Epidemiological Profile of Victim Patients of Facial Canine and Human Bites in a Public Hospital.

INTRODUCTION: Bites are among the most common types of trauma to which humans are exposed. The possibility of disfiguring lesions and the transmission of infectious diseases with high morbidity make this trauma a public health problem. METHOD: This was a retrospective, descriptive study that analyzed the medical records of patients treated at the Emergency Unit of the Plastic Surgery Service of the Asa Norte Regional Hospital from March 2019 to March 2020. The variables analyzed included age, sex, origin, time interval from aggression to hospital care, aggressor agent, wound site, lesion characteristics, and treatment. RESULTS: A total of 103 patients with a mean age of 25 years were evaluated. Most patients were male (57.3%), and 73.8% were from the Federal District. The most common type of treatment was direct suturing in 77.7% of cases, followed by local flaps (15.5%) or grafts (4.9%). There were no deaths or infections reported. CONCLUSION: The predominant profile of a facial bite victim is a young male adult living in the Federal District, bitten by a canine and treated with direct sutures. Adequate treatment for animal bites should include prevention of infection, such as rabies and tetanus, as well as primary wound closure for achieving a better prognosis and satisfactory esthetics for the patient.

Near-term pregnant women in the Dominican Republic experience high rates of Group B Streptococcus rectovaginal colonization with virulent strains.

Maternal colonization with Group B Streptococcus (GBS) is an important cause of stillbirth, prematurity, and serious infection and death in infants worldwide. Resource constraints limit prevention strategies in many regions. Maternal GBS vaccines in development could be a more accessible prevention strategy, but data on geographic variations in GBS clones are needed to guide development of a broadly effective vaccine. In the Dominican Republic (DR), limited data suggest that pregnant women experience GBS colonization at rates among the highest globally. We aimed to determine the prevalence of maternal rectovaginal GBS colonization and describe clonal characteristics of colonizing strains in the DR. A cross-sectional study assessed rectovaginal GBS colonization in 350 near-term pregnant women presenting for routine prenatal care at an urban tertiary center in the DR. Rectovaginal samples were tested with chromogenic Strep B Carrot Broth and cultured for confirmatory whole-genome sequencing. In a secondary analysis, participants' demographics and histories were assessed for association with GBS colonization. Rectovaginal GBS colonization occurred in 26.6% of women. Serotypes Ia, Ib, II, III, IV, and V were detected, with no one serotype predominating; serotype III was identified most frequently (21.5%). Virulent and emerging strains were common, including CC17 (15.1%) and ST1010 (17.2%). In this first characterization of maternal GBS serotypes in the DR, we found high rates of rectovaginal colonization including with virulent and emerging GBS strains. The serotypes observed here are all targeted by candidate hexavalent GBS vaccines, suggesting effective protection in the DR.

Atenção primária em Sergipe: o olhar de médicos cubanos e brasileiros do programa Mais Médicos / Primary Care in Sergipe: The view of Cuban and Brazilian doctors from the Mais Médicos program

Objetivo: Avaliar através da perspectiva dos profissionais do Programa Mais Médicos (PMM), a Atenção Primária à Saúde (APS), com base nos atributos essenciais e derivados e identificando diferenças nas avaliações de médicos brasileiros e médicos cubanos. Materiais e métodos: Trata-se de um estudo transversal utilizando o Instrumento de Avaliação da Atenção Primária (Primary Care Assessment Tool - PCATool) para profissionais da saúde com os médicos do Programa Mais Médicos (PMM) lotados no estado de Sergipe no período de 1° de dezembro de 2017 a 31 de janeiro de 2018. Os médicos foram subdivididos em 2 grupos: médicos brasileiros do PMM (PMM Brasil) e médicos cubanos do PMM (PMM Cuba). Resultados:Foram respondidos 182 questionários, sendo 87 PMM Brasil e 95 PMM Cuba. A média dos escores geral e essencial corresponde, respectivamente, a 7,72 e 7,37. O atributo acessibilidade foi o que obteve pior avaliação (4,8), tanto entre PMM Brasil quanto PMM Cuba. O atributo com melhor avaliação em ambos os grupos foi a orientação familiar (9,11). Os médicos de equipes que participaram do Programa Nacional da Melhoria e do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) apontaram proporcionalmente maior escore geral considerado alto, assim como nos atributos de integralidade (serviços disponíveis) e orientação comunitária. Conclusões: O estudo identifica que, apesar das diferenças na avaliação entre PMM Brasil e PMM Cuba, os dois grupos demonstram uma orientação para os atributos da APS, com grande fragilidade quanto à acessibilidade.

