Consumption of antibiotics in Brazil - an analysis of sales data between 2014 and 2019.

BACKGROUND: Antibiotic consumption is a driver for the increase of antimicrobial resistance. The objective of this study is to analyze variations in antibiotic consumption and its appropriate use in Brazil from 2014 to 2019. METHODS: We conducted a time series study using the surveillance information system database (SNGPC) from the Brazilian Health Regulatory Agency. Antimicrobials sold in retail pharmacies were evaluated. All antimicrobials recorded for systemic use identified by the active ingredient were eligible. Compounded products and formulations for topic use (dermatological, gynecological, and eye/ear treatments) were excluded. The number of defined daily doses (DDDs)/1,000 inhabitants/day for each antibiotic was attributed. The number of DDDs per 1,000 inhabitants per day (DDIs) was used as a proxy for consumption. Results were stratified by regions and the average annual percentage change in the whole period studied was estimated. We used the WHO Access, Watch, and Reserve (AWaRe) framework to categorize antimicrobial drugs. RESULTS: An overall increase of 30% in consumption from 2014 to 2019 was observed in all Brazilian regions. Amoxicillin, azithromycin and cephalexin were the antimicrobials more consumed, with the Southeast region responsible for more than 50% of the antibiotic utilization. Among all antimicrobials analyzed 45.0% were classified as watch group in all Brazilian regions. CONCLUSION: We observed a significant increase in antibiotics consumption from 2014 to 2019 in Brazil restricted to the Northeast and Central West regions. Almost half of the antibiotics consumed in Brazil were classified as watch group, highlighting the importance to promote rational use in this country.

Vocal Demand Response to the Educational Setting Based Communication Scenarios: A Single Subject Study

Objectives: This was a single-subject study, aimed to demonstrate different vocal demand situations that are typical for primary school and teacher's vocal demand response under two acoustical conditions, with and without voice amplification, during five working days. Methods: The long-term voice dosimetry with Vocal Holter Med (PR.O. Voice Srl) was carried out on a 49-year-old female teacher with voice disorders during daily teaching activities. A sound field amplification system (SFAS) PentaClass Runa was installed in the classroom. Voice dosimetry was provided under two different acoustical conditions: without SFAS (2 days) and with SFAS (3 days). Results: Phonation time percentage, sound pressure level (SPL), SPL SD, fundamental frequency (F0), F0 SD, cycle, and distance doses were investigated in seven communication scenarios (lessons, group/individual classes, sports lessons in the gym and schoolyard, breaks, lunch breaks, and other activities). The median scores of all voice parameters differed significantly between different vocal demand contexts. The significant statistical difference in the vocal demand response was in the communication situations with and without SFAS. In addition, the number of children, reverberation time, and ambient air relative humidity impacted voice SPL and the cycle dose. Conclusions: Lessons, sports lessons held in the gym or schoolyard, breaks, and lunch breaks were considered as high vocal demand communication situations requiring higher voice intensity and fundamental frequency, higher phonation time percentage, cycle, and distance doses. Group/individual work and other teacher activities during the day, unrelated to direct work with students, were categorized as low vocal demand communication scenarios.

Objetivos: Este fue un estudio de sujeto único, cuyo objetivo fue demostrar diferentes situaciones de demanda vocal típicas de la escuela primaria y la respuesta vocal de los docentes bajo dos condiciones acústicas, con y sin amplificación de voz, durante cinco días laborables. Métodos: Se llevó a cabo dosimetría vocal a largo plazo con Vocal Holter Med (PR.O. Voice Srl) durante las actividades diarias de enseñanza en una docente de 49 años con trastornos de la voz. Se instaló un sistema de amplificación de campo sonoro (SFAS) PentaClass Runa en el aula. La dosimetría vocal se realizó bajo dos condiciones acústicas diferentes: sin SFAS (2 días) y con SFAS (3 días). Resultados: Se investigaron el porcentaje de tiempo de fonación, el nivel de presión sonora (SPL), SPL SD, la frecuencia fundamental (F0), F0 SD, ciclos y dosis de distancia en siete escenarios de comunicación diferentes (clases, clases grupales/individuales, clases de educación física en el gimnasio y el patio de la escuela, recreos, almuerzos y otras actividades). Las puntuaciones medias de todos los parámetros vocales diferían significativamente entre los diferentes contextos de demanda vocal. La diferencia estadísticamente significativa en la respuesta a la demanda vocal se observó en las situaciones de comunicación con y sin SFAS. Además, el número de niños, el tiempo de reverberación y la humedad relativa del aire ambiente afectaron al SPL de la voz y la dosis de ciclo. Conclusiones: Las lecciones, las clases de educación física en el gimnasio o el patio de la escuela, los recreos y los almuerzos se consideraron situaciones de comunicación de alta demanda vocal, que requerían una mayor intensidad y frecuencia fundamental de la voz, un mayor porcentaje de tiempo de fonación y dosis de ciclo y distancia más altas. El trabajo grupal/individual y otras actividades del profesor durante el día no relacionadas con el trabajo directo con los estudiantes se categorizaron como escenarios de comunicación de baja demanda vocal.

