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Performance of the Wondfo 2019-nCoV antigen test using self-collected nasal versus professional-collected nasopharyngeal swabs in symptomatic SARS-CoV-2 infection.
(2022) Cardoso, Jamille Mirelle de Oliveira; Roatt, Bruno Mendes; Vieira, Paula Melo de Abreu; Paiva, Nívia Carolina Nogueira de; Souza, Breno Bernardes; Lisboa, Oscar Campos; Soares, Rodrigo Dian de Oliveira Aguiar; Reis, Alexandre Barbosa; Vital, Wendel Coura; Carneiro, Cláudia Martins
Coffea arabica extracts and their chemical constituents in a murine model of gouty arthritis : how they modulate pain and inflammation.
(2022) Matosinhos, Rafaela Cunha; Bezerra, Juliana Pantaleão; Barros, Camila Helena; Bernardes, Ana Catharina Fernandes Pereira Ferreira; Araújo, Marcela Carolina de Paula Michel; Coelho, Grazielle Brandão; Soares, Rodrigo Dian de Oliveira Aguiar; Sachs, Daniela; Guimarães, Dênia Antunes Saúde
Ethnopharmacological relevance: Coffea arabica is commonly known for its cardiotonic and neurotonic activities, but in some places’ folk medicine, like in Arabia and Africa, C. arabica is used to treat headache, migraine, the flu, anemia, oedema, asthenia, asthma, inflammation and wounds. Aims of the study: The aims were to evaluate if the aqueous extracts of Coffea arabica, prepared from beans with different degrees of roasting, and their main chemical constituents could exert an in vivo anti-gouty effect. Materials and methods: Coffea extracts were obtained from the beans of not roasted, light, medium and dark roasted coffee and from decaffeinated and traditional coffees and were prepared with water at 25◦C and at 98◦C. C57BL/6 mice were induced to gout by an injection of monosodium urate crystals and treated with coffee extracts at doses of 25, 75 and 225 mg/kg and their chemical constituents at a dose of 10 mg/kg. The antinociceptive and anti-inflammatory effects were evaluated. Results: Treatments with Coffea extracts prepared with water at 98◦C were more effective to exert antinociceptive and anti-inflammatory activities than the ones prepared with water at 25◦C. Caffeic and chlorogenic acids reduced hypernociception in animals when compared with negative control group (7.79 and 5.69 vs 18.53; P < 0.05 and P < 0.001, respectively), inhibited neutrophil migration (1.59 × 104 and 0.38 × 104 vs 9.47 × 104; P < 0.0001 both) and decreased pro-inflammatory cytokines concentration (IL-1β, IL-6 and TNF-α). Conclusions: We have demonstrated that our treatments attenuated gout, and this effect could be attributed to a reducement in hypernociception, neutrophil migration and cytokines concentration. These results suggest coffee as a potential candidate for studies in acute gout therapy.
Comparative evaluation of meglumine antimoniate encapsulated in a mixture of conventional and PEGylated liposomes and immunotherapy using an anti-canine IL-10 receptor-blocking monoclonal antibody on canine visceral leishmaniasis.
(2022) Cardoso, Jamille Mirelle de Oliveira; Brito, Rory Cristiane Fortes de; Mathias, Fernando Augusto Siqueira; Reis, Levi Eduardo Soares; Vieira, João Filipe Pereira; Ostolin, Thais Lopes Valentim Di Paschoale; Andrade, Hélida Monteiro de; Ramos, Guilherme Santos; Frezard, Frederic; Soares, Rodrigo Dian de Oliveira Aguiar; Roatt, Bruno Mendes; Reis, Alexandre Barbosa
This study compared the therapeutic potential of the chemotherapy using meglumine antimoniate encapsulated in a mixture of conventional and PEGylated liposomes (Nano Sbv ) and immunotherapy with anti-canine IL-10 receptor-blocking monoclonal antibody (Anti IL-10R) on canine visceral leishmaniasis (CVL). Twenty mongrel dogs naturally infected by L. infantum, displaying clinical signs of visceral leishmaniasis were randomly divided in two groups. In the first one, nine dogs received six intravenous doses of a mixture of conventional and PEGylated liposomes containing meglumine antimoniate at 6.5 mg Sb/kg/dose. In the second one, eleven dogs received two intramuscular doses of 4 mg of anti-canine IL-10 receptor-blocking monoclonal antibody. The animals were evaluated before (T0) and 30, 90, and 180 days after treatments. Our major results demonstrated that both treatments were able to maintain hematological and biochemical parameters, increase circulating T lymphocytes subpopulations, increase the IFN-γ producing T-CD4 lymphocytes, restore the lymphoproliferative capacity and improve the clinical status. However, although these improvements were observed in the initial post-treatment times, they did not maintain until the end of the experimental follow-up. We believe that the use of booster doses or the association of chemotherapy and immunotherapy (immunochemotherapy) is promising to improve the effectiveness of treating CVL for improving the clinical signs and possibly reducing the parasite burden in dogs infected with Leishmania infantum.
