The clinical cases of patients with multisystem inflammatory syndrome (MIS-C) were analyzed via a systematic review and meta-analysis of the clinical findings, treatments, and possible outcomes of articles retrieved via database searches. The authors searched the PubMed, Scielo, Web of Science, Science Direct, EMBASA, EBSCO, and Scopus databases for articles containing the keywords “multisystem inflammatory syndrome in children” or “MIS-C” or “PIMS-TS” or “SIMP” and “COVID-19” or “SARS-CoV-2” published between December 1st, 2019 and July 10th, 2021. Patient characteristics, tissue and organ comorbidities, the incidence of symptoms after COVID-19 infection, treatment, and patient evolution in the articles found were evaluated. The data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Newcastle-Ottawa Scale (NOS). In total, 98 articles (2275 patients) were selected for demographics, clinical treatment, and outcomes of patients diagnosed with MIS-C. The average age of children with MIS-C, 56.8% of whom were male, was of nine years. Fever (100%), gastrointestinal (GI) (82%), and abdominal pain (68%) were the decisive symptoms for the diagnosis of MIS-C. Shock and/or hypotension were common in patients with MIS-C. Cardiac symptoms (66%) predominated over respiratory (39%) and neurological (28%) symptoms. MIS-C treatment followed the common guidelines for treating children with septic shock and Kawasaki disease (KD) and proved to be effective. This meta-analysis highlights the main clinical symptoms used for the diagnosis of MIS-C, the differences between MIS-C and KD, and the severity of the inflammatory process and urgency for hospital care.

Carbapenem-resistant Klebsiella pneumoniae has become a public health problem with therapeutic limitations and high mortality associated with comorbidities. Methods: This is a systematic review and meta-analysis with a search in PubMed, SciELO, and Lilacs. Ten articles were selected, considering cohort, case-control, and cross-sectional studies. Tests for proportions and relative risk of mortality were performed, considering a 5% threshold for significance. Statistical analyses were performe dusing Rstudio^® software, version 4.0.2 of Ross Ihaka and Robert Genleman in Auckland, New Zealand. Results: Klebsiella pneumoniae, associated with chronic kidney disease, was responsible for 26%/258 deaths, chronic lung disease 28%/169, diabetes 31%/185, liver disease 15%/262, and heart disease 51%/262 deaths. Carbapenem-resistant Klebsiella pneumoniae associated with chronic kidney disease was responsible for 49%/83 deaths, with diabetes 29%/73, and with liver disease 33%/73 deaths. The risk of death from carbapenem-resistant Klebsiella pneumoniae was twice as high as the number of deaths associated with carbapenem-sensitive Klebsiella pneumoniae, RR = 2.07 (p < 0.00001). Conclusions: The present study showed an increase in mortality from carbapenem-resistant Klebsiella pneumoniae when associated with comorbidities.

The prevalence of patients hospitalized in ICUs with COVID-19 and co-infected by pathogenic bacteria is relevant in this study, considering the integrality of treatment. This systematic review assesses the prevalence of co-infection in patients admitted to ICUs with SARS-CoV-2 infection, using the PRISMA guidelines. We examined the results of the PubMed, Embase, and SciELO databases, searching for published English literature from December 2019 to December 2021. A total of 542 rec ords were identified, but only 38 were eligible and, and of these only 10 were included. The tabulated studies represented a sample group of 1394 co-infected patients. In total, 35%/138 of the patients were co-infected with Enterobacter spp., 27% (17/63) were co-infected with methicillin-sensitive Staphylococ cus aureus, 21% (84/404) were co-infected with Klebsiella spp., 16% (47/678) of patients were co-infected with coagulase-negative Staphylococcus, 13% (10/80) co-infected with Escherichia coli (ESBL), and 3% (30/1030) of patients were co-infected with Pseudomonas aeruginosa. The most common co-infections were related to blood flow; although in the urinary and respiratory tracts of patients Streptococcus pneumoniae was found in 57% (12/21) of patients, coagulase negative Staphylococcus in 44% (7/16) of patients, and Escherichia coli was found in 37% (11/29) of patients. The present research demonstrated that co-infections caused by bacteria in patients with COVID-19 are a concern.

Individuals in rural communities often obtain water from surface and groundwater sources, where the microbial quality is often unknown. Enteric viruses are among the main pathogenic microorganisms responsible for waterborne disease outbreaks. Thus, the objective of this work was to search for enterovirus in water samples from 25 rural communities. For this, 160 water samples were collected. Detection and quantification of the enterovirus (EV) were performed through molecular tests using the two main amplification reagents for qPCR. The prevalence of EV was identified in 4.4% (7/160) of the samples when Sybr Green^® was used, all in groundwater sources. Additionally, EV was found in 9.7% of shallow tubular wells, 3.8% of deep tubular wells, 4.3% of shallow dug wells and 5.9% of spring water. When using TaqMan^®, there was no amplification of the EV cDNA. Conclusions: Sybr Green^®, being a more accessible reagent, has a greater predilection for molecular tests, but the study showed that Taqman^® could suffer less interference from environmental samples, resulting in more reliable values of viral quantification. In this context, the detection of EV in groundwater can help in monitoring the virus in this source, in addition to helping managers of these communities in decision making.

This study aimed to measure the efficiency of cinnamon in patients with Type 2 Diabetes Mellitus (DM2), comparing fasting plasma glucose averages and lipid profiles with a placebo group through a meta-analysis. Four databases were the source of the research to find the articles used, including: Medline / PubMed, LILACS and NCBI. 11 randomized clinical trials that evaluated cinnamon on glycemic and lipid parameters were included in this study. Meta-analysis was performed with the aid of the STATA® 16.0 software, which determined the difference in glucose means and lipid profiles compared to a placebo group. Cinnamon at concentrations of 250 mg twice a day decreased blood glucose with MD = -0.25 (95%CI = - 0.36 to -0.14; p<0.00001) and in the intervention with 2 g 3 times a day with MD = -5.60 (95%CI = -6.98 to -4.22; p<0.00001). Total cholesterol was significant with 2 g 3 times a day with MD = 0.98 (95%CI = -1.27 to -0.69), followed by LDL-cholesterol MD = 0.64 (95%CI = 0.88 to 0.40; p<0.00001), and HDL-cholesterol with 500 mg 3 times daily with MD = 0.12 (95%CI = 0.05 to 0.19). High-dose supplementation of cinnamon can reduce glucose and lipid profiles in patients with DM2. This supporting treatment can be useful when added to the diet plan of patients with DM2.