Vertical Transmission of Trypanosoma Cruzi in a Non-Endemic Country: Histology of the Infected Placenta

Chagas disease, once confined to rural Latin America is an increasing public health concern in non-endemic countries due to population movements. Here we present an unexpected finding of a placenta infected with T. cruzi from a Brazilian woman residing in Ireland. Histology of the placenta showed a lymphocytic chorioamnionitis with multinucleated giant cells (MNGCs) as well as cord vasculitis and funisitis. Amastigotes of trypanosomiasis were found in both cord and membranes. The placenta parenchyma, however, had no villitis or amastigotes and maturation was appropriate for gestation. To date, there have been few reported cases of vertical transmission in non-endemic countries. We discuss the histological findings and review the literature on potential modes of transmission from mother to fetus.

Cardiotoxicity in chemotherapeutic agents

This Letter to the Editor aims to comment on the review by Duplyakov DV et al. published in this Journal, didactically discussing the cardiotoxicity in chemotherapy under the pathophysiological points of view as well as daily practical aspects. The growth of the oldest age groups of patients and the increased number of malignant entities undergoing chemotherapy enhances the significance of the cited work. One of the key points is the emphasis on the possibility of a known risk of cardiovascular damage due to chemotherapy surpass that of the malignancy under treatment. An additional short comment is about reversible cardiotoxicity in a 54-year-old Brazilian woman with breast cancer treated by trastuzumab. The herein commented articles can contribute to better understanding of mechanisms in cardiotoxicity related to chemotherapy, and to reduce the under diagnosis.

Genomic Characterization of Multidrug-Resistant Escherichia coli BH100 Sub-strains

The rapid emergence of multidrug-resistant (MDR) bacteria is a global health problem. Mobile genetic elements like conjugative plasmids, transposons, and integrons are the major players in spreading resistance genes in uropathogenic Escherichia coli (UPEC) pathotype. The E. coli BH100 strain was isolated from the urinary tract of a Brazilian woman in 1974. This strain presents two plasmids carrying MDR cassettes, pBH100, and pAp, with conjugative and mobilization properties, respectively. However, its transposable elements have not been characterized. In this study, we attempted to unravel the factors involved in the mobilization of virulence and drug-resistance genes by assessing genomic rearrangements in four BH100 sub-strains (BH100 MG2014, BH100 MG2017, BH100L MG2017, and BH100N MG2017). Therefore, the complete genomes of the BH100 sub-strains were achieved through Next Generation Sequencing and submitted to comparative genomic analyses. Our data shows recombination events between the two plasmids in the sub-strain BH100 MG2017 and between pBH100 and the chromosome in BH100L MG2017. In both cases, IS3 and IS21 elements were detected upstream of Tn21 family transposons associated with MDR genes at the recombined region. These results integrated with Genomic island analysis suggest pBH100 might be involved in the spreading of drug resistance through the formation of resistance islands. Regarding pathogenicity, our results reveal that BH100 strain is closely related to UPEC strains and contains many IS3 and IS21-transposase-enriched genomic islands associated with virulence. This study concludes that those IS elements are vital for the evolution and adaptation of BH100 strain.

Family with atypical Parkinsonism due to CHCHD10 gene mutation

Introduction: Parkinson’s disease - PD is the second most common agerelated neurodegenerative disorder. Characterized by a variety of motor and non-motor symptoms that relate to the loss of dopaminergic neurons in the midbrain black substance. Although most cases of PD are sporadic, 5–10% of patients have monogenetic mutations with a description of more than 20 genes for the familial form. Mitochondrial mutation in CHCHD10 has also been reported to be associated with a wide spectrum of neurodegenerative disorders, including PD. Objectives: Description of a rare recently described genetic cause of autosomal dominant parkinsonism. Methodology: Describe the case of a Brazilian woman with atypical parkinsonism due to CHCHD10 pathogenic variant that was followed up in our service. Result: Female, 64 years old. “. He started episodes of imbalance about 5 years ago, with falls, in addition to limb stiffness, worse on the left. 4 years ago, he started myalgia to great efforts with low subsequent tolerance to light effort. 1 year ago with urinary incontinence and choking past of poor performance in physical activities without pre-motor symptoms FAMILY: mother with clinical picture of possible dementia syndrome at age 60, history in the maternal family of myalgia, intolerance to physical exercise and hearing loss in adulthood. EXOMA: presence of variant c.146C > T (p.Ala49Val) in simple heterozygosity without CHCHD10 gene. MRI with thigh muscle hypotrophy in anterior and posterior thigh compartments; slight muscle edema in the legs. Conclusion: Pathogenic variants in the CHCHD10 gene should be considered in cases of atypical parkinsonism, especially in cases of positive familial history of mitochondrial myopathy or dementia.

