Shedding Light on Dark Chemical Matter: The Discovery of a SARS-CoV-2 Mpro Main Protease Inhibitor through Intensive Virtual Screening and In Vitro Evaluation.

The development of specific antiviral therapies targeting SARS-CoV-2 remains fundamental because of the continued high incidence of COVID-19 and limited accessibility to antivirals in some countries. In this context, dark chemical matter (DCM), a set of drug-like compounds with outstanding selectivity profiles that have never shown bioactivity despite being extensively assayed, appears to be an excellent starting point for drug development. Accordingly, in this study, we performed a high-throughput screening to identify inhibitors of the SARS-CoV-2 main protease (Mpro) using DCM compounds as ligands. Multiple receptors and two different docking scoring functions were employed to identify the best molecular docking poses. The selected structures were subjected to extensive conventional and Gaussian accelerated molecular dynamics. From the results, four compounds with the best molecular behavior and binding energy were selected for experimental testing, one of which presented inhibitory activity with a Ki value of 48 ± 5 µM. Through virtual screening, we identified a significant starting point for drug development, shedding new light on DCM compounds.

Use of Galleria mellonella as an Animal Model for Studying the Antimicrobial Activity of Bacteriophages with Potential Use in Phage Therapy.

Interest in phage therapy has increased in the last decade, and animal models have become essential in this field. The larval stage of the wax moth, Galleria mellonella, represents an easy-to-handle model. The larvae have an innate immune response and survive at 37 °C, which is ideal for infection and antimicrobial studies with bacteriophages. In this chapter, we describe the procedures used to study the antimicrobial activity of bacteriophages in a G. mellonella infection model.

Safety attributes of Pseudomonas sp. P26, an environmental microorganism with potential application in contaminated environments.

Currently, the selection of non-pathogenic microorganisms that lack clinically relevant antimicrobial resistance is crucial to bioaugmentation strategies. Pseudomonas sp. P26 (P26) is an environmental bacterium of interest due to its ability to remove aromatic compounds from petroleum, but its safety characteristics are still unknown. The study aimed to: a) determine P26 sensitivity to antimicrobials, b) investigate the presence of quinolone and ß-lactam resistance genes, c) determine the presence of virulence factors, and d) evaluate the effect of P26 on the viability of Galleria mellonella (an invertebrate animal model). P26 antimicrobial sensitivity was determined in vitro using the Kirby-Bauer agar diffusion method and the VITEK 2 automated system (BioMerieux®). Polymerase Chain Reaction was employed for the investigation of genes associated with quinolone resistance, extended-spectrum ß-lactamases, and carbapenemases. Hemolysin and protease production was determined in human blood agar and skimmed-milk agar, respectively. In the in vivo assay, different doses of P26 were injected into Galleria mellonella larvae and their survival was monitored daily. Control larvae injected with Pseudomonas putida KT2440 (a strain considered as safe) and Pseudomonas aeruginosa PA14 (a pathogenic strain) were included. Pseudomonas sp. P26 was susceptible to most evaluated antimicrobials, except for trimethoprim-sulfamethoxazole. No epidemiologically relevant genes associated with quinolone and ß-lactam resistance were identified. Hemolysin and protease production was only evidenced in the virulent strain (PA14). Furthermore, the results obtained in the in vivo experiment demonstrated that inocula less than 108 CFU/mL of P26 and P. putida KT2440 did not significantly affect larval survival, whereas larvae injected with the lowest dose of the pathogenic strain P. aeruginosa PA14 experienced instant mortality. The results suggest that Pseudomonas sp. P26 is a safe strain for its application in environmental bioremediation processes. Additional studies will be conducted to ensure the safety of this bacterium against other organisms.

Regulation of anti-phage defense mechanisms by using cinnamaldehyde as a quorum sensing inhibitor.