Down regulation of IL-10 and TGF-β1 mRNA expression associated with reduced inflammatory process correlates with control of parasitism in the liver after treating L. infantum infected dogs with the LBMPL vaccine therapy.
(2022) Roatt, Bruno Mendes; Cardoso, Jamille Mirelle de Oliveira; Brito, Rory Cristiane Fortes de; Reis, Levi Eduardo Soares; Moreira, Gabriel José Lucas; Vieira, Paula Melo de Abreu; Souza, Flávia Marques de; Lima, Wanderson Geraldo de; Soares, Rodrigo Dian de Oliveira Aguiar; Giunchetti, Rodolfo Cordeiro; Reis, Alexandre Barbosa
The liver plays an important role in human and canine visceral leishmaniasis, then it is considered as target to understand the mechanisms involved in the parasite control and a parameter to assess therapeutic responses. In this sense, our study focuses on evaluating the major alterations in the liver by histological (morphometric parenchyma inflammation/semi-quantitative portal inflammation), immunohistochemical assays (parasitism), and qPCR (parasitism and cytokine gene expression) in Leishmania infantum naturally infected dogs and treated with LBMPL vaccine. Animals were divided in four groups: NI group (n = 5): uninfected and untreated dogs; INT group (n = 7): L. infantum-infected dogs and not treated; MPL group (n = 6): L. infantum-infected dogs that received only monophosphoryl lipid A adjuvant, and LBMPL group (n = 10): L. infantum-infected dogs that received treatment with the vaccine composed by L. braziliensis disrupted promastigotes associated with MPL adjuvant. Ninety days after the end of treatments, the dogs were euthanized, and the liver was collected for the proposed evaluations. Significantly lower portal inflammatory reactions, and lower parenchyma inflammation were observed in the LBMPL group compared to INT and MPL groups. iNOS mRNA expression was higher in LBMPL group and in contrast, IL-10 and TGF-β1 mRNA expression was lower in this group when compared to INT group. Immunohistochemical and qPCR analysis showed significant parasite load reduction in LBMPL group compared to INT and MPL animals. Our data suggest that in naturally Leishmania-infected dogs, LBMPL vaccine reduces the damage in the hepatic tissue, being able to attenuate the type 2 immune response. It could be associated with a marked reduction in the parasitism decreasing liver inflammation in treated dogs. Along with previously obtained data, our results suggest that LBMPL vaccine can significantly contribute to the therapy strategy for L. infantum infected dogs.
Cell immune response in mice skin stimulated with different adjuvants by intradermal route.
(2022) Mathias, Fernando Augusto Siqueira; Cardoso, Jamille Mirelle de Oliveira; Reis, Levi Eduardo Soares; Souza, Juliana Vitoriano de; Moreira, Nádia das Dores; Ostolin, Thais Lopes Valentim Di Paschoale; Brito, Rory Cristiane Fortes de; Soares, Rodrigo Dian de Oliveira Aguiar; Vieira, Paula Melo de Abreu; Carneiro, Cláudia Martins; Roatt, Bruno Mendes; Reis, Alexandre Barbosa
Adjuvants act in the innate immunity and, when combined to vaccine antigens, can produce a more intense response, improving the antigen presentation, directing the immune system, excellent for new vaccine formulations. This study evaluated the use of the intradermal route and the immune response triggered by a single dose of the adjuvants Aluminum Hydroxide (Al(OH)3 ), Montanide Pet Gel A (MPGA), Glucopyranosyl Lipid A Stable Emulsion (GLA-SE), and Resiquimod (R-848) in the mice skin. As control mice received sterile saline. MPGA and GLA-SE led to cell recruitment when compared with control group, with intense presence of neutrophils in first 12 hours, replaced by macrophages after 168 hours. R-848 and Al(OH)3 showed similar cell recruitment profiles. Regarding cytokine production, groups that received MPGA and GLA-SE produced high levels of IL-6, TNF-α, and IFN-γ. R-848 and Al(OH)3 groups displayed similar profile of cytokine production only at the first hour. Our results suggest that the intradermal route is efficient inducing immune system activation and GLA-SE was promising adjuvants for a type 1 immune response vaccine.