Black Women in Parliament and on Social Media: Link Visibility as an Intersectional and Solidarity-Building Tool

This article tackles the multiple facets of visibility, ranging from invisibility, a lack of recognition in society, to hypervisibility, when bodies are hyperexposed for commodification or criminalization purposes. We analyze the specific implications of achieving media visibility for one Black Brazilian woman in politics: Renata Souza, a Rio de Janeiro state legislator. Souza’s campaign and mandate have drawn inspiration from the legacy of Marielle Franco, a Black lesbian favela-born city councillor and human rights advocate who was murdered in March 2018. Our theoretical framework consists of three strands of research: visibility studies, intersectional feminism, and intersectional work on technologies and surveillance. We draw from autoethnographic approaches with the use of field notes, audio diaries, and interviews with members of Souza’s staff. We complement these with digital ethnographic observations of Souza’s and her allies’ social media profiles. We ask: If visibility is a goal for groups that are marginalized and silenced, what happens when they achieve it? When does visibility help to protect Black women? And when does visibility bring even greater vulnerability? In this article, we propose and define the concept of “link visibility” as a process led by women of color who need a high degree of social media publicness but are affected disproportionately by visibility-induced high levels of vulnerability. We argue that link visibility represents an intersectional feminist approach as well as a tool for solidarity building, and that both—intersectionality and link visibility—help bind oppressed realities in Brazil and elsewhere. Finally, we interrogate what can be done to protect women of color online, stopping the violence, threats, and fear.

Partial laryngectomy and reconstruction with rotation of the epiglottis in the treatment of a rare laryngeal schwannoma: a case report

Background Neurogenic tumors of the larynx are rare, with few cases having been reported in the literature. Schwannomas are responsible for 0.1% of all benign tumors of the larynx. They arise in the sheaths of the peripheral, autonomic, and cranial nerves. The objective of this report is to describe a case of a bulky laryngeal schwannoma, the surgical procedure for its removal, and the long-term patient follow-up. Case presentation A 19-year-old Brazilian woman presented to our institution with a complaint of progressive dyspnea over the preceding year, as well as dysphonia, dysphagia for solids, and globus pharyngeus. Direct rigid laryngoscopy showed a supraglottic tumor obstructing approximately 90% of the larynx. With the symptoms progressing to severe dyspnea, an emergency tracheostomy was performed. After infusion of intravenous contrast, magnetic resonance imaging revealed a mass lesion with intense, heterogeneous contrast enhancement along the posterior wall of the hypopharynx, blocking all of the lumen and measuring 2.8 cm and 2.2 cm at its largest diameters. The image suggested a neoplastic lesion. The patient underwent open surgery for tumor resection. Her postsurgical recovery was uncomplicated. Histopathology and immunohistochemistry revealed the tumor to be a laryngeal schwannoma. Conclusion The definitive diagnosis of laryngeal lesions can be difficult, and histopathology plays a pivotal role. Laryngeal schwannomas are rare; however, tumors can become large and may ultimately lead to airway obstruction.

