicos de Medicina e Enfermagem na cidade de Recife, em Pernambuco. Método: Trata-se de um estudo transversal realizado a partir da análise de questionários respondidos por estudantes de Enfermagem e Medicina nos últimos períodos acadêmicos. Além de dados demográficos, os estudantes foram questionados quanto ao entendimento sobre aspectos da validação de possível doador, diretrizes do protocolo de morte encefálica, motivações e opções pessoais em relação à doação de órgãos. Resultado: De fevereiro a dezembro de 2022, 218 questionários foram coletados, dos quais 208 entraram para a amostra. Dentre os estudantes, 57,2% eram do sexo masculino, a média de idade foi de 24 ± 2,7 anos. Dos graduandos, 85,1% cursavam Medicina, e 14,9%, Enfermagem. Apenas 49% dos estudantes sabiam da não necessidade de neurologista para o diagnóstico de morte encefálica. Ademais, 63% não sabiam quem é o responsável por abordar a família do potencial doador. Grande parte dos acadêmicos já considerou a possibilidade de ser doador de órgãos, representando 92,3% do total de estudantes avaliados. Dos alunos, 67% afirmaram já ter conversado com as próprias famílias sobre a doação de órgãos e que elas conheciam essa decisão. Em caso de familiar apresentar diagnóstico de morte encefálica, 83,2% dos alunos consentiram a doação. Em relação aos possíveis benefícios materiais ou emocionais para a família do doador, 86,1% julgam que a doação de órgãos pode trazer algum benefício. Conclusão: Apesar da atitude positiva, o estudo evidenciou conhecimento insuficiente dos alunos, reforçando a necessidade de ampliação do currículo das universidades e criação de cadeiras direcionadas à aquisição de conhecimento e habilidades quanto à condução de casos de morte encefálica e atuação perante os potenciais doadores.

Abstract Background: The increasing demand for organ donors and proficient experts is prompting fresh research endeavors aimed at clarifying societal perceptions and actions related to organ donation. Students from the healthcare area have been a focal point in these studies. Despite their favorable attitudes, a notable gap in knowledge among students has been underscored. Objective: To assess the level of knowledge, willingness, and attitudes toward organ donation among medical and nursing students in the city of Recife, Brazil. Methods: A cross-sectional investigation was undertaken, involving the examination of questionnaires that were answered by medical and nursing students during their last academic years. Results: Between February and December 2022, a total of 218 questionnaires were gathered, of which 208 were included in the final sample. Among the participants, 57.2% identified as male, with an average age of 24 ± 2.7 years. In terms of academic background, 85.1% were enrolled in medical school, while 14.9% were attending nursing school. A notable observation was that only 49% of the students were aware that the diagnosis of brain death does not necessarily require the involvement of a neurologist. Furthermore, a significant proportion of students (63%) were unfamiliar with the entity responsible for initiating discussions with the potential donor's family. Interestingly, 92.3% of the students had contemplated the prospect of becoming organ donors themselves. If a family member were diagnosed with brain death, a significant majority of students, specifically 83.2%, expressed their willingness to grant consent for organ donation. Conclusions: Despite the positive attitudes, this study revealed insufficient knowledge among students, thereby underscoring the need for universities to expand their curricula and establish courses aimed at acquiring knowledge and skills related to brain death cases and actions related to potential donors.

Measures of women's empowerment based on individual-level data: a literature review with a focus on the methodological approaches.

Background: Quantifying women's empowerment has become the focus of attention of many international organizations and scholars. We aimed to describe quantitative indicators of women's empowerment that are based on individual-level data. Methods: In this scoping review, we searched PubMed, Scopus, Web of Science, Science Direct, Google, and Google Scholar for publications describing the operationalization of measures of women's empowerment. Results: We identified 36 studies published since 2004, half of them since 2019, and most from low- and middle-income countries. Twelve studies were based on data from the Demographic and Health Surveys and used 56 different variables from the questionnaires (ranging from one to 25 per study) to measure the overall empowerment of women 15-49 years. One study focused on rural women, two included married and unmarried women, and one analyzed the couple's responses. Factor analysis and principal component analysis were the most common approaches used. Among the 24 studies based on other surveys, ten analyzed overall empowerment, while the others addressed sexual and reproductive health (4 studies), agriculture (3) and livestock (1), water and sanitation (2), nutrition (2), agency (1), and psychological empowerment (1). These measures were mainly based on data from single countries and factor analysis was the most frequently analytical method used. We observed a diversity of indicator definitions and domains and a lack of consensus in terms of what the proposed indicators measure. Conclusion: The proposed women's empowerment indicators represent an advance in the field of gender and development monitoring. However, the empowerment definitions used vary widely in concept and in the domains/dimensions considered, which, in turn influence or are influenced by the adopted methodologies. It remains a challenge to find a balance between the need for a measure suitable for comparisons across populations and over time and the incorporation of country-specific elements.