Single anthocyanins effectiveness modulating inflammation markers in obesity: dosage and matrix composition analysis.

Anthocyanins (ACNs) are phytochemicals with numerous bioactivities, e.g., antioxidant and anti-inflammatory. Health benefits from consuming ACN-rich foods, extracts, and supplements have been studied in clinical trials (CT). However, the individual effect of single ACNs and their correlation with doses and specific bioactivities or molecular targets have not been thoroughly analyzed. This review shows a recompilation of single anthocyanins composition and concentrations used in CT, conducted to investigate the effect of these anti-inflammatory derivatives in obese condition. Single anthocyanin doses with changes in the levels of frequently monitored markers were correlated. In addition, the analysis was complemented with reports of studies made in vitro with single ACNs. Anthocyanins' efficacy in diseases with high baseline obesity-related inflammation markers was evidenced. A poor correlation was found between most single anthocyanin doses and level changes of commonly monitored markers. Correlations between cyanidin, delphinidin, and pelargonidin derivatives and specific molecular targets were proposed. Our analysis showed that knowledge of specific compositions and anthocyanin concentrations determined in future studies would provide more information about mechanisms of action.

Establishing national clinical diagnostic reference levels and achievable doses for CT examinations in Brazil: A prospective study.

PURPOSE: Diagnostic reference levels (DRL) and achievable doses (AD) are important tools for radiation dose optimization. Therefore, a prospective study was performed which aimed to establish a multi-parametric, clinical indication based - DRL(DRLCI) and clinical indication - AD (ADCI) for adult CT in Brazil. METHODS: The prospective study included 4787 patients (50 ± 18 years old; male:female 2041:2746) at 13 Brazilian sites that have been submitted to head, paranasal sinus, cervical spine, chest, or abdomen-pelvis CT between January and October 2021 for 13 clinical indications. The sites provided the following information: patient age, gender, weight, height, body mass index[BMI], clinical indications, scanner information(vendor, model, detector configuration), scan parameters (number of scan phases, kV, mA, pitch) and dose-related quantities (CT dose index volume- CTDIvol, dose length product- DLP). Median(AD) and 75th(DRL) percentile CTDIvol and DLP values were estimated for each body region and clinical indications. Non-normal data were analyzed with the Kruskal-Wallis test. RESULTS: In majority of Brazilian sites, body region and clinical indications based DRLs were at or lower than the corresponding DRLs in the US and higher than Europe. Although radiation doses varied significantly for patients in different body mass index groups (p < 0.001), within each body region, there were no differences in radiation doses for different clinical indications (p > 0.1). Radiation doses for 7/13 clinical indications were higher using iterative reconstruction technique than for the filtered back projection. CONCLUSIONS: There was substantial variation in Brazil DRLCI across different institutions with higher doses compared to the European standards. There was also a lack of clinical indication-based protocol and dose optimization based on different clinical indications for the same body region.

Up-Front ASCT Overcomes the Survival Benefit Provided by HDAC-Based Induction Regimens in Mantle Cell Lymphoma: Data from a Real-Life and Long-Term Cohort.

