ROBOTIC VERSUS LAPAROSCOPIC ROUX-EN-Y-GASTRIC BYPASS: A RETROSPECTIVE STUDY IN A SINGLE CENTER.

BACKGROUND: Bariatric surgery is the best treatment option for patients with obesity. As a result of the advancement of technology, the robotic gastric bypass presents promising results, despite its still high costs. AIMS: The aim of this study was to compare patients submitted to a robotic versus a laparoscopic gastric bypass at a single center by a single surgeon. METHODS: This retrospective study collected data from the medical records of 221 patients (121 laparoscopic procedures versus 100 with daVinci platform). The variables analyzed were sex, age, body mass index, comorbidities, surgical time, length of stay, and complications. RESULTS: The mean surgical time for patients in the robotic group was shorter (102.41±39.44 min versus 113.86±39.03 min, p=0.018). The length of hospital stay in robotic patients was shorter (34.12±20.59 h versus 34.93±11.74 h, p=0.007). There were no serious complications. CONCLUSIONS: The group submitted to the robotic method had a shorter surgical time and a shorter hospital stay. No difference was found regarding strictures, bleeding, or leakage.

Bypass gástrico em Y de Roux robótico versus laparoscópico: estudo retrospectivo em único centro / Robotic versus laparoscopic roux-en-y-gastric bypass: a retrospective study in a single center

ABSTRACT BACKGROUND: Bariatric surgery is the best treatment option for patients with obesity. As a result of the advancement of technology, the robotic gastric bypass presents promising results, despite its still high costs. AIMS: The aim of this study was to compare patients submitted to a robotic versus a laparoscopic gastric bypass at a single center by a single surgeon. METHODS: This retrospective study collected data from the medical records of 221 patients (121 laparoscopic procedures versus 100 with daVinci platform). The variables analyzed were sex, age, body mass index, comorbidities, surgical time, length of stay, and complications. RESULTS: The mean surgical time for patients in the robotic group was shorter (102.41±39.44 min versus 113.86±39.03 min, p=0.018). The length of hospital stay in robotic patients was shorter (34.12±20.59 h versus 34.93±11.74 h, p=0.007). There were no serious complications. CONCLUSIONS: The group submitted to the robotic method had a shorter surgical time and a shorter hospital stay. No difference was found regarding strictures, bleeding, or leakage.

RESUMO RACIONAL: A cirurgia bariátrica é a melhor opção de tratamento para pacientes portadores de obesidade. Em decorrência do avanço da tecnologia, o bypass gástrico robótico apresenta resultados promissores, apesar de seus custos ainda elevados. OBJETIVOS: Comparar pacientes submetidos a bypass gástrico robótico versus laparoscópico em um único centro por um único cirurgião. MÉTODOS: Estudo retrospectivo com coleta de dados dos prontuários de 221 pacientes (121 procedimentos laparoscópicos vs 100 com plataforma daVinci). As variáveis analisadas foram sexo, idade, IMC, comorbidades, tempo cirúrgico, tempo de internação e complicações. RESULTADOS: O tempo cirúrgico médio dos pacientes do grupo robótico foi menor (102,41 ± 39,44 min. vs 113,86±39,03 min, p=0,018). O tempo de internação em pacientes robóticos foi menor (34,12±20,59 h vs 34,93±11,74 h, p=0,007). Não houve complicações graves. CONCLUSÕES: O grupo submetido ao método robótico apresentou menor tempo cirúrgico e menor tempo de internação. Nenhuma diferença foi encontrada na amostra em relação a estenoses, sangramento ou vazamento.

Comida de rua: perfil dos manipuladores de alimentos e necessidades de conhecimentos sobre a gestão do negócio e boas práticas de manipulação / Street food: food handlers profile and their needs knowledge about business management and good handling practices

Introdução: O consumo de comida de rua tem aumentado nos últimos anos, transformando este segmento em um importante comércio de alimentos, com geração de emprego e renda. Objetivo: Este trabalho teve como objetivo conhecer o perfil socioeconômico e analisar a percepção sobre a gestão do negócio e boas práticas de manipulação dos manipuladores de comida de rua no município de Niterói/RJ, participantes de um curso on-line sobre boas práticas de manipulação no comércio de comida de rua. Método: A metodologia foi aplicada e descritiva, de abordagem qualitativa e quantitativa. Foi utilizado questionário on-line, com 56 perguntas, aplicado a 67 participantes do curso. Resultados: 86,4 % eram mulheres; faixa etária predominante entre 27 e 62 anos; renda média de até 3 salários mínimos; 35,8% relataram possuir ensino superior incompleto. Apenas 29,9% possuem registro MEI; 72,7% atuam nesse comércio por escolha; 46,3% fazem controle de estoque e 62,5% fazem controle de caixa; 67,2% possuem cursos na área de alimentação; e 47,8% afirmaram ter experiências anteriores. Conclusão: À medida que se observa a consolidação desse segmento, com um potencial de risco sanitário associado, assim como a insuficiência de trabalhos científicos na área, faz-se necessário ampliar os estudos sobre a formação dos manipuladores.

