Deep Learning in High-Resolution Anoscopy: Assessing the Impact of Staining and Therapeutic Manipulation on Automated Detection of Anal Cancer Precursors.

INTRODUCTION: High-resolution anoscopy (HRA) is the gold standard for detecting anal squamous cell carcinoma (ASCC) precursors. Preliminary studies on the application of artificial intelligence (AI) models to this modality have revealed promising results. However, the impact of staining techniques and anal manipulation on the effectiveness of these algorithms has not been evaluated. We aimed to develop a deep learning system for automatic differentiation of high-grade squamous intraepithelial lesion vs low-grade squamous intraepithelial lesion in HRA images in different subsets of patients (nonstained, acetic acid, lugol, and after manipulation). METHODS: A convolutional neural network was developed to detect and differentiate high-grade and low-grade anal squamous intraepithelial lesions based on 27,770 images from 103 HRA examinations performed in 88 patients. Subanalyses were performed to evaluate the algorithm's performance in subsets of images without staining, acetic acid, lugol, and after manipulation of the anal canal. The sensitivity, specificity, accuracy, positive and negative predictive values, and area under the curve were calculated. RESULTS: The convolutional neural network achieved an overall accuracy of 98.3%. The algorithm had a sensitivity and specificity of 97.4% and 99.2%, respectively. The accuracy of the algorithm for differentiating high-grade squamous intraepithelial lesion vs low-grade squamous intraepithelial lesion varied between 91.5% (postmanipulation) and 100% (lugol) for the categories at subanalysis. The area under the curve ranged between 0.95 and 1.00. DISCUSSION: The introduction of AI to HRA may provide an accurate detection and differentiation of ASCC precursors. Our algorithm showed excellent performance at different staining settings. This is extremely important because real-time AI models during HRA examinations can help guide local treatment or detect relapsing disease.

Children with extended oligoarticular and polyarticular juvenile idiopathic arthritis have alterations in B and T follicular cell subsets in peripheral blood and a cytokine profile sustaining B cell activation.

OBJECTIVES: The main goal of this study was to characterise the frequency and phenotype of B, T follicular helper (Tfh) and T follicular regulatory (Tfr) cells in peripheral blood and the cytokine environment present in circulation in children with extended oligoarticular juvenile idiopathic arthritis (extended oligo JIA) and polyarticular JIA (poly JIA) when compared with healthy controls, children with persistent oligoarticular JIA (persistent oligo JIA) and adult JIA patients. METHODS: Blood samples were collected from 105 JIA patients (children and adults) and 50 age-matched healthy individuals. The frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry. Serum levels of APRIL, BAFF, IL-1ß, IL-2, IL-4, IL-6, IL-10, IL-17A, IL-21, IL-22, IFN-γ, PD-1, PD-L1, sCD40L, CXCL13 and TNF were measured by multiplex bead-based immunoassay and/or ELISA in all groups included. RESULTS: The frequency of B, Tfh and Tfr cells was similar between JIA patients and controls. Children with extended oligo JIA and poly JIA, but not persistent oligo JIA, had significantly lower frequencies of plasmablasts, regulatory T cells and higher levels of Th17-like Tfh cells in circulation when compared with controls. Furthermore, APRIL, BAFF, IL-6 and IL-17A serum levels were significantly higher in paediatric extended oligo JIA and poly JIA patients when compared with controls. These immunological alterations were not found in adult JIA patients in comparison to controls. CONCLUSIONS: Our results suggest a potential role and/or activation profile of B and Th17-like Tfh cells in the pathogenesis of extended oligo JIA and poly JIA, but not persistent oligo JIA.

Seasonality and bait type driving the diversity of dung beetle (Scarabaeidae: Scarabaeinae) communities in urban remnants of the Atlantic Forest

