Tratamento da sífilis congênita e sua repercussão na rotina neonatal / Treatment of congenital syphilis and its impact on the neonatal routine

Introdução: A sífilis é uma doença infecto-contagiosa transmitida pela via sexual (sífilis adquirida) e verticalmente (sífilis congênita) durante a gestação pela placenta da mãe para o feto. Objetivos: Apresentar o tratamento proposto pelo Ministério da Saúde através do protocolo clínico atual para Sífilis transmitida verticalmente e relatar se foi uma opção viável, já que não havia a disponibilidade da Benzilpenicilina Procaína em todos os estados brasileiros; analisar quantas internações por um período mínimo de 10 dias poderiam ter sido evitadas se houvesse a disponibilidade da Benzilpenicilina Procaína conforme está no protocolo do Ministério da Saúde sendo notada a falta de tal medicação, prioritariamente, no Estado de São Paulo. Método: Estudo retrospectivo, investigativo, com revisão de prontuários de 23 gestantes com Sífilis e os respectivos recém-nascidos durante todo o ano de 2020, na maternidade de um hospital escola em Catanduva-SP. Resultados: Todos os recém-nascidos de mães com Sífilis na gestação recebiam o tratamento e/ou o seguimento para Sífilis Congênita de acordo com o teste - VDRL colhido ao nascimento. O tratamento para Sífilis Congênita sem Neurossífilis foi realizado com Benzilpenicilina Cristalina durante 10 dias, por via endovenosa, em quatorze bebês (56,5%). Destas 14 internações, apenas um caso de Sífilis Congênita com Neurossífilis realmente necessitava permanecer internada para tratamento endovenoso com Benzilpenicilina Cristalina. Uma mãe evadiu-se do hospital com o recém-nascido e não completou o tratamento no hospital-escola deste estudo, e para oito (34,8%) bebês definiu-se apenas o seguimento ambulatorial como conduta de acordo com as diretrizes do Ministério da Saúde. Em relação às intercorrências acometidas aos bebês que ficaram internados foram basicamente a dificuldade de amamentação e a perda do acesso venoso periférico com recorrência. Conclusão: A discordância nas Diretrizes do Ministério da Saúde para o tratamento da Sífilis Congênita, mesmo as mais atualizadas (2020), ocorre em decorrência da indisponibilidade desta medicação de baixo custo, Benzilpenicilina Procaína, aplicada intramuscular, o que facilita sua administração a nível de Unidades Básicas de Saúde e dispensa a internação hospitalar de bebês com necessidade de tratamento para a Sífilis Congênita sem Neurossífilis. Com isso, o trabalho sugere que a disponibilização da Benzilpenicilina Procaína para o tratamento dos casos simples de Sífilis Congênita culminará em incontáveis benefícios para o binômio mãe-bebê

Introduction: Syphilis is an infectious contagious disease transmitted sexually (acquired syphilis) and vertically (congenital syphilis) during pregnancy through the placenta from the mother to the fetus. Objectives: To prove whether the treatment proposed by the Ministry of Health through the current clinical protocol for vertically transmitted syphilis is a viable option, since Benzylpenicillin Procaine is not available in all Brazilian states; and to analyze how many hospitalizations for a minimum period of 10 days could have been avoided if Benzylpenicillin Procaine had been available as per the Ministry of Health protocol, with the lack of such medication being noted, primarily, in the State of São Paulo. Method: Retrospective, investigative study, reviewing the medical records of 23 pregnant women with Syphilis and their newborns throughout the year 2020, in the maternity hospital of a teaching hospital in Catanduva-SP. Results: All newborns of mothers with Syphilis during pregnancy received treatment and/or follow-up for Congenital Syphilis according to the test - VDRL collected at birth. Treatment for Congenital Syphilis without Neurosyphilis was performed with crystalline Benzylpenicillin for 10 days, intravenously, in fourteen babies (56.5%). Of these 14 hospitalizations, only one case of Congenital Syphilis with Neurosyphilis really needed to remain hospitalized for intravenous treatment with Crystalline Benzylpenicillin. One mother escaped from the hospital with the newborn and did not complete the treatment at the Hospital-Escola, and eight (34.8%) babies were defined only as outpatient follow-up as conduct in accordance with the guidelines of the Ministry of Health. Regarding the complications affected by the babies who were hospitalized, they were basically the difficulty in breastfeeding and the loss of peripheral venous access with recurrence. Conclusion: Disagreement in the Guidelines of the Ministry of Health for the treatment of Congenital Syphilis, even the most up-to-date ones (2020) occurs due to the unavailability of this low-cost medication, Benzylpenicillin Procaine, applied intramuscularly, which facilitates its administration at the Unit level Health Basics and waives the hospitalization of babies in need of treatment for Congenital Syphilis without Neurosyphilis. With this, the work suggests that the availability of Procaine Benzylpenicillin for the treatment of simple cases of Congenital Syphilis will culminate in countless benefits for the mother baby binomial

