A sad portrait of congenital syphilis in the State of Rio de Janeiro. Case report with Polymerase Chain Reaction (PCR) of scrapings from skin lesions and placenta fragment positive for Treponema pallidum

Introduction: Congenital syphilis is a serious public health problem that causes high rates of intrauterine morbidity and mortality, revealing flaws and weaknesses in the health system. Objective: to report a case of congenital syphilis in a university hospital in the Center-South Region of the State of Rio de Janeiro, Brazil. Case report: A pregnant woman, aged between 19 and 23 years old, carrying a Pregnant Woman's Handbook with a record of seven prenatal consultations and a note of the serological reaction for positive syphilis, but without any treatment, hospitalized at the University Hospital of Vassouras (RJ), in labor, gave birth to a newborn (NB) with a clinical picture and serological test of congenital syphilis. The NB required care in an intensive care unit and was discharged 28 days after birth. Scraping of skin lesions of the NB and placenta was performed for analysis by molecular biology (PCR in house) and genetic material of Treponema pallidum was detected. Conclusion: Congenital syphilis is a serious outcome of syphilis during pregnancy, consuming high financial resources and significant emotional distress for the mother, father, the whole family, as well as for the health teams. Our case report was the first that we are aware of in Brazil with a diagnosis by PCR for positive Treponema pallidum of skin scraping and placental fragment. It also showed poor quality prenatal care, a common factor in most cases of CS in our reality

Serological ineptitude in blood banks: is there an association with sexually transmitted infections? / Inaptidão sorológica em bancos de sangue: existe associação com infecções sexualmente transmissíveis?

Introduction: Sexually transmitted infections (STIs) are a serious public health problem, and some of these infections are also transmitted through blood transfusions. Objective: To identify publications in scientific journals in Brazil and in the world showing if there is an important association between serological inadequacy due to sexually transmitted infections traced in blood and blood products used for medical use. Methods: Systematic review of articles published from 2018 to 2023, using the LILACS, SciELO and PubMed databases, with a concomitant approach to the issues of serological disability and STI. Original studies or review articles in Portuguese, English and Spanish with Brazilian and international data were included. Editorial publications, letter to the editor, letter from the editor or comments on the subject were excluded. Results: The search found 571 articles, of which 106 (18.40%) met the inclusion criteria, that is, Serological disability and STI. In studies with international data, the prevalence of donors with hepatitis C ranged from 0.12 to 4.8%; with hepatitis B, from 1.3 to 8.2%; with HIV, from 0.0021 to 2.5%; with syphilis, from 1.73 to 2.4%; with HTLV, 0.66%; and with Chagas disease, from 0.017 to 2.76%. Among articles with Brazilian data, the prevalence of donors with seroreactive tests for hepatitis C ranged from 0.18 to 1.76%; with hepatitis B, from 0.05 to 7.9%; with HIV, from 0.03 to 0.82%; with syphilis, from 0.37 to 3.51%; with HTLV, from 0.02 to 0.3%, and with Chagas disease, from 0.8 to 0.5%. Conclusion: STIs are rarely discussed in the scientific literature in studies on serological inadequacy. In addition, a minority of articles were with Brazilian data. However, results show that STIs, despite being little discussed in the scientific literature in studies on the subject of serological inadequacy, have statistically significant percentages of seropositivity for STIs. Moreover, hepatitis C and B have a relevant seroprevalence, reaching 8.2% and 4.8%, respectively, in the international scenario. In Brazil, hepatitis B continues to occupy a prominent place with a seroprevalence of up to 7.9%. However, syphilis now holds a very important role, with a maximum percentage of 3.51%. More studies are needed for further reflection: although STIs are little addressed in studies about serological inadequacy in human blood banks, would they contribute to the maintenance and non-reduction of the general frequency of infections transmitted by blood transfusion