Introduction: The Consumption of street food has increased in recent years, transforming this segment into an important food trade, with job and income. Objective: This work aimed to know the socioeconomic profile and analyze the perception about business management and good handling practices of street food handlers in the city of Niterói/RJ, participants of an online course on good handling practices in the food trade. Methods: The methodology was applied and descriptive, with a qualitative and quantitative approach. An online questionnaire was used, with 56 questions, applied to 67 course participants. Results: 86.4 % were women; predominant age group between 27 and 62 years; average income of up to 3 minimum wages; 35.8 % reported having incomplete higher education. Only 29.9 % have a MEI record; 72.7 % work in this trade by choice; 46.3 % carry out inventory control and 62.5% carry out cash control; 67.2 % have courses in the field of food; and 47.8 % claimed to have previous experiences.Conclusions:As the consolidation of this segment is observed, with a potential associated health risk, as well as the lack of scientific work in this area, it is necessary to expand studies on the training of handlers.

Immunohistochemical expression of HER - 2 and Ki - 67 in granulosa cell tumor in bitches.

Granulosa cell tumour, an ovarian neoplasm of stromal origin, is an important tumour related to oestrogenic dominance syndrome and cystic endometrial hyperplasia-pyometra complex. In order to analyse ovarian tumour´s malignant potential, immunohistochemical markers can be used, such as anti-HER2 and anti-Ki-67. The aim of this study was to evaluate the expression of immunohistochemical markers HER-2 and Ki-67 in granulosa cell tumour from bitches´ ovaries. In HER-2 immunomarker analysis using the HercepTest® method, most tumours were classified as 2+ (moderate labelling). Concerning Ki-67 immunomarker, only one case was described as having a high proliferative index. An association was found between immunostained cell percentage by anti-HER-2 antibodies and high pleomorphism, represented by the pattern of follicular/trabecular tumour arrangement. There was no correlation between anti-Ki-67 and anti-HER-2 antibody immunostaining intensities, probably due to only one case with a high Ki-67 index. With an effective protocol for HER-2 and Ki-67 immunohistochemical identification in granulosa cell tumours in bitches, it was possible to characterize this neoplasm proliferation profile.

Bariatric surgery during the evolution of fatty liver-A randomized clinical trial comparing gastric bypass and sleeve gastrectomy based on transient elastography.

Nonalcoholic fatty liver disease (NAFLD) is closely related to patients with obesity. For patients with NAFLD, bariatric surgery is the best treatment. However, the best technique to patient with severe NAFLD is still unknown. Currently available, the imaging methods for assessing and monitoring NAFLD are of limited use for diagnosing. In contrast, compared with liver biopsy and transient hepatic elastography (THE) has shown good accuracy in individuals with obesity. To prospectively compare the evolution of THE parameters of NAFLD right after the procedures: gastric bypass vs sleeve gastrectomy. Patients with obesity were randomized into two groups: gastric bypass and sleeve gastrectomy in a previous study. Iin a previous study one week before and three months after surgery the patients underwent evaluation by THE. The patients were also analyzed with controlled attenuation parameter (CAP), which assesses the degree of hepatic steatosis using the same device. Sleeve gastrectomy group showed a greater decrease in THE values (from 8.13 to 5.53 kPa) compared to the gastric bypass group (from 9.25 to 8.81 kPa; P = .004). CAP also revealed a greater decrease in sleeve subjects (from 287 to 242 dB/m) compared to gastric bypass subjects (from 290 to 276 dB/m; P < .0001). The absolute values of these differences also had a largest decrease with both methods in sleeve gastrectomy group (P = .013 and P = .005 for THE and CAP, respectively).Sleeve gastrectomy showed a greater decrease in both parameters (THE and CAP) than gastric bypass in the first months.

Gastrointestinal Parasites in Captive Animals at the Rio de Janeiro Zoo.