IL-10 receptor blockade controls the in vitro infectivity of Leishmania infantum and promotes a Th1 activation in PBMC of dogs with visceral leishmaniasis.
(2021) Cardoso, Jamille Mirelle de Oliveira; Brito, Rory Cristiane Fortes de; Costa, Ana Flávia Pereira; Mathias, Fernando Augusto Siqueira; Reis, Levi Eduardo Soares; Vieira, João Filipe Pereira; Soares, Rodrigo Dian de Oliveira Aguiar; Reis, Alexandre Barbosa; Roatt, Bruno Mendes
An important strategy to reduce the risk of visceral leishmaniasis (VL) in humans is to control the infection and disease progression in dogs, the domestic reservoir of Leishmania infantum parasites. Certain therapeutic strategies that modulate the host immune response show great potential for the treatment of experimental VL, restoring the impaired effector functions or decreasing host excessive responses. It is known that the overproduction of interleukin-10 (IL-10) promotes parasite replication and disease progression in human VL as well as in canine visceral leishmaniasis (CVL). Thus, in the present study we investigated the potential of the anticanine IL-10 receptor-blocking monoclonal antibody (Bloq IL-10R) to control and reduce in vitro infectivity of L. infantum and improve the ability of PBMC isolated from VL dogs to alter the lymphoproliferative response and intracytoplasmic cytokines. Overall, GFP+ Leishmania showed lower capacity of in vitro infectivity in the presence of Bloq IL-10R. Moreover, addition of Bloq IL-10R in cultured PBMC enhanced T-CD4 and CD8 proliferative response and altered the intracytoplasmic cytokine synthesis, reducing CD4+IL-4+ cells and increasing CD8+IFNγ+ cells after specific antigen stimulation in PBMC of dogs. Furthermore, we observed an increase of TNF-α levels in supernatant of cultured PBMC under IL-10R neutralizing conditions. Together, our findings are encouraging and reaffirm an important factor that could influence the effectiveness of immune modulation in dogs with VL and suggest that blocking IL-10R activity has the potential to be a useful approach to CVL treatment.
Heterologous vaccine therapy associated with half course of Miltefosine promote activation of the proinflammatory response with control of splenic parasitism in a hamster model of visceral leishmaniasis.
(2021) Carvalho, Lívia Mendes; Ferreira, Francielle Carvalho; Gusmão, Miriã Rodrigues; Costa, Ana Flávia Pereira; Brito, Rory Cristiane Fortes de; Soares, Rodrigo Dian de Oliveira Aguiar; Reis, Alexandre Barbosa; Cardoso, Jamille Mirelle de Oliveira; Carneiro, Cláudia Martins; Roatt, Bruno Mendes
Visceral leishmaniasis (VL) is a serious and neglected disease present worldwide. Chemotherapy using pentavalent antimony (SbV) is the most practical and inexpensive strategy available for the VL treatment today, however, it has high toxicity. Alternatively, other drugs are used as viable leishmanicidal therapeutic options. Miltefosine is the only anti-leishmanial agent administered orally, however, it has been reducing its effectiveness. In this sense, there is no ideal therapy for VL since the drugs currently used trigger severe side effects causing discontinuation of treatment, which carries an imminent risk for the emergence of parasite resistance. With that, other therapeutic strategies are gaining prominence. Among them, immunotherapy and/or immunochemotherapy, which the activation/modulation of the immune system can redirect the host’s immune response to an effective therapeutic result. Therefore, this work was designed to assess an immunochemotherapy protocol composed of half course of Miltefosine associated with LBSap vaccine (Milt+LBSap) using the hamster Mesocricetus auratus as an experimental model for VL treatment. When evaluating the main hematobiochemical, immunological and therapeutic efficacy parameters, it was demonstrated that the treatment with Milt+LBSap showed restoration of hematobiochemical condition and reduced serum levels of IgG-anti-Leishmania compared to animals infected non treated (INT). Beyond that, an increase in the number of CD4+ lymphocytes producers of IFN-γ in relation to INT or to animals treated with miltefosine during 28 days, and TNF-α increased compared to INT were observed. Also, it was found a reduction of IL-10-production in relation to INT, or animals that received LBSap vaccine only, or miltefosine, following by a reduction in the splenic parasitic burden. These results demonstrate that the immunochemotherapy protocol used can stimulate the immune response, inducing an expressive cellular response sufficient to control spleen parasitism, standing out as a promising proposal for the VL treatment.