Background: Multidrug-resistant bacteria and the shortage of new antibiotics constitute a serious health problem. This problem has led to increased interest in the use of bacteriophages, which have great potential as antimicrobial agents but also carry the risk of inducing resistance. The objective of the present study was to minimize the development of phage resistance in Klebsiella pneumoniae strains by inhibiting quorum sensing (QS) and thus demonstrate the role of QS in regulating defense mechanisms. Results: Cinnamaldehyde (CAD) was added to K. pneumoniae cultures to inhibit QS and thus demonstrate the role of the signaling system in regulating the anti-phage defense mechanism. The QS inhibitory activity of CAD in K. pneumoniae was confirmed by a reduction in the quantitative expression of the lsrB gene (AI-2 pathway) and by proteomic analysis. The infection assays showed that the phage was able to infect a previously resistant K. pneumoniae strain in the cultures to which CAD was added. The results were confirmed using proteomic analysis. Thus, anti-phage defense-related proteins from different systems, such as cyclic oligonucleotide-based bacterial anti-phage signaling systems (CBASS), restriction-modification (R-M) systems, clustered regularly interspaced short palindromic repeat-Cas (CRISPR-Cas) system, and bacteriophage control infection (BCI), were present in the cultures with phage but not in the cultures with phage and CAD. When the QS and anti-phage defense systems were inhibited by the combined treatment, proteins related to phage infection and proliferation, such as the tail fiber protein, the cell division protein DamX, and the outer membrane channel protein TolC, were detected. Conclusion: Inhibition of QS reduces phage resistance in K. pneumoniae, resulting in the infection of a previously resistant strain by phage, with a significant increase in phage proliferation and a significant reduction in bacterial growth. QS inhibitors could be considered for therapeutic application by including them in phage cocktails or in phage-antibiotic combinations to enhance synergistic effects and reduce the emergence of antimicrobial resistance.

Single-cell analysis reveals that cryptic prophage protease LfgB protects Escherichia coli during oxidative stress by cleaving antitoxin MqsA.

Although toxin/antitoxin (TA) systems are ubiquitous, beyond phage inhibition and mobile element stabilization, their role in host metabolism is obscure. One of the best-characterized TA systems is MqsR/MqsA of Escherichia coli, which has been linked previously to protecting gastrointestinal species during the stress it encounters from the bile salt deoxycholate as it colonizes humans. However, some recent whole-population studies have challenged the role of toxins such as MqsR in bacterial physiology since the mqsRA locus is induced over a hundred-fold during stress, but a phenotype was not found upon its deletion. Here, we investigate further the role of MqsR/MqsA by utilizing single cells and demonstrate that upon oxidative stress, the TA system MqsR/MqsA has a heterogeneous effect on the transcriptome of single cells. Furthermore, we discovered that MqsR activation leads to induction of the poorly characterized yfjXY ypjJ yfjZF operon of cryptic prophage CP4-57. Moreover, deletion of yfjY makes the cells sensitive to H2O2, acid, and heat stress, and this phenotype was complemented. Hence, we recommend yfjY be renamed to lfgB (less fatality gene B). Critically, MqsA represses lfgB by binding the operon promoter, and LfgB is a protease that degrades MqsA to derepress rpoS and facilitate the stress response. Therefore, the MqsR/MqsA TA system facilitates the stress response through cryptic phage protease LfgB.IMPORTANCEThe roles of toxin/antitoxin systems in cell physiology are few and include phage inhibition and stabilization of genetic elements; yet, to date, there are no single-transcriptome studies for toxin/antitoxin systems and few insights for prokaryotes from this novel technique. Therefore, our results with this technique are important since we discover and characterize a cryptic prophage protease that is regulated by the MqsR/MqsA toxin/antitoxin system in order to regulate the host response to oxidative stress.

Phages produce persisters.

Arguably, the greatest threat to bacteria is phages. It is often assumed that those bacteria that escape phage infection have mutated or utilized phage-defence systems; however, another possibility is that a subpopulation forms the dormant persister state in a manner similar to that demonstrated for bacterial cells undergoing nutritive, oxidative, and antibiotic stress. Persister cells do not undergo mutation and survive lethal conditions by ceasing growth transiently. Slower growth and dormancy play a key physiological role as they allow host phage defence systems more time to clear the phage infection. Here, we investigated how bacteria survive lytic phage infection by isolating surviving cells from the plaques of T2, T4, and lambda (cI mutant) virulent phages and sequencing their genomes. We found that bacteria in plaques can escape phage attack both by mutation (i.e. become resistant) and without mutation (i.e. become persistent). Specifically, whereas T4-resistant and lambda-resistant bacteria with over a 100,000-fold less sensitivity were isolated from plaques with obvious genetic mutations (e.g. causing mucoidy), cells were also found after T2 infection that undergo no significant mutation, retain wild-type phage sensitivity, and survive lethal doses of antibiotics. Corroborating this, adding T2 phage to persister cells resulted in 137,000-fold more survival compared to that of addition to exponentially growing cells. Furthermore, our results seem general in that phage treatments with Klebsiella pneumonia and Pseudomonas aeruginosa also generated persister cells. Hence, along with resistant strains, bacteria also form persister cells during phage infection.