BACKGROUND: Gastrointestinal parasites may determine diarrhea, dysentery or even death in captive mammals. These animals tend to be more susceptible to parasitic infections due to confinement and stress. Purpose To increase the information about these etiological agents in captive animals in Brazil, the gastrointestinal parasites of the captive mammals of the Rio de Janeiro Zoo were investigated. METHODS: From 2016 to 2018, 180 fecal samples were collected from animals housed in the Rio de Janeiro Zoo: 63 from animals of the order Primates, 26 of Carnivora, 78 of Artiodactyla, 9 of Perissodactyla and 4 of the order Rheiformes. The feces were processed by direct examination and by the techniques of Faust et al., Sheather, Ritchie, Lutz, and smears were stained with safranin. Immunoenzymatic assays were also performed to investigate antigens of Giardia duodenalis, Cryptosporidium spp., Entamoeba histolytica/Entamoeba dispar. RESULTS: Parasite positivity was identified in 68.3% of the fecal samples, with a parasite positivity rate of 68.2% among primates, 65.3% among carnivores, 69.2% among artiodactyls, 33.3% among perissodactyls, and 100% among rheiformes. The most frequently detected parasite was Entamoeba histolytica/E. dispar antigens, which showed a statistically significant positivity rate (33.3%; p = 0.000), particularly in the feces of carnivores (30.7%) and artiodactyls (53.8%). A statistically significant positivity rate of Balantioides coli (11.1%; p = 0.001) was also detected in feces from nonhuman primates, tapirs, collared peccaries and rheas. The positivity of Cryptosporidium sp. antigens in feces of the orders Carnivora, Artiodactyla and Primates was also statistically significant (7.2%, p = 0.010). Oocysts compatible with Cryptosporidium spp. were detected in 6.3% from primates. The helminths most frequently detected were thin-shelled eggs of nematodes (17.7%, p = 0.000), nematode larvae (15.5%, p = 0.000) and Trichuris trichiura eggs (6.1%, p = 0.018). CONCLUSION: The positivity rate for gastrointestinal parasites demonstrates the need for a sanitation management program to be implemented in the zoo, including routine diagnostic parasitology tests followed by specific treatment for each parasitosis.

Detection of Dirofilaria immitis using microscopic, serological and molecular techniques among dogs in Cabo Frio, RJ, Brazil / Detecção de Dirofilaria immitis utilizando técnicas microscópicas, imunológicas e moleculares em cães de Cabo Frio, RJ

Abstract Heartworm disease is a health problem for dogs and cats, especially in tropical and subtropical coastal regions of the world. Some studies have compared the efficacy of the diagnostic techniques used to detect this parasitosis. Therefore, the aim of this study was to compare parasitological optical microscopy (POM), serological and molecular techniques for diagnosing canine heartworm infection. Samples were collected between July 2015 and April 2016 from 103 dogs in Cabo Frio, RJ, Brazil. The wet fresh blood, thick smears, thin smears and modified Knott's test were used to detect microfilariae. ELISA (Snap™ 4Dx ® IDEXX) was used to detect antigens and the polymerase chain reaction (PCR) was used to detect DNA and enable sequencing for species differentiation and confirmation. 19.4% of samples were positive according to microscopy. Through PCR, 15.5% of the total were positive. Using ELISA, the positivity rate was 29.1%. Occult heartworm infection was detected in 11.6% of the samples. ELISA sensitivity was shown to be higher than PCR or microscopy (P = 0.001). Sequencing of samples confirmed the presence of Dirofilaria immitis and Acanthocheilonema reconditum . ELISA was more effective for serological diagnosis canine heartworm and should be used in clinical and epidemiological studies.

Resumo A dirofilariose é um problema de saúde para cães e gatos, especialmente nas regiões costeiras tropicais e subtropicais do mundo. Alguns estudos compararam a eficácia das técnicas de diagnóstico usadas para detectar esta parasitose. Portanto, o objetivo deste estudo foi comparar a microscopia óptica (OM), técnicas sorológicas e moleculares para o diagnóstico de infecção por Dirofilaria immitis . Foram coletadas, entre julho de 2015 e abril de 2016, amostras de 103 cães em Cabo Frio, RJ, Brasil. O exame direto, distensão espessa, distensão delgada e o teste de Knott modificado foram usados para detectar microfilárias. O ELISA (Snap ™ 4Dx ® IDEXX) foi usado para detectar antígenos e a reação em cadeia da polimerase (PCR) foi usada para detectar DNA e o sequenciamento para diferenciação e confirmação de espécie. Das amostras, 19,4% foram positivas de acordo com a microscopia. Por PCR, 15,5% do total foram positivos. Utilizando o ELISA, a taxa de positividade foi de 29,1%. Dirofilariose oculta foi detectada em 11,6% das amostras. A sensibilidade ao ELISA mostrou-se superior à PCR ou microscopia (P = 0,001). O sequenciamento das amostras confirmou a presença de Dirofilaria immitis e Acanthocheilonema reconditum . O ELISA foi mais eficaz no diagnóstico sorológico de dirofilariose canina e deve ser usado em estudos clínicos e epidemiológicos.

Epidermal growth factor receptor 2 immunoexpression in gastric cells of domestic cats with H. heilmannii infection.

