Revista da Sociedade Brasileira de Medicina Tropical最新文献

{"title":"Snakebite Envenomations In The Brazilian Amazon: A Little Less Neglected.","authors":"Jacqueline Sachett, Fan Hui Wen, Allyson Guimarães da Costa, Felipe Murta, Erica Silva Carvalho, Felipe Queiroz Araújo, Vinícius Azevedo Machado, Alexandre Vilhena da Silva Neto, Pedro Ferreira Bisneto, Fernando Val, Luiz Carlos de Lima Ferreira, Elder Figueira, Marco Aurélio Sartim, Wuelton Monteiro","doi":"10.1590/0037-8682-0462-2025","DOIUrl":"10.1590/0037-8682-0462-2025","url":null,"abstract":"<p><p>Snakebite envenomations have a disproportionate burden in the Brazilian Amazon compared to other regions of Brazil. Studies conducted in the state of Amazonas show that Bothrops atrox snakebites are the most common, occurring in every municipality of the state. All the 62 municipalities in the state have at least one urban health unit that offers antivenom treatment. The most affected populations in terms of incidence and fatality rate are riverine communities and indigenous people, who have limited access to antivenom treatment. A significant proportion of cases are not reported to the official surveillance system, and many deaths occur due to lack of medical care. In the last decade, important advances have been made in research into snakebites in the state of Amazonas, in a collaborative network led by the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, a referral institution for patient care, teaching and research in tropical medicine. Findings on the burden of disease in vulnerable populations; clinical, therapeutic and pathophysiological aspects; long-term disabilities; barriers to antivenom treatment; and cultural aspects of snakebites, are presented in this paper. We highlight the findings of the SAVING Program, which aimed to implement a culturally tailored antivenom decentralization program in indigenous community-health centers. We conclude by presenting a priority research agenda for snakebites for the coming years in the Amazon region.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 suppl 1","pages":"e0462"},"PeriodicalIF":2.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B and Delta and the role of the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado.","authors":"Arlene Dos Santos Pinto, Yanka Karolinna Batista-Rodrigues, Ramon Peixoto de Castro, Bernardo Maia da Silva, Camila Helena Bôtto-Menezes, Marcia da Costa Castilho, Wornei Silva Miranda Braga","doi":"10.1590/0037-8682-0505-2025","DOIUrl":"10.1590/0037-8682-0505-2025","url":null,"abstract":"<p><p>Hepatitis B and D display a distinctive epidemiological pattern in the Western Amazon, disproportionately affecting Indigenous peoples and riverine populations across Brazil, Peru, Colombia, Venezuela, and Ecuador. Despite more than three decades of universal hepatitis B vaccination, moderate endemicity and a high burden of chronic carriers persist in the region. In the state of Amazonas, Brazil, the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD) has played a pivotal historical and contemporary role in the recognition, diagnosis, clinical management, surveillance, and research of HBV and HDV infections, serving as a major reference center for the region. The local health-care network is aligned with national policies but faces substantial challenges related to the vast geographic territory, strong centralization of specialized services in Manaus, and limited availability of trained professionals in endemic and remote areas. Logistical, socioeconomic, and cultural barriers continue to restrict timely access to diagnosis and treatment, while universal vaccination, widespread rapid testing, and ongoing decentralization efforts represent key facilitating factors. Looking ahead, the proposed research agenda emphasizes integrated surveillance, genomic and clinical-epidemiological studies, evaluation of the care cascade, and strengthening of primary health care as essential strategies to reduce regional inequalities and accelerate progress toward the elimination of viral hepatitis by 2030.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 suppl 1","pages":"e0505"},"PeriodicalIF":2.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate change and tropical medicine in the Amazon: contributions from a research center, gaps and future priorities.","authors":"Fernando Almeida-Val, Eduardo Fernandes Silva-Junior, Alexandre Vilhena Silva-Neto, Bernardo Maia Silva, Felipe Nery Saldanha Braga, Erika de Oliveira Gomes, Daniel Barros de Castro, Camila Fabbri, Luarle de Souza Lima, Felipe Leão Gomes Murta, Rubelmar Maia de Azevedo Cruz-Neto, Taynna Vernalha Rocha Almeida, Vanderson de Souza Sampaio, Guilherme Peixoto Tinôco Arêas, Wuelton Marcelo Monteiro","doi":"10.1590/0037-8682-0470-2025","DOIUrl":"10.1590/0037-8682-0470-2025","url":null,"abstract":"<p><p>The Amazon Basin is undergoing rapid climatic and environmental changes, with direct impacts on infectious disease transmission and public health. Rising temperatures, altered rainfall patterns, and more frequent extreme events are reshaping vector and pathogen dynamics. Additionally, deforestation and land-use change increase human and animal exposure. These combined factors intensify the risk of disease transmission in the region. This narrative review synthesizes evidence generated by researchers from a reference center in tropical medicine in the Amazon, integrating epidemiological analyses, experimental studies, ecological and predictive modelling, and health systems research conducted over the past decade. The evidence indicates that temperature and hydrological variability affect vector competence, pathogen development, and host-vector contact rates, producing nonlinear and context-dependent transmission outcomes. Extreme hydroclimatic events additionally disrupt healthcare delivery, hinder surveillance, and compromise continuity of care for infections requiring sustained treatment, such as tuberculosis and HIV. Emerging advances, including species distribution modelling, remote sensing, and integrated climate-epidemiological surveillance, provide predictive capacity to anticipate outbreaks and identify emerging hotspots. However, substantial research gaps persist, particularly regarding multi-stressor interactions, mechanistic pathways of climate-pathogen-vector adaptation, and health system resilience under climatic extremes. From the perspective of a reference center that integrates education, research, and healthcare delivery in tropical medicine, this article articulates a research agenda for climate-informed tropical medicine, highlighting priorities for interdisciplinary research, surveillance innovation, and adaptive public health strategies in the Amazon and other climate-sensitive regions.