ABSTRACT Describing dung beetle communities in tropical forest remnants located in disturbed/urbanized and conserved areas can provide information about the functioning of these ecosystems and support conservation plans. This study aimed to verify the effect of seasons and bait type on dung beetle communities in remnants of the Atlantic Forest in order to describe their composition and diversity parameters. The study was carried out during both the rainy and dry seasons in periurban and urban remnants. Eighteen pitfall traps baited with feces, carrion, and injured millipedes were established in each site. A total of 3501 individuals and 23 species were recorded. Urban remnant presented higher abundance of individuals in the dry season. On the other hand, in periurban remnant the higher abundance was verified in the rainy season. The diversity was higher in the rainy season in both sites. In urban remnant, Coprophanaeus ensifer was found to be generalist regarding its choice of bait (feces and carrion). The use of injured millipedes as bait allowed the record of the predatory species Deltochilum alpercata. Among the types of bait used, the injured millipedes proved to be very effective, capturing a greater diversity of dung beetles during the rainy season in both remnants, and allowed the collection of specialized, necrophages, and generalists species. Therefore, we propose the use of mixed-bait sampling designs in inventories and surveys to increase the chances of sampling species with different traits or dietary preferences, which are often rare in collections.

As Strong as We Are United: Effects of Intrapersonal and Interpersonal Emotion Regulation on Quality of Life in Women With Breast Cancer.

Women diagnosed with breast cancer often experience unpleasant emotions, resulting in higher levels of emotional burden and decreased levels of wellbeing and quality of life. The present correlational and cross-sectional study aims to compare the implementation of two regulatory levels, intrapersonal and interpersonal (as social sharing of emotions), and two types of strategies, antecedent-focused and response-focused, and explore their impact on breast cancer patients' perception of quality of life. Sixty-eight women previously diagnosed with the disease participated in this study, with a mean age of 63years old (SD=11.58). Data were collected through a self-report questionnaire to assess emotional experience, intrapersonal regulation, social sharing of emotions, and breast cancer-related wellbeing and quality of life. Data yielded that most of the participants regulated their negative emotions within social interactions and made more use of antecedent-focused strategies to cognitively reformulate the emotional episode. Social and family wellbeing were positively associated with antecedent-focused strategies, as well as intrapersonal and interpersonal regulatory levels. Moreover, the occurrence of sharing episodes and social interactions played an important and beneficial role on patients' perceived quality of life. These findings reinforce the importance of promoting an adaptive intrapersonal regulation among breast cancer patients. Results also suggest that social sharing of emotions is an efficient process to help them to better cope with the psychological and emotional burden of the disease, thus positively influencing the way they perceive their social and family wellbeing, as well as their quality of life.

Recurrent Klebsiella pneumoniae Infection Causing Transcatheter Aortic Valve Implantation (TAVI)-Related Endocarditis.

The authors report the case of an 86-year-old woman presenting with recurrent Klebsiella pneumoniae bacteraemia. She had severe aortic stenosis submitted to a recent transcatheter aortic valve implantation (TAVI). Initially, Klebsiella pneumoniae bacteraemia from a urinary source was diagnosed. Following another 4 episodes of bacteraemia with the same agent, the source was ultimately found to be a periprosthetic abscess. Considering the patient's unsuitability for surgery, a decision was made for life-long antimicrobial therapy. This approach has been successful in preventing recurrences or complications. Endocarditis is one of the most severe complications seen following TAVI, often carrying a poor prognosis. Even though Klebsiella spp. are common pathogens for healthcare-associated infections among the elderly, they are seldom the causative agent for endocarditis. Being the first reported case of TAVI-related Klebsiella endocarditis, it was successfully managed using a medical approach. LEARNING POINTS: Non-HACEK Gram-negative bacilli are organisms infrequently found to cause infective endocarditis (IE). This is the first reported case of transcatheter aortic valve implantation (TAVI)-related Klebsiella IE.Diagnosing an infectious complication associated with procedural or prosthetic material is not always straightforward; a high level of suspicion and a systematic approach are essential.Most cases of TAVI-related IE are ineligible for surgery due to a prohibitive procedural risk. Long-term antibiotic therapy may be a suitable alternative for patients with uncontrolled infection considered unfit for surgery.

B-cell phenotype and IgD-CD27- memory B cells are affected by TNF-inhibitors and tocilizumab treatment in rheumatoid arthritis.