BACKGROUND: Mantle cell lymphoma (MCL) is a rare malignancy with heterogeneous behavior. Despite the therapeutic advances recently achieved, MCL remains incurable. Currently, the standard of care for young and fit patients involves induction immunochemotherapy followed by up-front autologous stem cell transplantation (ASCT). However, the role of more intensive induction regimens, such as those based on high doses of cytarabine (HDAC), remains controversial in the management of ASCT-eligible patients. METHODS: This retrospective, observational, and single-center study involved 165 MCL patients treated at the largest oncology center in Latin America from 2010 to 2022. We aimed to assess outcomes, determine survival predictors, and compare responses between different primary therapeutic strategies, with a focus on assessing the impact of HDAC-based regimens on outcomes in ASCT-eligible patients. RESULTS: The median age at diagnosis was 65 years (38-89 years), and 73.9% were male. More than 90% of the cases had a classic nodal form (cnMCL), 76.4% had BM infiltration, and 56.4% presented splenomegaly. Bulky ≥ 7 cm, B-symptoms, ECOG ≥ 2, and advanced-stage III/IV were observed in 32.7%, 64.8%, 32.1%, and 95.8%, respectively. Sixty-four percent of patients were categorized as having high-risk MIPI. With a median follow-up of 71.1 months, the estimated 2-year OS and EFS were 64.1% and 31.8%, respectively. Patients treated with (R)-HDAC-based regimens had a higher ORR (85.9% vs. 65.7%, p = 0.007) compared to those receiving (R)-CHOP, as well as lower POD-24 rates (61.9% vs. 80.4%, p = 0.043) and lower mortality (43.9% vs. 68.6%, p = 0.004). However, intensified induction regimens with (R)-HDAC were not associated with a real OS benefit in MCL patients undergoing up-front consolidation with ASCT (2-year OS: 88.7% vs. 78.8%, p = 0.289). Up-front ASCT was independently associated with increased OS (p < 0.001), EFS (p = 0.005), and lower POD-24 rates (p < 0.001) in MCL. Additionally, CNS infiltration, TLS, hypoalbuminemia, and the absence of remission after induction were predictors of poor OS. CONCLUSIONS: In the largest Latin American cohort of MCL patients, we confirmed the OS benefit promoted by up-front consolidation with ASCT in young and fit patients, regardless of the intensity of the immunochemotherapy regimen used in the pre-ASCT induction. Although HDAC-based regimens were not associated with an unequivocal increase in OS for ASCT-eligible patients, it was associated with higher ORR and lower rates of early relapses for the whole cohort.

Simulated Drift of Dicamba and Glyphosate on Coffee Crop.

Weed management in areas adjacent to coffee plantations makes herbicide drift a constant concern, especially with the use of nonselective products such as dicamba. The objective of this study was to evaluate the phytotoxic effects of the herbicide dicamba alone and mixed with glyphosate as a result of simulated drift in a coffee-producing area. The study was conducted in duplicate at two different coffee cherry development stages. The study was performed with a randomized block design and a 2 × 5 + 1 factorial scheme with four replications using two herbicide spray solutions (dicamba and dicamba + glyphosate) and five low doses (0.25; 1; 5; 10; and 20%). Additionally, a control treatment without herbicide application was also employed. In this study, we evaluated the phytotoxic damage and biometric and productive parameters. Visual damages were observed with the use of dicamba and dicamba + glyphosate doses reduced by 0.25% to 5% in the first days after application. The main symptoms were new leaf epinasty, changes in the internodal distance, and plagiotropic branch curvature. Low doses led to reduced plant height and branch length. The treatments did not reduce productivity and performance but altered the physical classifications of grains.

Determination of the discriminant doses to identify resistance to fipronil, flumethrin and coumaphos, in Rhipicephalus sanguineus s.l. (Acari: Ixodidae) from Mexico.

Rhipicephalus sanguineus s.l. is an intra- and peridomiciliary tick of medical and veterinary importance, whose control is carried out through the application of various ixodicides, to which it can develop resistance. The objective of this work was to determine the discriminant doses (d.d.) to identify resistance against three ixodicides - fipronil, flumethrin and coumaphos - in R. sanguineus s.l. larvae originating from Mexico. Engorged ticks were collected from naturally infested dogs residing in rural communities in five Mexican states; the dogs had no history of recent treatment with ixodicides. All ticks were identified as R. sanguineus s.l. They were incubated for 25 days and their progeny was used in the larval package test (LPT) to be exposed to d.d. as determined in Rhipicephalus microplus, and those that were susceptible were analyzed using the LPT with six concentrations, for fipronil from 0.1 to 0.003125%, for flumethrin from 0.02 to 0.000625% and for coumaphos from 0.4 to 0.0125%. Mortality was analyzed with Probit methodology, to calculate the 50 and 99% lethal concentrations (LC50 and LC99). The d.d. was determined as a consensus value by multiplying the LC99 value × 2. Nine double susceptible samples (fipronil + flumethrin) and one triple susceptible sample (fipronil + flumethrin + coumaphos) were found; the d.d. determined were fipronil 0.05%, flumethrin 0.01% and coumaphos 0.43%. These doses can be used to rapidly and inexpensively identify resistant populations in samples collected in the field.