Lychnophora pinaster’s effects on inflammation and pain in acute gout.
(2021) Barros, Camila Helena; Matosinhos, Rafaela Cunha; Bernardes, Ana Catharina Fernandes Pereira Ferreira; Araújo, Marcela Carolina de Paula Michel; Bezerra, Juliana Pantaleão; Sachs, Daniela; Soares, Rodrigo Dian de Oliveira Aguiar; Guimarães, Dênia Antunes Saúde
Ethnopharmacological relevance: Ethanolic extract of aerial parts from Lychnophora pinaster Mart. are used in traditional Brazilian medicine for treating pain, rheumatism and inflammation. Aim of the study: Drugs for the treatment of gout present severe adverse effects, justifying the need to search for new therapeutic options. The aim of the present study was to evaluate the effects of the ethanolic extract of L. pinaster and its main constituents in arthritis induced in mice by the injection of monosodium urate (MSU) crystals. Materials and methods: Antinociceptive effect was investigated using an electronic pressure-meter nociception paw test in C57BL/6 mice. Anti-gouty arthritis was investigated in mice induced with gout by the injection of MSU crystals into their femur-tibial tissue. Ethanolic extract of the aerial parts of Lychnophora pinaster and its main chemical constituents were evaluated as treatment. Results: The ethanolic extract and their main chemical constituents inhibited neutrophil migration, reduced IL-1β and TNF-α concentrations in the inflamed tissue and showed antinociceptive activity. Conclusions: Gouty arthritis effects of the ethanolic extract can be attached to a synergistic effect of terpenes, flavonoids and phenolic acids present in the extract. Results obtained support the use of this extract and its main chemical constituents in the treatment of gout, inflammation, and pain.
New studies in vitro antibacterial evaluation and cell viability in PMMA-G-PEG 4000 derivatives with encapsulated Erythromycin.
(2022) Azevedo, Maria Luíza Schaefer; Rezende, Giselle A. S.; Sousa, Lucas Resende Dutra; Reis, Rúbia Castro Fernandes Melo; Novack, Kátia Monteiro; Barboza, Ana Paula Moreira; Neves, Bernardo Ruegger Almeida; Amparo, Tatiane Roquete; Teixeira, Luiz Fernando de Medeiros; Vieira, Paula Melo de Abreu; Perasoli, Fernanda Barçante; Santos, Viviane Martins Rebello dos
Synthetic polymers have been extensively studied in several areas of knowledge, one of which is the pharmaceutical. The drug when encapsultated into the PMMA-g-PEG 4000 matrix can produce fewer side effects. The most frequent side effects of erythromycin are gastrointestinal and are dose related. Nausea, vomiting and diarrhea occur in low frequency with the usual oral doses. The drug used in this study was Erythromycin, an antimicrobial that acts directly on bacterial protein synthesis. Erythromycin was encapsulated into PMMA-g-PEG 4000 derivatives. All copolymers afther encapsultaions were characterized and identified by atomic force microscopy (AFM). In vitro assays of release, antimicrobial activity and cytotoxicity were performed for the copolymers obtained. The copolymers PMMA-g-PEG 4000 HAL and PMMA-g-PEG 4000 ACET showed drug controlled release profiles. All PMMA-g-PEG 4000 derivatives showed antibacterial activity against Staphylococcus aureus and did not show a cytotoxic effect on human fibroblasts.
Additive effects of resveratrol and doxorubicin on bladder cancer cells.