Late adult-onset Hereditary Sensory and Motor Neuropathy due to TECPR2 mutations

Objective: The description of a new genetic association with late-onset axonal Charcot-Marie-Tooth disease (CMT). Method. A 57-year-old Brazilian woman presented with a slowly progressive history of paresthesia, muscle wasting and weakness in her lower limbs since age 50 years. Examination disclosed peroneal amyotrophy, bilateral pes cavus, mild distal weakness, reduced vibration, pain and temperature sensation in the the lower limbs and brisk tendon reflexes. Results. Neurophysiological studies showed chronic sensorimotor axonal polyneuropathy. Whole-genome sequencing showed compound heterozygous pathogenic variants in the TECPR2 gene (14q32.31). Conclusion. This novel genetic presentation of late-onset axonal CMT with brisk tendon reflexes associated with TECPR2.

The House of the Brazilian Woman: impacts of a cross-sectoral public health policy for abused women

Issue Violence against women is a serious public health concern in Brazil; the country ranks 5th globally for femicide and has high rates of intimate partner violence. In response, a national policy created the House of the Brazilian Woman (HBW). HBWs aimed at caring for abused women, are staffed 24/7 with multi-disciplinary teams; cross-sectoral services include: psychosocial support; healthcare; specialized police; courts; public attorney's offices; temporary shelter; and access to financial support. Description of the Problem The purpose of this study was to characterize the preliminary impacts of the HBW of Curitiba. Based on mixed-methods participatory action-research, data were collected between 2018-2020. We present quantitative measures describing the individuals served and a thematic analysis of in-depth interviews with HBW staff. Results Since its opening, in 2016, the HBW of Curitiba has served around 50,000 users, including women and perpetrators. The most prevalent type of violence reported was psychological (67%, n = 14,343), followed by physical (25.8%, n = 5,531), economic (5.2%, n = 1,104) and sexual (2%, n = 428). Positive qualitative impacts perceived by staff were: 1) improved women's empowerment; 2) the importance of centralized resources; 3) acting as a support to ensure existing legal protections. The main challenges were: 1) high demand; 2) discontinuous care; 3) negative impacts on staff's health. Lessons The HBW of Curitiba is a key cross-sectoral service for abused women, part of a greater national policy to prevent violence and support women. Despite serving a large number of women in a short period of time challenges remain including integration with other parts of the network and considerations of staff burnout. Key messages Effective cross-sectoral policies for abused women are paramount for comprehensive women’s health. Having cross-sectoral services in just one place operating 24/7 has high impact for abused women.

One Health Education for Future Physicians: A Case Report of Cat-Transmitted Sporotrichosis

A healthy 35-year-old Brazilian woman presented with persistent redness, swelling, and multiple wounds on the hand 2 weeks after a cat bite in her home country. She was treated twice with amoxicillin-clavulanate but failed to demonstrate improvement. She then presented to our institution with a newly developed abscess on the right hand. Incision and drainage were performed and she was admitted to the hospital. She was subsequently treated with broad-spectrum antibiotics. Her symptoms improved but did not resolve. Four days after hospital discharge, a wound culture resulted as positive for Sporothrix schenchii. The patient was treated with itraconazole. Sporotrichosis is endemic in many countries including Brazil and is known to be transmitted by cat bites. Sporotrichosis should be considered in the differential diagnosis for patients who have symptoms of cellulitis after cat bites in an endemic area.

“When I discovered I was índia”: racialization processes in the migratory experiences of peruvians in Rio Janeiro

In this article, I reflect upon the ways in which Peruvians in Rio de Janeiro negotiate their process of racialization, based on the category Indian and their interaction with me, a Black Brazilian woman. Despite the fact that Indian is part of both the Brazilian and Peruvian racial classification system, this category has particular meanings in each context. When they “discover” they are Indians”, Peruvians face the specificities of anti-Indigenous racism in the urban context of Rio de Janeiro. They also deal with discrimination within the Peruvian community. This article analyzes the case of Peruvians who create self-definitions (Hill-Collins, 2016), both individually and collectively, that challenge stereotypes of peruanidad. Racialization also opens up possibilities for anti-racist solidarity between Peruvians and Black Brazilians. My research is based on ethnographic fieldwork carried out in Brazil and the United States from 2011 to 2016.