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OBJECTIVES: In the American regions, Brazil accounts for 97% of visceral leishmaniasis (VL) cases, with a case fatality rate of approximately 10%. This study aimed to investigate the VL mortality distribution in Brazil and identify high-priority and high-risk areas for intervention strategies. STUDY DESIGN: This was an ecological study that analysed the spatial-temporal patterns of VL mortality in Brazilian municipalities. METHODS: Age-standardised VL mortality rates from the Global Burden of Disease study from 2001 to 2018 were used. The distribution of mortality in the municipalities was assessed, and subsequently the Local Index of Spatial Autocorrelation (LISA) analysis was conducted to identify contiguous areas with high mortality rates. Scan analysis identified clusters of high spatial-temporal risks. RESULTS: The highest mortality rates and clusters were in municipalities located in the Northeast region and in the states of Tocantins and Roraima (North region), Mato Grosso do Sul (Central-West region), and Minas Gerais (Southeast region). According to LISA, there was an increase in the number of municipalities classified as high priority from the first 3-year period (n = 434) to the last 3-year period (n = 644). The spatio-temporal analysis identified 21 high-risk clusters for VL mortality. CONCLUSION: Areas with a high risk of VL mortality should prioritise preventing transmission, invest in early diagnosis and treatment, and promote the training of healthcare professionals.

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The present study sought to evaluate the antimicrobial and anti-adherent potential of Eucalyptus radiata essential oil against food-borne strains of Escherichia coli. The study was performed using the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). In addition, the disk diffusion technique was used to evaluate the association of Eucalyptus radiata essential oil with synthetic antimicrobials. The Minimum Inhibitory Adherence Concentration (MIC) was also performed. The results revealed that E. radiata showed antimicrobial activity against the E. coli strains tested, with MIC values ranging from 500 µg/mL to 1000 µg/mL and MBC values ranging from 500 µg/mL to 1,024 µg/mL. As for the associations, it was observed that E. radiata oil exhibited a synergistic effect for some antibiotics, especially Ceftriaxone, with greater interference from the essential oil. Furthermore, it was effective in inhibiting the adherence of bacterial strains of E. coli, showing a more significant antibiofilm effect than the antibacterial agent 0.12% chlorhexidine digluconate. In summary, the essential oil of E. radiata showed antimicrobial potential against strains of E. coli of food origin, and can therefore, through in-depth studies, be used alone or in association with synthetic antimicrobials to combat infections caused by this pathogen.

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OBJECTIVE: To summarize evidence regarding the effectiveness of using chlorhexidine for oral healthcare on patients in the intensive care unit for the prevention of nosocomial pneumonia and ventilator-associated pneumonia. METHODS: This overview of systematic reviews was developed using articles found in PUBMED, Cochrane Library, LILACS, CRD, CINHAL, manual search and grey literature. RESULTS: Of the total 16 systematic reviews, 14 included meta-analysis. Most of them were classified with high methodological quality. In seven systematic reviews, chlorhexidine was effective for prevention of nosocomial pneumonia and ventilator-associated pneumonia in adult population in cardiothoracic intensive care unit. The effectiveness was contradictory with other population patients in intensive care units. CONCLUSION: Chlorhexidine has proven to be effective for the prevention of NP among adult populations in cardiothoracic ICU. In ICUs with patients who have varied clinical-surgical conditions, the effectiveness of chlorhexidine for the prevention of PN and VAP was inconclusive.