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 suppl 1","pages":"e0470"},"PeriodicalIF":2.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated paracoccidioidomycosis in a patient with human immunodeficiency virus infection with the spectroscopic detection of trehalose.","authors":"Bruno Rigonato, Mariani Garcia de Lima, Fernanda Veloso Pereira, Monica Jacques de Moraes, Fabiano Reis","doi":"10.1590/0037-8682-0106-2026","DOIUrl":"10.1590/0037-8682-0106-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01062026"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous sporotrichosis after contact with a domestic cat.","authors":"Júlia de Souza Lopes, Ianara Castor Soares, Luana Ferreira Marques Cordeiro, Joziana Muniz de Paiva Barçante, Leonardo Lima Gorza","doi":"10.1590/0037-8682-0074-2026","DOIUrl":"10.1590/0037-8682-0074-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00742026"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of a Suspected Autochthonous Cholera Case in Brazil After an 18-Year Absence of Reported Cases.","authors":"Maria Goreth Matos de Andrade Barberino, Ana Verena Almeida Mendes, Gabriela Noronha Marques, Camila Araújo de Lorenzo Barcia, Marcela Almeida Muhana, Aline Macedo Carvalho Freitas, Mariana Leal de Souza Mercês, Ênio Silva Soares, Lázaro José Rodrigues de Souza, Arabela Leal E Silva de Mello, Felicidade Mota Pereira, André Felipe das Mercês Santos, Dália Dos Prazeres Rodrigues, Guilherme de Sousa Ribeiro, Cristiane Wanderley Cardoso","doi":"10.1590/0037-8682-0558-2025","DOIUrl":"10.1590/0037-8682-0558-2025","url":null,"abstract":"<p><p>Cholera has caused multiple pandemics and remains a significant global public health threat. After 18 years without autochthonous transmission in Brazil, a 60-year-old man with no travel history presented with abdominal discomfort and acute watery diarrhea. Laboratory testing detected Vibrio cholerae O1 Ogawa, prompting classification as a suspected cholera case. However, genomic analysis showed that the strain lacked the toxigenic virulence factor required to cause cholera, leading to its reclassification as a non-cholera case. This investigation highlights the importance of clinical suspicion, advanced laboratory diagnostics, and continuous epidemiological surveillance for accurate case identification and an appropriate public health response.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e05582025"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchonodal fistula: An uncommon complication of tuberculosis.","authors":"Edson Marchiori, Bruno Hochhegger, Alexandre Dias Mançano, Gláucia Zanetti","doi":"10.1590/0037-8682-0127-2025","DOIUrl":"10.1590/0037-8682-0127-2025","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01272026"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an ICF Core Set for adults with Chagas disease: a qualitative study capturing patients' perspective on functioning.","authors":"Natielle Cecilia Santos Ottone, Henrique Silveira Costa, Sara Gabrielle Souza, Paulo Victor Mendes Santos, Rafael de Oliveira Castro, Pedro Henrique Scheidt Figueiredo, Vanessa Pereira de Lima, Marcus Alessandro de Alcantara","doi":"10.1590/0037-8682-0401-2025","DOIUrl":"10.1590/0037-8682-0401-2025","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease affects multiple dimensions of human functioning, requiring assessments that extend beyond the biomedical model. The International Classification of Functioning, Disability and Health (ICF) offers an integrative framework for capturing these impacts. This qualitative study aimed to identify, from the perspective of adults diagnosed with Chagas disease, the aspects of functioning most relevant to them, as a step toward developing an ICF Core Set for this population.</p><p><strong>Methods: </strong>Thirteen focus group discussions were conducted with adults diagnosed with Chagas disease, covering all ICF components. Two independent researchers extracted meaningful concepts from verbatim transcripts and linked them to ICF categories.</p><p><strong>Results: </strong>Thirty-two adults with Chagas disease participated. From the discussions, 248 concepts were identified and linked to 49 second-level ICF categories: 13 related to body functions, 5 to body structures, 18 to activities and participation, and 13 to environmental factors. The most frequently mentioned categories were sleep, pain, emotional functions, and cardiac functions. In the Activities and Participation component, limitations were noted in household tasks, mobility, and social participation, with spirituality emerging as a key coping resource. For Environmental Factors, immediate family support and access to healthcare services were identified as primary facilitators of functioning.</p><p><strong>Conclusion: </strong>Adults with Chagas disease reported impairments across a wide range of body functions and activities, underscoring the significant influence of environmental factors. The identified categories will serve as a foundation of candidate items to support the consensus process for developing an ICF Core Set for adults with Chagas disease.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e04012025"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Life-Threatening Urinary Emergency: Radiologic Characterization of Emphysematous Pyelonephritis.","authors":"Ramazan Kerim Yılmaz, Huseyin Er, Kemal Bugra Memis, Ayse Sena Celik, Sonay Aydin","doi":"10.1590/0037-8682-0011-2026","DOIUrl":"10.1590/0037-8682-0011-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00112026"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil dysmorphisms and extracellular trap-like structures in a patient with severe coronavirus disease 2019.","authors":"Andrezza do Espirito Santo Cucinelli, Diêgo Roberto Dos Santos, Hye Chung Kang, Isabela Resende Pereira","doi":"10.1590/0037-8682-0099-2026","DOIUrl":"10.1590/0037-8682-0099-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00992026"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}