Género, infodemia y desinformación en salud. Revisión de alcance global, vacíos de conocimiento y recomendaciones.

OBJETIVO: explorar el estado de la literatura científica sobre los aspectos de infodemia y desinformación en salud vinculados al género y a la interseccionalidad, detectar vacíos de conocimiento y brindar recomendaciones. MÉTODOS: revisión de alcance global, con la detección de vacíos de conocimiento y recomendaciones. Se buscó en ocho bases de datos: MEDLINE (Pubmed), Anthropological Index Online, Studies on Women & Gender Abstracts, LILACS, Scielo, Global Index Medicus, Web of Science, Google académico y se hizo una búsqueda manual en Google de documentos de los últimos 10 años, sin restricciones de idioma y geográficas. Se realizó un análisis de contenido de los estudios incluidos. RESULTADOS: 855 registros fueron identificados y 21 cumplieron con los criterios de inclusión. Predominan los estudios que tuvieron como primer autor/a una mujer (13/21), aunque en la autoría global se destacaron los hombres (10/21). El modelo binario fue el enfoque principal (16/21). La mayoría (18/21) se publicaron a partir del 2020. Se abordaron principalmente temas relacionados con la COVID-19 y la salud sexual y reproductiva (antes de la pandemia), y en menor medida la salud mental. Se identificaron interacciones entre diferencias de sexo/género en la desinformación/infodemia en salud especialmente en mujeres, colectivos de género diverso, personas mayores y población de bajo nivel socioeducativo. CONCLUSIONES: existen brechas de conocimiento en el tema explorado, con escaso número de estudios, y limitaciones de alcances y del enfoque de género y/o feminista (más allá del binario). No obstante, los resultados tentativos constatan la presencia de inequidades de género e interseccionalidad en la desinformación en salud. PALABRAS CLAVE: infodemia, desinformación, género, COVID-19, revisión sistemática.

Improving phage therapy by evasion of phage resistance mechanisms.

Antibiotic failure is one of the most worrisome threats to global health. Among the new therapeutic efforts that are being explored, the use of bacteriophages (viruses that kill bacteria), also known as 'phages', is being extensively studied as a strategy to target bacterial pathogens. However, one of the main drawbacks of phage therapy is the plethora of defence mechanisms that bacteria use to defend themselves against phages. This review aims to summarize the therapeutic approaches that are being evaluated to overcome the bacterial defence systems, including the most innovative therapeutic approaches applied: circumvention of phage receptor mutations; modification of prophages; targeting of CRISPR-Cas systems and the biofilm matrix; engineering of safer and more efficacious phages; and inhibition of the anti-persister strategies used by bacteria.

Elastic and inelastic strain in submicron-thick ZnO epilayers grown on r-sapphire substrates by metal-organic vapour phase deposition.

A significant part of the present and future of optoelectronic devices lies on thin multilayer heterostructures. Their optical properties depend strongly on strain, being essential to the knowledge of the stress level to optimize the growth process. Here the structural and microstructural characteristics of sub-micron a-ZnO epilayers (12 to 770 nm) grown on r-sapphire by metal-organic chemical vapour deposition are studied. Morphological and structural studies have been made using scanning electron microscopy and high-resolution X-ray diffraction. Plastic unit-cell distortion and corresponding strain have been determined as a function of film thickness. A critical thickness has been observed as separating the non-elastic/elastic states with an experimental value of 150-200 nm. This behaviour has been confirmed from ultraviolet photoelectron spectroscopy, X-ray photoelectron spectroscopy and high-resolution transmission electron microscopy measurements. An equation that gives the balance of strains is proposed as an interesting method to experimentally determine this critical thickness. It is concluded that in the thinnest films an elongation of the Zn-O bond takes place and that the plastic strained ZnO films relax through nucleation of misfit dislocations, which is a consequence of three-dimensional surface morphology.

