Background: In the past two decades, a new epidemiological profile of Chagas’ disease (CD) has been registered in the Brazilian Amazon where oral transmission has been indicated as responsible for the increase of acute cases. In the Amazonas state, five outbreaks of acute CD have been registered since 2004. The cardiac manifestations in these cases may be characterized by diffuse myocarditis, with alteration in the electrocardiogram (ECG) and transthoracic echocardiogram (TTE). Objective: To perform a cardiac evaluation in autochthonous patients in the acute phase and at least one year after submitted to treatment for acute CD and evaluate the demographic variables associated with the presence of cardiac alterations. Methods: We evaluated patients diagnosed with acute CD through direct parasitological or serological (IgM) methods from 2007 to 2015. These patients were treated with benznidazole and underwent ECG and TTE before and after treatment. We assumed a confidence interval of 95% (CI 95%, p < 0.05) for all variables analyzed. Results: We observed 63 cases of an acute CD in which oral transmission corresponded to 75%. Cardiac alterations were found in 33% of the cases, with a greater frequency of ventricular repolarization alteration (13%), followed by pericardial effusion (10%) and right bundle branch block and left anterior fascicular block (2%). The follow-up occurred in 48 patients with ECG and 25 with TTE for a mean period of 15.5 ± 4.1 months after treatment. Of these, 8% presented normalization of the cardiac alterations in ECG, 62.5% remained with the normal exams. All of the patients presented normal results in TTE in the post-treatment period. As for the demographic variables, isolated cases presented more cardiac alterations than outbreaks (p = 0.044) as well as cases from Central Amazonas mesoregion (p = 0.020). Conclusions: Although cardiac alterations have not been frequent in most of the studied population, a continuous evaluation of the clinical-epidemiological dynamics of the disease in the region is necessary in order to establish preventive measures.

Chagas disease is gaining importance in the Brazilian Amazon region as a differential diagnosis of febrile syndrome. The most recent microoutbreak occurred in Ipixuna, in Amazonas state. An epidemiological survey was conducted using parasitological and serological tests, and electrocardiographic analysis. The patients belonged to one family and had ingested açaí acquired from Ipixuna. All patients reported fever and initially a thick blood smear test was done to identify Trypanosoma cruzi. Benznidazole treatment was administered to all patients. Knowledge of the epidemiological dynamics of Chagas disease allows us to improve control and management measures for this disease.

Background: Chagas disease is a neglected tropical disease that is still considered a global health emergency. In the Amazon region, most of the reports are of acute cases that are associated with oral transmission. This study aimed to evaluate myocardial injury in patients with acute Chagas disease before and after treatment. Methods and Results: We evaluated 23 patients with acute Chagas disease in 3 different stages of progression. Group 1 had 12 patients evaluated during the acute phase, at the time of diagnosis, and 1 year after treatment, and Group 2 had 11 patients in the late postacute phase who were evaluated 5.2 years on average after diagnosis and treatment. ECGs with the Selvester score, 24‐hour Holter exam, and cardiovascular magnetic resonance imaging were performed. The mean age of the 23 patients was 44.3±18.9 years, and they were mostly men (15/65.24%) from Amazonas state (22/95.6%). In 69.6% (n=16) of the patients, some ECG alterations were found, the most frequent being left anterior fascicular block and ventricular repolarization. In Group 1, the 24‐hour Holter exam showed atrial tachycardia in 3 (25%) patients and ventricular extrasystoles in 2 (16.7%) patients. In Group 2, 1 patient had ventricular extrasystoles. Myocardial injury was observed in 7 patients (58.3%) at the acute phase and in 5 (50%) patients at the 1‐year follow‐up in Group 1 and in 2 (18.2%) patients in Group 2. Conclusions: This article describes, for the first time, myocardial injury shown by cardiovascular magnetic resonance imaging in a group of patients with acute Chagas disease and reveals the importance of early detection and follow‐up of the cardiac impairment in these patients.