Introducción: La sífilis es una enfermedad infectocontagiosa de transmisión sexual (sífilis adquirida) y vertical (sífilis congénita) durante el embarazo a través de la placenta de la madre al feto. Objetivos: Probar si el tratamiento propuesto por el Ministerio de Salud a través del protocolo clínico vigente para la sífilis de transmisión vertical es una opción viable, ya que la Bencililpenicilina Procaína no está disponible en todos los estados brasileños; y analizar cuántas hospitalizaciones por un período mínimo de 10 días se podrían haber evitado si la bencililpenicilina procaína hubiera estado disponible según el protocolo del Ministerio de Salud, observándose la falta de dicha medicación, principalmente, en el estado de São Paulo. Método: Estudio retrospectivo, investigativo, revisando las historias clínicas de 23 gestantes con Sífilis y sus recién nacidos a lo largo del año 2020, en la maternidad de un hospital universitario de Catanduva-SP. Resultados: Todos los recién nacidos de madres con Sífilis durante el embarazo recibieron tratamiento y/o seguimiento para Sífilis Congénita según prueba - VDRL recogido al nacer. El tratamiento de la Sífilis Congénita sin Neurosífilis se realizó con Bencilpenicilina cristalina durante 10 días, por vía intravenosa, en catorce bebés (56,5%). De estas 14 hospitalizaciones, solo un caso de Sífilis Congénita con Neurosífilis necesitó realmente permanecer hospitalizado para recibir tratamiento intravenoso con Bencilpenicilina Cristalina. Una madre se escapó del hospital con el recién nacido y no completó el tratamiento en el hospital escuela en este estudio, y ocho (34,8%) bebés fueron definidos solo como seguimiento ambulatorio como conducta de acuerdo con las directrices del Ministerio de Salud. En cuanto a las complicaciones que afectaron a los bebés que fueron hospitalizados fueron básicamente la dificultad en la lactancia y la pérdida del acceso venoso periférico con recurrencia. Conclusión: La inconformidad en las Directrices del Ministerio de Salud para el tratamiento de la Sífilis Congénita, incluso las más actualizadas (2020) se da por la indisponibilidad de este medicamento de bajo costo, la Bencilpenicilina Procaína, de aplicación intramuscular, que facilita su administración a nivel de Unidad Básicos de Salud y renuncia a la hospitalización de bebés con necesidad de tratamiento por Sífilis Congénita sin Neurosífilis. Con ello, el trabajo sugiere que la disponibilidad de la Bencilpenicilina Procaína para el tratamiento de casos simples de Sífilis Congénita culminará en innumerables beneficios para el binomio madre-bebé

Pantanal yacare (Caiman yacare) tail fillets subjected to traditional hot smoking and liquid smoke.

BACKGROUND: The present study aimed to evaluate the effects of hot smoking and liquid smoke on process yield, physicochemical properties, microbiological parameters, fatty acid profile, benzo(a)pyrene levels, and sensory profile of Pantanal yacare tail fillets. The fillets were subjected to two types of smoking processes: hot smoking and liquid smoke flavoring. RESULTS: The process yield of liquid-smoked fillets was higher (69.8%) compared to hot-smoked fillets (58.0%). All fillets were with good microbiological quality and low benzo(a)pyrene levels and were well accepted by consumers. The hot-smoked fillets and the liquid-smoked fillets presented 456.2 and 589.7 g kg-1 moisture, 262.3 and 263.7 g kg-1 crude protein, 218 and 85 g kg-1 total lipids, and 26.0 and 20.9 g kg-1 ash, respectively. The major fatty acids identified in the smoked tail fillets were palmitic, stearic, oleic, and linoleic acids. CONCLUSION: The liquid-smoked fillets had lower lipid content, and higher process yield because of lower losses; thus, they proved to be more advantageous and practical to obtain than the hot-smoked fillets. © 2022 Society of Chemical Industry.

