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This paper aims to explore the impact of the COVID-19 pandemic on the health and mental health of necessary entrepreneurs in Brasilian favelas, the social problems they experienced and implications for public health social work. The study used structured in-person interviews within selected Favela's, with a sample size of 721 entrepreneurs, aged between 16-70 years. All participants both worked and were resident in 15 out of the 27 Brasilian federal states. The bespoke questions explored socio-demographic questions, sought information on their entrepreneurship, health and administered the Warwick-Edinburgh Mental Wellbeing Scale for Health. The results highlighted that many entrepreneurs have engaged in this form of enterprise due to economic necessity, with 64% of women and 43.6% of men identifying increased levels of anxiety through the pandemic, with the presence of children in the family being statistically significant (p ≤ 0.05 chi-square test) for anxiety. Of the 9.8% sample respondents have accessed the health care service and for women with children, the impact of the pandemic accentuated existing problems of childcare and patriarchy. We conclude by highlighting the importance of universal and accessible health and mental health support and care, their ongoing accessibility, along with the importance of social work during crisis.

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This study sought to identify monocyte alterations from septic patients after hospital discharge by evaluating gene expression of inflammatory mediators and monocyte polarization markers. It was hypothesized that sepsis reprograms the inflammatory state of monocytes, causing effects that persist after hospital discharge and influencing patient outcomes. DESIGN: The gene expression patterns of inflammatory receptors, M1 and M2 macrophage polarization markers, NLRP3 inflammasome components, and pro- and anti-inflammatory cytokines in monocytes were assessed. PATIENTS: Thirty-four patients from the University of São Paulo Hospital, during the acute sepsis phase (phase A), immediately after ICU discharge (phase B), and 3 months (phase C), 6 months (phase D), 1 year (phase E), and 3 years (phase F) after discharge, were included. Patients that died during phases A and B were grouped separately, and the remaining patients were collectively termed the survivor group. MEASUREMENTS AND MAIN RESULTS: The gene expression of toll-like receptor (TLR)2 and TLR4 (inflammatory receptors), NLRP3, NFκB1, adaptor molecule apoptosis-associated speck-like protein containing a CARD, caspase 1, caspase 11, and caspase 12 (NLRP3 inflammasome components), interleukin-1α, interleukin-1ß, interleukin-18, and high-mobility group box 1 protein (proinflammatory cytokines), interleukin-10 (anti-inflammatory cytokine), C-X-C motif chemokine ligand 10, C-X-C motif chemokine ligand 11, and interleukin-12p35 (M1 inflammatory polarization markers), and C-C motif chemokine ligand 14, C-C motif chemokine ligand 22, transforming growth factor-beta (TGF-ß), SR-B1, and peroxisome proliferator-activated receptor γ (M2 anti-inflammatory polarization and tissue repair markers) was upregulated in monocytes from phase A until phase E compared with the control group. CONCLUSIONS: Sepsis reprograms the inflammatory state of monocytes, probably contributing to postsepsis syndrome development and mortality.

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OBJECTIVES: To determine the differences between sexes in perceptions of asthma symptoms, asthma control, daily activities, and symptom exacerbation in Latin American countries. METHODS: This cross-sectional study was performed using data from the Latin America Asthma Insight and Management (LA-AIM) study (n = 2167) carried out in Argentina, Brazil, Mexico, Venezuela, and Puerto Rico. Face-to-face interviews were conducted, and patients orally completed a 53-question survey assessing five main domains of asthma: symptoms, impact on daily activities, disease control, exacerbation, and treatment/medication. RESULTS: Of the 2167 participants, 762 (35.2%) were males and 1405 (64.8%) were females. Male participants smoked more than females, but history of rhinitis and allergies was more common in females (p < 0.05). Women aged 18-40 years had a higher proportion of uncontrolled asthma compared to men of the same age (37.8% and 30.0%, respectively). A higher proportion of symptomatic females reported more frequent symptoms (daytime cough, shortness of breath, breathlessness/wheezing, sputum, tightness in the chest, etc.) than males (p < 0.05). Females also experienced more limitations in sports/recreational activities, normal physical exertion, social activities, sleep, and daily activities. Females consulted with health professionals more often than males (67.8% and 59.6%, respectively; p < 0.05). Asthma caused a feeling of lack of control over life in 42.6% of females and 31.4% of males. CONCLUSION: In Latin America, females report more asthma symptoms, poorer asthma control, more impact on their daily activities, and more visits with health professionals than males.