BACKGROUND: The use of TNF-inhibitors and/or the IL-6 receptor antagonist, tocilizumab, in rheumatoid arthritis (RA) have pleiotropic effects that also involve circulating B-cells. The main goal of this study was to assess the effect of TNF-inhibitors and tocilizumab on B-cell phenotype and gene expression in RA. METHODS: Blood samples were collected from untreated early RA (ERA) patients, established RA patients under methotrexate treatment, established RA patients before and after treatment with TNF-inhibitors and tocilizumab, and healthy donors. B-cell subpopulations were characterized by flow cytometry and B-cell gene expression was analyzed by real-time PCR on isolated B-cells. Serum levels of BAFF, CXCL13 and sCD23 were determined by ELISA. RESULTS: The frequency of total CD19+ B cells in circulation was similar between controls and all RA groups, irrespective of treatment, but double negative (DN) IgD-CD27- memory B cells were significantly increased in ERA and established RA when compared to controls. Treatment with TNF-inhibitors and tocilizumab restored the frequency of IgD-CD27- B-cells to normal levels, but did not affect other B cell subpopulations. TACI, CD95, CD5, HLA-DR and TLR9 expression on B-cells significantly increased after treatment with either TNF-inhibitors and/ or tocilizumab, but no significant changes were observed in BAFF-R, BCMA, CD69, CD86, CXCR5, CD23, CD38 and IgM expression on B-cells when comparing baseline with post-treatment follow-ups. Alterations in B-cell gene expression of BAFF-R, TACI, TLR9, FcγRIIB, BCL-2, BLIMP-1 and ß2M were found in ERA and established RA patients, but no significant differences were observed after TNF-inhibitors and tocilizumab treatment when comparing baseline and follow-ups. Serum levels of CXCL13, sCD23 and BAFF were not significantly affected by treatment with TNF-inhibitors and tocilizumab. CONCLUSIONS: In RA patients, the use of TNF-inhibitors and/ or tocilizumab treatment affects B-cell phenotype and IgD-CD27- memory B cells in circulation, but not B-cell gene expression levels.

Infections on the rise: Raoultella spp., clinical and microbiological findings from a retrospective study, 2010-2014.

We performed a retrospective analysis of clinical and laboratory data over 5 years in a tertiary centre to assess clinical and microbiological characteristics of patients with Raoultella spp. infection. Raoultella spp. were deemed responsible for clinical infections in 57 patients (R. planticola, n = 32 and R. ornithinolytica, n = 25). The most prevalent diagnoses for R. planticola were cystitis (50%; n = 16) followed by bacteraemia and pneumonia (9.4%; n = 3); for R. ornithinolytica, cystitis (36%; n = 9) followed by pneumonia (24%; n = 6). Immunodeficiency was present in 18 patients (56.3%) with R. planticola and in 16 patients (64%) with R. ornithinolytica infection. Of these, 55.6% and 37.5% had diabetes and 27.8% and 18.% were solid organ transplant recipients, respectively. All isolates were sensitive to third-generation cephalosporins, fluoroquinolones and aminoglycosides. Mortality of infections with R. planticola (n = 5; 15.6%) was higher than for R. ornithinolytica (n = 2; 8.0%), but the difference was not statistically significant.

Streptococcus gallolyticus: a single bacteria, two different conditions.

The authors describe the case of a 48-year-old woman presenting with fever, joint pain and migratory skin lesions. She had no other symptoms or medical history. After an extensive and inconclusive work up, she was admitted to the hospital for further study. This patient was ultimately found to have Streptococcus gallolyticus subsp gallolyticus bacteraemia. This finding led to the diagnosis of mitral valve infective endocarditis related to an underlying rectum adenocarcinoma. This article points out diagnostic difficulties related to an unusual presentation of the underlying disease. Furthermore, the authors reinforce the need of keeping a high level of suspicion and a systematic approach in every case of fever of unknown origin. This case highlights the importance of performing a colonoscopy in the event of S. gallolyticus subsp gallolyticus bacteraemia, as it may provide an opportunity for detecting colonic lesions at an earlier stage.

BAFF and TACI gene expression are increased in patients with untreated very early rheumatoid arthritis.