Avaliação do desempenho de um contrato de gestão entre uma organização social de saúde (OSS) e prefeitura de uma cidade do interior paulista / Evaluation of the performance of a management contract between a health social organization and the mayor of a city in the interior of São Paulo

Introdução: A Organização Social de Saúde é uma entidade sem fins lucrativos que se encontra em estágio de expansão e há uma nítida divergência de opiniões quanto a sua efetividade e cumprimento das metas designadas pelo contrato de gestão proposto pelas instituições públicas. Objetivo: Analisar se há o cumprimento de metas estabelecidas pelo con-trato de gestão entre a Prefeitura Municipal de Catanduva/SP e o Hospital Psiquiátrico Espírita Mahatma Gandhi (OSS). Métodos: É um estudo descritivo e transversal. A coleta de dados foi realizada a partir do Relatório do Observatório de Saúde de Catanduva de 2019, estabelecendo uma relação comparativa com as metas propostas no Contrato de Gestão vigente. Foram analisadas as seguintes variáveis: número de consultas médicas, número de consultas de enfermagem e taxa de encaminhamento médico nas Unidades de Saúde da Família. Resultados: Em relação à taxa de encaminhamen-tos realizados durante o ano de 2019 em todas as USF, a média foi inferior ao valor de referência estabelecido no contra-to, sugerindo alta taxa de resolubilidade desses serviços. Além disso, produção médica e de enfermagem nas Unidades de Saúde da Família do município de Catanduva encontra-se, em sua maioria, acima do previsto no contrato de gestão, representando o cumprimento dos valores estabelecidos pela contratante. Conclusão: As metas atribuídas à OSS no contrato foram cumpridas pelas unidades de saúde conforme os valores pactuados pela Prefeitura Municipal (AU)

Introduction: The Social Health Organization is a non-profit entity that is in an expansion stage and there is a clear divergence of opinions regarding its effectiveness and compliance with the goals designated by the man-agement contract proposed by public institutions. Objective: To evaluate if the goals established by the manage-ment contract between the City of Catanduva / SP and the Psychiatric Hospital Spiritist Mahatma Gandhi (OSS) are met. Methods : It is an observational, descriptive and cross-sectional study. Data collection was carried out based on the 2019 Catanduva Health Observatory Report, establishing a comparative relationship with the goals proposed in the current Management Contract. The following variables were analyzed: number of medical consultations, number of nursing consultations and medical resolvability index in Family Health Units. Results: Regarding medical resolution, the average rate of referrals made during 2019 in all FHUs was lower than the reference value established in the contract, suggesting a high rate of resolution of these services. In addition, medical and nursing production in the Family Health Units in the municipality of Catanduva is mostly above that provided for in the management contract, representing compliance with the values established by the contractor. Conclusion: The targets assigned to the OSS in the contract were met by the health units in accordance with the values agreed by the City Hall (AU)

Antiprotozoal agents: How have they changed over a decade?

Neglected tropical diseases are a diverse group of communicable diseases that are endemic in low- or low-to-middle-income countries located in tropical and subtropical zones. The number and availability of drugs for treating these diseases are low, the administration route is inconvenient in some cases, and most of them have safety, efficacy, or adverse/toxic reaction issues. The need for developing new drugs to deal with these issues is clear, but one of the most drastic consequences of this negligence is the lack of interest in the research and development of new therapeutic options among major pharmaceutical companies. Positive changes have been achieved over the last few years, although the overall situation remains alarming. After more than one decade since the original work reviewing antiprotozoal agents came to light, now it is time to question ourselves: How has the scenario for the treatment of protozoal diseases such as malaria, leishmaniasis, human African trypanosomiasis, and American trypanosomiasis changed? This review covers the last decade in terms of the drugs currently available for the treatment of these diseases as well as the clinical candidates being currently investigated.

Chimeric Protein Designed by Genome-Scale Immunoinformatics Enhances Serodiagnosis of Bovine Neosporosis.

Neosporosis has become a concern since it is associated with abortion in cattle. Currently, in situ diagnosis is determined through anamnesis, evaluation of the history, and perception of the clinical signs of the herd. There is no practical and noninvasive test adapted to a large number of samples, which represents a gap for the use of new approaches that provide information about infections and the risks of herds. Here, we performed a search in the Neospora caninum genome by linear B-cell epitopes using immunoinformatic tools aiming to develop a chimeric protein with high potential to bind specifically to antibodies from infected cattle samples. An enzyme-linked immunosorbent assay with the new chimeric antigen was developed and tested with sera from natural field N. caninum-infected bovines. The cross-reactivity of the new antigen was also evaluated using sera from bovines infected by other abortive pathogens, including Trypanosoma vivax, Leptospira sp., Mycobacterium bovis, and Brucella abortus, and enzootic bovine leucosis caused by bovine leukemia virus, as well as with samples of animals infected with Toxoplasma gondii The assay using the chimeric protein showed 96.6% ± 3.4% of sensitivity in comparison to healthy animal sera. Meanwhile, in relation to false-positive results provided by cross-reactivity with others pathogens, the specificity value was 97.0% ± 2.9%. In conclusion, immunoinformatic tools provide an efficient platform to build an accurate protein to diagnose bovine neosporosis based on serum samples.

