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The COVID-19 pandemic has caused delays in the diagnosis, treatment and follow-up of patients with malignant neoplasms (MN). To analyze the distribution pattern of MN cases in Brazil, we collected data in August 2022, provided by the Department of Informatics of the Brazilian Ministry of Health, from 2013 to 2021. The data were organized in Microsoft Excel, the analysis and presentation of the data were made using ggplot and Reshape packages, and temporal patterns and forecast models were obtained by ARIMA method together with aTSA. The results show that the COVID-19 pandemic did not directly impact the notifications of MN cases, but changed the profile of notifications, as in 2018 there was an increase in the diversity of notified neoplasms, and a change in the number of cases in 2019 and 2020. In addition, the distribution between the evaluations of neoplasms was not proportional, showing conversion in 12 (32.4%), decrease in 24 (64.9%) and increase in 1 neoplasm (2.7%). The findings help to understand the new behavior of notifications, demonstrating a pattern similar to the seasonal forecast model, with random or linear trending patterns. This distribution, with a seasonal pattern, shows variability in certain periods of the year, providing important information for early diagnosis and better planning. Data from this research reinforce the need for active screening methods and incentives for preliminary screening for better detection and management of this malignancy. (AU)

A pandemia de COVID-19 causou atrasos no diagnóstico, tratamento e acompanhamento de pacientes com neoplasias malignas (NM). Para analisar o padrão de distribuição dos casos de MN no Brasil, coletamos dados em agosto de 2022 disponibilizados pelo Departamento de Informática do Ministério da Saúde do Brasil de 2013 a 2021. Os dados foram organizados no Microsoft Excel, a análise e apresentação dos dados foram feitas usando os pacotes ggplot e Reshape, e os padrões temporais e modelos de previsão foram obtidos pelo método ARIMA junto com o aTSA. Os resultados mostram que a pandemia de COVID-19 não impactou diretamente nas notificações dos casos de NM, mas mudou o perfil das notificações, pois em 2018 houve aumento na diversidade de neoplasias notificadas, e mudança no número de casos em 2019 e 2020. Além disso, a distribuição entre as avaliações das neoplasias não foi proporcional, mostrando conversão em 12 (32,4%), diminuição em 24 (64,9%) e aumento em 1 neoplasia (2,7%). As descobertas ajudam a entender o novo comportamento das notificações demonstrando um padrão semelhante ao modelo de previsão sazonal, com padrões de tendência aleatórios ou lineares. Essa distribuição com padrão sazonal, apresenta variabilidade em determinados períodos do ano, fornecendo informações importantes para o diagnóstico precoce e melhor planejamento. Os dados desta pesquisa reforçam a necessidade de métodos de triagem ativa e incentivos à triagem preliminar para melhor detecção e manejo dessa malignidade. (AU)

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Obesity alters the capacity of effective immune responses in infections. To further address this phenomenon in the context of COVID-19, this study investigated how the immunophenotype of leukocytes was altered in individuals with obesity in severe COVID-19. This cross-sectional study enrolled 27 ICU COVID-19 patients (67% women, 56.33 ± 19.55 years) that were assigned to obese (BMI ≥ 30 kg/m2, n = 9) or non-obese (BMI < 30kg/m2, n = 18) groups. Monocytes, NK, and both Low-Density (LD) and High-Density (HD) neutrophils were isolated from peripheral blood samples, and surface receptors' frequency and expression patterns were analyzed by flow cytometry. Clinical status and biochemical data were additionally evaluated. The frequency of monocytes was negatively correlated with BMI, while NK cells and HD neutrophils were positively associated (p < 0.05). Patients with obesity showed a significant reduction of monocytes, and these cells expressed high levels of PD-L1 (p < 0.05). A higher frequency of NK cells and increased expression of TREM-1+ on HD neutrophils were detected in obese patients (p < 0.05). The expression of receptors related to antigen-presentation, phagocytosis, chemotaxis, inflammation and suppression were strongly correlated with clinical markers only in obese patients (p < 0.05). Collectively, these outcomes revealed that obesity differentially affected, and largely depressed, innate immune response in severe COVID-19.