Chemical Composition, In Vitro Antitumor Effect, and Toxicity in Zebrafish of the Essential Oil from Conyza bonariensis (L.) Cronquist (Asteraceae).

The essential oil from Conyza bonariensis (Asteraceae) aerial parts (CBEO) was extracted by hydrodistillation in a Clevenger-type apparatus and was characterized by gas chromatography-mass spectrometry. The antitumor potential was evaluated against human tumor cell lines (melanoma, cervical, colorectal, and leukemias), as well as non-tumor keratinocyte lines using the MTT assay. The effect of CBEO on the production of Reactive Oxygen Species (ROS) was evaluated by DCFH-DA assay, and a protection assay using the antioxidant N-acetyl-L-cysteine (NAC) was also performed. Moreover, the CBEO toxicity in the zebrafish model was assessed. The majority of the CBEO compound was (Z)-2-lachnophyllum ester (57.24%). The CBEO exhibited selectivity towards SK-MEL-28 melanoma cells (half maximal inhibitory concentration, IC50 = 18.65 ± 1.16 µg/mL), and induced a significant increase in ROS production. In addition, the CBEO's cytotoxicity against SK-MEL-28 cells was reduced after pretreatment with NAC. Furthermore, after 96 h of exposure, 1.5 µg/mL CBEO induced death of all zebrafish embryos. Non-lethal effects were observed after exposure to 0.50-1.25 µg/mL CBEO. Additionally, significant alterations in the activity of enzymes associated with oxidative stress in zebrafish larvae were observed. These results provide evidence that CBEO has a significant in vitro antimelanoma effect by increasing ROS production and moderate embryotoxicity in zebrafish.

Heat Tolerance of Siberian Husky Dogs Living in Brazil: A Case Study on the Perceptions and Attitudes of Their Owners.

The management of the thermal environment to which dogs are exposed should be included in strategies to improve their welfare. An online questionnaire was administered to 624 owners of Siberian Husky dogs residing in Brazil, with the objective of assessing their perceptions regarding their dogs' capacity to adapt to heat, and its association with the owners' routine care. Owners who believed that dogs are low-heat-tolerant animals were more likely to report heat response behaviors from their dogs. Overall, owners reported walk with their dogs during early morning, late afternoon and nighttime. They also reported solar radiation as the primary criteria for determining the time to walk with their dogs. However, owners who reported walking with their dogs at noon mentioned time availability as their primary criteria. In conclusion, owners perceive Siberian Husky dogs living in Brazil as being poorly adapted to heat, and this perception appeared to influence their positive attitudes towards protecting their dogs from heat stress by choosing to walk them during times with less solar exposure. However, the lack of time for owners to walk with their dogs during cooler periods can still be a risk factor in exposing the animals to extreme hot conditions.

Pregnancy after sugery and brachytherapy for vaginal cancer.

Introduction: Primary vaginal cancer is infrequent, corresponding to 1-2% of all female genital tract cancer diagnoses.Treatment for vaginal cancer varies depending on tumor histology, size, location and staging, and may include one or more of the following: surgical excision, radiation therapy and/or chemotherapy. All treatments negatively affect fertility/pregnancy outcomes.Pelvic radiation therapy, even in doses < 2 Gy, may extinguish up to 50% of immature oocytes. In addition, radiotherapy may cause modifications in cervical length, loss of uterine junctional zone anatomy and lead to myometrial atrophy and fibrosis, increasing the risk for adverse pregnancy outcomes. Methods: Case report of a patient who carried a pregnancy to term after surgery and brachytherapy for vaginal cancer. Results: A 28 year-old woman, presented with a 3 cm right midvagina wall tumor, diagnosed as grade 2, vaginal squamous cell carcinoma - FIGO 2009, stage IB. Computed tomography showed no evidence of lymph node involvement or distant metastasis. The patient underwent surgery followed by 4 fractions of vaginal brachytherapy, once a week, with a dose of 6 Gy at a 5 mm depth, amounting to a total dose of 24 Gy.One year and 9 months after treatment, the patient gave birth to a healthy child at 39 weeks pregnancy. A C-section was needed due functional dystocia during labor. Conclusion: This case report recounts a successful pregnancy carried to term after surgery and brachytherapy for squamous cell vaginal cancer.

Clinical Profile of SARS-CoV-2 Infection: Mechanisms of the Cellular Immune Response and Immunogenetic Markers in Patients from Brazil.