Introdução: As infecções sexualmente transmissíveis (IST) são um grave problema de saúde pública e algumas dessas infecções, também, transmitidas por intermédio de transfusões de sangue. Objetivo: Identificar publicações em periódicos científicos no Brasil e no mundo sobre se existe importante associação entre inaptidão sorológica por infecções sexualmente transmissíveis rastreadas em sangue e hemoderivados usados para uso médico. Métodos:Revisão sistemática de artigos publicados no período de 2018 a 2023, usando as bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Scientific Electronic Library Online (SciELO) e United States National Library of Medicine (PubMed) com abordagem concomitante para os assuntos de inaptidão sorológica e IST. Incluíram-se estudos originais ou artigos de revisão nos idiomas português, inglês e espanhol com dados brasileiros e internacionais. Foram excluídas publicações do tipo editorial, carta ao editor, carta do editor ou comentários sobre o tema. Resultados:A busca localizou 571 artigos dos quais 106 (18,40%) se encaixavam nos critérios de inclusão, ou seja, inaptidão sorológica e IST. Em estudos com dados internacionais, a prevalência de doadores com hepatite C variou de 0,12 a 4,8%; com hepatite B de 1,3 a 8,2%; com HIV de 0,0021 a 2,5%; com sífilis de 1,73 a 2,4%; com HTLV 0,66%; e com doença de Chagas de 0,017 a 2,76 %. Já entre os artigos com dados brasileiros, a prevalência de doadores com exames soro-reatores para hepatite C variou de 0,18 a 1,76%; com hepatite B de 0,05 a 7,9%; com HIV de 0,03 a 0,82%; com sífilis de 0,37 a 3,51%; com HTLV 0,02 a 0,3%, e com doença de Chagas de 0,8 a 0,5%. Conclusão: As IST são pouco abordadas na literatura científica em estudos com o tema inaptidão sorológica. Além disso, uma minoria de artigos era com dados brasileiros. Entretanto, resultados demonstram que, apesar de pouco abordadas na literatura científica em estudos com o tema inaptidão sorológica, as IST possuem percentuais de soropositividade estatisticamente significativos. Além disso, as hepatites C e B possuem soroprevalência relevante, podendo chegar a 8,2 e 4,8%, respectivamente, no cenário internacional. Já no cenário nacional, brasileiro, a hepatite B continua ocupando um lugar de destaque, com soroprevalência de até 7,9%. Todavia, a sífilis passa a ocupar um papel de altíssima relevância, com percentual máximo de 3,51%. São necessários mais estudos para mais reflexão: apesar de as IST serem pouco abordadas em estudos acerca da inaptidão sorológica em bancos de sangue humano, seriam elas contribuintes para a manutenção e a não redução da frequência geral de infecções transmitidas por transfusão sanguínea?

Adapted Murine Sepsis Score: Improving the Research in Experimental Sepsis Mouse Model.

The Murine Sepsis Score (MSS) is used to assess the severity of sepsis in rats and mice based on observational characteristics. The quantitative variables of glycemia, body weight, and temperature are predictors of severity in experimental models of sepsis. Therefore, our study sought to adapt the MSS with the same variables to indicate earlier the severity of the disease in murine models of the disease. Sepsis mice presented hypoglycemia, weight loss, and hypothermia. Therefore, these variables were included in the Adapted Murine Sepsis Score (A-MSS). The A-MASS presented 100% specificity and 87.5% sensibility been able to differentiate the early sepsis symptoms and its severity. The A-MSS allows an early and more complete diagnosis of sepsis in mice and might be considered as a procedure to improve the analysis of systemic sepsis dysfunction in murine experimental models.

Sports and social assistance policies: an analysis of the program projovem adolescente / Esporte e política de assistência social: análise do programa projovem adolescente

ABSTRACT This work sought to analyze sports in the service offered through Brazilian Social Assistance Policies, the Service for Coexistence and Community Reinforcement (SCCR), with a central axis of analysis in the qualification program for the people aged 15 to 17, called Projovem Adolescente. Here we explain the theoretical and conceptual understanding of SCCR in Brazil and its structuring axes. We also describe the theoretical and methodological proposal for sports in Projovem and develop a methodology for analysis that proposes to reveal whether the sports experience proposed in the program is aligned with the delimitations of the SCCR. This article is characterized by a qualitative social research of exploratory nature, using bibliographical reviews and document research. We concluded that there is considerable alignment between Projovem's sports field proposals and SCCR regulations, in addition to its success in its theoretical conception, from a critical perspective on sports and advances in originality.

RESUMO Este trabalho buscou analisar o esporte no serviço ofertado na Política de Assistência Social brasileira, o Serviço de Convivência e Fortalecimento de Vínculos (SCCR), tendo como eixo central de análise o seu programa qualificador para o público de 15 a 17 anos, o Projovem Adolescente. Em suas linhas explicitamos o entendimento teórico-conceitual do SCCR no Brasil, assim como seus eixos estruturantes. Descrevemos também a proposta teórico-metodológica para o esporte no Projovem e desenvolvemos uma metodologia de análise que propõe revelar se a vivência esportiva proposta no programa se alinha ao exposto sobre o SCCR. Este artigo caracteriza-se como uma pesquisa social qualitativa de caráter exploratório, utilizando-se de revisão bibliográfica e pesquisa documental. Concluímos que há um alinhamento considerável entre as propostas do Projovem no campo esportivo e as normativas do SCCR, além de ser bem-sucedido na sua concepção teórica sob uma perspectiva crítica de esporte e fazer avançar na originalidade.