OBJECTIVE: B cells play important roles in rheumatoid arthritis (RA). Given the beneficial effect of B cell depletion therapy in RA as well as the observed alterations in B cell subpopulations in this disease, we evaluated whether changes in the expression of genes related to B cell survival and activation were already present in patients with untreated very early RA (VERA; < 6 weeks of disease duration). METHODS: The expression of a group of B cell-related activation and survival genes was quantified in peripheral blood mononuclear cells from patients with VERA by real-time PCR and compared with untreated early RA (< 1 year), established treated RA, and other untreated early arthritis conditions. Serum B cell-activating factor belonging to the tumor necrosis factor family (BAFF) was quantified by ELISA. RESULTS: BAFF gene expression and serum levels were highest in patients with VERA. The expression of BAFF receptor (BAFF-R) increased with disease progression, while transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI) was elevated since the first weeks of RA onset. Paired box 5 gene expression was also increased at all RA stages. Chemokine (C-X-C motif) receptor 5 was elevated only in established RA. No differences were observed in B cell maturation antigen, activation-induced cytidine deaminase, B lymphocyte-induced maturation protein, and B cell lymphoma 2 expression. CONCLUSION: Disturbances in the expression of B cell-related activation and survival genes, particularly BAFF and TACI, occur from the onset of RA and precede changes in BAFF-R. These alterations can lead to the development of autoreactive B cells from the first weeks of RA onset.

Chronic q Fever with no elevation of inflammatory markers: a case report.

We describe the case of a 55-year-old man with a biological prosthetic aortic valve who suffered from epigastrium and right hypochondrium pain associated with intermittent night sweats. Liver biopsy showed infectious hepatitis pattern without pathognomonic features. Coxiella burnetii serology was suggestive of chronic Q fever, and modified Duke's criteria for endocarditis were also fulfilled. The authors present a brief literature review concerning chronic Q fever, emphasizing absent previous reports of chronic Q fever with hepatitis and endocarditis and no increase in inflammatory markers.

Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine.

BACKGROUND: The aim of this study was to evaluate the clinical and inflammatory responses to surgical trauma caused by the natural orifice transluminal endoscopic surgery (NOTES) transvaginal endoscopic procedure compared with those of the laparoscopic route. METHODS: Twenty-one female swine were divided into three groups of seven animals and subjected to cholecystectomy using laparoscopic, laparotomic, and exclusively NOTES transvaginal routes. A group of five animals served as a control. The animals were monitored during surgery to evaluate anesthetic/surgical time and the presence of complications, which were evaluated after surgery with respect to roaming time, feeding, and the presence of clinical occurrence Measurements of TNF-α, IL-1ß, IL-6, CRP, IFN-γ were obtained before and after surgery, on the second and seventh postoperative days, and when the animals were killed and necropsied. RESULTS: All procedures were successfully completed as proposed in each group. Perioperative complications consisted of only gallbladder perforation and hepatic bleeding. The anesthetic/surgical time was longer in the NOTES vaginal group (p < 0.001). The postanesthetic recovery time, roaming, nutrition, and clinical evolution were similar in all groups. IL-1ß and IL-6 were undetectable in all groups. Levels of TNF-α, CRP, and IFN-γ were similar among the groups. However, the evolution of the inflammatory process, measured as the difference between the peak dose and the basal dose of IFN-γ, was lower in the NOTES group than in the laparotomy group. In the necropsy findings, only adhesions were found, with no difference among the groups. CONCLUSIONS: The entirely NOTES transvaginal cholecystectomy was feasible and safe. The surgical time was greater for the NOTES vaginal route. The inflammatory response was similar among the groups based on the levels of CRP and IFN-γ. However, the evolution of the inflammatory process seems to have been shorter in the vaginal NOTES group than in the laparotomy group as demonstrated by the difference between the peak and basal doses of IFN-γ.

Cytokine pattern in very early rheumatoid arthritis favours B-cell activation and survival.

OBJECTIVES: B cells play an important role in the perpetuation of RA, particularly as autoantibody-producing cells. The ICs that further develop deposit in the joints and aggravate the inflammatory process. However, B-cell contribution in the very early stage of the disease remains unknown. The main goal of this work was to determine the concentration of cytokines potentially relevant for B-cell activation in serum from very early polyarthritis patients, with <6 weeks of disease duration, who latter on evolved into very early RA (VERA). METHODS: A proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF) and IL-21 levels were measured by ELISA in the serum of VERA, other very early arthritis (VEA), established RA patients and controls. SF samples of established RA were also analysed. RESULTS: VERA patients have higher levels of APRIL and BAFF as compared with VEA, established RA and controls. Furthermore, APRIL and BAFF levels are also significantly elevated in RA-SF when compared with serum. CONCLUSIONS: The increased levels of APRIL and BAFF in VERA patients suggests that B-cell activation and the development of autoreactive B-cell responses might be crucial in early phases of RA. Therefore, APRIL and BAFF could be promising targets for therapy in the early phase of RA.