A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population.

Serratia spp. is a well-recognized pathogen in neonates; however, limited data are available in adults. We studied microbiological and clinical characteristics of Serratia spp. causing bloodstream infections (BSI) in our institution (January 2005-July 2020). Overall, 141 BSI episodes affecting 139 patients were identified and medical records reviewed. Antimicrobial susceptibility was recovered from our informatics system and 118 isolates from 116 patients were available for further microbiological studies. Whole genome sequencing (WGS) was completed in 107 isolates. Incidence of Serratia BSI was 0.3/1000 overall admissions (range 0.12-0.60), with maximum prevalence (27 episodes, 19.1%) during 2017-2018. Relevant patients' clinical characteristics were 71.9% ≥60 years (n = 100), with high comorbidity rates (49%, ≥2), 23 (74.2%) of them died within 1 month of the BSI episode. WGS identified all isolates as Serratia marcescens when Kraken bioinformatics taxonomic tool was used despite some which were identified as Serratia nematodiphila (32/118) or Serratia ureilytica (5/118) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Nevertheless, when using MASH distance, Serratia nevei (63/107), S. ureilytica (38/107), and S. marcescens (6/107) were assigned. Carbapenemase (blaVIM-1) and extended-spectrum ß-lactases (ESBL) (blaSHV-12) genes were found in seven and three isolates, respectively, one of them expressing both genes. The worldwide-disseminated IncL/M scaffold plasmid was identified in six VIM producers. Four genotypes were established based on their virulence factors and resistome. Serratia spp. emerged as a relevant nosocomial pathogen causing BSI in elderly patients in our hospital, particularly in recent years with a remarkable increase in antibiotic resistance. ESBL and carbapenemases production related to plasmid dissemination are particularly noteworthy.IMPORTANCESerratia spp. is the third most frequent pathogen involved in outbreaks at neonatal facilities and is primarily associated with bacteremia episodes. In this study, we characterized all causing bloodstream infection (BSI) in patients admitted to our hospital during a 16-year period (2005-2020). Despite having no neonatal intensive care unit in our hospital, this study revealed that Serratia spp. is a relevant pathogen causing BSI in elderly patients with high comorbidity rates. A significant increase of antimicrobial resistance was detected over time, particularly in 2020 and coinciding with the coronavirus disease (COVID-19) pandemic and nosocomial spread of multidrug-resistant Serratia spp. isolates. extended-spectrum ß-lactases and carbapenemases genes associated with plasmid dissemination, typically detected in other Enterobacterales species, were also identified, reinforcing the role of Serratia spp. in the antimicrobial resistance landscape. Additionally, this work highlights the need to reclassify the species of Serratia, since discrepancies were observed in the identification when using different tools.

P53 expression correlates with low axillary tumor burden in breast cancer.

BACKGROUND: The p53 mutation in breast cancer confers a worse prognosis and is usually associated with p53 overexpression (p53+) on immunohistochemistry. Previous studies have shown that p53+ tumors could be associated with low axillary tumor burden (ATB). OBJECTIVE: We aimed to evaluate the association between p53+ and ATB in a large series of breast cancers as an aid to personalizing axillary surgical treatment. METHODS: We retrieved 1762 infiltrating breast carcinomas from our database that were treated with upfront surgery in Hospital del Mar from 2004 to 2018. We compared p53+ and p53-negative (p53-) tumors in terms of the percentage of cases with high ATB and overall survival. This comparison was made overall and for each immunophenotype. RESULTS: Overall, 18.7% of breast tumors were p53+. High ATB was less common in p53+ tumors than in p53- tumors in the luminal B-Her2-negative immunophenotype (6.2% versus 16.9%, respectively, P = 0.025), but not in the other immunophenotypes or overall. Overall survival was worse in patients with p53+ breast cancer (P = 0.002). CONCLUSION: p53+ breast cancers were associated with worse overall survival. However, low ATB was more common in these tumors than in p53- tumors in the luminal B-Her2-negative subtype. Information on p53 expression could be of use to predict ATB in some breast cancer tumors.

Resistance against two lytic phage variants attenuates virulence and antibiotic resistance in Pseudomonas aeruginosa.