A single dose of eHSP72 attenuates sepsis severity in mice.

High levels of extracellular 72 kDa heat shock protein (eHSP72) can be detected in the serum of septic patients and are associated with increased oxidative profiles and elevated rates of mortality among these patients. However, a possible immunomodulatory role for this protein, resulting in tissue protection during sepsis, has never been assessed. In this study, we investigated whether eHSP72 administration could attenuate the severity of sepsis in a mouse peritonitis model. Animals (90-day-old male C57BL/6J mice) were divided into Sepsis (n = 8) and Sepsis + eHSP72 (n = 9) groups, which both received injections of 20% fecal solution [1 mg/g body weight (wt), intraperitoneal (i.p.)], to trigger peritonitis induced-sepsis, whereas a Control group (n = 7) received a saline injection. eHSP72 was administered (1.33 ng/g body wt) to the Sepsis+eHSP72 group, 12 h after sepsis induction. All animals were evaluated for murine sepsis score (MSS), hemogram, core temperature, and glycemia (before and 4, 12, and 24 h after sepsis induction). Treatment with eHSP72 promoted reduced sepsis severity 24 h after sepsis induction, based on MSS scores (Control = 1.14 ± 1.02; Sepsis = 11.07 ± 7.24, and Sepsis + eHSP72 = 5.62 ± 1.72, P < 0.001) and core temperatures (°C; Control = 37.48 ± 0.58; Sepsis = 35.17 ± 2.88, and Sepsis + eHSP72 = 36.94 ± 2.02; P = 0.006). eHSP72 treatment also limited the oxidative profile and respiratory dysfunction in mice with sepsis. Although sepsis modified glycemic levels and white and red blood cell counts, these variables were not influenced by eHSP72 treatment (P > 0.05). Finally, eHSP72 improved the survival rate after sepsis (P = 0.0371). Together, our results indicated that eHSP72 may ameliorate sepsis severity and possibly improve some sepsis indices in mice.

Esporte e políticas sociais no Brasil: uma discussão sobre cidadania e emancipação humana / Sport and social policies in Brazil: a discussion about citizenship and human emancipation / Deportes y políticas sociales en Brasil: una discusión sobre ciudadanía y emancipación humana

Este artigo caracteriza-se como um ensaio teórico sob uma perspectiva crítica e dialética da relação entre esporte e políticas sociais, referenciada em clássicos da literatura políticofilosófica, bem como em autores contemporâneos. O objetivo desse estudo é teorizar os conceitos de cidadania (na perspectiva de Marshall) e emancipação humana à luz de referências do materialismo-dialético, observando a relação entre esporte e políticas sociais. Após esse exercício teórico-analítico, observamos que a cidadania não é criação subjetiva, mas sim uma vivência e uma construção histórica a partir do acesso a determinados bens políticos, sociais e culturais. Assim, a luta pelo acesso ao esporte como direito apresenta-se como elemento constituinte do processo emancipatório.

This article is characterized as a theoretical essay from a critical and dialectical perspective of the relationship between sport and social policies, referenced in classics of the politicalphilosophical literature, as well as in contemporary authors. The purpose of this study is to theorize the concepts of citizenship (in Marshall's perspective) and human emancipation in the light of dialectical-materialism works, observing the relationship between sport and social policies. After this theoretical-analytical exercise, we observe that citizenship is not a subjective creation, but rather an experience and a historical construction based on access to certain political, social and cultural goods. Thus, the struggle for access to sport as a right presents itself as a constituent element of the emancipatory process.

En este artículo se caracteriza por ser una prueba teórica en una perspectiva crítica y dialéctica de la relación entre el deporte y las políticas sociales que se hace referencia en la literatura política-filosófica clásica, así como los autores contemporáneos. El objetivo de este estudio esteorizar conceptos de ciudadanía [la perspectiva de Marshall] y la emancipación humana a la luz de las referencias materialismo dialéctico, teniendo en cuenta la relación entre el deporte y las políticas sociales. Después de este ejercicio teórico y analítico, hemos observado que la ciudadanía no es la creación subjetiva, sino una experiencia y un edificio histórico del acceso a determinados activos político, social y cultural. Por lo tanto, la lucha por el acceso al deporte como un derecho se presenta como un elemento constitutivo del proceso emancipador.

Evolution of laparoscopic donor nephrectomy technique and outcomes: a single-center experience with more than 1300 cases.