B-cell-activating factor receptor expression on naive and memory B cells: relationship with relapse in patients with rheumatoid arthritis following B-cell depletion therapy.

OBJECTIVES: To examine the expression of B-cell-activating factor receptor (BAFF-R) on naive CD27- and memory CD27+ B cells in normal individuals and patients with rheumatoid arthritis (RA) undergoing B-cell depletion therapy with rituximab. PATIENTS AND METHODS: BAFF-R expression on B-cell subsets was determined in normal controls (NC; n = 11), active patients with RA pre-rituximab (pre-RX; n = 15), relapsing patients either concordant for B-cell repopulation (C-R, n = 13) or discordant, with relapse more than 3 months after repopulation (D-R, n = 11) and patients in remission over 3 months postrepopulation (discordant non-relapsing (D-NR), n = 5). Serum BAFF was measured by ELISA and analysed using Mann-Whitney. RESULTS: There was no significant difference between NC, pre-RX and D-NR patients in %BAFF-R-positive B cells or mean fluorescence intensity (MFI) in naive and memory B cells. Relapsing patients had significantly lower MFI and %BAFF-R-positive cells in both naive and memory compartments from NC and pre-RX (C-R and D-R; p < 0.01). BAFF levels in pre-RX patients were within the normal range and did not correlate with BAFF-R expression in any patient group. D-NR patients had relatively lower proportions of pre and postswitch CD27+ B cells than pre-RX patients (D-NR vs pre-RX; p < 0.05 for both) and also lower numbers of postswitch B cells than D-R patients (D-NR vs D-R, p < 0.05). CONCLUSION: BAFF-R expression was significantly reduced on both naive and memory B cells in patients at relapse, regardless of the relationship with B-cell repopulation or serum BAFF levels. Re-establishment of active disease was also associated with an increase in class-switch recombination. Factors responsible for lower levels of BAFF-R may relate to altered thresholds for autoreactive B-cell generation at relapse in patients with RA.

Alterations on peripheral blood B-cell subpopulations in very early arthritis patients.

OBJECTIVE: To characterize circulating B-cell subpopulations of arthritis patients with <6 weeks of disease duration. METHODS: Peripheral blood samples were collected from very early untreated polyarthritis patients, with <6 weeks of disease duration, for flow cytometric evaluation of B-cell subpopulations. Samples from patients who were later diagnosed as RA [very early RA (VERA)] were also collected 4-6 weeks after starting a low dose of prednisone (5-10 mg) and 4 months after reaching the minimum effective dose of MTX. A matched healthy group was used as a control. RESULTS: VERA patients have a lower percentage of total peripheral blood memory B cells (CD19(+)CD27(+)) and a significant decrease in the frequency of circulating pre-switch memory B cells (CD19(+)IgD(+)CD27(+)) as compared with controls. Therapy with corticosteroids or MTX was unable to restore the normal frequencies of these B-cell subpopulations. A significant decrease in peripheral pre-switch memory B cells is equally observed in other early arthritis patients. Furthermore, no significant differences are found in the frequencies of CD4(+) and CD8(+) T cells in all patient groups. CONCLUSIONS: In very early polyarthritis patients, there is a reduction in circulating pre-switch memory B cells. The reasons that may account for this effect are still unknown. Short-term corticosteroids and MTX do not seem to have a direct effect on circulating B-cell subpopulations in VERA patients.