Background: Bacteriophage therapy is becoming part of mainstream Western medicine since antibiotics of clinical use tend to fail. It involves applying lytic bacteriophages that self-replicate and induce cell lysis, thus killing their hosts. Nevertheless, bacterial killing promotes the selection of resistant clones which sometimes may exhibit a decrease in bacterial virulence or antibiotic resistance. Methods: In this work, we studied the Pseudomonas aeruginosa lytic phage φDCL-PA6 and its variant φDCL-PA6α. Additionally, we characterized and evaluated the production of virulence factors and the virulence in a Galleria mellonella model of resistant mutants against each phage for PA14 and two clinical strains. Results: Phage φDCL-PA6α differs from the original by only two amino acids: one in the baseplate wedge subunit and another in the tail fiber protein. According to genomic data and cross-resistance experiments, these changes may promote the change of the phage receptor from the O-antigen to the core lipopolysaccharide. Interestingly, the host range of the two phages differs as determined against the Pseudomonas aeruginosa reference strains PA14 and PAO1 and against nine multidrug-resistant isolates from ventilator associated pneumonia. Conclusions: We show as well that phage resistance impacts virulence factor production. Specifically, phage resistance led to decreased biofilm formation, swarming, and type III secretion; therefore, the virulence towards Galleria mellonella was dramatically attenuated. Furthermore, antibiotic resistance decreased for one clinical strain. Our study highlights important potential advantages of phage therapy's evolutionary impact that may be exploited to generate robust therapy schemes.

Coronavirus Pandemics Era and Cancer Patients / A Era do Coronavirus Pandêmico e os Pacientes Oncológicos / Era de Coronavirus Pandémico y Pacientes con Cáncer

There are more and more studies that establish that viruses similar to the coronavirus (SARS) can be transmitted from animals to people hundreds of thousands of times a year, facilitating new adaptations in humans and therefore the development of pandemics1 . Recently, a work under review based on samples from the Indochinese peninsula, concludes that these viruses can move rapidly in wide geographic ranges in bat reservoirs, frequently infecting people who work in caves, such as guano collectors, or certain ascetic religious communities who spend time in or very close to caves, as well as tourists who visit caves, at particular risk of exposure2 . In addition, it must be considered that it will also depend on the evolution of the SARS-CoV-2 (COVID-19) variants associated with global vaccination campaigns in order to maintain the efficacy of current vaccines3 . It is therefore of vital importance to continue innovating in new vaccination strategies that allow covering the majority of coronaviruses of animal origin, as well as new variants derived from SARS-CoV-2

Ventilación no invasiva versus oxigenoterapia convencional tras fracaso de la extubación en pacientes de alto riesgo en una unidad de cuidados intensivos: un ensayo clínico pragmático / Noninvasive ventilation versus conventional oxygen therapy after extubation failure in high-risk patients in an intensive care unit: a pragmatic clinical trial

RESUMEN Objetivo: Determinar la efectividad de la ventilación no invasiva frente a oxigenoterapia convencional en pacientes con insuficiencia respiratoria aguda tras fracaso de la extubación. Métodos: Ensayo clínico pragmático realizado una unidad de cuidados intensivos de marzo de 2009 a septiembre de 2016. Se incluyeron pacientes sometidos a ventilación mecánica > 24 horas, y que desarrollaron insuficiencia respiratoria aguda tras extubación programada, siendo asignados a ventilación no invasiva u oxigenoterapia convencional. El objetivo primario fue reducir la tasa de reintubación. Los objetivos secundarios fueron: mejora de los parámetros respiratorios, reducción de las complicaciones, de la duración de la ventilación mecánica, de la estancia en unidad de cuidados intensivos y hospitalaria, así como de la mortalidad en unidad de cuidados intensivos, hospitalaria y a los 90 días. También se analizaron los factores relacionados con la reintubación. Resultados: De un total de 2.574 pacientes, se analizaron 77 (38 en el grupo de ventilación no invasiva y 39 en el grupo de oxigenoterapia convencional). La ventilación no invasiva redujo la frecuencia respiratoria y cardíaca más rápidamente que la oxigenoterapia convencional. La reintubación fue menor en el grupo de ventilación no invasiva [12 (32%) versus 22(56%) en grupo oxigenoterapia convencional, RR 0,58 (IC95% 0,34 - 0,97), p = 0,039], el resto de los parámetros no mostró diferencias significativas. En el análisis multivariante, la ventilación no invasiva prevenía la reintubación [OR 0,17 (IC95% 0,05 - 0,56), p = 0,004], mientras que el fracaso hepático previo a la extubación y la incapacidad para mantener vía aérea permeable predisponían a la reintubación. Conclusión: El empleo de la ventilación no invasiva en pacientes que fracasa la extubación podría ser beneficiosa frente a la oxigenoterapia convencional.