OBJECTIVE: To describe and illustrate the evolution of surgical technique, emphasizing technical modifications of laparoscopic donor nephrectomy (LDN) and the impact on complication outcome. METHODS: This is a retrospective observational study of prospectively collected data on all consecutive purely LDN surgeries performed at a tertiary academic medical center (n = 1325), performed between March 2000 and October 2013. RESULTS: Over time, LDN was performed on older patients, changing from a mean of 35.7 years in 2000 to 41.2 years in 2013 (P <.001). Additionally, mean blood loss decreased from 75 mL in 2000 to 21.6 mL in 2013 (P <.001). However, body mass index, operative time, and length of stay remained similar. Overall, there were 105 (7.9%) complications: Clavien grade 1 (n = 81, 6.1%) and grade 2 or higher (n = 23, 1.8%). Procedure duration, blood loss, surgeon, year of procedure, laterality, body mass index, age, and gender did not significantly predict complications. There was no significant difference for Clavien complication rates between the early learning period (first 150 cases) and the rest of the series. CONCLUSION: With continual refinement with LDN techniques based on intraoperative observations and technological advances, complication rates remain consistently low, despite increasing donor age.

Lymphogranuloma venereum and non-Hodgkin lymphoma: a case report.

Lymphogranuloma venereum (LGV) is an uncommon, contagious, sexually transmitted disease (STD). We report a case of a 17-year-old teenager who presented with a 2-month-old ulcerous vegetant lesion in the right inguinal region. The patient was diagnosed with LGV and received erythromycin treatment. Three months after treatment, he presented with a new ulcerous lesion, very similar to the previous one, in the right supraclavicular region. He was diagnosed with a diffuse large B-cell non-Hodgkin lymphoma. Both diseases are rare in Rio de Janeiro City, Brazil, and physicians should not neglect the possibility of STDs in such cases.

Lymphogranuloma venereum and non-Hodgkin lymphoma: a case report / Linfogranuloma venéreo e linfoma não Hodgkin: um relato de caso

Lymphogranuloma venereum (LGV) is an uncommon, contagious, sexually transmitted disease (STD). We report a case of a 17-year-old teenager who presented with a 2-month-old ulcerous vegetant lesion in the right inguinal region. The patient was diagnosed with LGV and received erythromycin treatment. Three months after treatment, he presented with a new ulcerous lesion, very similar to the previous one, in the right supraclavicular region. He was diagnosed with a diffuse large B-cell non-Hodgkin lymphoma. Both diseases are rare in Rio de Janeiro City, Brazil, and physicians should not neglect the possibility of STDs in such cases.

Linfogranuloma venéreo (LGV) é uma doença sexualmente transmissível e de ocorrência pouco frequente. Relatamos um caso de um adolescente com 17 anos de idade que apresentou uma lesão ulcerativa vegetante a cerca de dois meses na região inguinal direita. Foi diagnosticado como LGV e o paciente foi tratado com eritromicina. Três meses após o tratamento o paciente apresentou uma nova lesão ulcerativa, muito semelhante à anterior, na região supraclavicular direita. O diagnóstico desta lesão foi de linfoma difuso de células B do tipo não-Hodgkin. Ambas as patologias não são comuns na Cidade do Rio de Janeiro, Brasil e um médico não deve negligenciar a possibilidade da ocorrência de uma doença sexualmente transmissível (DST).

Herpes genital vulvar e uso tópico de uncaria tomentosa: relato de caso / Uncaria tomentosa and topical use in genital herpes in vulva: case report

Introdução: herpes genital é uma doença infectocontagiosa de transmissão sexual que acomete pessoas das mais diversas camadas sociais. Herpes genital está disseminado em todo o mundo e é uma causa frequente de lesões genitais dolorosas em homens e em mulheres. Objetivo e Métodos: descrever caso de mulher adulta com quadro clínico e citológico de primomanifestação de herpes genital vulvar, no qual foi usado, na lesão, gel com 50 mg/g de Uncaria tomentosa três vezes ao dia, durante 4 dias. Resultados: os sintomas de dor e ardor tiveram rápida remissão. Ainda na consulta, cerca de 25 minutos apósaplicação tópica do fitoterápico, a paciente relatou grande melhora do quadro doloroso genital. A evolução clínica foi satisfatória e após 6 dias a paciente, já sem lesão, informou ter tido coito vaginal sem incômodos. Conclusão: a aplicação tópica de gel de Uncaria tomentosa em primomanifestação de herpes genital vulvar foi bem tolerada, não apresentou efeitos colaterais e melhorou rápida e sensivelmente o quadro clínico da doença.