Predictive factors for spasticity among ischemic stroke patients / Fatores preditivos para espasticidade após acidente vascular cerebral

Spasticity is a determining for functional loss following ischemic stroke. OBJECTIVE: To detect possible predictive factors for its occurrence. METHOD: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. RESULTS: Spasticity was noted more frequently among patients who underwent physiotherapy (p<0.0001; OR=19.4; 95 percent CI: 4.4-84.5), those who underwent such treatment for long periods (p=0.028; OR=4.80; 95 percent CI: 1.1-8.3) and those with manual work (p=0.041; OR=2.2; 95 percent CI: 1.02-4.6), lower income (p=0.038), pain complaints (p<0.0001; OR=107.0; 95 percent CI: 13.5-847.3), appearance of pain at the same time as spasticity (p<0.0001), previous vascular disease (p=0.001; OR=4.2; 95 percent CI: 1.7-10.3), muscle weakness (p<0.0001; OR=91.9; 95 percent CI: 12.0-699.4), extensive lesions as seen on tomography (p=0.01) and lesions affecting more than one cerebral lobe (p=0.018). Manual work had a relative risk of 2.9; previous stroke 3.9, and extensive lesion 3.6. CONCLUSION: Spasticity affected 25 percent of the patients, and was associated with: manual work, previous stroke, extensive lesions, decrease in individual income, underwent physiotherapy, underwent physiotherapy for longer period, pain complaints, the pain started simultaneously with the spasticity, presented changes in strength.

A espasticidade é fator determinante para perda funcional após o acidente vascular cerebral isquêmico (AVCI). OBJETIVO: Detectar possíveis fatores preditivos para a ocorrência da espasticidade. MÉTODO: Foram analisados dados demográficos, clínicos e tomográficos de 146 pacientes pós-AVCI. RESULTADOS: Na análise univariada a espasticidade foi notada com maior freqüência em pacientes que realizaram fisioterapia (p<0,0001; OR=19,4; 95 por cento CI: 4,4-84,5), com maior tempo de duração desse tratamento (p=0,028; OR=4,80; 95 por cento CI: 1,1-8,3) e que realizavam trabalho braçal (p=0,041; OR=2,2; 95 por cento CI: 1,02-4,6), renda menor (p=0,038), referência de dor (p<0,0001; OR=107,0; 95 por cento CI: 13,5-847,3) e seu aparecimento simultâneo à espasticidade (p<0,0001), acidente vascular cerebral (AVC) pregresso (p=0,001; OR=4,2; 95 por cento CI: 1,7-10,3), fraqueza muscular (p<0,0001; OR=91,9; 95 por cento CI: 12,0-699,4), lesão tomográfica extensa (p=0,01) e lesão afetando mais de um lobo cerebral (p=0,018). Na análise de regressão multivariada a atividade braçal apresentou risco relativo de 2,9; acidente vascular cerebral prévio com risco relativo de 3,9 e lesão tomográfica extensa risco relativo de 3,6. CONCLUSÃO: A espasticidade afetou um quarto da população estudada e esteve associada ao trabalho braçal, AVC pregresso, lesões tomográficas extensas, diminuição da renda individual, realização de fisioterapia, realização de fisioterapia por um período maior, presença de dor, surgimento da dor simultânea à espasticidade e alteração da força.

Comparative cytogenetics of three species of Dichotomius (Coleoptera, Scarabaeidae)

Meiotic and mitotic chromosomes of Dichotomius nisus, D. semisquamosus and D. sericeus were analyzed after conventional staining, C-banding and silver nitrate staining. In addition, Dichotomius nisus and D. semisquamosus chromosomes were also analyzed after fluorescent in situ hybridization (FISH) with an rDNA probe. The species analyzed had an asymmetrical karyotype with 2n = 18 and meta-submetacentric chromosomes. The sex determination mechanism was of the Xy p type in D. nisus and D. semisquamosus and of the Xyr type in D. sericeus. C-banding revealed the presence of pericentromeric blocks of constitutive heterochromatin (CH) in all the chromosomes of the three species. After silver staining, the nucleolar organizer regions (NORs) were located in autosomes of D. semisquamosus and D. sericeus and in the sexual bivalent of D. nisus. FISH with an rDNA probe confirmed NORs location in D. semisquamosus and in D. nisus. Our results suggest that chromosome inversions and fusions occurred during the evolution of the group.