(2022) Soares, Luciana Bicalho Moreira; Lima, Ana Paula Braga; Melo, André Sacramento; Almeida, Tamires Cunha; Teixeira, Luiz Fernando de Medeiros; Silva, Glenda Nicioli da
The treatment of bladder cancer remains a challenge in clinical practice. Different chemotherapeutic protocols can be used; however, it is common to observe tumor recurrence and secondary effects that result in toxicity. Doxorubicin (DOX), one of the most effective anticancer agents used to treat bladder cancer, can cause chronic cardiotoxicity, limiting its use in clinical practice. Resveratrol (RES), a natural product with potential antitumor activity against bladder cancer, is associated with rapid metabolism and low bioavailability and needs to be combined with chemotherapeutic drugs to improve its use. Our study aimed to assess the therapeutic effect of a low concentration of DOX (2µM) in combination with RES (150, 200 and 250µM) on two bladder cancer cell lines. We investigated the mechanism of interaction between the drugs by performing cytotoxicity, clonogenic, oxidative stress, cell migration, cell morphology and nuclear division index (NDI) assays. Cytotoxicity evaluation revealed an additive interaction between RES and DOX for both cell lines. Additionally, the results of cell colony formation, oxidative stress, cell migration, cell morphology and NDI assays showed that a combination of DOX and RES was more effective than RES or DOX alone. In conclusion, a low concentration of DOX combined with RES could potentiate the antitumor effects of the drugs on bladder cancer cells, thus overcoming the secondary effects caused by DOX and the low bioavailability of resveratrol.
Avaliação do desempenho dos serviços de atenção primária à saúde no controle da tuberculose em metrópole do Sudeste do Brasil.
(2021) Rabelo, Juliana Veiga Costa; Navarro, Pedro Daibert de; Carvalho, Wânia da Silva; Almeida, Isabela Neves de; Oliveira, Camila Stefânie Fonseca; Haddad, João Paulo Amaral; Miranda, Silvana Spíndola de
A Organização Mundial da Saúde destaca a importância da organização e do desempenho dos serviços de saúde nas ações de controle da tuberculose. O objetivo deste estudo foi avaliar o desempenho dos serviços de atenção primaria à saúde em Belo Horizonte, Minas Gerais, Brasil, em relação às ações de controle da tuberculose nos eixos Estrutura e Processo, antes e após a utilização do instrumento validado denominado Estratificação por Grau de Risco Clínico e de Abandono do Tratamento da Tuberculose (ERTB). Estudo descritivo e prospectivo, no qual foram realizadas duas entrevistas (455 profissionais), tendo a segunda ocorrido após a ERTB. A classificação do desempenho seguiu os valores: ≤ 49,9%, críticos; entre 50% e 79,9%, insatisfatórios; e, ≥ 80%, satisfatórios. Na avaliação comparativa, foi utilizado o teste estatístico de McNemar, com p < 0,05. Após a estratificação de risco, a maior parte das variáveis de cada eixo melhorou significativamente. Nós concluímos que, por meio de um questionário padronizado, foi possível identificar o desempenho satisfatório dos serviços de atenção primária à saúde em Belo Horizonte em relação às ações de controle da tuberculose, na maioria das variáveis avaliadas nos eixos Estrutura e Processo.
The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment.
(2021) Navarro, Pedro Daibert de; Haddad, João Paulo Amaral; Rabelo, Juliana Veiga Costa; Silva, Claudia Hermínia de Lima e; Almeida, Isabela Neves de; Carvalho, Wânia da Silva; Miranda, Silvana Spíndola de
Objective: Evaluate the impact of the instrument of the “Stratification by Degree of Clinical Severity and Abandonment Risk of Tuberculosis Treatment” (SRTB) on the tuberculosis outcome. Methods: This study was a pragmatic clinical trial involving patients with a confirmed diagnosis of tuberculosis treated at one of the 152 primary health care units in the city of Belo Horizonte, Brazil, between May of 2016 and April of 2017. Cluster areas for tuberculosis were identified, and the units and their respective patients were divided into intervention (use of SRTB) and nonintervention groups. Results: The total sample comprised 432 participants, 223 and 209 of whom being allocated to the nonintervention and intervention groups, respectively. The risk of treatment abandonment in the nonintervention group was significantly higher than was that in the intervention group (OR = 15.010; p < 0.001), regardless of the number of risk factors identified. Kaplan-Meier curves showed a hazard ratio of 0.0753 (p < 0.001). Conclusions: The SRTB instrument was effective in reducing abandonment of tuberculosis treatment, regardless of the number of risk factors for that. This instrument is rapid and easy to use, and can be adapted to different realities. Its application showed characteristics predisposing to a non-adherence to the treatment and established bases to mitigate its impact.