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OBJECTIVES: To compare the efficacy and safety of three orthodontic treatment modalities for agenesis of maxillary lateral incisors: 1) closing the space with the reshaped canine substituting the lateral incisor, 2) opening the space with placement of a conventional fixed bridge, and 3) opening the space with placement of a single-unit implant and an implant-supported crown. SETTING: Brazilian Cochrane Center and Universidade Federal de São Paulo, Brazil. MATERIAL AND METHODS: The following databases were investigated: Cochrane Register of Controlled Trials (Edition 12, 2011), EMBASE (from 1974 to December 2011), MEDLINE (from 1965 to December 2011), LILACS (from 1966 to November 2011), and Odontology Brazilian Bibliography Database (from 1966 to November 2011). Conference abstracts, main Brazilian dissertations and theses databases, and reference lists were handsearched. This systematic review included randomized or quasi-randomized controlled trials (RCTs) including women aged 15 years or over and men aged 21 years or over who received one of the interventions stated above. Two observers independently evaluated all the studies regarding eligibility criteria and assessed the risk of bias of included studies. RESULTS: No studies were included in the review as no RCTs were found. Most of the evidence comes from case reports and narrative reviews on case reports and from three studies with a single post-intervention evaluation and non-comparable control groups with high risk of bias. CONCLUSIONS: There is no scientific evidence for any of the three most common types of treatment for agenesis of the maxillary lateral incisors. RCTs into this issue are still necessary.

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Foram analisados os resultados de exames de microaglutinação rápida, para pesquisa de aglutininas anti-Leptospira interrogans, em 39.012 soros sangüíneos de bovinos provenientes de 398 (47%) municípios de Minas Gerais de 1980 a 2002. As sorovariedades mais freqüentes foram: hardjo (amostra Norma), 23,7%, hardjo (OMS), 19,7%, hardjo (hardjobovis), 13,8%, e wolffi, 13,2%. Os resultados mostraram relevância da hardjo como problema prioritário nas leptospiroses em bovinos em Minas Gerais. A baixa porcentagem de soros reagentes à pomona (2,8%) e a mini (amostra Neguita) (3,0%) indica que essas sorovariedades devem ser consideradas para esclarecer casos clínicos em bovinos quando a hardjo (OMS), hardjo (Norma) e hardjo (hardjobovis) não forem detectadas nos testes sorológicos. As porcentagens de reagentes para as sorovariedades canicola e icterohaemorrhagiae foram inferiores a 1%. A infecção por Leptospira interrogans é endêmica em bovinos em Minas Gerais.(AU)

Blood samples from 39,012 bovines were tested for microscopic agglutination through Leptospira interrogans. An overall of 398 (47%) of Minas Gerais State's municipalities from 1980 to 2002 composed the sample. The most frequent serovars were hardjo (Norma sample), 23.7%, followed by hardjo (OMS sample), 19.7%, hardjo (hardjobovis sample), 13.8%, and wolffi, 13.2% of positivity. The results showed the importante of hardjo serovars as a major cattle health problem in Minas Gerais. The low rates of the seropositivity for Pomona, 2.8%, and mini (Neguita sample), 3.0%, are an indicative which these serovars should be considered as an explanation of clinical cases in cattle when the absence of reaction for hardjo (Norma sample), hardjo (OMS sample) and hardjo (hardjobovis sample). The reaction rates for canicola and icterohaemorrhagiae serovars were below 1.0%. The bovine infection for Leptospira interrogans is endemic in the State of Minas Gerais.(AU)

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Foram analisados os resultados de exames de microaglutinação rápida, para pesquisa de aglutininas anti-Leptospira interrogans, em 39.012 soros sangüíneos de bovinos provenientes de 398 (47 por cento) municípios de Minas Gerais de 1980 a 2002. As sorovariedades mais freqüentes foram: hardjo (amostra Norma), 23,7 por cento, hardjo (OMS), 19,7 por cento, hardjo (hardjobovis), 13,8 por cento, e wolffi, 13,2 por cento. Os resultados mostraram relevância da hardjo como problema prioritário nas leptospiroses em bovinos em Minas Gerais. A baixa porcentagem de soros reagentes à pomona (2,8 por cento) e a mini (amostra Neguita) (3,0 por cento) indica que essas sorovariedades devem ser consideradas para esclarecer casos clínicos em bovinos quando a hardjo (OMS), hardjo (Norma) e hardjo (hardjobovis) não forem detectadas nos testes sorológicos. As porcentagens de reagentes para as sorovariedades canicola e icterohaemorrhagiae foram inferiores a 1 por cento. A infecção por Leptospira interrogans é endêmica em bovinos em Minas Gerais.

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