Despite the considerable advances in the last years, the health information systems for health surveillance still need to overcome some critical issues so that epidemic detection can be performed in real time. For instance, despite the efforts of the Brazilian Ministry of Health (MoH) to make COVID-19 data available during the pandemic, delays due to data entry and data availability posed an additional threat to disease monitoring. Here, we propose a complementary approach by using electronic medical records (EMRs) data collected in real time to generate a system to enable insights from the local health surveillance system personnel. As a proof of concept, we assessed data from São Caetano do Sul City (SCS), São Paulo, Brazil. We used the “fever” term as a sentinel event. Regular expression techniques were applied to detect febrile diseases. Other specific terms such as “malaria,” “dengue,” “Zika,” or any infectious disease were included in the dictionary and mapped to “fever.” Additionally, after “tokenizing,” we assessed the frequencies of most mentioned terms when fever was also mentioned in the patient complaint. The findings allowed us to detect the overlapping outbreaks of both COVID-19 Omicron BA.1 subvariant and Influenza A virus, which were confirmed by our team by analyzing data from private laboratories and another COVID-19 public monitoring system. Timely information generated from EMRs will be a very important tool to the decision-making process as well as research in epidemiology. Quality and security on the data produced is of paramount importance to allow the use by health surveillance systems.

Subsistence hunting provides an important food source for rural populations in tropical forests but can lead to wildlife depletion. Management of wildlife resources depends on assessments of hunting sustainability. We assessed the sustainability of subsistence hunting in two Amazonian Extractive Reserves. We examined hunting data from a community-based monitoring programme conducted in 30 communities during 63 consecutive months to address temporal trends in hunting yields in terms of catch per unit of effort of all game species and the six most hunted species. We also assessed the prey profiles across different communities. Game species composition did not differ between monitored communities, and the most hunted species were Tayassu pecari, large cracids, Cuniculus paca, Mazama spp., Tapirus terrestris and Pecari tajacu. Catch per unit of effort was stable for all game species and each of the most hunted species, indicating that hunting was generally sustainable. These findings reflect the exceptionally low human population density and continuous forest cover of the study landscape, and long-term hunting sustainability and local protein acquisition will depend on maintaining these social and environmental settings. The results also show that large Sustainable Use Protected Areas can help foster sustainable game management and should thus be included in public policies.

This study aimed to compare fruits and vegetables (FV), and carbonated soft drink (CSD) consumption among adolescents from seventy-four countries, according to macroeconomic indicators. This is an ecological study, developed with countries evaluated through the Global School-based Student Health Survey (2003–2014) and the National School Health Survey (PeNSE-Brazil, 2015). The percentages of students in each country who consumed CSD and FV daily and their association with the Human Development Index (HDI) and the Gross National Income per capita (GNIpc) were assessed. Scatter plots were constructed for each marker, and a multilevel model was tested to consider the effects of region in the associations. The overall prevalence of daily CSD consumption was 54·1 %. CSD consumption was positively associated with HDI and GNIpc through multilevel models, and Central and South America showed a considerable higher consumption compared with other regions. Overall, FV daily consumption was 67·9 % and 74·6 %, respectively, and no associations with macroeconomic indicators were found. The study shows concerning rates of CSD consumption among adolescents, and a trend of increased consumption with the improvement of the country’s development and GNIpc. This points for the importance of public policies that regulate food and beverage industries to reduce CSD consumption and related co-morbidities among adolescents.