O Programa de Agentes Comunitários de Saúde adaptado à cidade do Rio de Janeiro: uma análise das suas concepções / Health Community Agent’s program adapted to the city of Rio de Janeiro: na analysis of its conceptions

Este trabalho trata de um estudo sobre uma experiência de adaptação do modelo Programa de Agentes Comunitários de Saúde, executado pela Coordenação de Saúde da Comunidade, da Secretaria Municipal de Saúde do Rio de Janeiro, no período de 2002 a 2005, que se coloca com certa divergência ao projeto político do Ministério da Saúde. Propõe-se a apresentar o contexto em que surge essa proposta e identificar e analisar as concepções da sua formulação. Poucos foram os documentos oficiais disponíveis para este estudo, transformando as entrevistas na técnica primordial para a realização do mesmo. Verificamos que havia um vazio de formulação de uma política de mudança da atenção básica para a cidade e, dessa forma, a oportunidade para formulações técnicas de modelos experimentais se colocou. Nesse cenário, surge a proposta da implantação de equipes de PACS, como uma tentativa de dar resposta aos obstáculos colocados à expansão da ESF, sendo aproveitado para ser adaptado de forma a aumentar a oferta de ações da atenção básica, nas áreas consideradas estratégicas pela NOAS 01/01.

Diversidade de Scarabaeinae (Coleoptera, Scarabaeidae) coletados com armadilha de interceptação de vôo no Refúgio Ecológico Charles Darwin, Igarassu-PE, Brasil / Diversity of Scarabaeinae (Coleoptera, Scarabaeidae) collected with flight intercept trap in the Charles Darwin Ecologic Refuge, Igarassu-PE, Brazil

O objetivo deste trabalho foi estudar riqueza, abundância, diversidade e equitabilidade das espécies de Scarabaeinae em dois ambientes no Refúgio Ecológico Charles Darwin (RECD), Pernambuco. As coletas foram realizadas com armadilha de interceptação de vôo entre os meses de Abril e Junho de 2007, totalizando seis coletas. Foram capturados 4576 escarabeíneos, pertencentes a 35 espécies, 15 gêneros e seis tribos. Sete novos registros de espécies foram feitos para Pernambuco, passando de 26 para 33 espécies. As tribos registradas foram Canthonini, Ateuchini, Coprini, Phanaeini, Eurystenini e Onthophagini. Os gêneros melhor representados foram: Dichotomius com 84,6 por cento dos besouros coletados, seguido por Canthidium com 7,62 por cento e Canthon com 2,48 por cento. A espécie Dichotomius aff.sericeus foi a mais abundante com 3889 indivíduos. Em todo o estudo foram verificadas 17 espécies para a área aberta, sendo 11 restritas a esse ambiente, enquanto para mata foram registradas 24, sendo 18 espécies restritas. Grande parte dos indivíduos capturados na mata foi da espécie D. aff.sericeus, enquanto no ambiente aberto nenhum indivíduo desta espécie foi coletado. Os estimadores indicaram uma estimativa máxima de riqueza de 21 espécies para o ambiente aberto e 32 espécies para o ambiente de mata. A curva de acumulação de espécies baseada em valores de riqueza observada média para os dois ambientes do RECD, não apresentou tendência a assíntota.

The objective of this work was to study richness, abundance, diversity and equitability of the species of Scarabaeinae, in two environments in the Charles Darwin Ecology Refuge (CDER), Pernambuco. Sampling was carried with flight intercept trap from April through June 2007, totaling six samples. 4576 scarabaeinaes, belonging to 35 species, 15 genera and six tribes were captured. Seven new species records were found for Pernambuco, whose known fauna increased from 26 to 33 species. The tribes recorded were Canthonini, Ateuchini, Coprini, Phanaeinae, Eurystenini and Onthophagini. The better represented genera were: Dichotomius with 84,6 percent of the beetles collected, followed by Canthidium with 7,62 percent and Canthon with 2,48 percent. Dichotomius aff.sericeus was the most abundant species with 3889 individuals. 17 species were sampled in open areas, with 11 of them restricted to this habitat, while 24 were recorded within the forest, 18 of them found only in this habitat. Most individuals captured in the forest belong to D. aff.sericeus, while in open areas no specimen of this species was collected. The estimators indicate a maximum richness of 21 species for the open environment and 32 species for the forest. The species accumulation curve, based on average richness values for the two environments at CDER, did not show tendency to assintote.