Evaluación del comportamiento agronómico del cultivo de col (Brassica oleracea var. capitata) con la aplicación de dos abonos orgánicos en el cantón Pangua, Ecuador / Evaluation of the agronomic performance of cabbage (Brassica oleracea var. capitata) with the application of two organic fertilizers in the Pangua canton, Ecuador

Resumen Los abonos orgánicos son una de las alternativas dentro del grupo de productos utilizados en la agricultura sostenible. La investigación tuvo como objetivo evaluar el comportamiento agronómico del cultivo de col (Brassica oleracea var. capitata) con la aplicación de dos abonos orgánicos (gallinaza y compost) en el Cantón Pangua, las dosis utilizadas fueron: 2 kg, 4 kg y 6 kg por metro cuadrado. El estudio se realizó en la Finca San Luis perteneciente a la Parroquia el Corazón del Cantón Pangua, la investigación tuvo una duración de 90 días para el establecimiento del ensayo y trabajo experimental. La evaluación de los datos se realizó en tres edades: 30, 60 y 90 días, se utilizó un diseño de bloques completamente al azar, con un arreglo factorial de A*B + un testigo (sin abono) con siete tratamientos, tres repeticiones y 20 plantas como unidad experimental. Las variables evaluadas fueron: altura de planta, diámetro del tallo, diámetro de repollo, peso de repollo y rendimiento por hectárea. Los resultados demostraron que la aplicación del abono orgánico compost permitió obtener mejores resultados, mientras que los demás tratamientos reportaron resultados inferiores. Los resultados a nivel de campo mostraron el mejor efecto donde se aplicó compost. El comportamiento agronómico de la col demostró una adecuada respuesta a la aplicación de este abono orgánico y adaptabilidad a las condiciones climáticas de la zona, con los mejores resultados para la dosis de 6 kg.

Abstract Organic fertilizers are one of the alternatives within the group of products used in sustainable agriculture. The objective of this research was to evaluate the agronomic performance of cabbage (Brassica oleracea var. capitata) with the application of two organic fertilizers (poultry manure and compost in the Pangua Canton, the doses used were: 2 kg, 4 kg and 6 kg per square meter. The study was carried out at the San Luis Farm belonging to the Corazón Parish of Pangua Canton, the research had a duration of 90 days for the establishment of the trial and experimental work. The evaluation of the data was carried out at three ages: 30, 60 and 90 days, a completely randomized block design was used, with a factorial arrangement of A*B + a control (without fertilizer) with seven treatments, three replications and 20 plants as experimental unit. The variables evaluated were: plant height, stem diameter, cabbage diameter, cabbage weight and yield per hectare. The results showed that the application of the compost organic fertilizer yielded better results, while the other treatments reported inferior results. The results at field level showed the best effect where compost was applied. The agronomic behavior of the cabbage showed an adequate response to the application of organic fertilizer and adaptability to the climatic conditions of the area with the best results for the 6 kg dose.

Substitute a half dose of macro fertilizers with liquid organic fertilizers on sweet corn plants (Zea mays saccharata) on Inceptisol Soil in Indonesia / Substitua metade da dosemacrofertilizantes por fertilizantes orgânicos líquidos em plantas de milho doce (Zea mays saccharata) em Cambissolosna Indonésia

Corn is a promising commodity economically for cultivation. A part from not requiring a long harvest time, sweet corn has a high selling value, without a long post-harvest process. The locationof the research was conducted in rice fields in Tawangargo Village, Karangploso District, Malang Regency. Altitude ± 749 m above sea level, Inceptisol soil type and moderate tropical climate. The implementation was carried out from December 2019 to July 2020. The research design was carried out using a Complete Randomized Block Design, with 2 factors. Factor 1, is the recommended fertilizer dosage of 3 doses (0, ½ and 1 dose), the second factor is the dose of liquids fertilizer organic (0, 4, 8, and 12 g /l) with 4 repetitions, with intervals onceevery 7-10 days. Giving 4 ml/l dose of inorganic fertilizer at an interval of once a week, together with 1 recommended dosage of Macro fertilizer affects the growth and yield of sweet corn plants. The highest production per ha in this treatment was 13,339 kg. The highest RAE value is 325.6% in the recommended 1 dose of NPK treatment plus 4 g / l of "liquids fertilizer organic". The economic approach is by calculating the R/C ratio, the treatment with the highestRAEis the R/C ratio of 8.59 with a net income of Rp. 176,785,041.(AU)