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SARS-CoV-2 has caused a high number of deaths in several countries. In Brazil, there were 37 million confirmed cases of COVID-19 and 700,000 deaths caused by the disease. The population size and heterogeneity of the Brazilian population should be considered in epidemiological surveillance due to the varied tropism of the virus. As such, municipalities and states must be factored in for their unique specificities, such as socioeconomic conditions and population distribution. Here, we investigate the spatiotemporal dispersion of emerging SARS-CoV-2 lineages and their dynamics in each microregion from Sergipe state, northeastern Brazil, in the first 3 years of the pandemic. We analyzed 586 genomes sequenced between March 2020 and November 2022 extracted from the GISAID database. Phylogenetic analyses were carried out for each data set to reconstruct evolutionary history. Finally, the existence of a correlation between the number of lineages and infection cases by SARS-CoV-2 was evaluated. Aracaju, the largest city in northeastern Brazil, had the highest number of samples sequenced. This represented 54.6% (320) of the genomes, and consequently, the largest number of lineages identified. Studies also analyzed the relationship between mean lineage distributions and mean monthly infections, daily cases, daily deaths, and hospitalizations of vaccinated and unvaccinated patients. For this, a correlation matrix was created. Results revealed that the increase in the average number of SARS-CoV-2 variants was related to the average number of SARS-CoV-2 cases in both unvaccinated and vaccinated individuals. Thus, our data indicate that it is necessary to maintain epidemiological surveillance, especially in capital cities, since they have a high rate of circulation of resident and non-resident inhabitants, which contributes to the dynamics of the virus.

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Visceral leishmaniasis (VL) is a systemic chronic and potentially fatal disease for humans. Mechanisms related to the dysregulation of the inflammatory response may be involved in both the pathogenesis and prognosis of VL. Triggering Receptor Expressed on Myeloid Cells-1 (TREM-1) is a receptor constitutively expressed on neutrophils and monocyte subsets. The protein serves to regulate and amplify inflammatory responses. This study aimed to evaluate the expression profile of TREM-1 on the surface of neutrophils from patients with VL at varying time points during leishmanicidal treatment. For this purpose, neutrophils were isolated from the peripheral blood of patients with VL at different stages of treatment, which include 0, 7, and 30 days after treatment. Surface TREM-1 expression was assessed by immunophenotyping neutrophil populations. In addition, the association of TREM-1 expression on the surface of neutrophils with clinical and laboratory parameters and serum levels of inflammatory mediators was also evaluated. Results demonstrate a lower surface expression of TREM-1 in VL patients in the absence of treatment. However, increased levels of TREM-1 expression were observed 7 and 30 days after the start of treatment, with levels similar to those of healthy controls. TREM-1 expression was directly correlated with lymphocyte and erythrocyte count and indirectly correlated with spleen and liver size. Furthermore, elevated levels of TREM-1 expression were also correlated with lower serum levels of interleukin (IL)-22. Taken together, these results suggest that infection by Leishmania infantum leads to depressed TREM-1 expression on the neutrophil surface and may contribute to the inflammatory imbalance that characterizes active VL disease.

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Chagas disease is caused by the protozoan parasite Trypanosoma cruzi. During the chronic phase of disease, while most infected people do not present symptoms, characterizing the asymptomatic form, some patients develop the cardiac form or chronic chagasic cardiomyopathy, which is considered the most severe manifestation of this disease. Considering that the activation of the PI3Kγ signaling pathway is essential for an efficient immune response against T. cruzi infection, we evaluated the PIK3CG C > T (rs1129293) polymorphism in exon 3 of this gene, which encodes the catalytic subunit of PI3Kγ. The PIK3CG CT and TT genotypes were found to be associated with an increased risk of developing the cardiac form of the disease rather than the asymptomatic or digestive forms. In conclusion, the presence of the T allele at single or double doses may differentiate the cardiac from other clinical manifestations of Chagas disease. This finding should help in further studies to evaluate the mechanisms underlying the differential association of PIK3CG in Chagas disease.

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Human T-lymphotropic virus 1 (HTLV-1) was the first recognized human retrovirus. Infection can lead to two main symptomatologies: adult T-cell lymphoma/leukemia (ATLL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Each manifestation is associated with distinct characteristics, as ATLL presents as a leukemia-like disease, while HAM/TSP presents as severe inflammation in the central nervous system, leading to paraparesis. Previous studies have identified molecules associated with disease development, e.g., the downregulation of Foxp3 in Treg cells was associated with increased risk of HAM/TSP. In addition, elevated levels of CXCL10, CXCL9, and Neopterin in cerebrospinal fluid also present increased risk. However, these molecules were only associated with specific patient groups or viral strains. Furthermore, the majority of studies did not jointly compare all clinical manifestations, and robust analysis entails the inclusion of both ATLL and HAM/TSP. The low numbers of samples also pose difficulties in conducting gene expression analysis to identify specific molecular relationships. To address these limitations and increase the power of manifestation-specific gene associations, meta-analysis was performed using publicly available gene expression data. The application of supervised learning techniques identified alterations in two genes observed to act in tandem as potential biomarkers: GBP2 was associated with HAM/TSP, and CD40LG with ATLL. Together, both molecules demonstrated high sample-classification accuracy (AUC values: 0.88 and 1.0, respectively). Next, other genes with expression correlated to these genes were identified, and we attempted to relate the enriched pathways identified with the characteristic of each clinical manifestation. The present findings contribute to knowledge surrounding viral progression and suggest a potentially powerful new tool for the molecular classification of HTLV-associated diseases.