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Introducción: La mortalidad materna constituye un problema de salud pública a nivel internacional. Su comportamiento es expresión del funcionamiento integral de los sistemas de salud, así como, del avance de los derechos sexuales y reproductivos de las mujeres. Objetivo: Comparar los indicadores de mortalidad materna de Brasil y Cuba en el periodo 2005-2017. Métodos: La metodología implementada responde a un análisis de tipo documental. Se utilizaron como fuentes de información las principales bases de datos del Departamento de Informática del Sistema Único de Salud de Brasil, y los anuarios estadísticos publicados por el Ministerio de Salud Pública de Cuba y la Oficina Nacional de Estadística e Información. Resultados: La meta sobre mortalidad materna dentro de los Objetivos de Desarrollo Sustentable es un requisito actualmente cumplido por los dos países. En Cuba, las cifras de la Razón de Mortalidad Materna se mantienen con valores siempre inferiores a los del propio país en el año 2005; no obstante, a partir de 2013 muestran un comportamiento creciente. En Brasil, por su parte, son superiores a las de Cuba y nunca disminuyen en relación con el año 2005, y presentan una marcada tendencia creciente. Conclusiones: Los programas de salud materna analizados para Brasil y Cuba muestran avances y desafíos diferenciados. El comportamiento de los indicadores analizados reafirma la necesidad de intensificar las acciones para la reducción de los óbitos maternos en los dos países, con más urgencia para Brasil(AU)

Introduction: Maternal mortality is a public health problem at the international level. Its behavior is an expression of the comprehensive functioning of health systems, as well as the advancement of women's sexual and reproductive rights. Objective: Compare the maternal mortality indicators of Brazil and Cuba in the period 2005-2017. Methods: The implemented methodology responds to a documentary analysis. The main databases of the Department of Informatics of the Unified Health System of Brazil, and the statistical yearbooks published by the Ministry of Public Health of Cuba and the National Office of Statistics and Information were used as sources of information. Results: The target on maternal mortality within the Sustainable Development Goals is a requirement currently met by both countries. In Cuba, the figures for the Maternal Mortality Ratio remain at values always lower than those of the country itself in 2005; however, as of 2013 they show an increasing behavior. In Brazil, on the other hand, they are higher than those of Cuba and never decrease in relation to 2005, and present a marked growing trend. Conclusions: The maternal health programs analyzed for Brazil and Cuba show differentiated progress and challenges. The behavior of the indicators analyzed reaffirms the need to intensify actions to reduce maternal deaths in both countries, with more urgency for Brazil(AU)

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This essay reflects on the implementation of federal government emergency aid in Brazil in the context of the COVID-19 pandemic, highlighting elements from the work of Social Workers in the context of growing demand for the supply of material provisions. Economic and social conditions in Brazil have particularities that impact the operationalisation of this benefit, which is aimed at the poor, that add complexity and impose limits. When considering the structural limits set, this context imposes challenges on the work of Social Workers. The need to reconnect and enhance the struggle for social rights is emphasised through the different strategies of the working class.