Optimized strategy for in vivo Cas9-activation in Drosophila.

While several large-scale resources are available for in vivo loss-of-function studies in Drosophila, an analogous resource for overexpressing genes from their endogenous loci does not exist. We describe a strategy for generating such a resource using Cas9 transcriptional activators (CRISPRa). First, we compare a panel of CRISPRa approaches and demonstrate that, for in vivo studies, dCas9-VPR is the most optimal activator. Next, we demonstrate that this approach is scalable and has a high success rate, as >75% of the lines tested activate their target gene. We show that CRISPRa leads to physiologically relevant levels of target gene expression capable of generating strong gain-of-function (GOF) phenotypes in multiple tissues and thus serves as a useful platform for genetic screening. Based on the success of this CRISRPa approach, we are generating a genome-wide collection of flies expressing single-guide RNAs (sgRNAs) for CRISPRa. We also present a collection of more than 30 Gal4 > UAS:dCas9-VPR lines to aid in using these sgRNA lines for GOF studies in vivo.

Commercial cuts of Pantanal caiman meat according to sex / Caracterização dos cortes comerciais da carne de jacaré-do-Pantanal em função do sexo

ABSTRACT: This study evaluated the yield, color, and chemical composition of commercial cuts (tail, sirloin cut, back fillet, and thigh) of Pantanal caiman meat in both sexes. The yield of tail was higher than other cuts, and the yield of females (17.0%) was higher than males (15.9%). The thigh of males had lower protein content (20.8%) compared with other cuts. Females showed a higher lipid content in the tail (2.4%) and thigh (0.8%) compared with males (1.7% and 0.4%, respectively). The tail presented the greatest content of monounsaturated fatty acids (45.2%) and higher n6/n3 ratio (4.6). Although lightness was not different among cuts or between sexes, there were differences in color. Males have more yellowish meat compared with females. Thigh and back fillet were more reddish when compared to sirloin cut and tail, regardless of sex. In conclusion, female tail meat provided greater yield and lipid content than males, and this result was statistically significant. These findings can help producers and consumers alike, better understand yield, quality, and nutritional quality of Pantanal caiman meat.

RESUMO: Objetivando avaliar rendimento, cor e composição química dos cortes comerciais (cauda, filé de lombo, filé de dorso e coxa) da carne do jacaré-do-Pantanal nos diferentes sexos, foram processados 20 animais, sendo estes, dez fêmeas (3677g) e dez machos (3510g). Não houve interação significativa (P>0,05) entre cortes comerciais e sexo para peso dos cortes, teor de umidade e cor. O rendimento da cauda foi superior aos demais cortes, sendo o rendimento das fêmeas (17.0%) superior ao dos machos (15,9%). A coxa dos machos apresentou menor teor de proteína (20,8%), em relação aos demais cortes. As fêmeas apresentaram maior teor de lipídeos na cauda (2,4%) e na coxa (0,8%), em relação aos machos (1,7% e 0,4%, respectivamente). A cauda apresentou maior quantidade de ácidos graxos monoinsaturados (45,2%) e maior razão n6/n3 (4,6). A luminosidade não foi diferente entre cortes e sexos. Os machos apresentaram carne com coloração mais amarelada em relação às fêmeas, e a coxa e o filé de dorso tiveram cor mais avermelhada, comparadas ao filé de lombo e cauda, independente do sexo. Concluiu-se que houve influência do sexo no corte de cauda, para o teor de lipídios e rendimento, sendo que a fêmea apresentou rendimento e lipídeos maiores que o macho.

Yacare caiman (Caiman yacare) trim hamburger and sausage subjected to different smoking techniques.

BACKGROUND: Caiman, as well as having skin that, after tanning, produces leather of high added value, exceptional quality and good market value, also possesses a meat with a remarkably smooth taste and appearance. This study aimed to characterize hamburger and sausages made from Yacare caiman (Caiman yacare) meat trim. RESULTS: Hot smoked products contained less moisture than the unsmoked products. Protein and ash were higher, respectively, for hot smoked hamburger and sausage. Lipids had greater presence in hot smoked sausage (9.72%), whereas in the burgers they were higher in the liquid smoked burgers (6.71%). The hot smoked products had lower water activity. Hot smoked products displayed less luminance, but the a* and b* chroma were higher in smoked hamburgers. Taste, texture and general acceptability were significant for the hamburger, whereas for the sausage there was a significant effect for texture, salt and purchase intent. CONCLUSION: For all the products, the hot smoking resulted in the lowest acceptability.