The present study aimed to evaluate the inflammatory response, oxidative status and fatty acid deposition in reproductive tissues of cats supplemented with the dried microalgae Schizochytrium spp. (Thraustochytriaceae) as a DHA source. Thirty-seven cats (males, n 21; females, n 16; 11·5 (sd 0·5) months of age) were divided by sex into five groups. Treatment diets contained algae biomass at 4·0, 8·0, 12·0 or 16·0 g/kg replacing poultry fat (n-6 source). Cats were fed the respective diet for 62 d and neutered on day 58. Blood samples were collected at the beginning of the experiment (day 1), before neutering (day 58) and 4 d after surgery (day 62) for analysis of inflammation and oxidative markers. Acute-phase protein levels were altered (P < 0·01) in the postoperative period, without any treatment effect (P > 0·05). PGE2 concentrations after surgery were reduced linearly (R2 0·8706; P = 0·002) with microalgal inclusion. Blood platelet count was reduced (P = 0·001) after the surgery regardless treatment, but it was higher in the DHA group compared with control (P < 0·001). The DHA deposition (testicles, R2 0·846; ovaries, R2 0·869) and the n-6:n-3 ratio (testicles, R2 0·859; ovaries, R2 0·955) in gonads had a pattern which fitted a quadratic model. DHA from Schizochytrium spp. modifies PGE2 response after the surgery in cats. The physiological roles of the DHA in the reproduction of cats were not investigated, but its gonadal deposition after supplementation was observed.

Background: In 7 hospitals in Belo Horizonte, a city with >3,000,000 inhabitants, a survey was conducted between July 2016 and June 2018, focused on surgical site infection (SSI) in patients undergoing arthroplasty surgery procedures. The main objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI through pattern recognition algorithms, the MLPs (multilayer perceptron). Methods: Data were collected on SSI by the hospital infection control committees (CCIHs) of the hospitals involved in the research. All data used in the analysis during their routine SSI surveillance procedures were collected. The information was forwarded to the NOIS (Nosocomial Infection Study) Project, which used SACIH automated hospital infection control system software to collect data from a sample of hospitals participating voluntarily in the project. After data collection, 3 procedures were performed: (1) a treatment of the database collected for the use of intact samples; (2) a statistical analysis on the profile of the hospitals collected; and (3) an assessment of the predictive power of 5 types of MLP (backpropagation standard, momentum, resilient propagation, weight decay, and quick propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% or 75% for testing and 35% or 25% for validation). The results were compared by measuring AUC (area under the curve; range, 0–1) presented for each of the configurations. Results: Of 1,246 records, 535 were intact for analysis. We obtained the following statistics: the average surgery time was 190 minutes (range, 145–217 minutes); the average age of the patients was 67 years (range, 9–103); the prosthetic implant index was 98.13%; the SSI rate was 1.49%, and the death rate was 1.21%. Regarding the prediction power, the maximum prediction power was 0.744. Conclusions: Despite the considerable loss rate of almost 60% of the database samples due to the presence of noise, it was possible to perform relevant sampling for the profile evaluation of hospitals in Belo Horizonte. For the predictive process, some configurations have results that reached 0.744, which indicates the usefulness of the structure for automated SSI monitoring for patients undergoing hip arthroplasty surgery. To optimize data collection and to enable other hospitals to use the SSI prediction tool (available in www.sacihweb.com ), a mobile application was developed.

Funding: None

Disclosures: None

Cochliomyia hominivorax larvae cause myiasis in animals and humans. To register a commercial product to control this dipteran is necessary to experiment on animals. The in vitro test was standardized to evaluate the larvicidal efficacy of commercial topical products. Five formulations were analysed in vitro and in vivo. For the in vitro test, a colony was formed and three replicates (n = 200) of each larval stage (L1, L2 and L3) were treated. The viability of the larvae was evaluated after 5 and 30 min, and at 1, 2, 6, 12, 24, 48, 60 and 72 h post-treatment (HPT). For the in vivo test, 30 bovines divided into six groups were castrated to achieve natural infestation with C. hominivorax. Animals in the treated groups received the product. Myiasis and efficacy were evaluated 12, 24, 36, 48, 60 and 72 HPT. Four formulations tested in the in vitro test achieved 100% efficacy at 24 HPT. In the in vivo experiment only one achieved 100% efficacy at 24 HPT. However, all products achieved the maximum efficacy by the end of study. The in vitro test developed here could be adopted to evaluate the efficacy of topical products for the control of C. hominivorax larvae.