Introduction: genital herpes is a sexually transmitted infectious disease that affects people from many different social strata. Genital herpes is spreadb worldwide and is a frequent cause of painful genital sores in men and women. Objective and Methods: to describe the case of adult women with clinical and cytologic clinical picture of a vulvar initial outbreak of genital herpes in which the lesion was treated with Uncaria tomentosa gel 50 mg/g three times a day for four days. Results: the symptoms of pain and burning had rapid remission. During the consultation, about 25 minutes after topical application of theherbal medicine, the patient reported great improvement in genital pain. The clinical outcome was satisfactory and after six days the patient, whose lesion had already healed, reported having had vaginal intercourse without discomfort. Conclusion: application of Uncaria tomentosa topical gel in a vulvar initial outbreak of genital herpes was well tolerated, showed no side effects, and rapidly and significantly improved the clinical symptoms of disease.

Penile myiasis as a differential diagnosis for genital ulcer: a case report.

The genital localized myiasis is a rare zooparasitic dermatosis. This case reported to a penile myiasis by Dermatobia hominis larvae in a 62 year-old man, who is a retired military official from São Gonçalo city, Rio de Janeiro state, Brazil. This patient was guided to the sexually transmitted diseases (STD) clinic from Universidade Federal Fluminense (UFF) by professionals from a urology outpatient clinic of a public hospital from Rio de Janeiro state. The exam showed a 2 cm diameter nodular lesion with a hyperemic area in the glands penis that had arisen 20 days before the exam. It evolved in a favorable way after larvae removal, through previous local anesthesia and slight pressure in lesion's base with the extraction of the larvae. Penile myiasis is not a very frequent situation, although it must be considered as an option in differential diagnosis of genital infectious diseases, even among people of low economical level, as in the case presented.

Penile myiasis as a differential diagnosis for genital ulcer: a case report

The genital localized myiasis is a rare zooparasitic dermatosis. This case reported to a penile myiasis by Dermatobia hominis larvae in a 62 year-old man, who is a retired military official from São Gonçalo city, Rio de Janeiro state, Brazil. This patient was guided to the sexually transmitted diseases (STD) clinic from Universidade Federal Fluminense (UFF) by professionals from a urology outpatient clinic of a public hospital from Rio de Janeiro state. The exam showed a 2 cm diameter nodular lesion with a hyperemic area in the glands penis that had arisen 20 days before the exam. It evolved in a favorable way after larvae removal, through previous local anesthesia and slight pressure in lesion's base with the extraction of the larvae. Penile myiasis is not a very frequent situation, although it must be considered as an option in differential diagnosis of genital infectious diseases, even among people of low economical level, as in the case presented.

Significado laboratorial dos baixos títulos de VDRL para o diagnóstico da sífilis em gestantes, à luz das provas treponêmicas / Laboratorial meaning of low titles of VDRL to syphilis diagnosis in pregnant women, according to treponemal tests

Introdução: a melhor prevenção para sífilis congênita possivelmente seja a realização dos testes de triagem durante o pré-natal, principalmente nas mulheres consideradas de comportamento de risco para a infecção pelo HIV e demais DST. Para o obstetra, a importância dessa doença transcende seus aspectos clínicos, principalmente pela transmissão vertical de seu agente etiológico. Desta forma, o diagnóstico laboratorial precoce e correto é uma poderosa ferramenta na profilaxia da sífilis congênita. Objetivo: estabelecer o significado dos baixos títulos para o teste de VDRL frente aos testes treponêmicos em gestantes. Métodos: foram analisadas 215 amostras de soro de gestantes de duas maternidades da cidade do Rio de Janeiro, RJ. Utilizou-se o teste VDRL e testes treponêmicos (TPHA, ELISA e Western-blotting). Os títulos de VDRL foram confrontados com testes não-reagentes, tendo como variável independente os testes treponêmicos. Resultados: houve associação estatisticamente significativa (?<0,05) entre os diversos títulos de VDRL (baixos títulos:1/1, 1/2 e 1/4 e altos títulos: ?1/8) quando confrontados com os testes treponêmicos. Por meio da análise comparativa de sensibilidade e especificidade obteve-se a curva ROC (Receiver Operator Characteristic). Títulos de VDRL acima de 1/1 associaram-se, de modo significativo, com os testes treponêmicos. Conclusão: os resultados mostraram que os baixos títulos de VDRL devem ser valorizados e que o teste considerado como screening pode também ser útil quando utilizado como teste diagnóstico para asífilis em gestantes.