ABSTRACT Objective: To determine the effectiveness of noninvasive ventilation versus conventional oxygen therapy in patients with acute respiratory failure after extubation failure. Methods: A pragmatic clinical trial was conducted in an intensive care unit from March 2009 to September 2016. Patients on mechanical ventilation > 24 hours who developed acute respiratory failure after scheduled extubation were included and were assigned to noninvasive ventilation or conventional oxygen therapy. The primary objective was to reduce the reintubation rate. The secondary objectives were to improve respiratory parameters and reduce complications, the duration of mechanical ventilation, the intensive care unit stay, the hospital stay, and mortality in the intensive care unit, in the hospital, and 90 days after discharge. Factors correlated with reintubation were also analyzed. Results: Of a total of 2,574 patients, 77 were analyzed (38 in the noninvasive ventilation group and 39 in the conventional oxygen therapy group). Noninvasive ventilation reduced the respiratory and cardiac rates more rapidly than conventional oxygen therapy. Reintubation was less common in the noninvasive ventilation group [12 (32%) versus 22 (56%) in the conventional oxygen therapy group, relative risk 0.58 (95%CI 0.34 - 0.97), p = 0.039]. The rest of the parameters did not show significant differences. In the multivariate analysis, noninvasive ventilation protected against reintubation [OR 0.17 (95%CI 0.05 - 0.56), p = 0.004], while liver failure before extubation and the inability to maintain airway patency predisposed patients to reintubation. Conclusion: The use of noninvasive ventilation in patients who failed extubation could be beneficial compared to conventional oxygen therapy.

Fluidez racial na Região Metropolitana de Belo Horizonte: características individuais e contexto local na construção da raça / Racial fluidity in the Metropolitan Region of Belo Horizonte: individual characteristics and local context in the construction of race / Fluidez racial en la Región Metropolitana de Belo Horizonte: características individuales y contexto local en la construcción de la raza

O artigo discute como variáveis individuais e características do local de moradia influenciam a heteroclassificação e suas diferenças com a autoclassificação racial, na Região Metropolitana de Belo Horizonte. A análise busca compreender a construção social da raça e sua fluidez na sociedade, uma vez que as classificações refletem formas de vivências e interpretações da raça. Os dados utilizados são do BH Area Survey (2005), do Censo Demográfico (2010) e do Atlas do Desenvolvimento Humano (2013), por meio de modelos de regressão logística. Os resultados apontam que a heteroclassificação é influenciada por características individuais e contextuais. Para aqueles que se autoidentificam brancos, a escolaridade, a renda e a distribuição racial local se associam às chances de serem heteroclassificados como brancos, ao passo que para os autoidentificados negros, apenas a escolaridade aumenta as chances de sua heteroclassificação ser branca. Dessa forma, sustenta-se que há fluidez racial na Região Metropolitana de Belo Horizonte, no sentido de que a classificação é influenciada pelas características socioeconômicas e contextuais.

The article discusses how individual variables and neighborhood characteristics influence heteroclassification and its differences with racial self-classification, in the Belo Horizonte Metropolitan Area. The analysis seeks to understand the social construction of race and its fluidity in society, given that different types of classifications reflect distinct experiences and interpretations of race. Data used are from the BH Area Survey (2005), the Brazilian Demographic Census (2010) and the Human Development Atlas (2013), for the analysis we used logistic regression models. Results indicate that hetero-classification is influenced by individual and contextual characteristics. For those who self-identify as white, schooling, income and local racial distribution are associated with opportunities of being hetero-classified as white, whereas for individuals self-identifying as black, only schooling increases the chances of being hetero-classified as white. Thus, we conclude that there is racial fluidity in the Belo Horizonte Metropolitan Area, in the sense that classification is influenced by socioeconomic and contextual characteristics.