The aim of this study was to evaluate the immunoexpression of HER-2 in gastric cells of cats infected with Non H. pylori Helicobacter (NHPH) and to investigate an association with the presence of inflammatory infiltrate. Forty-eight paraffin-embedded gastric samples were retrieved from the archives of the Veterinary Anatomic Pathology Laboratory that had previously been shown to be positive for NHPH with the rapid urease test and cytology. Infection by NHPH was confirmed by histopathology using the Warthin-Starry staining. Hematoxylin-eosin stained sections were reviewed to evaluate inflammatory cell infiltrates. Immunohistochemical analysis was done using anti- H. pylori antibody and anti-HER-2 antibody. Molecular analysis was performed by PCR to confirm the presence of Helicobacter. Statistical analysis was performed to determine whether there was an association between the presence of H. Heilmannii and HER-2 expression in gastric samples. All samples were positive for NHPH, by immunohistochemistry, and confirmed by PCR as H. Heilmannii. On histopathologic analysis, 56,3% of the samples had lymphocytes and plasma cells infiltrates, 52,1% of which were mild and 4,2% moderate. The intensity of the inflammatory infiltrate in the gastric mucosa was significantly greater in the complete plasma membrane of parietal cells of gastric glands that had greater HER-2 immunoexpression (p = 0.0001). A statistically significant association (p = 0.007) between the H. Heilmannii infection score and the expression of HER-2 in the lateral membrane of gastric surface cells was observed. HER-2 expression may be increased in feline gastric cells infected by H. Heilmannii and in parietal cells of gastric glands with an increased inflammatory infiltrate.

Expression of interleukins 6 and 10 and population of inflammatory cells in the equine endometrium: diagnostic implications.

Endometritis consists of an acute or chronic inflammatory process involving the endometrium and together with endometrosis constitute the main causes of infertility in mares. The aim of this study was to associate the histopathological findings with the immunohistochemical markers interleukins 6 (IL-6) and 10 (IL-10) to evaluate the inflammatory changes and progression of uterine tissue lesions of mares in the diestrus phase and their diagnostic implications. Twelve crossbred cyclic mares were used for endometrial biopsy collection. Samples were collected in the diestrus period (6 ± 1 day after ovulation) without previous artificial insemination. In the histopathological analysis the samples were classified according to the type and intensity of inflammation, alterations regarding endometrial fibrosis and biopsy categories (I, IIA, IIB and III). In the immunohistochemical analysis, the markers of IL-6 and IL-10 were evaluated by scores (0, 2, 4, 6) according to the intensity of the immunostaining and inflammatory cells (CD-3, CD-20, CD-68 and MPO antibodies) and were counted according to the number of cells immunostained in brown, in ten random fields. An association (p ≤ 0.05) occurred between low score (2) for IL-6 in the endometrial glandular area and moderate fibrotic nets; and between high scores (4 and 6) for IL-10 in sub-epithelial connective tissue and moderate periglandular fibrosis. In conclusion, immunohistochemical analysis demonstrated an association between interleukins and inflammatory cells with endometrial lesions. In addition, this research may be useful in the future to evaluate the progress of the inflammatory process, contributing to the adequate optimization of the reproductive management of the mares.

Agreement between upper endoscopy and esophagography in the diagnosis of megaesophagus in Chagas disease.

INTRODUCTION: The diagnosis and classification of megaesophagus can be challenging in patients with Chagas disease. The present study aimed to evaluate the agreement between upper endoscopies and esophagographies for the diagnosis and classification of megaesophagus in Chagas disease. METHODS: A cross-sectional study of 50 patients with Chagas disease with upper digestive symptoms was undertaken. Esophagography and upper endoscopy exams were performed to compare diagnoses. Statistical analysis included sensitivity and specificity used to evaluate the diagnostic accuracy of upper endoscopies, and measures of agreement: linearly weighted Kappa (κw) and Cohen`s classical Kappa (κ) coefficients with 95% confidence intervals (95% CI). RESULTS: Twenty-three patients (46%) were diagnosed with megaesophagus by esophagography. The upper endoscopy sensitivity and specificity for megaesophagus diagnosis were 100% and 33.3%, respectively. Regarding megaesophagus classifications, there was a substantial agreement between the two exams (κw = 0.622; 95% CI: 0.498 to 0.746). Within megaesophagus groups, agreement for group I was slight (κ = 0.096; 95% CI: 0.000 to 0.403); for group II, substantial (κ = 0.703; 95% CI: 0.456 to 0.950); and for groups III and IV, inconclusive (κ = 0.457; 95% CI: 0.000 to 0.967; κ = 0.540; 95% CI: 0.035 to 1.000, respectively). CONCLUSIONS: Upper endoscopy has a high sensitivity, but a low specificity to diagnose megaesophagus. Agreement between the two exams varies depending on the megaesophagus grade. Thus, upper endoscopy can be used in the diagnostic workup of a possible Chagas disease megaesophagus, but all identified cases should undergo esophagography.