High levels of chromosomal differentiation in Euchroma gigantea L. 1735 (Coleoptera, Buprestidae)

Euchroma gigantea was karyotypically studied using conventional staining, C-banding, silver nitrate staining and ribosomal fluorescent in situ hybridization (rDNA FISH). Broad wide autosomal polymorphism and a complex sex determination system were found in this beetle. Karyotype complements ranging from 2n = 32, X1X2X3Y1Y2Y3 to 2n = 36,X1X2X3Y1Y2Y3 were detected in the sample analyzed. Punctiform supernumerary chromosomes were present in the different karyotypes. The karyotypic evolution of Brazilian E. gigantea may have taken two directions, reduction in the diploid number of 2n = 36 to 24 through centric fusions or 2n = 24 to 36 due to chromosomal fissions. In addition, pericentric inversions were also involved. The complex multiple sex mechanism of this species seems to be old and well established since it is found in specimens from different populations. Small pericentromeric blocks of constitutive heterochromatin were located on the autosomes and terminal blocks were also found on some small pairs. The sex chromosomes showed larger constitutive heterochromatin blocks. Silver nitrate staining during prophase I of meiosis showed labeling of the sex chromosome chain. However, the rDNA sites could only be precisely determined by FISH, which permitted the identification of these ribosomal sites on chromosomes X1 and X2 of this species.

Comunidade de escarabeíneos (Coleoptera, Scarabaeidae) copro-necrófagos da região de Brejo Novo, Caruaru, Pernambuco, Brasil / Copro-necrophagous scarab community (Coleoptera, Scarabaeidae) of the Brejo Novo region, Caruaru, Pernambuco, Brazil

Este estudo objetivou levantar preliminarmente os escarabeíneos copro-necrófagos da região de Brejo Novo, Caruaru, Pernambuco, e verificar aspectos da estrutura da comunidade como sazonalidade, diversidade, equitabilidade, riqueza e abundância das espécies. Foram realizadas 10 coletas, com intervalos de 30 dias e duração de 48 horas, de setembro de 2003 a julho de 2004. Utilizaramse 24 armadilhas de queda, com dois tipos de isca, fezes humanas e carne bovina em estado de putrefação. Foram coletados 1.540 indivíduos pertencentes a seis tribos, 12 gêneros e 28 espécies. As espécies Canthon af. carbonarius, Canthon chalybaeus, Dichotomius nisus, D. semisquamosus, Digitonthophagus gazella e Eurysternus hirtellus aparentemente são as mais adaptadas ao ambiente estudado. Foram coletados 826 indivíduos em armadilhas iscadas com fezes humanas e 714 em carne bovina apodrecida. Ocorreu um número maior de espécies consideradas "raras" (15), sendo três destas "singletons", duas "doubletons" e 10 com abundância entre três e 10 indivíduos, 13 espécies foram consideradas "comuns". Das espécies analisadas, sete apresentaram hábitos alimentares generalistas, quatro são estritamente coprófagas e uma estritamente necrófaga. Foram verificadas correlações positivas entre a precipitação mensal e a abundância e a riqueza de espécies. O levantamento preliminar das espécies de Scarabaeinae da região de Brejo Novo contribuiu para aumentar o número de espécies registradas para o estado de Pernambuco e região Nordeste do Brasil.

This paper reports the results of the preliminary survey of copro-necrophagous dung beetles of Brejo Novo region, Caruaru, Pernambuco, as well as some aspects of the community structure such as seasonality, diversity, equitability, richness and abundance of species. Ten samplings with intervals of 30 days and duration of 48 hours, fortnightly were done between September 2003 to July 2004. Scarab beetles were collected with 24 pitfall traps baited with two types of baits, human excrements and rotting bovine meat. A total of 1,540 individuals belonging to six tribes, 12 genera and 28 species were collected. The species Canthon af. carbonarius, Canthon chalybaeus, Dichotomius nisus, D. semisquamosus, Digitonthophagus gazella and Eurysternus hirtellus are, apparently, adapted to the studied environment. Traps baited with human excrements attracted 826 individuals and those with rotting bovine meat attracted 714 specimens. Large number of species (15) considered "rare" occurred, being three of them "singletons", two "doubletons" and 10 with abundance between three and 10 individuals; 13 species were considered "common". Of the analyzed species, seven present generalist alimentary habits, four are strictly coprophagous and one is strictly necrophagous. Positive correlations were verified between the precipitation and the abundance of the individuals and the species richness. This preliminary survey of the dung beetles of the Brejo Novo region contributed to increase the number of species registered for Pernambuco and northeast region of Brazil.