Universidade de Cuiabá

Este estudo aborda a análise epidemiológica do recrudescimento da tuberculose no Brasil, com ênfase nas tendências recentes de incidência, nos principais determinantes associados ao aumento dos casos e nas implicações para a saúde pública. Trata-se de uma revisão bibliográfica narrativa associada à análise de dados secundários, fundamentada em artigos publicados entre 2014 e 2026 em bases de dados científicas reconhecidas, bem como em informações provenientes de sistemas oficiais de vigilância epidemiológica. Os achados da literatura indicam impacto significativo das fragilidades estruturais do sistema de saúde e da descontinuidade de ações de vigilância durante a pandemia, com repercussões diretas na detecção precoce e no acompanhamento terapêutico. Entretanto, também são evidenciadas limitações relacionadas à subnotificação, à heterogeneidade metodológica dos estudos epidemiológicos e à variabilidade regional dos indicadores.

Conducting multicenter, longitudinal epidemiological studies on emerging pathogens in real time during health emergencies presents significant challenges, especially in low- and middle-income countries, where substantial logistical and resource constraints hinder the rapid design and implementation of research protocols. This is particularly difficult when the disease spreads rapidly and its nature changes due to the onset of vaccination. During the COVID-19 pandemic, a cohort study (AVISA) was conducted in eleven research sites to assess seroprevalence. The objective of this study is to identify the challenges to the successful execution of the AVISA study through a retrospective analysis of quantitative and qualitative indicators. The rapid spread of SARS-CoV-2 infections, particularly in large urban areas in Brazil, and the initiation of COVID-19 vaccination in January 2021 posed significant challenges for recruiting individuals who met the eligibility criteria. Participant enrollment was slower than initially planned, and fewer participants from the youngest and oldest cohorts were recruited. The implementation of the study protocol encountered significant logistical and operational challenges due to the evolving COVID-19 context, including the effects of vaccination, the loosening of social distancing measures, and difficulties conducting household visits and collecting samples in high-risk areas. To ensure participant retention and protocol adherence, the study employed flexible strategies, including rescheduling visits, enhancing communication, and mobilizing experienced staff, which were crucial for maintaining data collection and study continuity over time. Despite concurrent demands of the COVID-19 response, Instituto Butantan and its partners successfully mobilized resources, staff, and infrastructure to conduct the AVISA study across 11 sites, leveraging existing collaborations from prior clinical trials. The study conducted over 16,000 household visits, collected nearly 7,000 blood samples, and gathered detailed clinical and sociodemographic data from participants. Despite the complexities of conducting real-time research during a public health emergency, the AVISA study demonstrated that large-scale, multi-site longitudinal studies can be implemented in resource-constrained settings through adaptive strategies, institutional partnerships, and flexible field operations. The lessons learned offer essential insights for strengthening the design and execution of epidemiological studies in future health emergencies, particularly in low- and middle-income contexts.

Background/Objectives: Galleria mellonella (G. mellonella) larvae have emerged as a valuable in vivo model for antifungal drug screening. This study aimed to determine the optimal inoculum concentrations of Candida albicans (C. albicans) in G. mellonella, as well as the appropriate fluconazole concentrations, in order to standardize a preliminary screening method for compounds with antifungal activity. Methods: Larvae were infected with four C. albicans strains, including two reference strains (ATCC® 10231 and ATCC® 90028) and two oral isolates (A1 and A2). Fluconazole toxicity was evaluated at doses of 20, 40, and 80 mg/kg over a 72 h period. In the treatment assays, larvae were infected via the left pro-leg and treated with fluconazole, administered as a single or two doses, one hour after infection. Larval viability was monitored over five days based on movement, cocoon formation, and melanization, and survival data were analyzed using Kaplan–Meier curves and the log-rank test. Results: Fluconazole showed no toxicity at the tested concentrations. Infection with up to 2 × 107 cells/mL was non-lethal for most strains, except for A2, which exhibited 50% mortality within 48 h but it was effectively controlled with a single 20 mg/kg dose of fluconazole. Infection with 2 × 108 cells/mL resulted in complete mortality within 48 h; however, a single 80 mg/kg dose significantly improved survival. Conclusions: The G. mellonella model proved to be a suitable and reproducible in vivo system for the preliminary screening of antifungal compounds. The standardized experimental conditions established in this study support its applicability for evaluating antifungal activity in early research stages. Future studies should expand this approach to different fungal species and antifungal agents, as well as explore its applicability in combination therapies.