Agreement between upper endoscopy and esophagography in the diagnosis of megaesophagus in Chagas disease

Abstract INTRODUCTION The diagnosis and classification of megaesophagus can be challenging in patients with Chagas disease. The present study aimed to evaluate the agreement between upper endoscopies and esophagographies for the diagnosis and classification of megaesophagus in Chagas disease. METHODS: A cross-sectional study of 50 patients with Chagas disease with upper digestive symptoms was undertaken. Esophagography and upper endoscopy exams were performed to compare diagnoses. Statistical analysis included sensitivity and specificity used to evaluate the diagnostic accuracy of upper endoscopies, and measures of agreement: linearly weighted Kappa (κw) and Cohen`s classical Kappa (κ) coefficients with 95% confidence intervals (95% CI). RESULTS: Twenty-three patients (46%) were diagnosed with megaesophagus by esophagography. The upper endoscopy sensitivity and specificity for megaesophagus diagnosis were 100% and 33.3%, respectively. Regarding megaesophagus classifications, there was a substantial agreement between the two exams (κw = 0.622; 95% CI: 0.498 to 0.746). Within megaesophagus groups, agreement for group I was slight (κ = 0.096; 95% CI: 0.000 to 0.403); for group II, substantial (κ = 0.703; 95% CI: 0.456 to 0.950); and for groups III and IV, inconclusive (κ = 0.457; 95% CI: 0.000 to 0.967; κ = 0.540; 95% CI: 0.035 to 1.000, respectively). CONCLUSIONS Upper endoscopy has a high sensitivity, but a low specificity to diagnose megaesophagus. Agreement between the two exams varies depending on the megaesophagus grade. Thus, upper endoscopy can be used in the diagnostic workup of a possible Chagas disease megaesophagus, but all identified cases should undergo esophagography.

Vimentin, osteocalcin and osteonectin expression in canine primary bone tumors: diagnostic and prognostic implications.

Canine primary bone tumors have a plastic radiographic image, demanding histopathological confirmation. Bone tumors are characterized by the type and amount of extracellular matrix produced what cannot be easily recognized, especially in biopsy samples. Identifying cellular markers that could aid diagnosis has supported various studies in oncological pathology. This study aimed to evaluate 22 canine primary bone neoplasms, establishing their histopathological diagnosis and evaluated vimentin, osteonectin and osteocalcin expression and their implication in diagnosis and prognosis. There were 12 productive osteoblastic osteosarcomas, six minimally productive osteoblastic osteosarcoma, two chondrosarcomas, one fibrosarcoma and one hemangiosarcoma. Immunostaining was cytoplasmatic in all cases, with average percentage of 87.9% for vimentin, 98.0% for osteonectin and 99.9% for osteocalcin. In this last case, only osteosarcomas were considered. Intensity was higher in vimentin labeling (+++), followed by osteonectin (++) and osteocalcin (+). One osteosarcoma showed negative immunostaining for vimentin and of samples submitted to anti-osteocalcin immunostaining, three osteosarcomas and one fibrosarcoma had negative staining. Besides identifying mesenchymal origin, vimentin elevated expression in canine bone tumors can be related to epithelial-mesenchymal transition, leading to more aggressive tumoral phenotypes and metastasis development. Similarly, high osteonectin expression is implicated in neoplastic cell invasion and is also related to metastasis spread. Decreased osteocalcin expression was found in some osteosarcoma samples and can be related to poor prognosis, as in human osteosarcomas. Our findings suggest that vimentin, osteonectin and osteocalcin not only aid diagnosis but can be related to prognosis in canine primary bone tumors, especially osteosarcomas and its osteoblastic subtype.

Comparative study of three xenic media culture for cultivation of Balantidium coli strains / Estudo comparativo entre três meios de cultivo xênicos para o cultivo de cepas de Balantidium coli

Abstract The aim of the present study was to evaluate the growth rate of Balantidium coli in three xenic media cultures. Between 2013 and 2015, 10 B. coli isolates obtained from feces of Cynomolgus macaques, and 30 isolates from feces of pigs were studied. An inoculum of 500 trophozoites was transferred to tubes containing LES, TYSGM-9 and Pavlova media. These cultures were evaluated at incubation times of 24, 48, 72 and 96 hours. In most of strains analyzed wasn't showed significant difference in the growth rate comparing TYSGM-9 and Pavlova media (Wilcoxon p>0.016). In Pavlova medium, the trophozoites showed a maximum growth at 72 hours with significant difference when compared with the times of 24 h and 96 h (Wilcoxon <0.008). In LES, viable trophozoites were observed until 24 hours, with a significant difference (Friedman p<0.05, Wilcoxon p<0.016) in the number of parasite cells compared with Pavlova and TYSGM-9 media cultures. Thus, LES medium seemed to be less adequate than the other media for maintenance of B. coli. Despite the satisfactory results in TYSGM-9, Pavlova medium was considered ideal for the maintenance of this protozoan strain, guaranteeing the viability of the parasite with subculture every three days, presenting lower costs.