Um exame improvável: a regulamentação da medicina sob a lente da teoria dos sistemas / An improbable examination: regulation of medicine through the lens of systems theory

Este artigo pretende observar sociologicamente, com base na teoria dos sistemas, as questões suscitadas pelo debate sobre a regulamentação da medicina. O conhecimento construído no presente trabalho orienta-se por uma reflexão acerca da capacidade do direito de encaminhar os conflitos que surgem no bojo dessa regulamentação. Nesse contexto, examina se o direito é capaz de regular a medicina ou de controlar os possíveis efeitos da legislação. O artigo também aponta para um quadro teórico útil na análise das relações entre o direito e o tratamento de doentes na sociedade moderna. A partir de uma observação sistêmica de eventos históricos referentes ao tema, a relação entre o direito e o tratamento de doentes é descrita em sua evolução. O tratamento de doentes apresenta desafios e alternativas ao direito. Este seleciona certas expectativas e deixa outras tantas sem o mesmo respaldo. Ao fazê-lo, não determina o tratamento de doentes nem o substitui.

This article aims at analyzing in a sociological approach, based on systems theory, issues raised by the current debate about the regulation of medicine. The knowledge built in this paper is guided by a reflection on the ability of the law to address the conflicts brought to light by such regulation. In this context, it examines whether the law is able to regulate medicine or to control the possible effects of legislation. The paper also points to a useful theoretical framework to analyze the relationship between law and treatment of patients in a modern society. From a systemic observation of historical events related to the subject, the relationship between law and treatment of patients is described in its evolution. Treatment of patients presents challenges and alternatives to the law which selects certain expectations and leaves so many without the same support. In doing so, the law does not determine the treatment of patients or replace it in its specific function, but law’s decision reverberate in the operations of the system and present issues also for other social systems.

Susceptibility of non-target invertebrates to Brazilian microbial pest control agents.

Microbial pest control agents or entomopathogens have been considered an interesting alternative to use instead of chemical insecticides. Knowledge of ecotoxicity data is very important to predict the hazard of any product released in the environment and subsidize the regulation of these products by governmental agencies. In the present study four new Brazilian strains of Bacillus and one fungus were tested to evaluate their acute toxicity to the microcrustacean Daphnia similis, the snail Biomphalaria glabrata and the dung beetle Digitonthophagus gazella. The microcrustaceans and the snails were exposed to entomopathogens in synthetic softwater and the beetles were exposed directly in cattle dung. Obtained data reveal low susceptibility of the non-target species to tested microorganisms, with lethal concentrations being observed only at much higher concentrations than that effective against target insects. These results show that the tested strains are selective in their action mode and seem to be non-hazardous to non-target species.

Acute toxicity and cytotoxicity of Bacillus thuringiensis and Bacillus sphaericus strains on fish and mouse bone marrow.

The insecticidal properties of delta-endotoxins from Bacillus thuringiensis (Bt) serotypes kurstaki and israelensis and crystal proteins of Bacillus sphaericus (Bs) serotype H5 have been used in insect control for decades. The availability of microbial toxins in biopesticides as well as in plants with incorporated protection has been increasing the concerns about biosafety. Acute toxicity to Danio rerio and cytotoxicity on mouse bone marrow cells and peripheral erythrocytes of Oreochromis niloticus were tested with Bt israelensis, Bt kurstaki and Bs H5 strains. The concentration and dose tested were 10(6) and 10(8) spores/ml, respectively. Neither lethality nor effects on mouse bone marrow were promoted by any strain. In necrosis-apoptosis study on peripheral erythrocytes of O. niloticus an increased frequency of necrotic cells caused by exposure to strains of B. thuringiensis was found. Exposure to B. sphaericus did not show cytotoxic effects in either tested system. None of the strains studied induced apoptosis in contrast with the chemical controls.