: The prevalence and characteristics of chronic Chagas disease (CCD) in the Amazon Region remain underexplored. This study aimed to describe the challenges encountered during a serological survey and follow-up of CCD, while also highlighting potential risk factors in the Amazon Region. The serological survey involved residents of periurban and rural areas of Manaus in the Brazilian Amazon. All participants were invited to complete a clinical, epidemiological, and demographic questionnaire and provide a blood sample for anti-Trypanosoma cruzi (T. cruzi) IgG tests. A total of 1,845 participants were included, of whom 43 were identified as having presumed CCD, based on having at least two positive serological tests. Only 35 underwent complementary tests, and five had cardiac alterations not consistent with CCD. The main risk factors associated with CCD were age ≥20 years, living in periurban areas, reporting the presence of the insect vector inside the household, entering the forest, consumption of bushmeat, and having undergone blood transfusion. In the Amazon, the population is exposed to the sylvatic T. cruzi life cycle and is unaware of the associated risk factors. The divergent serology results raise doubts about the reliability of the commercial serological tests used for CCD screening in the region. Surveillance for CCD is important in the Amazon.

A OMS (Organização Mundial de Saúde) classifica a ansiedade como: transtorno de ansiedade generalizada, transtorno do pânico, fobias sociais ou específicas e transtorno de ansiedade social (SAD). Todos os tipos compartilham sintomas comuns, incluindo sentimentos de mal-estar, pânico e medo, problemas de sono, não ser capaz de ficar calmo, estar com frio e / ou suando, falta de ar, palpitações cardíacas, boca seca, náusea, e prevenção de situações, estes transtornos acabam prejudicando a qualidade de vida de muitas pessoas e levando muita das vezes a cometer suicídios. O objetivo do presente estudo foi descrever a eficácia do uso do canabidiol para tratamento da ansiedade, descrever os mecanismos fisiológicos e seus efeitos adversos. Para isso foi realizado uma pesquisa bibliográfica através de artigos publicados e atuais onde foi possível analisar o seus efeitos em animais e humanos, os estudos foram realizados em uma população com idades entre 18-37 anos com transtorno de ansiedade social, fobia de falar em público e pessoas com transtorno pós-traumático causado por algum trauma na infância. Os resultados mostraram que o canabidiol pode ser uma potente opção para o tratamento da ansiedade, sua eficácia em relação à dosagem, vias de administração e efeitos adversos mostraram resultados significantes. O presente estudo demonstra que mais estudos clínico e controlado por placebo são necessários para demonstrar a eficácia da canabis.

Tendo em vista os relatos sobre o uso de informações genéticas germinativas na forma preventiva e no tratar desse tipo de carcinoma, bem como o seu potencial como padrões de marcadores genéticos análogos aos perfis de expressão obtidos a partir do tecido tumoral, permitindo uma previsão mais poderosa de quem responderá melhor a um tratamento ou regime específico. Com isso, este estudo tem como objetivo avaliar a importância da farmacogenética no tratamento do câncer de mama. Trata-se de uma revisão de literatura, onde foram utilizadas as bases de dados: MEDLINE, LILACS e Scielo, em que publicações em português e inglês foram selecionadas entre os anos de 2016 e 2021. Por meio dos resultados obtidos observou-se que a introdução da farmacogenética na oncologia tem possibilitado o desenvolvimento de uma nova geração de agentes farmacológicos capazes de serem seletivos contra células neoplásicas, possibilitando uma melhora significativa na relação risco/benefício de inúmeros tipos de câncer, em particular ao câncer de mama. Dessa forma, a função do farmacêutico torna-se essencial na Farmacogenética quando associado à prática clínica, já que é um profissional da saúde que detém de toda uma compreensão dos fenômenos que ocorrem nessa categoria, contribuindo no auxílio dos demais componentes do grupo funcional de saúde, realizando uma interpretação plausível dos resultados das análises e de sua posterior aplicabilidade.