Pulmonary toxoplasmosis is rare in immunocompetent subjects. Here, we describe a 41-year-old previously healthy male patient who presented to the emergency department of a hospital with a life-threatening case of pneumonia due to Toxoplasma gondii infection, which responded to specific therapy. Clinical and image-based findings overlap with those for atypical pneumonias, and toxoplasmosis should be considered in the differential diagnosis--especially if immunoglobulin M-specific antibodies are detected.

Chronic postoperative osteomyelitis represents an important health problem due to its significant morbidity and low mortality rate. This pathology is challenging because of difficulties in understanding the pathogenesis and the decision-making involving the treatment. The present article had the goal of reviewing the definition, pathogenesis, clinical aspects, diagnosis, and treatment of chronic postoperative osteomyelitis, and of gathering this information in a single Brazilian updated publication.The PubMed, LILACS, and the Cochrane Library medical databases were analyzed using pertinent keywords. Current and relevant articles were selected.The present article gathered the established information, as well as innovations related to chronic osteomyelitis and its treatment, to offer updated data to assist the professionals involved in the management of chronic osteomyelitis.

OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

OBJETIVO: Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS: Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS: A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4–17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6–20,6) e estadual (16,2%; IC95% 14,4–18,2) em relação à rede privada (11,7; IC95% 10,0–13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8–20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9–20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO: A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal.

Introdução: O processo de transição demográfica no Brasil vem sendo acompanhado de um aumento na incidência de HIV em idosos, fator esse que deve ser investigado a fim de encontrar possíveis condições relacionadas, permitindo a criação de estratégias eficazes para a redução de tal incidência. Objetivos: Avaliar o conhecimento sobre HIV/AIDS e o uso de preservativo em um grupo de idosos da cidade de São Paulo. Métodos: Estudo analítico, transversal e quantitativo realizado a partir da aplicação do “Questionário sobre conhecimento e prevenção pessoal de HIV/AIDS“ em 115 idosos de ambos os sexos com idade igual ou superior a 60 anos, orientados em tempo e espaço e que aceitaram os termos do TCLE. A análise de dados foi feita de forma quantitativa, sob os aspectos: conhecimento sobre HIV/AIDS (conceito, transmissão e prevenção) e prevenção pessoal. Os dados foram analisados por estatística descritiva e inferencial pelo programa R 3.6.0. Resultados: Houve predominância de respondentes do sexo feminino (68,7%). A maioria dos entrevistados não faz o uso de preservativo (75%). Apesar de 83% apresentarem conhecimento suficiente sobre HIV/AIDS, 66% acreditam que existe cura para a doença e 54% afirmaram que o vírus pode ser transmitido por picada de mosquito. Conclusões: constatou-se que, apesar do bom nível de conhecimento demonstrado pelos participantes sobre o HIV/AIDS, ainda persistem dúvidas quanto às formas de transmissão e possibilidade de cura da doença. Demonstra-se a necessidade de compreensão do processo de expansão do HIV/AIDS pelos profissionais de saúde e que a população acima de 60 anos entenda como a doença funciona, seus mecanismos de transmissão e prevenção.

No abstract

Objectives: To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of Sao Paulo. Methods: This is a population-based household survey conducted every 15 days, between June and September 2020 and January and February 2021. In total, 11 phases were performed. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, it was combined with an immunoenzymatic test, Euroimmun. Participants also answered a semi-structured questionnaire on sociodemographic and economic factors and social distancing measures. Prevalence estimates and 95% confidence intervals were estimated according to the region, Human Development Index, sex, age group, ethnicity, education, income and variables associated with risk or prevention of the infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao Scott correction was used, considering a 5% significance level. Results: In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9-11.8%) to 25.0% (95%CI: 21.7-28.7). The prevalence of individuals with antibodies against SARS-CoV-2 was higher among black and pardo people, people with lower schooling, people with lower income and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. Conclusion: The estimated prevalence of SARS-CoV-2 infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed the social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain the social distancing measures as ways to prevent SARS-CoV-2 infection.