Resumo O objetivo do presente estudo foi avaliar a taxa de crescimento de Balantidium coli em três meios de cultura xênicos. Entre 2013 e 2015 foram estudados 10 isolados de B. coli obtidos de Cynomolgus macaques e 30 isolados de suínos. Um inóculo contendo 500 trofozoítos foi transferido para tubos contendo os meios LES, TYSGM-9 e Pavlova. Os cultivos foram avaliados com tempos de incubação de 24, 48, 72 e 96 horas. Na maioria das cepas analisadas não foi observado diferença significativa na taxa de crescimento comparando TYSGM-9 e Pavlova (Wilcoxon p>0,016). Em Pavlova, os trofozoítos apresentaram máximo de crescimento a 72 h com diferença significativa quando se comparou com os tempos de 24 h e 96 h (Wilcoxon <0,008). Em LES observou-se trofozoítos viáveis até 24 horas com diferença significativa (Friedman p<0,05 e Wilcoxon p<0,016), na quantidade de células parasitárias, quando comparado com Pavlova e TYSGM-9. Dessa forma, o meio LES mostrou-se ser menos adequado do que os outros, para a manutenção de B. coli. Apesar do resultado satisfatório em TYSGM-9, Pavlova foi considerado ideal para manutenção do protozoário, por garantir a viabilidade do parasito com subcultivos a cada três dias, além de apresentar menor custo.

Intestinal parasites in children with neurological disorders treated at a rehabilitation institution in Niterói, Rio de Janeiro, Brazil

Enteroparasitosis presents high prevalence in developing countries, and is frequent among children, and those with disabilities present even higher susceptibility. The present study evaluated 156 children with neurological disorders to whose parents or guardians an epidemiological questionnaire was applied with a view to identifying risk factors. Stool samples were processed using Ritchie modified by Young, Faust et al., Lutz and Baermann-Moraes techniques. Thirteen samples (8.3%) were positive, being Blastocystis sp. the most frequent parasite (46.2%). Higher positivity was observed for protozoa, especially non-pathogenic. A statistically significant association was only found between the educational level of the mother and positivity for enteroparasites. Among positive children, the habit of placing their hands and objects in their mouths and the consumption of raw vegetables was more frequent. The results show the existence of care and sanitation minimizing the acquisition of intestinal parasite diseases. It is important to alert parents and caregivers about personal hygiene, water and food quality, as well as the environment, considering that transmission of these parasites occurs via the fecal-oral route, in association with multiple factors.

Congenital toxoplasmosis: perception of knowledge and primary prevention measures among healthcare professionals and pregnant women treated in public healthcare facilities / Toxoplasmose congênita: percepção do conhecimento e medidas de prevenção primária entre profissionais de saúde e gestantes atendidas em unidades públicas de saúde

AIMS: To evaluate knowledge about toxoplasmosis among pregnant women and healthcare professionals and to evaluate the knowledge acquired by pregnant women after health education actions. METHODSethods: Five hundred pregnant women and 141 healthcare professionals from health units in Niterói, state of Rio de Janeiro, answered a questionnaire, received information about toxoplasmosis and had access to an interactive educational model and to folders between 2013 and 2016. After 3 months, 145 pregnant women answered the questionnaire once again. RESULTS: Of 500 pregnant women, 226 (45.2%) reported having heard about toxoplasmosis. Among these, 23.5% had obtained information from friends and 19.0% from their doctors. About their exposure to risk factors, 6.8% had had contact with cat feces; 14.0% had had contact with soil without gloves; 23.4% had ingested undercooked meat; and 24.0% had drunk unfiltered water from the public supply system. The questionnaires of 145 pregnant women before and after the educational activities were compared and showed that contact with soil without gloves dropped significantly from 11.0% to 4.8% (p = 0.022) while consumption of unfiltered water fell from 26.9% to 20.0% (p < 0.001). Washing foods (62.1%), washing hands (62.1%) and consumption of well-cooked meat (61.4%) were the most widely cited preventive measures. Many mistakes were reported among healthcare professionals, and one nursing technician and 13 community healthcare agents (9.9%) had not heard about toxoplasmosis. CONCLUSIONS: Lack of knowledge about toxoplasmosis by most of the interviewed pregnant women, in addition to the misconceptions observed among healthcare professionals, leads to the conclusion that little importance has been given so far to primary prevention of toxoplasmosis during the prenatal period. Also, health professionals' inadequate knowledge could be detrimental to secondary prevention, which consists of early detection and treatment of toxoplasmosis during pregnancy. In this study, educational intervention contributed to improving knowledge about the transmission and prevention of toxoplasmosis by pregnant women and, to a lesser extent, to reducing exposure to some risk factors.