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Inflammation is a driven force in modulating microbial communities, but little is known about the interplay between colonizing microorganisms and the immune response in periodontitis. Since local and systemic inflammation may play a whole role in disease, we aimed to evaluate the oral and fecal microbiome of patients with periodontitis and to correlate the oral microbiome data with levels of inflammatory mediator in saliva. Methods: Nine patients with periodontitis (P) in Stage 3/Grade B and nine age-matched non-affected controls (H) were evaluated. Microbial communities of oral biofilms (the supra and subgingival from affected and non-affected sites) and feces were determined by sequencing analysis of the 16SrRNA V3-V4 region. Salivary levels of 40 chemokines and cytokines were correlated with oral microbiome data. Results: Supragingival microbial communities of P differed from H (Pielou's evenness index, and Beta diversity, and weighted UniFrac), since relative abundance (RA) of Defluviitaleaceae, Desulfobulbaceae, Mycoplasmataceae, Peptostreococcales-Tissierellales, and Campylobacteraceae was higher in P, whereas Muribaculaceae and Streptococcaceae were more abundant in H. Subgingival non-affected sites of P did not differ from H, except for a lower abundance of Gemellaceae. The microbiome of affected periodontitis sites (PD ≥ 4 mm) clustered apart from the subgingival sites of H. Oral pathobionts was more abundant in sub and supragingival biofilms of P than H. Fecal samples of P were enriched with Acidaminococcus, Clostridium, Lactobacillus, Bifidobacterium, Megasphaera, and Romboutsia when compared to H. The salivary levels of interleukin 6 (IL-6) and inflammatory chemokines were positively correlated with the RA of several recognized and putative pathobionts, whereas the RA of beneficial species, such as Rothia aeria and Haemophilus parainfluenzae was negatively correlated with the levels of Chemokine C-C motif Ligand 2 (CCL2), which is considered protective. Dysbiosis in patients with periodontitis was not restricted to periodontal pockets but was also seen in the supragingival and subgingival non-affected sites and feces. Subgingival dysbiosis revealed microbial signatures characteristic of different immune profiles, suggesting a role for candidate pathogens and beneficial organisms in the inflammatory process of periodontitis.

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SARS-CoV-2 is the causative agent of the COVID-19 pandemic. This novel coronavirus emerged in China, quickly spreading to more than 200 countries worldwide. Although most patients are only mildly ill or even asymptomatic, some develop severe pneumonia and become critically ill. One of the biggest unanswered questions is why some develop severe disease, whilst others do not. Insight on the interaction between SARS-CoV-2 and the immune system and the contribution of dysfunctional immune responses to disease progression will be instrumental to the understanding of COVID-19 pathogenesis, risk factors for worst outcome, and rational design of effective therapies and vaccines. In this review we have gathered the knowledge available thus far on the epidemiology of SARS-COV-2 infection, focusing on the susceptibility of older individuals, SARS-CoV-2-host cell interaction during infection and the immune response directed at SARS-CoV-2. Dendritic cells act as crucial messengers linking innate and adaptative immunity against viral infections. Thus, this review also brings a focused discussion on the role of dendritic cells and their immune functions during SARS-CoV-2 infection and how immune evasion strategies of SARS-CoV-2 and advancing age mediate dendritic cell dysfunctions that contribute to COVID-19 pathogenesis and increased susceptibility to worst outcomes. This review brings to light the hypothesis that concomitant occurrence of dendritic cell dysfunction/cytopathic effects induced by SARS-CoV-2 and/or aging may influence disease outcome in the elderly. Lastly, a detailed discussion on the effects and mechanisms of action of drugs currently being tested for COVID-19 on the function of dendritic cells is also provided.

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O microbioma pode influenciar a fisiologia humana, tanto na saúde quanto na doença. O uso das tecnologias de sequenciamento de última geração ajudou a ampliar o conhecimento a cerca de vários micro-organismos. No entanto, a detecção da diversidade em larga escala ainda apresenta resultados conflitantes devido a heterogeneidade dos protocolos e dos métodos de análise. Aqui, foi projetado e implementado um protocolo computacional para ser incorporado à facility de Bioinformática do A.C. Camargo Cancer Center para a detecção do microbioma humano em câncer gástrico. Avaliamos também os principais aspectos que possam influenciar o resultado final considerando o protocolo de sequenciamento, parametrização e algoritmos de classificação. O pipeline desenvolvido utiliza uma estrutura de gerenciamento de fluxo de trabalho (Snakemake), que permite obter uma análise automatizada e reprodutível, independente do ambiente de execução. Usando os resultados do sequenciamento de uma amostra controle com diversidade conhecida, mostramos que o pipeline proposto identifica com acurácia (TAR =0.89) os organismos a nível de gênero, bem como uma taxa de detecção sem falsos negativos (TDR=1). Como prova de conceito, usamos o pipeline em um conjunto de amostras provenientes de tumor primário e suco gástrico. De importância, ao avaliar como as várias etapas da análise podem influenciar os resultados, observamos que a combinação dos algoritmos deblur e BLAST durante a limpeza das leituras e classificação, respectivamente, apresentam os resultados mais próximos do esperado em relação à amostra controle. Diante da importância do microbioma em estudos de pesquisa básica e translacional, o pipeline proposto será útil na detecção da diversidade de bactérias em um ambiente computacional