O milho é uma commoditypromissora economicamente para o cultivo. Além de não exigir um longo tempo de colheita, o milho doce tem alto valor de venda, sem um longo processo de pós-colheita. O local da pesquisafoi conduzido em campos de arroz na vila de Tawangargo, distrito de Karangploso, regência de Malang(Indonésia). A altitude é de ±749 m acima do nível do mar, cambissoloe clima tropical moderado. A implementação foi realizada de dezembro de 2019 a julho de 2020. O projeto de pesquisa foi realizado usando um projeto de bloco aleatório completo, com 2 fatores. O fator 1, é a dosagem recomendada de adubo de trêsdoses (0, ½ e 1 dosagem), o segundo fator é a dosagem de adubo líquido orgânico (0, 4, 8 e 12g/l) com quatro repetições, em intervalos de 7-10 uma vez por dia. Administrar 4 ml/l de fertilizante inorgânico com intervalos de uma vez porsemana, juntamentecom 1 dose recomendada de Macrofertilizante, afeta o crescimento e rendimento das plantas de milho doce. A maior produção por ha neste tratamento foi de 13.339 kg. O maior valor de RAE é de 325,6% no recomendado 1 dose do tratamento NPKmais 4 g/l de "fertilizante orgânico líquido". A abordagem econômica é calcular a relação R/C, o tratamento com o RAE mais alto é a relação R/C de 8,59 com um lucro líquido de Rp. 176.785.041.(AU)

Diagnostic reference level quantities for adult chest and abdomen-pelvis CT examinations: correlation with organ doses.

OBJECTIVES: To evaluate correlations between DRL quantities (DRLq) stratified into patient size groups for non-contrast chest and abdomen-pelvis CT examinations in adult patients and the corresponding organ doses. METHODS: This study presents correlations between DRLq  (CTDIvol, DLP and SSDE) stratified into patient size ranges and corresponding organ doses shared in four groups: inside, peripheral, distributed and outside. The demographic, technical and dosimetric parameters were used to identify the influence of these quantities in organ doses. A robust statistical method was implemented in order to establish these correlations and its statistical significance. RESULTS: Median values of the grouped organ doses are presented according to the effective diameter ranges. Organ doses in the regions inside the imaged area are higher than the organ doses in peripheral, distributed and outside regions, excepted to the peripheral doses associated with chest examinations. Different levels of statistical significance between organ doses and the DRLq were presented. CONCLUSIONS: Correlations between DRLq and target-organ doses associated with clinical practice can support guidance's to the establishment of optimization criteria. SSDE demonstrated to be significant in the evaluation of organ doses is also highlighted. The proposed model allows the design of optimization actions with specific risk-reduction results.

HPV vaccination programs in LMIC: is it time to optimize schedules and recommendations?

Abstract Objectives: Prophylactic HPV vaccines are a fundamental tool to reduce infections and tumors caused by the most prevalent types of these viruses, as this review points out. Several countries have adopted immunization programs that recommend vaccination against HPV for girls and adolescents between 9 and 14 years of age and, in some of them, also for boys. The programs also contemplate the immunization of adults, particularly in the case of individuals with different immunodeficiencies. Sources of data: The available vaccines are recommended for the prevention of tumors of the uterine cervix, vulva, vagina, penis, and anal canal. Moreover, two of the vaccines prevent the occurrence of genital warts, having been recently indicated for the prevention of oropharyngeal cancer. Data synthesis: Based on the evidence that antibody responses in girls were non-inferior after two doses when compared to three doses, several countries have decided to reduce the vaccination schedule for girls and boys up to 14 years of age from three to two doses, with an interval of six months between them. Recently, knowledge has been accumulating about the immunogenicity, duration of protection, and efficacy of a single-dose HPV vaccine regimen in girls and young women. Conclusion: Single-dose HPV vaccination could substantially reduce the incidence of pre-cancer and cervical cancer attributable to HPV, with reduced costs for vaccine delivery and simplified implementation, allowing more countries to introduce HPV vaccination or increase the adherence of the target population.

Adverse Events and Drug Resistance in Critically Ill Patients Treated with Colistimethate Sodium: A Review of the Literature.

The adverse events related to sodium colistimethate have had variability regarding the prevalence of nephrotoxicity, neurotoxicity, and less frequent respiratory depression. In recent years, its use has been relevant due to the increase of multidrug-resistant bacteria since it is considered the last-line drug, being its main adverse event and reason for discrepancies between authors' nephrotoxicity. The indiscriminate use of antibiotic therapy has generated multiple mechanisms of resistance, the most common being related to Colistin, the bactericidal escape effect. Based on the search criteria, no randomized clinical trials were identified showing safety and efficacy with the use of Colistin, inferring that the application of the appropriate dose is governed by expert opinion and retrospective and prospective observational studies, which confounding factors such as the severity of the patient and the predisposition to develop acute renal failure are constant. In this review, we focus on identifying the mechanism of nephrotoxicity and bacterial resistance, where much remains to be known.