El artículo discute cómo variables individuales y características de la vivienda influencian la heteroclasificación y sus diferencias con la autoclasificación racial, en la Región Metropolitana de Belo Horizonte. El análisis busca comprender la construcción social de la raza y su fluidez en la sociedad, ya que las clasificaciones reflejan formas de vivencias e interpretaciones de ella. Los datos utilizados son del BH Area Survey de 2005, del censo demográfico de 2010 y del Atlas del Desarrollo Humano (2013). Para el análisis se usaron modelos de regresión logística. Los resultados apuntan a que la heteroclasificación es influenciada por características individuales y contextuales. Para aquellos que se autoidentifican blancos, la escolaridad, la renta y la distribución racial local se asocian a las posibilidades de ser heteroclasificado como blanco, mientras que para los autoidentificados negros, solo la escolaridad aumenta las posibilidades de su heteroclasificación ser blancos. De esta forma, se sostiene que hay fluidez racial en la Región Metropolitana de Belo Horizonte, en el sentido de que la clasificación es influenciada por las características socioeconómicas y contextuales.

Edad de inicio en el consumo, motivos y cantidad de alcohol en la determinación de consecuencias en consumidores intensivos universitarios / Age of Onset, Motives and Amount of Alcohol Consumed in the Determination of Consequences in College Binge Drinkers

Las implicaciones clínicas y sociales derivadas del consumo intensivo de alcohol (CIA) en universitarios motivan la necesidad de analizar los factores que favorecen su aparición. Este estudio evalúa cómo influye la cantidad de alcohol ingerido, la edad de inicio en el consumo de esta sustancia y los motivos asociados a esta conducta en la presencia de un mayor o menor número de consecuencias psicosociales. 312 estudiantes de primero de la Universidad de Valencia que realizan CIA cumplimentaron el instrumento IECI (Cortés et al., 2012): autoregistro de consumo, motivos asociados a esta ingesta y consecuencias psicosociales derivadas. Se confirman resultados de investigaciones precedentes. Ambos sexos duplican los gramos de alcohol que definen un CIA. Aparecen diferencias en los efectos esperados en función del sexo, así como en la edad de inicio en el consumo y en el número de consecuencias experimentadas. Los análisis de regresión de orden jerárquico muestran la importancia de la edad de inicio y los motivos, por encima de los gramos consumidos, para dar cuenta del deterioro psicosocial generado por la ingesta. Esto apoya la necesidad de atender a la combinación de variables en la explicación y posterior intervención para paliar las consecuencias derivadas del CIA.

Drinking onset, motives and alcohol use in the prediction of alcohol-related problems in undergraduate binge drinkers. The clinical and social implications derived from binge drinking (BD) in university students cause the need to analyze the factors which contribute to its appearance. This research assesses the influence of the amount of alcohol consumed, drinking onset and the motives associated with this behaviour in the presence of a greater or least number of psychological consequences. 312 first year university students at Valencia University performing BD completed the IECI instrument (Cortés et al., 2012): self report about consumption, associated motives to their consumption and the psychosocial consequences. Results are confirmed by previous research. Both sexes double the grams of alcohol which define a BD. Differences appear in the expected outcome depending on the sex as well as the age at which they drinking onset and the number of experienced consequences. The hierarchical regression analysis shows the importance of the drinking onset and the motives, above the quantity of consumed grams, in order to report the psychosocial impairment generated by the intake. This supports the need to comply with the combination of variables in the explanation and subsequent intervention to alleviate the consequences of the BD.

Temporal distribution of tuberculosis in the State of Amazonas, Brazil

Tuberculosis (TB) is one of the infectious diseases that contributes most to the morbidity and mortality of millions of people worldwide. Brazil is one of 22 countries that accounts for 80% of the tuberculosis global burden. The highest incidence rates in Brazil occur in the States of Amazonas and Rio de Janeiro. The aim of this study was to describe the temporal distribution of TB in the State of Amazonas. Between 2001 and 2011, 28,198 cases of tuberculosis were reported in Amazonas, distributed among 62 municipalities, with the capital Manaus reporting the highest (68.7%) concentration of cases. Tuberculosis was more prevalent among males (59.3%) aged 15 to 34 years old (45.5%), whose race/color was predominantly pardo (64.7%) and who had pulmonary TB (84.3%). During this period, 81 cases of multidrug-resistant TB were registered, of which the highest concentration was reported from 2008 onward (p = 0.002). The municipalities with the largest numbers of indigenous individuals affected were São Gabriel da Cachoeira (93%), Itamarati (78.1%), and Santa Isabel do Rio Negro (70.1%). The future outlook for this region includes strengthening the TB control at the primary care level, by expanding diagnostic capabilities, access to treatment, research projects developed in collaboration with the Dr. Heitor Vieira Dourado Tropical Medicine Foundation .;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD).; and financing institutions, such as the project for the expansion of the Clinical Research Center and the creation of a hospital ward for individuals with transmissible respiratory diseases, including TB.