Hepatocytes constitute the majority of hepatic cells, and play a key role in controlling systemic innate immunity, via pattern-recognition receptors (PRRs) and by synthesizing complement and acute phase proteins. Leishmania infantum, a protozoan parasite that causes human and canine leishmaniasis, infects liver by establishing inside the Kupffer cells. The current study proposes the elucidation of the immune response generated by dog hepatocytes when exposed to L. infantum. Additionally, the impact of adding leishmanicidal compound, meglumine antimoniate (MgA), to parasite-exposed hepatocytes was also addressed. L. infantum presents a high tropism to hepatocytes, establishing strong membrane interactions. The possibility of L. infantum internalization by hepatocytes was raised, but not confirmed. Hepatocytes were able to recognize parasite presence, inducing PRRs [nucleotide oligomerization domain (NOD)1, NOD2 and Toll-like receptor (TLR)2] gene expression and generating a mix pro- and anti-inflammatory cytokine response. Reduction of cytochrome P 450s enzyme activity was also observed concomitant with the inflammatory response. Addition of MgA increased NOD2, TLR4 and interleukin 10 gene expression, indicating an immunomodulatory role for MgA. Hepatocytes seem to have a major role in coordinating liver's innate immune response against L. infantum infection, activating inflammatory mechanisms, but always balancing the inflammatory response in order to avoid cell damage.

Background: Dystrophinopathies are X-linked muscular dystrophies characterized by pathogenic mutations in the dystrophin gene. Symptomatic dystrophinopathy female carriers may present with limb-girdle weakness. The diagnosis may be challenging in the absence of affected male relatives. We aimed to describe the phenotypic variability in a series of molecular-confirmed female dystrophinopathy patients. Methods: This is a retrospective analysis of medical records from 1997 to 2015. Results: Ten female dystrophinopathy patients were selected, two with unusual phenotypes: one with early joint contractures muscular dystrophy and the other with very late onset myopathy. Muscle imaging studies demonstrated predominant asymmetric fat replacement. Muscle biopsy immunohistochemistry demonstrated clear mosaic pattern in two cases and only subtle reduction of dystrophin intensity in three. Conclusions: Adequate diagnosis is fundamental for genetic counseling and cardiologic follow-up. Female patients with dystrophinopathy may present unusual phenotypes such as early contractures and very late onset myopathy.

The aim of this study was to assess the effect of sulfamethoxazole/trimethoprim (ST) supplemented with diphenyl diselenide and sodium selenite in experimental toxoplasmosis, on oxidant/antioxidant biomarkers and cytokine levels. Eighty-four BALB/c mice were divided in seven groups: group A (negative control), and groups B to G (infected). Blood and liver samples were collected on days 4 and 20 post infection (p.i.). Levels of thiobarbituric acid (TBA) reactive substances and advanced oxidation protein products (AOPP) were assessed in liver samples. Both biomarkers were significantly increased in infected groups on day 4 p.i., while they were reduced on day 20 p.i., compared with group A. Glutathione reductase (GR) activity significantly (P<0·01) increased on day 4 p.i., in group G, compared with group A. INF-γ was significantly increased (P<0·001) in both periods, day 4 (groups B, C, F and G) and 20 p.i. (groups C, F and G). IL-10 significantly reduced (P<0·001) on day 4 p.i. in group B; however, in the same period, it was increased (P<0·001) in groups C and G, compared with group A. On day 20 p.i., IL-10 increased (P<0·001) in groups F and G. Therefore, our results highlighted that these forms of selenium, associated with the chemotherapy, were able to reduce lipid peroxidation and protein oxidation, providing a beneficial immunological balance between the production of pro- and anti-inflammatory cytokines.