Cancer risk in healthy patients who underwent chest tomography comparing three different technologies.

This research aimed to estimate the risk of cancer associated with patients without previous disease undergoing chest tomography. Siemens CT scanners have 6, 64, and 128 detectors. The Biologic Effects of Ionizing Radiation Reports - BEIR VII methodology was used. The study presented a sample of 64 patients aged between 18 and 80 years, in the city of Belo Horizonte, Minas Gerais - Brazil. The IMPACT CT software and CalDose X CT Online were used to calculate the absorbed and equivalent dose from the Volumetric Computed Tomography Dose Index - CTDIvol (mGy) and Dose Length Product - DLP values provided by the equipment. CT-Expo Software was also used to estimate Specific Dose Estimates (SSDEs) values. The CTDvol results for the MG1, MG,2 and MG3 Diagnostic Centers in mGy were respectively 4.369 ± 1.352, 6.99 4 ± 1.53,3 and 9.984 ± 2.282 and the SSDE values were 3.800, 6.40,0 and 9,.500. The values for the equivalent dose, at the MG2 Diagnostic Center, by IMPACT CT, in (mSv) for the breasts, esophagus, heart, thyroid, lung and thymus were respectively 3.9, 5.7, 4.7, 1.0, 4.8 and 5.7. The CalDose Software, for the same equipment and the same organs, in mSv, estimated the values 7.4, 9.4, 11.1, 5.3, 10.8 and 11.3 for women and 7.1, 9.3, 11.0, 5.3, 10.2 and 10.9 for men. The estimated risk of cancer decreased according to the patient's age, but with a higher incidence for females. The use of each software must be carefully analyzed to avoid undue values due to the particularities of each one. The results also showed that the risk of developing cancer due to radiation decreases with patient age and is higher in females.

The third vaccine dose significantly reduces susceptibility to the B.1.1.529 (Omicron) SARS-CoV-2 variant.

The main coronavirus disease 2019 (COVID-19) vaccine formulations used today are mainly based on the wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein as an antigen. However, new virus variants capable of escaping neutralization activity of serum antibodies elicited in vaccinated individuals have emerged. The Omicron (B.1.1.529) variant caused epidemics in regions of the world in which most of the population has been vaccinated. In this study, we aimed to understand what determines individual's susceptibility to Omicron in a scenario of extensive vaccination. For that purpose, we collected nasopharynx swab (n = 286) and blood samples (n = 239) from flu-like symptomatic patients, as well as their vaccination history against COVID-19. We computed the data regarding vaccine history, COVID-19 diagnosis, COVID-19 serology, and viral genome sequencing to evaluate their impact on the number of infections. As main results, we showed that vaccination in general did not reduce the number of individuals infected by Omicron, even with an increased immune response found among vaccinated, noninfected individuals. Nonetheless, we found that individuals who received the third vaccine dose showed significantly reduced susceptibility to Omicron infections. A relevant evidence that support this finding was the higher virus neutralization capacity of serum samples of most patients who received the third vaccine dose. In summary, this study shows that boosting immune responses after a third vaccine dose reduces susceptibility to COVID-19 caused by the Omicron variant. Results presented in this study are useful for future formulations of COVID-19 vaccination policies.

HPV vaccination programs in LMIC: is it time to optimize schedules and recommendations?

OBJECTIVES: Prophylactic HPV vaccines are a fundamental tool to reduce infections and tumors caused by the most prevalent types of these viruses, as this review points out. Several countries have adopted immunization programs that recommend vaccination against HPV for girls and adolescents between 9 and 14 years of age and, in some of them, also for boys. The programs also contemplate the immunization of adults, particularly in the case of individuals with different immunodeficiencies. SOURCES OF DATA: The available vaccines are recommended for the prevention of tumors of the uterine cervix, vulva, vagina, penis, and anal canal. Moreover, two of the vaccines prevent the occurrence of genital warts, having been recently indicated for the prevention of oropharyngeal cancer. DATA SYNTHESIS: Based on the evidence that antibody responses in girls were non-inferior after two doses when compared to three doses, several countries have decided to reduce the vaccination schedule for girls and boys up to 14 years of age from three to two doses, with an interval of six months between them. Recently, knowledge has been accumulating about the immunogenicity, duration of protection, and efficacy of a single-dose HPV vaccine regimen in girls and young women. CONCLUSION: Single-dose HPV vaccination could substantially reduce the incidence of pre-cancer and cervical cancer attributable to HPV, with reduced costs for vaccine delivery and simplified implementation, allowing more countries to introduce HPV vaccination or increase the adherence of the target population.