Pulmonary functional assessment : longitudinal study after treatment of pulmonary tuberculosis.
(2021) Nishi, Marina Pires; Mancuzo, Eliane Viana; Sulmonett, Nara; Almeida, Isabela Neves de; César, Aina Liz Alves; Miranda, Silvana Spíndola de
Even when treated adequately, pulmonary tuberculosis can lead to pulmonary sequelae. Patients treated for PTB between 2012 and 2016 answered a standardized questionnaire and underwent chest radiography and spirometry, measurement of absolute pulmonary volume, Diffusing Capacity for Carbon Monoxide (DLCO) and the 6-min walk test (6MWT) on two occasions: within the first year after the end of treatment (follow-up 1), and one and two years after follow-up 1 (follow-up 2). A total of 55 patients they underwent spirometry, 23 (41.82%) had obstructive ventilatory disorder (OVD) and eight (14.5%) had moderate OVD. In total, 29 patients underwent pulmonary function tests (PFTs) and 24 patients underwent the 6MWT on two occasions. The functional changes after PTB treatment appear not to have varied between one and two years of follow-up. There was a correlation between low FEV1 and low DLCO (p<0.001); low DLCO and low 6MWT (p<0.001) and radiographic abnormalities and low FEV1 (p=0.033). The most frequently observed change in spirometry was found in patients with OVD.
Cost analysis for patients with presumed pulmonary tuberculosis attended in the public health system of Rio de Janeiro, Brazil.
(2022) Vater, Maria Cláudia; Maximo, Mário Motta; Moreira, Adriana da Silva Rezende; Silva, Suely Conceição Alves da; Almeida, Isabela Neves de; Kritski, Afrânio Lineu
Background: In last years, few attention has given to the patient’s prediagnostic costs when evaluating the introduction of new technologies for tuberculosis (TB) and in this context, this study evaluated patient’s costs and cost‑effectiveness incurred with TB diagnosis comparing BactecTMMGITTM960 system (MGIT) to the Löwestein–Jensen (LJ) culture in a health center and in a university hospital, in Rio de Janeiro City, Brazil. Methods: Patient’s mean costs were evaluated during the diagnosis process and cost‑effectiveness based on mean time in days for the adoption of appropriate clinical anti‑TB treatment in two health units comparing culture by means LJ and MGIT. Results: The mean cost of LJ and MGIT in the health center was U. S. dollars (US$) 26.6 and US$ 45.13, respectively, and in university hospital was US$ 206.87 and US$ 285.48, respectively. Comparing the two approaches for TB diagnosis incurred by the patients, the incremental cost‑effectiveness of MGIT compared to LJ was US$ 0.88 and US$ 4.03 per patient, respectively, to reduce the average time to adopt appropriate treatment. Conclusions: The culture method directly impacts patient costs while waiting for the correct diagnosis and contributing to aggravating costs with patients with TB.
Frequência de sepse neonatal do Brasil causada por streptococcus galactial : uma revisão.
(2021) Ribeiro, Thaís Justi; Ferreira, Linziane Lopes; Ricci, Natasha Delaqua; Almeida, Isabela Neves de
OBJETIVO: Avaliar a frequência de sepse neonatal no Brasil causada por Streptococcus agalactiae (S. agalactiae) a partir de dados da literatura. MÉTODOS: Foi realizada uma revisão integrativa da literatura no período de 2005 a 2019 de trabalhos publicados no Brasil, e foi avaliado a frequência das seguintes variáveis: procedência dos pacientes, tipo de serviço de saúde, métodos de diagnóstico laboratorial, o número de casos, a média gestacional, realização da pesquisa de S. agalactiae no pré-natal, desfechos, e antimicrobianos utilizados. RESULTADOS: Foram incluídos 20 artigos publicados no Brasil nas regiões sul, sudeste, nordeste e centro oeste. A pesquisa pelo S. agalactiae durante o período do pré-natal foi realizada em 90% dos estudos, e a hemocultura em 20% dos estudos (4/20) que descreveram casos de sepse neonatal. Houve uma grande variação na frequência de casos por S. agalactiae, sendo encontrado uma média de 55,6 casos/ano, e em quatro foram descritos mais de 120 casos/ano. Neste estudo a maior parte dos desfechos foi favorável 97% (cura) em relação a 3% de óbitos e estes foram os desfechos avaliados. CONCLUSÃO: Este estudo ressalta a importância da pesquisa do S. agalactiae nos exames laboratoriais do pré-natal, incorporação de novos métodos de diagnóstico laboratorial, a necessidade constante levantamentos na literatura, inquéritos epidemiológicos e estudos experimentais, como estratégias de controle e prevenção deste patógeno que se não controlado contribui para a ocorrência de altas taxas de morbidade e mortalidade neonatal.