Reference values for cardiac chamber quantification are essential for clinical decision-making. Brazil is a continental country with marked racial diversity and substantial regional socioeconomic and anthropometric variability, which may not be adequately represented in international echocardiographic standards. To establish reference echocardiographic measurements for healthy Brazilian adults and to investigate geographic and sex-related differences across Brazil's major regions. In this prospective, multicenter study, transthoracic echocardiograms were performed in 496 healthy volunteers (mean age 41 ± 15 years; 55% women) from five Brazilian regions. Left ventricular (LV) and left atrial (LA) dimensions, volumes, mass, ejection fraction, and global longitudinal strain (GLS) were analyzed in accordance with current guidelines. Comparisons were conducted by sex (Student's t test or Mann-Whitney U test) and by region (analysis of variance). Cardiac chamber dimensions and LV mass were greater in men, even after indexing for body surface area. LA volumes were also higher in men, although these differences were attenuated after indexing. Absolute LVGLS and right ventricle (RV) GLS (RVGLS) values were higher in women, whereas LA strain reservoir (LASr) was similar between sexes. Regionally, the Center-West exhibited significantly smaller LV volumes, a difference primarily driven by women, along with lower LVGLS and RVGLS (p < 0.001). In contrast, LA volumes were smaller in the Northeast region. No significant associations were observed between self-reported race and echocardiographic parameters, except for RVGLS and LASr, which were lower in White participants. This study establishes echocardiographic reference values in a nationally representative Brazilian cohort, confirms expected sex-related differences, and identifies previously unrecognized regional variations in cardiac chamber dimensions. These findings underscore the need for population-specific standards to ensure accurate cardiac quantification.

Nesta pesquisa sobre a revista cubana Bohemia, examinou-se sua evolução estrutural e editorial desde sua concepção como um semanário cultural ilustrado, não especializado e com um enfoque estético superficial, até sua transformação em um meio multidisciplinar com projeção nacional. Ao longo de suas diferentes etapas, a publicação incorporou novas seções com um jornalismo abrangente sobre temas políticos, sociais e culturais, até se tornar um arquivo vivo da nação. O estudo fundamenta-se na análise documental de edições representativas, entrevistas com colaboradores editoriais e revisão bibliográfica de outros meios de informação. Observa-se como, graças a esse alcance massivo e prestígio acumulado, autores cubanos e estrangeiros confiaram à revista suas criações, muitas vezes inéditas. Mostra-se como, com o triunfo da Revolução Cubana, Bohemia caminhou junto a um processo político humano e tem sido um espaço onde cada avanço e contratempo foram apresentados com análises objetivas. Palavras-chave: Cuba, Bohemia, revista, informação, jornalismo, cultura cubana, história cubana.

The use of narrow-diameter implants has emerged as a strategy to compensate for the reduced bone dimensions of maxillary lateral incisor agenesis (MLIA). This study integrates finite element analysis (FEA) and systematic review (SR) to assess the biomechanical and clinical viability of implant-supported crowns in MLIA scenarios. Three-dimensional FEA were built, comprising a control and an atrophic model representative of an MLIA case. Simulations were performed using implants with varying diameters and materials. The risk of implant and abutment mechanical failure and bone resorption were evaluated. The SR was designed to evaluate the consistency between in silico predictions and clinical outcomes. Reduced implant diameter was associated with an increased risk of implant fracture and bone resorption. All implants and abutments in the simulated models exhibited stress values below the critical threshold for titanium and zirconia failure, indicating a low mechanical failure risk under simulated conditions. Additionally, among the 25 studies included in the SR, 19 reported successful outcomes for implant therapy, but no zirconia implants were identified. Titanium implants with regular diameter combined with hybrid abutments demonstrated favorable biomechanical behavior and seem a reliable option for MLIA rehabilitation, offering both structural integrity and esthetic benefits. The implant-prosthetic rehabilitation of MLIA has demonstrated high reliability and predictability in both esthetic and functional outcomes, especially when performed through a multidisciplinary approach involving orthodontics, periodontics, implantology, and prosthodontists. Long-term studies are still necessary to validate the longevity and performance of zirconia implants in MLIA.