Effectiveness of mRNA, protein subunit vaccine and viral vectors vaccines against SARS-CoV-2 in people over 18 years old: a systematic review.

INTRODUCTION: Vaccines prevent disease and disability; save lives and represent a good assessment of health interventions. Several systematic reviews on the efficacy and effectiveness of COVID-19 vaccines have been published, but the immunogenicity and safety of these vaccines should also be addressed. AREAS COVERED: This systemic investigation sought to explain the efficacy, immunogenicity, and safety of new vaccination technologies against SARS-CoV-2 in people over 18 years old. Original research studying the effectiveness on mRNA, protein subunit vaccines, and viral vector vaccines against SARS-CoV-2 in people over 18 years old was analyzed. Several databases (Web of Science, Scopus, MEDLINE and EMBASE) were searched between 2012 and November 2022 for English-language papers using text and MeSH terms related to SARS-CoV-2, mechanism, protein subunit vaccine, viral vector, and mRNA. The protocol was registered on PROSPERO, CRD42022341952. Study quality was assessed using the NICE methodology. We looked at a total of six original articles. All studies gathered and presented quantitative data. EXPERT OPINION: Our results suggest that new vaccinations could have more than 90% efficacy against SARS-CoV-2, regardless of the technology used. Furthermore, adverse reactions go from mild to moderate, and good immunogenicity can be observed for all vaccine types.

Post-vaccination seropositivity against SARS-CoV-2 in peruvian health workers vaccinated with BBIBP-CorV (Sinopharm).

OBJECTIVE: To estimate the prevalence of post-vaccination seropositivity against SARS-CoV-2 and identify its predictors in Peruvian Social Health Insurance (EsSalud) personnel in 2021. METHODS: We conducted a cross-sectional study in a representative simple stratified sample of EsSalud workers. We evaluated IgG anti-SARS-CoV-2 antibodies response (seropositivity) by passive (previous infection) and active immunization (vaccination), and epidemiological and occupational variables obtained by direct interview and a data collection form. Descriptive and inferential statistics were used with correction of sample weights adjusted for non-response rate, and crude and adjusted odds ratio (OR) and geometric mean ratio (GMR) with their respective 95% confidence intervals (95%CI) were estimated. RESULTS: We enrolled 1077 subjects. Seropositivity was 67.4% (95%CI: 63.4-71.1). Predictors of seropositivity were age (negative relation; p < 0.001), previous infection (aOR = 11.7; 95%CI: 7.81-17.5), working in COVID-19 area (aOR = 1.47; 95%CI: 1.02-2.11) and time since the second dose. In relation to antibody levels measured by geometric means, there was an association between male sex (aGMR = 0.77; 95%CI: 0.74-0.80), age (negative relation; p < 0.001), previous infection (aGMR = 13.1; 95%CI:4.99-34.40), non-face-to-face/licensed work modality (aGMR = 0.78; 95%CI: 0.73-0.84), being a nursing technician (aGMR = 1.30; 95%CI: 1.20-1.41), working in administrative areas (aGMR = 1.17; 95%CI: 1.10-1.25), diagnostic support (aGMR = 1.07; 95%CI: 1.01-1.15), critical care (aGMR = 0.85; 95%CI: 0.79-0.93), and in a COVID-19 area (aGMR = 1.30; 95%CI: 1.24-1.36) and time since receiving the second dose (negative relation; p < 0.001). CONCLUSIONS: Seropositivity and antibody levels decrease as the time since receiving the second dose increases. Older age and no history of previous infection were associated with lower seropositivity and antibody values. These findings may be useful for sentinel antibody surveillance and the design of booster dose strategies.

Treatment of benign tumours and related pathologies with radiotherapy: experience of the General Hospital of Mexico.