Factors associated with tuberculosis and multidrug-resistant tuberculosis in patients treated at a tertiary referral hospital in the state of Minas Gerais, Brazil.
(2020) Soares, Valéria Martins; Almeida, Isabela Neves de; Figueredo, Lida Jouca de Assis; Haddad, João Paulo Amaral; Oliveira, Camila Stefanie Fonseca de; Carvalho, Wânia da Silva; Miranda, Silvana Spíndola de
Objective: To evaluate the risk factors for the development of tuberculosis and multidrugresistant tuberculosis (MDR-TB) in patients treated at a tertiary referral hospital. Methods: This was a cross-sectional study based on data obtained from patients treated at the Júlia Kubitschek Hospital, located in the city of Belo Horizonte, Brazil, between October of 2012 and October of 2014. We evaluated sociodemographic, behavioral, clinical, and radiological variables. The outcome considered to identify associations between tuberculosis and the explanatory variables was the treatment prescribed. To evaluate the associations between MDR-TB and the same explanatory variables, the change in MDR-TB treatment was considered. Results: The factors associated with tuberculosis were alcoholism, comorbidities, pulmonary cavitations, and a radiological pattern suggestive of tuberculosis. Cavitation and previous treatment for tuberculosis were associated with MDR-TB. Conclusions: Despite the significant progress made in the fight against tuberculosis, there is a need for coordinated actions that include social protection measures and patient support.
Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis : pragmatic study.
(2021) Silva, Suely Conceição Alves da; Vater, Maria Cláudia; Ramalho, Daniela Maria de Paula; Almeida, Isabela Neves de; Miranda, Silvana Spíndola de; Kritski, Afrânio Lineu
Introduction: The intensification of research and innovation with the creation of networks of rapid and effective molecular tests as strategies for the end of tuberculosis are essential to avoid late diagnosis and for the eradication of the disease. We aimed to evaluate the cost-effectiveness of Xpert®MTB/RIF (Xpert) in the diagnosis of drug-resistant tuberculosis in reference units, in scenarios with and without subsidies, and the respective cost adjustment for today. Methods: The analyses were performed considering as criterion of effectiveness, negative culture or clinical improvement in the sixth month of follow-up. The comparison was performed using two diagnostic strategies for the drug susceptibility test (DST), BactecTMMGITTM960 System, versus Xpert. The cost effectiveness and incremental cost-effectiveness ratio (ICER) were calculated and dollar-corrected for American inflation (US$ 1.00 = R$ 5,29). Results: Subsidized Xpert had the lowest cost of US$ 33.48 (R$67,52) and the highest incremental average efficiency (13.57), thus being a dominated analysis. After the inflation was calculated, the mean cost was DST-MGIT=US$ 74.85 (R$ 396,73) and Xpert = US$ 37.33 (R$197,86) with subsidies. Conclusions: The Xpert in the diagnosis of TB-DR in these reference units was cost-effective with subsidies. In the absence of a subsidy, Xpert in TB-DR is not characterized as cost effective. This factor reveals the vulnerability of countries dependent on international organizations’ subsidy policies.
Genotype®MTBDRplus and Xpert®MTB/RIF in the diagnosis of tuberculosis and resistant tuberculosis : cost analysis in a tertiary referral hospital.
(2020) Soares, Valéria Martins; Almeida, Isabela Neves de; Vater, Maria Cláudia; Alves, Suely; Figueredo, Lida Jouca de Assis; Scherer, Luciene; Kritski, Afranio Lineu; Carvalho, Wânia da Silva; Miranda, Silvana Spindola de
Introduction: The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques—Xpert®MTB/RIF and Genotype®MTBDRplus—in a tertiary referral hospital in Brazil. Methods: The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. Results: The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)–proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST–BACTECTM MGITTM 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. Conclusions: The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.