OBJECTIVES: The aim of this study is to evaluate some mechanisms of the immune response of people infected with SARS-CoV-2 in both acute infection and early and late convalescence phases. METHODS: This is a cohort study of 70 cases of COVID-19, confirmed by RT-PCR, followed up to 60 days. Plasma Samples and clinical data were. Viral load, blood count, indicators inflammation were the parameters evaluated. Cellular immune response was evaluated by flow cytometry and Luminex immunoassays. RESULTS: In the severe group, hypertension was the only reported comorbidity. Non severe patients have activated memory naive CD4+ T cells. Critically ill patients have central memory CD4+ T cell activation. Severe COVID-19 patients have both central memory and activated effector CD8+ T cells. Non-severe COVID-19 cases showed an increase in IL1ß, IL-6, IL-10 and TNF and severely ill patients had higher levels of the cytokines IL-6, IL-10 and CXCL8. CONCLUSIONS: The present work showed that different cellular responses are observed according to the COVID-19 severity in patients from Brazil an epicenter the pandemic in South America. Also, we notice that some cytokines can be used as predictive markers for the disease outcome, possibility implementation of strategies effective by health managers.

[For the return of high vaccination coverage]. / Pela reconquista das altas coberturas vacinais.

The global decline in vaccine coverage led the World Health Organization (WHO) in 2019 to define vaccine hesitation as one of the world's top ten threats to public health. In Brazil, the drop in vaccination coverage began in 2012, increasing from 2016, and was aggravated by the COVID-19 pandemic. The warning of low vaccination coverage is accompanied by the reintroduction of immunopreventable diseases such as measles. The return of diseases so far eradicated, such as polio, can aggravate the ongoing health crisis. Despite the Brazilian National Immunization Program being recognized as one of the most effective worldwide and its continuous efforts, it is facing an extremely challenging scenario regarding immunization coverage. This article describes the Project for the Regaining of the High Vaccination Coverage (PRCV) and the strategy of working at the frontline, conducted in the local level, which has been implemented since 2021 and is already starting to show promising results. The PRCV was organized in three thematic axes with shared and specific actions, including: vaccination; information systems; communication and education. The outcomes achieved allow us to affirm that it is possible to reverse the low vaccination coverage, based on the articulation of structural and interinstitutional actions, with the strengthening of public policies and development of short-, medium-, and long-term measures. The most powerful factors of the PRCV are its approach to frontline professionals, the social pact for vaccination, and the establishment of local support networks for vaccinations.

O declínio global das coberturas vacinais levou a Organização Mundial da Saúde (OMS), em 2019, a definir a hesitação vacinal como uma das dez maiores ameaças mundiais à saúde pública. No Brasil, a queda da cobertura vacinal teve início em 2012, acentuando-se a partir de 2016, e sendo agravada pela pandemia de COVID-19. O alerta da baixa cobertura vacinal vem acompanhado pela reintrodução de doenças imunopreveníveis como o sarampo. O retorno de doenças até então eliminadas, como a poliomielite, pode agravar a crise sanitária ainda em curso. Mesmo sendo reconhecido como um dos mais efetivos programas de imunizações do mundo e dos esforços permanentes, o Programa Nacional de Imunizações enfrenta um cenário extremamente adverso no que tange às coberturas vacinais. Este artigo descreve o Projeto pela Reconquista das Altas Coberturas Vacinais (PRCV) e a estratégia de trabalhar na ponta do sistema, executada nos territórios, que vem sendo implementada desde 2021 e já começa a apresentar resultados promissores. O PRCV foi organizado em três eixos temáticos com atuação compartilhada e ações específicas, a saber: vacinação; sistemas de informação; comunicação e educação. Os resultados já alcançados permitem afirmar que é possível conseguir a reversão das baixas coberturas vacinais, a partir da articulação de ações estruturais e interinstitucionais, com o fortalecimento das políticas públicas e desenvolvimento de medidas de curto, médio e longo prazos. Os fatores mais potentes do PRCV são sua abordagem junto aos profissionais da ponta, o pacto social pela vacinação, e a estruturação de redes locais de apoio às imunizações.

La disminución global de las coberturas de vacunación llevó a la Organización Mundial de la Salud (OMS), en 2019, a definir la vacilación de la vacunación como una de las diez mayores amenazas para la salud pública en el mundo. En Brasil, la caída de la cobertura de vacunación comenzó en 2012, se acentuó a partir de 2016 y se vio agravada por la pandemia de COVID-19. La alerta de baja cobertura vacunal va acompañada de la reintroducción de enfermedades prevenibles por vacunación como el sarampión. El regreso de enfermedades hasta ahora eliminadas, como la poliomielitis, puede agravar la crisis sanitaria aún en curso. A pesar de ser reconocido como uno de los programas de inmunización más efectivos del mundo y de los esfuerzos permanentes, el Programa Nacional de Inmunización enfrenta un escenario extremadamente adverso en lo que se refiere a las coberturas vacunales. Este artículo describe el Proyecto por la Reconquista de las Altas Coberturas Vacunales (PRCV) y la estrategia de trabajo al final del sistema, ejecutada en los territorios, que se implementa desde 2021 y ya comienza a mostrar resultados prometedores. El PRCV fue organizado en tres ejes temáticos con actuación compartida y acciones específicas, a saber: vacunación; sistemas de Información; comunicación y educación. Los resultados ya alcanzados permiten afirmar que es posible lograr la reversión de las bajas coberturas vacunales, a partir de la articulación de acciones estructurales e interinstitucionales, con el fortalecimiento de las políticas públicas y desarrollo de medidas de corto, mediano y largo plazo. Los factores más potentes del PRCV son su abordaje junto a los profesionales de la punta, el pacto social por la vacunación, y la estructuración de redes locales de apoyo a las inmunizaciones.