Background: Benign diseases include tumours or localized growths with low potential for progression. The use of radiotherapy (RT) at a low dose (LD) or intermediate dose for benign pathologies has been widely proposed and studied. Currently, the use of RT is limited mainly to hyperproliferative and inflammatory diseases as a first or second line of treatment. Materials and methods: This was a retrospective, observational and descriptive study conducted in the Radiotherapy Unit of the Oncology Service of the General Hospital of Mexico "Dr. Eduardo Liceaga" from January 2, 2016, to December 31, 2020. Patients diagnosed with benign pathology and treated with RT were included. The response to treatment was recorded based on the imaging study report and/or clinical review that determined control of the disease, and toxicity was recorded based on the RTOG evaluation for acute effects and CTCAE V. 4.0 for chronic effects. Results: The records of 222 patients were analysed. The mean follow-up duration was 31.53 months (range 6-61), and the median was 24 months. Of all of the analysed pathologies that were treated with RT, keloid scars predominated in 112 patients (50.5%), and paragangliomas predominated in 72 patients (32.4%); the other patients were treated for rare pathologies. The prescribed dose was dependent on the diagnosis, with the mean dose being 31.63 Gy (1500-6000 cGy) and the median being 2000 cGy. Most of the cases of acute and chronic toxicity were grades 1 and 2, and a disease response was achieved in 94.1% of the patients. Conclusion: Our series shows that for cases of benign pathology, RT offers acceptable toxicity, improves quality of life and yields a good response, achieving disease control. These results suggest the inclusion of inflammatory pathology among the indications for treatment.

Effects of Chemical Fertilization and Microbial Inoculum on Bacillus subtilis Colonization in Soybean and Maize Plants.

Plant growth-promoting endophytic microorganisms in agriculture have been expanding in Brazil and are an excellent strategy to face the challenges of current agriculture, such as reducing production costs with fewer environmental impacts, without detriment to productivity. However, little is known about the factors that can affect the colonization of endophytic such as inoculant concentration and mineral fertilization. The present study aimed to evaluate the influence of these factors on soybean and maize crops and found that for soybean crops, the highest Bacillus subtilis concentration of 1 × 104 and 1 × 1010 CFU ml-1 promoted the highest number of recovered bacteria, when there was no mineral fertilization. However, mineral fertilization limited the number of recovered bacteria, suggesting that mineral fertilization interferes with endophytic colonization. For maize crops, the highest number of recovered bacteria occurred from the concentration of 1 × 106 CFU ml-1, not differing from the highest concentrations. A mineral fertilization dose of 25% promoted the greatest B. subtilis recovery compared to the other treatments. Regarding plant development, the highest microbial inoculum concentrations did not necessarily promote greater positive growth promotion effects compared to the concentration of 1 × 104 CFU ml-1 for both crops. The results also suggest that the higher number of endophytic bacteria recovered in the plant does not necessarily affect plant growth in the same proportion. For soybean plants, there is a strong tendency that with the increase in the B. subtilis inoculant concentration, the need for mineral fertilization doses to achieve the same plant development is consequently increased, and inoculations with 1 × 105 and 1 × 106 CFU ml-1 with fertilization doses between 44% and 62% are the ideal combinations for greater plant development. In maize plants, the best growth promotion response (height) was obtained using inoculation concentration of 1 × 102 and 1 × 1010 CFU ml-1, increasing according to the increase in fertilization doses. The findings suggest, for soybean crop, that these high inoculum concentrations required more photosynthetic metabolites from the plants and more nutrients from the soil. Thus, the need for mineral fertilization for plant growth must be increased.

Study of the acute and repeated dose 28-day oral toxicity in mice treated with PT-31, a molecule with a potential antipsychotic profile.

Schizophrenia is a psychiatric disorder that affects 1% of the world population and is treated with antipsychotics, which may induce important biochemical and hematological alterations. Since it is necessary to verify the safety of new molecules with antipsychotic potential, the present study aimed to evaluate the oral toxicity of PT-31, a putative α2-adrenoreceptor agonist, after acute (2000 mg/kg) and repeated doses (28 days) gavage treatment, in three different doses: minimum effective dose in animal models (10 mg/kg), twice the dose (20 mg/kg), and four times the dose (40 mg/kg), as recommended by the OECD guidelines. Balb/C female adult mice were used, and biochemical, hematological, and histopathological analyses were performed. PT-31 10 and 20 mg/kg did not cause biochemical alterations related to hepatic and renal toxicity, and neither altered glycemic and lipid profiles. The preclinical dose of PT-31 also did not promote mice histopathological changes in the liver, kidney, and brain. In the hematimetric parameters, PT-31 only increased HGB at 20 mg/kg, and MCH and MCHC at 40 mg/kg. However, all the tested doses of PT-31 showed platelet increase, which must be better investigated. Therefore, further studies are needed to investigate the safety of PT-31 as a potential antipsychotic drug.