The human microbiome has a great potential to influence human physiology, both in health and in disease. The use of state-of-the-art sequencing technologies has helped to extend knowledge about microorganisms. However, diversity detection in large scale basis still presents conflicting results due to the heterogeneity of protocols and analysis methods. Here, a computational protocol was designed and implemented to be incorporated into the A.C. Camargo Cancer Center's Bioinformatics facility in order to detect the human gastric cancer microbiome. We also evaluate the main aspects that can influence final results according to the characteristics of the sequencing protocol, parameterization and classification algorithms. The developed pipeline uses a workflow management structure, called Snakemake, which allows automated and reproducible analysis, regardless of the execution environment. Using the sequencing oa control sample with known diversity, we show that the proposed pipeline accurately identifies organisms at the gender level (TAR = 0.89), as well as a detection rate without false negatvies (TDR = 1). As a proof of concept, we used the pipeline in a set of samples from primary tumor and gastric juice. Of importance, when evaluating how the various stages of the analysis can influence the results, we observed that the combination of the deblur and BLAST algorithms during the denoising and classification steps, respectively, presents the results closer to the expected regarding the control sample. Given the importance of the microbiome in basic and translational research studies, the proposed pipeline will be useful in detecting the microbiome diversity in a computational environment

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AIMS: To analyze the prostatic compartments, extracellular matrix, microvascularization, transforming growth factor-beta (TGF-ß) and angiotensin II receptors type 1 (AT1) levels, and histopathology of the ventral prostate in a rat model for rheumatoid arthritis, and to evaluate the effect of angiotensin II AT1 receptor blocker (ARB) in the disease. MAIN METHODS: Fifteen male rats (90 days old) were divided into three groups (n = 5/group): control, adjuvant-induced arthritis without (AIA) or with AT1 receptor blocker (AIA + ARB). Animals were euthanized 60 days after immunization. The ventral prostate was collected, weighed, and processed for histological and immunohistochemical analysis. KEY FINDINGS: Our results show that AIA increases production of the prostatic epithelium and extracellular matrix, accompanied by a reduction in the number of tissue capillaries. ARB treatment promotes decreased production of extracellular matrix and increased TGF-ß and AT1 receptor immunostaining. SIGNIFICANCE: AIA may activate specific mechanisms that modify the prostatic environment; the use of ARB attenuates some altered prostate parameters in a rat model for arthritis.

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PURPOSE: To evaluate the association between the rectus femoris cross-sectional area (RFCSA) and the muscular strength obtained at the bedside in patients forwarded to the intensive care unit (ICU) for severe sepsis and septic shock. METHODS: An observational study of prospective cohort. RFCSA was assessed by ultrasound on the following day of the ICU admission and monitored during hospitalization. The patients performed clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip dynamometry), when they could understand the verbal commands of the examiners. RESULTS: In 37 patients hospitalized for sepsis there was a significant decline in RFCSA of 5.18 (4.49-5.96) cm on the 2nd day of ICU for 4.37 (3.71-5.02) cm at hospital discharge. Differently, the handgrip strength showed an increase from the awakening of 12.00 (7.00-20.00) Kgf to 19.00 (14.00-26.00) Kgf until hospital discharge. Patients in mechanical ventilation had a greater tendency to decline in the RFCSA compared with patients who did not receive mechanical ventilation, however without being significant (P = 0.08). There was a negative association between RFCSA delta (2nd day of ICU-ICU discharge) and handgrip strength (r = 0.51, P < 0.05), and a male and Sepsis-related Organ Failure Assessment score positive association with the RFCSA delta. CONCLUSION: There was an association of RFCSA with clinical muscle strength tests. In addition, it has been shown that sepsis can lead to short-term muscle degradation, regardless of whether they are submitted to mechanical ventilation or not.

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