Evaluation of pulmonary tuberculosis diagnostic tests in children and adolescents at a pediatric reference center.
(2022) Rossoni, Andrea Maciel de Oliveira; Lovero, Kathryn L.; Tahan, Tonny T.; Ruffino Netto, Antonio; Rossoni, Marssoni Deconto; Almeida, Isabela Neves de; Lizzi, Elisângela Aparecida da Silva; Kritski, Afranio Lineu; Rodrigues, Cristina O.
This study compared the therapeutic potential of the chemotherapy using meglumine antimoniate encapsulated in a mixture of conventional and PEGylated liposomes (Nano Sbv ) and immunotherapy with anti-canine IL-10 receptor-blocking monoclonal antibody (Anti IL-10R) on canine visceral leishmaniasis (CVL). Twenty mongrel dogs naturally infected by L. infantum, displaying clinical signs of visceral leishmaniasis were randomly divided in two groups. In the first one, nine dogs received six intravenous doses of a mixture of conventional and PEGylated liposomes containing meglumine antimoniate at 6.5 mg Sb/kg/dose. In the second one, eleven dogs received two intramuscular doses of 4 mg of anti-canine IL-10 receptor-blocking monoclonal antibody. The animals were evaluated before (T0) and 30, 90, and 180 days after treatments. Our major results demonstrated that both treatments were able to maintain hematological and biochemical parameters, increase circulating T lymphocytes subpopulations, increase the IFN-γ producing T-CD4 lymphocytes, restore the lymphoproliferative capacity and improve the clinical status. However, although these improvements were observed in the initial post-treatment times, they did not maintain until the end of the experimental follow-up. We believe that the use of booster doses or the association of chemotherapy and immunotherapy (immunochemotherapy) is promising to improve the effectiveness of treating CVL for improving the clinical signs and possibly reducing the parasite burden in dogs infected with Leishmania infantum.
Mapping the tuberculosis scientific landscape among BRICS countries : a bibliometric and network analysis.
(2020) Castor, Kamaiaji; Mota, Fabio Batista; Silva, Roseli Monteiro da; Cabral, Bernardo Pereira; Maciel, Ethel Leonor; Almeida, Isabela Neves de; Arakaki Sanchez, Denise; Andrade, Kleydson Bonfim; Testov, Vadim; Vasilyeva, Irina; Zhao, Yanlin; Zhang, Hui; Singh, Manjula; Rao, Raghuram; Tripathy, Srikanth; Gray, Glenda; Padayatchi, Nesri; Bhagwandin, Niresh; Swaminathan, Soumya; Kasaeva, Tereza; Kritski, Afranio Lineu
BACKGROUND The five BRICS (Brazil, Russian, Indian, China, and South Africa) countries bear 49% of the world’s tuberculosis (TB) burden and they are committed to ending tuberculosis. OBJECTIVES The aim of this paper is to map the scientific landscape related to TB research in BRICS countries. METHODS Were combined bibliometrics and social network analysis techniques to map the scientific publications related to TB produced by the BRICS. Was made a descriptive statistical data covering the full period of analysis (1993-2016) and the research networks were made for 2007-2016 (8,366 records). The bubble charts were generated by VantagePoint and the networks by the Gephi 0.9.1 software (Gephi Consortium 2010) from co-occurrence matrices produced in VantagePoint. The Fruchterman- Reingold algorithm provided the networks’ layout. FINDINGS During the period 1993-2016, there were 38,315 peer-reviewed, among them, there were 11,018 (28.7%) articles related by one or more authors in a BRICS: India 38.7%; China 23.8%; South Africa 21.1%; Brazil 13.0%; and Russia 4.5% (The total was greater than 100% because our criterion was all papers with at least one author in a BRICS). Among the BRICS, there was greater interaction between India and South Africa and organisations in India and China had the highest productivity; however, South African organisations had more interaction with countries outside the BRICS. Publications by and about BRICS generally covered all research areas, especially those in India and China covered all research areas, although Brazil and South Africa prioritised infectious diseases, microbiology, and the respiratory system. MAIN CONCLUSIONS An overview of BRICS scientific publications and interactions highlighted the necessity to develop a BRICS TB research plan to increase efforts and funding to ensure that basic science research successfully translates into products and policies to help end the TB epidemic.

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