OBJETIVOS: Avaliar o conhecimento da toxoplasmose entre gestantes e profissionais de saúde e avaliar o conhecimento adquirido pelas gestantes após ações de educação em saúde. MÉTODOS: Quinhentas gestantes e 141 profissionais de saúde provenientes de Unidades de Saúde de Niterói-RJ de 2013 a 2016, foram entrevistados por meio de um questionário, receberam informações sobre a toxoplasmose, tiveram acesso a um modelo educativo interativo e folders. Após três meses, 145 gestantes responderam novamente ao questionário. RESULTADOS: Das 500 gestantes, 226 (45,2%) relataram que já tinham ouvido falar sobre toxoplasmose. Destas, 23,5% tiveram informações por amigos e 19,0% pelo médico. Sobre exposição aos fatores de risco, 6,8% relataram contato com fezes de gatos; 14,0% tiveram contato com o solo sem luvas; 23,4% ingeriam carne mal passada; e 24,0% bebiam água de abastecimento público sem filtrar. Ao comparar os questionários de 145 gestantes antes e após atividades educativas, o contato com o solo sem uso de luvas teve redução significativa de 11,0% para 4,8% (p=0,022) e o consumo de água sem filtro reduziu de 26,9% para 20,0% (p=0,001). Foram mais citados como medidas preventivas a lavagem dos alimentos (62,1%), a lavagem das mãos (62,1%) e o consumo de carne bem cozida (61,4%). Dentre os profissionais de saúde, muitos erros foram relatados e um técnico de enfermagem e 13 agentes comunitários de saúde (9,9%) não conheciam a toxoplasmose. CONCLUSÕES: A falta de conhecimento sobre a toxoplasmose pela maioria das gestantes entrevistadas, além de concepções equivocadas por parte dos profissionais de saúde, levam à conclusão de que vem sendo dada pouca importância para a prevenção primária da toxoplasmose durante o período pré-natal. Adicionalmente, algumas falhas no conhecimento dos profissionais podem prejudicar até mesmo a prevenção secundária, que consiste na detecção e tratamento precoce da toxoplasmose na gestação. Neste estudo, a intervenção educacional contribuiu para aumentar o conhecimento sobre a transmissão e a prevenção da toxoplasmose entre as gestantes e, em menor extensão, para reduzir a exposição a alguns fatores de risco.

Enterococcus spp. Resistant to Multiple Antimicrobial Drugs and Determination of Fecal Contamination Levels in Mangrove Oysters (Crassostrea rhizophorae)

ABSTRACT The aim of this study was to determine and compare the Most Probable Number (MPN) of Total Coliforms (TC), Escherichia coli and Enterococcus spp. and to characterize the antimicrobial resistance profiles of Enterococcus spp. isolated from oysters collected in the Barra de Guaratiba Mangrove, Rio de Janeiro, Brazil. The enumeration of E. coli has been used to indicate fecal contamination and hygienic-sanitary conditions of bivalve molluscs. Enterococci are capable to transfer several antimicrobial resistance genes to pathogenic bacteria, including those from Gram-negative group. The oysters were bought from local fishermen and a total of 123 individuals were analyzed. The TC, E. coli and Enterococcus spp. MPN mean were 26,300/100 g, 3,260/100 g and 2,820/100 g, respectively. The only correlation found was between TC and E. coli. Two strains of Enterococcus spp. were resistant to three different antimicrobial categories, including a high level resistance to streptomycin. One strain presented intermediate resistance to vancomycin. The E. coli levels exceeded the limits established by international legislation. This microbiological contamination in oysters reflects the water pollution and indicates a probable contamination of other seafood species from this mangrove, which can represent a risk for consumers and a threat to the environment and public health.

Knowledge about parasite infections among pregnant and postpartum women who attended a university hospital in Niteroi, Rio de Janeiro, Brazil

Parasite infections are frequent in Brazil during pregnancy. The aim of the present study was to assess the knowledge about parasite infections among pregnant and post-partum women, attending a public University Hospital in Niteroi, RJ, Brazil. Knowledge was assessed using a standardized interview and questionnaire. A total of 100 interviews were conducted (60 pregnant and 40 post-partum women). Educational achievement did not influence knowledge about parasites. The majority of the women interviewed stated that they habitually always washed hands after using the bathroom and before eating. Consumption of fruits and vegetables was prevalent, but 17% did not wash them before eating and 39% ate raw or undercooked meat. Educational achievement and number of pregnancies did not influence hygiene habits. Neither the late pre-natal care nor the number of pregnancies influenced knowledge about parasites. Also, there was no correlation between the initial date of pre-natal care and the number of correct answers in the questionnaire. Similarly, there was no association between the initial date of pre-natal care and receiving information about parasite infections. 79% of the women interviewed stated that they had never received any information about parasite infection and pregnancy, and the harm it could cause to them and/or their baby. Despite advances in pre-natal care assistance in the last decade, the lack of knowledge among pregnant and post-partum women regarding parasites and risk factors for infection still remains.

