RESUMOIntrodução: A AIDS entre adultos mais velhos é um problema de saúde pública emergente. Comparamos o perfil epidemiológico e sociodemográfico, bem como a evolução e a tendência da epidemia entre homens e mulheres nas faixas etárias de 50 anos e mais e 20 a 39 anos acometidos pela AIDS, no Estado do Espírito Santo, Brasil. Métodos: Realizamos um estudo de série temporal, com dados secundários do SINAN/AIDS, no período de Janeiro de 1991 a dezembro 2006. Resultados: Neste período, foram notificados 3.382 casos de AIDS em indivíduos com idade entre 20 e 39 anos e 551 casos entre indivíduos com 50 anos e mais. Em ambas as faixas etárias, os mais acometidos são os homens. Há diferenças referentes à raça/ cor, em que a maioria dos mais velhos são brancos (45,3% -p-valor = 0,044) e os mais jovens pardos (44,7%, p-valor = 0,003). O analfabetismo prevalece entre os mais velhos (17,7% -p-valor = 0,001). Mais da metade (80%) das notificações ocorreu em municípios de médio a grande porte. A principal categoria de exposição foi a heterossexual, em ambos as faixas etárias, com maior frequência para o grupo de 50 anos ou mais (77,3% -p=0,0001). A incidência acumulada é maior para a faixa etária de 20 a 39 anos (R 2 =0,68); porém, vem aumentando proporcionalmente, entre as duas faixas no decorrer dos anos, com tendência de crescimento significativa para ambas (p <0,01). Conclusões: A epidemia de AIDS pode ser considerada em expansão entre mais velhos no Espirito Santo. Palavras-chaves:Saúde pública. Epidemiologia. Envelhecimento. AIDS. ABSTRACTIntroduction: AIDS among older adults is a public health problem emerging. This study compared the demographic and epidemiological profile and the evolution and trend of the epidemic among men and women aged 50 years and older and 20 to 39 years affected by AIDS in the State of Espirito Santo, Brazil. Methods: We conducted a time serie study with secondary data from SINAN/AIDS for the period January 1991 to December 2006. Results: In this period were 3,382 reported cases of AIDS in individuals aged 20 to 39 years and 551 cases among individuals with 50 years or older. In both age groups most affected are men. There are differences related to race or color, where the majority of the older is white (45.3% -p-value = 0.044) and the young brown (44.7%, p = 0.003). Illiteracy prevails among the older (17.7% -p-value = 0.001). More than half (80%) of the notifications occurred in cities of medium to large. The main risk factor was heterosexual in both the age groups more frequently to the group of 50 or more (77.3% -p = 0.0001). The cumulative incidence is higher for the age group 20 to 39 years (R 2 = 0.68), but is increasing proportionally between the two bands over the years, with a significant upward trend for both (p<0.01). Conclusions: The AIDS epidemic among the elderly can be seen growing among older on the Espirito Santo State.

The consequences of exposure to environmental contaminants have shown significant effects on brain function and behavior in different experimental models. The endocrine-disrupting chemicals (EDC) present various classes of pollutants with potential neurotoxic actions, such as organotins (OTs). OTs have received special attention due to their toxic effects on the central nervous system, leading to abnormal mammalian neuroendocrine axis function. OTs are organometallic pollutants with a tin atom bound to one or more carbon atoms. OT exposure may occur through the food chain and/or contaminated water, since they have multiple applications in industry and agriculture. In addition, OTs have been used with few legal restrictions in the last decades, despite being highly toxic. In addition to their action as EDC, OTs can also cross the blood–brain barrier and show relevant neurotoxic effects, as observed in several animal model studies specifically involving the development of neurodegenerative processes, neuroinflammation, and oxidative stress. Thus, the aim of this short review is to summarize the toxic effects of the most common OT compounds, such as trimethyltin, tributyltin, triethyltin, and triphenyltin, on the brain with a focus on neuronal damage as a result of oxidative stress and neuroinflammation. We also aim to present evidence for the disruption of behavioral functions, neurotransmitters, and neuroendocrine pathways caused by OTs.

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Yellow Fever (YF) vaccination is suggested to induce a large number of adverse events (AE) and suboptimal responses in patients with autoimmune diseases (AID); however, there have been no studies on 17DD-YF primary vaccination performance in patients with AID. This prospective non-interventional study conducted between March and July, 2017 assessed the safety and immunogenicity of planned 17DD-YF primary vaccination in patients with AID. Adult patients with AID (both sexes) were enrolled, along with healthy controls, at a single hospital (Vitória, Brazil). Included patients were referred for planned vaccination by a rheumatologist; in remission, or with low disease activity; and had low level immunosuppression or the attending physician advised interruption of immunosuppression for safety reasons. The occurrence of AE, neutralizing antibody kinetics, seropositivity rates, and 17DD-YF viremia were evaluated at various time points (day 0 (D0), D3, D4, D5, D6, D14, and D28). Individuals evaluated (n = 278), including Valim et al. Yellow Fever Vaccination-Autoimmune Diseases patients with rheumatoid arthritis (RA; 79), spondyloarthritis (SpA; 59), systemic sclerosis (8), systemic lupus erythematosus (SLE; 27), primary Sjögren's syndrome (SS; 54), and healthy controls (HC; 51). Only mild AE were reported. The frequency of local and systemic AE in patients with AID and HC did not differ significantly (8 vs. 10% and 21 vs. 32%; p = 1.00 and 0.18, respectively). Patients with AID presented late seroconversion profiles according to kinetic timelines of the plaque reduction neutralization test (PRNT). PRNT-determined virus titers (copies/mL) [181 (95% confidence interval (CI), 144-228) vs. 440 (95% CI, 291-665), p = 0.004] and seropositivity rate (78 vs. 96%, p = 0.01) were lower in patients with AID after 28 days, particularly those with SpA (73%) and SLE (73%), relative to HC. The YF viremia peak (RNAnemia) was 5-6 days after vaccination in all groups. In conclusion, consistent seroconversion rates were observed in patients with AID and our findings support that planned 17DD-YF primary vaccination is safe and immunogenic in patients with AID.

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