The newly discovered SARS-CoV-2 is the cause of COVID-19, including severe respiratory symptoms with an important lethality rate and high dissemination capacity. Considering the indigenous people of Brazil, it is feared that COVID-19 will spread to these communities, causing another stage of decimation. Despite advances in indigenous health care in the country, there are still many challenges due to the social vulnerability of this population, whose lands continue to be illegally exploited. Based on these considerations, this article discusses challenges in caring for the indigenous population in the context of the COVID-19 pandemic in Brazil.

This study investigated the effect of acute exposition to zinc (Zn) on histology of the liver and testes of yellow tail lambari (Astyanax aff. bimaculatus). The exposure consisted of six concentrations of Zn (0, 3, 5, 10, 15, and 20 mg/L) for 96 hours of exposure. Fragments of liver and testis were routinely processed and embedded in plastic resin based on glycol methacrylate. Fragments of bones, muscles, liver and testis were dehydrated and digested to quantify the absorption levels of Zn in the tissue. Acute exposure to concentrations above 10mg/L has produced structural changes in the liver and gonads. The changes found in the liver were vascular congestion; decrease of cellular volume; displacement of the hepatocyte nucleus; necrosis; disarrangement of cordon structure; leukocyte infiltrate and vacuolization. The changes found in the gonads were ruptured cyst, delayed development of germ cells, pyknotic nucleus, cell cluster, displacement of cyst wall and vacuolization. The histological changes observed were compatible with the increasing concentration of zinc in environment, compromising liver and reproductive functions, because there was an increase in relative frequency of hepatocytes and reduced sperm production

Introdução: A doença falciforme (DF) é uma enfermidade hematológica hereditária. Na sua patogênese destaca-se a rigidez eritrocitária alterando a morfologia normal das hemácias, de disco bicôncavo para o formato de meia-lua, desencadeando uma ampla gama de manifestações clínicas. O entendimento da natureza desses sintomas propicia o diagnóstico precoce e a terapêutica adequada. Objetivo: Descrever e discutir as manifestações clínicas agudas dependentes do tempo de complicações comumente descritas em adultos com DF, a fim de possibilitar uma intervenção educacional para profissionais de saúde na atenção terciária. Métodos: Revisão narrativa da literatura. Resultados e discussão: As complicações agudas na DF são diversas destacando-se: crises vaso-oclusivas, infecções por microrganismos encapsulados, principalmente do trato respiratório e sepse síndrome torácica aguda, sequestro esplênico, priapismo, Acidente Vascular Cerebral (AVC) e crise aplástica. As manifestações clínicas agudas podem variar em tipo (neurológicas, pulmonares ou falência de vários órgãos) e gravidade (quadro álgico moderado até um choque hipovolêmico, potencialmente fatal). O diagnóstico oportuno e o tratamento dessas complicações são essenciais para o gerenciamento ideal, que deve ser feito a partir de padronização de protocolos, melhor capacitação da rede e preparo das famílias. O conhecimento das intercorrências na DF é de extrema importância para todos os níveis de atendimento dos pacientes. A detecção precoce das complicações possibilita tratamento adequado e diminuição da morbimortalidade relacionada a elas, sendo essencial o acesso a informação sobre condutas a serem tomadas nas diversas manifestações clínicas do paciente com diagnóstico de DF. Conclusão: É essencial que os profissionais de saúde reconheçam as manifestações clínicas agudas e potenciais fatores de risco associados a cada complicação, mantendo monitoramento regular dos pacientes. As complicações verificadas afetam a qualidade de vida desses pacientes e a prevenção de complicações deve ser o principal alvo das políticas de saúde voltadas para o paciente com essa condição mórbida.

Introduction: Acute bacterial meningoencephalitis (ABM) are severe infections caused by microorganisms that are capable of reaching the meninges, as well as the brain. They areconsidered medical emergencies that require early diagnosis and immediate treatment. However, medical professionals have routinely encountered difficulties resulting from the Streptococcus pneumoniae’s antimicrobial resistance in the medical practice, becoming a public health problem in Brazil. The present article has the objective of revising literature and compiling data on S. pneumoniae’s resistance in ABM cases, with the intent of assisting the decision-making process on which therapy should be adopted. Methods: The study was conducted through the revision of literature regarding the treatment of ABM in humans published in the last 20 years, found in the PubMed/Medline, LILACS and SciELO digital databases. The first selection of articles was carried out by analyzing the titles and abstracts. The selected studies were read completely to determine their eligibility. Results and Discussions: The 45 selected articles described varying resistance of S. pneumoniae's to penicillin and ceftriaxone, which can reach approximately 50% to the first drug. The SIREVA Project (2016), developed in Brazil, deserves do to commended for being able to identify the following resistance patterns of the isolated pathogen in ABM cases: (1) 31,% to penicillins (sample of 334 patients), and (2) intermediate and high resistance to ceftriaxone, 6.9% and 5.6% respectively (sample of 320 patients). Despite the infrequent occurrence, present studies document the emergence of resistance mechanisms in pathogen strains to vancomycin. Nevertheless, the studies conducted in Brazil showed that the S. pneumoniae strains were completely sensitive to the previously mentioned drug. Conclusion: The association of ceftriaxone and vancomycin should be considered the best option to treat pneumococcal ABM in Brazil, due to the severity of the condition and the rising resistance of the pathogen to cephalosporins.