Avaliação dos resultados dos cursos de capacitação em bem-estar animal na pendura e na qualidade de carcaça de frangos

Este trabalho teve como objetivo realizar um estudo comparativo em 15 estabelecimentos de abate de aves com serviço de inspeção federal, nos estados de Santa Catarina e Paraná, antes e após receberem o curso de capacitação do Programa Nacional de Abate Humanitário - Steps da Sociedade Mundial de Proteção Animal (WSPA) em parceria com o Ministério da Agricultura, Pecuária e Abastecimento (MAPA). Foram avaliados os pontos críticos de bem-estar das aves na etapa de pendura, além de seus efeitos na qualidade da carne. Para análise dos dados colhidos, foi aplicado o teste de Wilcoxon, a fim de verificar diferenças significativas (p < 0,05) entre as avaliações. Foram verificados diversos pontos em não conformidade, como condições das aves na área de pendura e índice de lesões de carcaça. Após ser administrado o curso de capacitação, melhorias foram observadas, principalmente no manejo e no índice de hematomas. Desse modo, pode-se inferir que o curso permitiu grandes avanços nas plantas avaliadas, contudo, há necessidade de se fiscalizar e dar continuidade aos treinamentos por meio da atuação dos multiplicadores formados em cada estabelecimento, em conjunto com um programa de bem-estar animal implantado com metas para alcançar os parâmetros ideais.

This work aimed to conduct a comparative study in 15 slaughterhouses with federal inspection service in Santa Catarina and Paraná states, before and after receiving the training course of the National Humane Slaughter Program - Steps from the World Society for the Protection of Animals (WSPA) in partnership with the Ministry of Agriculture (MAPA). The critical points of poultry welfare were evaluated at the shackling stage and their effects on meat quality. For data analysis, Wilcoxon test was applied in order to identify significant differences (p < 0.05) between assessments. Several points in noncompliance were verified, such as conditions of birds during shackling and carcass downgrading rate. After being given the training course, improvements were observed mainly in handling and bruises rates. This way, one can infer that the course has enabled great advances in evaluated plants, however, there is need to inspect and to get on with the training by means of the action of multipliers trained in each plant along with an animal welfare program implemented to achieve the ideal standards.

Atenção em Saúde Bucal no Brasil: uma análise a partir da Avaliação Externa do PMAQ-AB / Dental care in Brazil: an analysis based on PMAQ-AB External Evaluation

Este estudo tem como objetivos identificar as características da oferta de serviços de odontologia acessados pelos usuários e analisar a organização da atenção à saúde bucal das equipes participantes do Programa Nacional do Acesso e da Qualidade da Atenção Básica quanto aos atributos do acesso de primeiro contato e da integralidade. Utilizaram-se dados secundários da Avaliação Externa relativos aos módulos usuário e profissional. Os resultados indicam que 45,1% dos usuários conseguem marcar consulta com o dentista. A garantia de continuidade de tratamento é menor nas regiões Norte e Nordeste. O acesso e o tempo de espera nas especialidades ainda se constituem em problema da rede de atenção.

This study aims to identify the characteristics of dental service supply accessed by users and to analyze the organization of Oral teams participating in the National Program for Access and Quality Improvement in Primary Care, as for access and first contact comprehensiveness. Secondary data concerning to External Evaluation were applied in their user and professional component modules. The results indicate that 45.1% of users succeed in making an appointment with the dentist. The ensuring continuity of treatment is lower in the North and Northeast regions. Access and waiting times for specialty still constitute a problem of the care network.

Toxoplasmosis-rllated knowledge among pregnant nd postpartum women attended inn public health units in niterói, rio de janeiro, Braill / Conhecimento sobre toxoplasmose entre gestantes e puérperas atendidas na rede pública de saúde do município de Niterói, Rio de Janeiro, Brasil

The present study conducted a toxoplasmosis-related knowledge level survey with 400 pregnant and puerperal women attended in public health units in the municipality of Niterói, Rio de Janeiro. Only 111 (27.8%) women claimed to know about the disease. Most of them (n = 289; 72.2%) had never heard about toxoplasmosis nor knew how to prevent the infection by Toxoplasma gondii. A significant difference (p = 0.013) regarding the presence of anti-T. gondii IgG was observed between women who claimed to know about the disease and those who had never heard about it. These results highlight the importance of a systematic serological screening process for toxoplasmosis, as well as the importance of primary prevention by accurate information during prenatal care, an important Public Health action to be implemented.

Este estudo teve por objetivo realizar um levantamento do conhecimento de 400 gestantes e puérperas atendidas na rede pública de saúde do município de Niterói, Estado do Rio de Janeiro sobre a toxoplasmose. Apenas 111 (27,8%) participantes relataram conhecer a doença. A maioria 289 (72,2%) nunca ouviu falar sobre a toxoplasmose, principalmente sobre as formas de prevenção da infecção pelo Toxoplasma gondii. Foi encontrada diferença significativa entre as pacientes que disseram conhecer a toxoplasmose e aquelas que relataram desconhecer a doença com relação à presença de anticorpos IgG anti- T.gondii (p = 0,013). Estes resultados permitem ressaltar a importância do rastreamento sorológico sistemático na infecção toxoplásmica, bem como a prevenção primária por meio de informações corretas durante o pré-natal, sendo esta uma importante medida de saúde pública a ser implementada.