Distúrbios hipertensivos relacionados ao ciclo gravídico-puerperal e ao período tardio pós-gestacional contribuem para morbimortalidade materna e para aumento do risco cardiovascular a longo prazo. Nesse contexto, a lactação e o aleitamento materno vêm sendo investigados como potenciais fatores protetores sobre a pressão arterial, porém as evidências permanecem distribuídas em diferentes desenhos de estudo e populações. Assim, este artigo objetiva sintetizar achados sobre a associação entre lactação/aleitamento materno e risco de hipertensão materna no pós-parto e em seguimento tardio, além de discutir mecanismos fisiopatológicos propostos. Realizou-se revisão de literatura com buscas em PubMed, SciELO e LILACS, incluindo publicações de 2016 a 2025, por meio de descritores e termos livres relacionados a aleitamento/lactação, hipertensão/pressão arterial, gestação e pós-parto. Priorizaram-se revisões sistemáticas e metanálises, seguidas de estudos observacionais com desfechos pressóricos, excluindo-se editoriais e estudos sem avaliação de aleitamento/lactação ou sem desfechos de pressão arterial. Os resultados apontam associação protetora entre amamentação e menor risco de hipertensão, com tendência dose–resposta; em metanálise, duração ≥12 meses associou-se a redução relativa de 13% (OR 0,87; IC95% 0,78–0,97). Conclui-se que, até 2025, o aleitamento pode compor estratégias de prevenção e vigilância do risco cardiovascular materno, embora limitações por confundimento residual exijam cautela na inferência causal.

Este artigo analisa o avanço da contraofensiva neoliberal fascista, que reforça e dissemina a perspectiva de que a Economia Política Marxista frequentemente "aparece" como uma "ciência estrangeira" em dois sentidos: ao marxismo e à economia. O objetivo é reivindicar o papel da Crítica da Economia Política como fundamento para transformações sociais possíveis e necessárias em duas dimensões essenciais: a partir da tradição marxista e a partir da perspectiva da economia. No primeiro caso, enfatizar que a Crítica da Economia Política é o marxismo e, consequentemente, o fundamento da economia como ciência social não neutra, isto é, como economia marxista. Ela se estrutura em três partes fundamentais: Economia Convencional: Ciência ou Pseudociência; Economia e Crítica da Economia Política: Economia Marxista; e Economia Marxista e a Alternativa Socialista.

Tampering with raw milk by adding water is a prevalent form of food fraud driven by economic motives. Although the freezing point can detect this adulteration, Brazil and many other regions only mandate this analysis for bulk-tank samples, which can mask the fraud when raw milk is pooled. However, individual compositional analysis of milk from producers is conducted monthly. This study aimed to leverage compositional analysis combined with artificial intelligence to predict water addition. Between 2021 and 2023, 278 raw milk samples from a dairy plant were analyzed using mid-infrared spectroscopy to determine fat, protein, lactose, urea, ash, total solids, and non-fat solids. Simultaneously, these samples were assessed for freezing point, excluding samples with a freezing point above -0.555°CH from the analysis. Of the remaining 251 samples, the Naive Bayes classifier was applied to distinguish between samples with a freezing point greater than -0.530°CH (indicating water addition) and those between -0.531°CH and -0.555°CH (normal). The classifier was trained with 75% of the data, and its performance was evaluated for sensitivity and specificity. The Naive Bayes classifier demonstrated 8% sensitivity, 98% specificity, and 38% positive predictive value. Limitations included a small sample size and the low frequency (15%) of adulterated samples. Future studies with larger sample sizes could improve predictions. Despite its low sensitivity, this algorithm can assist dairy processing plants in identifying potential cases of water addition, aiding in the gradual elimination of such adulteration.