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It is estimated that more than 600,000 new cases of cancer will be reported in Brazil during the 2018-2019 biennium, especially with regard to prostate, breast, lung and colorectal cancers. Due to the high prevalence, incidence and mortality rates of these diseases, cancer campaigns such as 'Pink October' and 'Blue November' were strongly promoted in the past decade throughout the country to raise awareness of breast and prostate cancer, respectively. Nevertheless, whether the implementation of these campaigns has been proven efficient is still unknown. In the present study, we analysed the effectiveness of these campaigns on eliciting population online interest for cancer information. The Google Trends database was evaluated for the relative Internet search popularity for the terms 'breast cancer' and 'prostate cancer' from 2014 to 2019. Aside from some regional differences, we found that there was a high demand for 'breast cancer' and, to a lesser extent, 'prostate cancer' searches in a seasonal fashion (during October and November, respectively). Despite the worldwide high incidence of lung and colorectal cancers, searches including these keywords did not show increases in any specific period of the year, demonstrating the efficiency of the 'Pink October' and 'Blue November' campaigns in engaging the interest of the Brazilian population on the subject. These results allow us to infer that campaigns are effective in mobilising the attention of the Brazilian population with regard to breast and prostate cancers, but the practical aspects in reducing incidence and mortality should still be discussed.

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Oxidative and inflammatory substances play an important role in the genesis of processes related to cardiometabolic risk. High levels of oxidized low-density lipoprotein (Ox-LDL) and of triggering receptor-expressed myeloid cells (TREM-1) are associated with cardiovascular and inflammatory diseases. In this study, we evaluate the association of the plasma concentrations of Ox-LDL and serum levels of circulating TREM-1 (sTREM-1) with the components of cardiometabolic risk (CMR) and other associated risk parameters. Although the individuals in this study were young, nonobese, and did not have signs, symptoms, and diagnosis of diseases, they already presented components of CMR. Ox-LDL lipid fraction correlated positively with CMR-related markers: body mass index (BMI), waist circumference (WC), body fat percentage, total cholesterol, LDL-c, VLDL-c, triglycerides, atherogenic cholesterol, and atherogenic index. Among these parameters, atherogenic cholesterol had a greater predictive effect for Ox-LDL alterations. Individuals with higher serum concentrations of sTREM-1 presented higher values for BMI, WC, triglycerides, VLDL-c, and atherogenic cholesterol. WC showed an effect on the association between the sTREM-1's inflammatory response and the components of CMR. The association of oxidative and inflammatory markers with anthropometric parameters and atherogenic cholesterol in nonobese, clinically healthy, and young individuals suggests the importance of early evaluation of these markers in order to prevent future cardiac events.

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The mosquito Aedes aegypti is the main vector of several arthropod-borne diseases that have global impacts. In a previous meta-analysis, our group identified a vector gene set containing 110 genes strongly associated with infections of dengue, West Nile and yellow fever viruses. Of these 110 genes, four genes allowed a highly accurate classification of infected status. More recently, a new study of Ae. aegypti infected with Zika virus (ZIKV) was published, providing new data to investigate whether this "infection" gene set is also altered during a ZIKV infection. Our hypothesis is that the infection-associated signature may also serve as a proxy to classify the ZIKV infection in the vector. Raw data associated with the NCBI/BioProject were downloaded and re-analysed. A total of 18 paired-end replicates corresponding to three ZIKV-infected samples and three controls were included in this study. The nMDS technique with a logistic regression was used to obtain the probabilities of belonging to a given class. Thus, to compare both gene sets, we used the area under the curve and performed a comparison using the bootstrap method. Our meta-signature was able to separate the infected mosquitoes from the controls with good predictive power to classify the Zika-infected mosquitoes.

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