Viability of Probiotic Microorganisms and the Effect of Their Addition to Fruit and Vegetable Juices.

Consumers' recent interest in healthier diets has increased the demand for food products with functional properties, such as probiotics. However, most probiotic food types available on the market are of dairy origin, which limits their consumption by individuals with food intolerances and by those who adhere to strict vegan and vegetarian diets. The aim of the current review is to assess both the limitations and impacts of the addition of probiotic microorganisms to fruit, vegetable, and/or mixed juices. Thus, an integrative literature review was herein carried out. A bibliographic survey was carried out in the following databases: Lilacs, Medline, Web of Science, Scopus, and Scielo. In addition, searches for studies published in English from 2010 to 2021 were carried out, based on the following meshes: "fruit", ''vegetable", ''juice", and "probiotics", which were used both in combination with each other and with Boolean operators such as "AND" and "OR". Although 254 articles were initially found in the literature search, only 21 of them were selected to compose the final sample. The included studies mainly addressed microorganism viability and physicochemical analyses. Overall, fruit and/or vegetable juices can be suitable matrices used to help the development of probiotic food types. However, the microorganisms added to these products must be capable of adapting to and surviving in them to enable a product's success. Therefore, factors such as pH, fiber content, amino acids, and phenolic compounds play an essential role in the survival of probiotic microorganisms. Given the wide variety of analyses, a comparison between parameters was the major limitation of the present study. Future studies should focus on filling the gaps persisting in the development of probiotic fruit and/or vegetable juices as well as mixed juices.

A case report of vaccine-induced immune thrombotic thrombocytopenia (VITT) with genetic analysis.

The emergence of the rare syndrome called vaccine-induced immune thrombocytopenia and thrombosis (VITT) after adenoviral vector vaccines, including ChAdOx1 nCov-19, raises concern about one's predisposing risk factors. Here we report the case of a 56-year-old white man who developed VITT leading to death within 9 days of symptom onset. He presented with superior sagittal sinus thrombosis, right frontal intraparenchymal hematoma, frontoparietal subarachnoid and massive ventricular hemorrhage, and right lower extremity arterial and venous thrombosis. His laboratory results showed elevated D-dimer, C-reactive protein, tissue factor, P-selectin (CD62p), and positive anti-platelet factor 4. The patient's plasma promoted higher CD62p expression in healthy donors' platelets than the controls. Genetic investigation on coagulation, thrombophilia, inflammation, and type I interferon-related genes was performed. From rare variants in European or African genomic databases, 68 single-nucleotide polymorphisms (SNPs) in one allele and 11 in two alleles from common SNPs were found in the patient genome. This report highlights the possible relationship between VITT and genetic variants. Additional investigations regarding the genetic predisposition of VITT are needed.

A review on the ecotoxicity of macrocyclic lactones and benzimidazoles on aquatic organisms.

Despite its wide production and several applications, veterinary antiparasitics from macrocyclic lactones and benzimidazole classes have not received much scientific attention concerning their environmental risks. Thus, we aimed to provide insights into the state of the environmental research on macrocyclic lactone and benzimidazole parasiticides, emphasizing their toxicity to non-target aquatic organisms. We searched for relevant information on these pharmaceutical classes on PubMed and Web of Science. Our search yielded a total of 45 research articles. Most articles corresponded to toxicity testing (n = 29), followed by environmental fate (n = 14) and other issues (n = 2) of selected parasiticides. Macrocyclic lactones were the most studied chemical group (65% of studies). Studies were conducted mainly with invertebrate taxa (70%), with crustaceans being the most predominant group (n = 27; 51%). Daphnia magna was the most used species (n = 8; 15%). Besides, it also proved to be the most sensitive organism, yielding the lowest toxicity measure (EC50 0.25 µg/L for decreased mobility after 48 h-abamectin exposure) reported. Moreover, most studies were performed in laboratory settings, tracking a limited number of endpoints (acute mortality, immobility, and community disturbance). We posit that macrocyclic lactones and benzimidazoles warrant coordinated action to understand their environmental risks.