Complicaciones anestesicas en la unidad de recuperacion postanestesica / Anesthetic complications in the post-anesthesia recovery unit

El objetivo de este estudio fue determinar la frecuencia de complicaciones anestesiológicas que se presentaron en la unidad de cuidados anestésicos postoperatorios del Hospital de Clínicas Dr. Manuel Quintela en un periodo de 6 meses. El objetivo de este estudio fue determinar la frecuencia de complicaciones anestesiológicas que se presentaron en la unidad de cuidados anestésicos postoperatorios del Hospital de Clínicas Dr. Manuel Quintela en un periodo de 6 meses. La frecuencia de complicaciones hallada fue similar a la de la mayor parte de los trabajos publicados, lo que nos sirve como “control de calidad” de nuestro Servicio de Anestesiología.

The aim of this study was to determine the frequency of complications presented anesthesiologic the postoperative anesthesia care unit of the Hospital de Clínicas Dr. Manuel Quintela over a period of 6 months. The frequency of complications was found similar to that of most of the published works, which serves as a "quality control" of our Anesthesiology.

O objetivo deste estudo foi determinar a freqüência de complicações apresentadas anestesiológicos a unidade de pós-operatório cuidados de anestesia do Hospital de Clínicas Dr. Manuel Quintela durante um período de 6 meses. O objetivo deste estudo foi determinar a freqüência de complicações apresentadas anestesiológicos a unidade de pós-operatório cuidados de anestesia do Hospital de Clínicas Dr. Manuel Quintela durante um período de 6 meses. A freqüência de complicações foi encontrado semelhante ao da maioria dos trabalhos publicados, que serve como um "controle de qualidade" da nossa Anestesiologia.

Reviewing family studies: a brief comment on selected topics / Revendo estudos sobre famílias: um breve comentário sobre tópicos selecionados / /Revisando Estudios familiares: un breve comentario sobre temas seleccionados

In the face of changes in the family and of academic concerns that have become evident in the study of the influence of such changes, the data collecting and theoretical framework used in family research deserve close attention. In this paper I review briefly some important international contributions to the field of family studies and point out challenges and still unanswered questions for future research in Brazil. The three main topics treated here are: 1) changes in the concept of family; 2) women's, and especially mothers', presence in the labor market (income, job opportunities, hiring preferences, etc.) and, more specifically, the transformation of the discussion from the working woman to the working family; and, 3) the influence of both these aspects on child rearing. At the end of the paper I reinforce previous research suggesting improvements in projects for collecting data. On the theoretical side I highlight the importance of three frameworks. First, the economic aspect of social action is not the only factor effecting how people make decisions in the family sphere. Second, there is need to revise the theory of the Second Demographic Transition approach, especially regarding migration and mortality and their relationship to family. Third, there is need for greater integration among demographic studies, gender studies, and feminist theories.

Em face das mudanças na esfera da família e das preocupações acadêmicas ao se analisarem estas mudanças, a coleta de dados e as abordagens teóricas usadas em pesquisas sobre família merecem atenção. Neste artigo, são revisadas brevemente algumas importantes contribuições internacionais na área da família e apontados alguns desafios e perguntas ainda sem respostas para futuras pesquisas no Brasil. Os três assuntos principais são: mudanças no conceito de família; retorno no mercado de trabalho (salário, oportunidades de trabalho, preferências por contratação) de mulheres e, principalmente, mães e mais especificamente a transformação da discussão de mulheres trabalhadoras para famílias trabalhadoras; e a influência dos dois primeiros tópicos nos resultados das crianças. Ao final do artigo, reforçam-se estudos anteriores, com sugestões pontuais para a coleta de dados. Do lado teórico, é destacada a importância de três abordagens: não é suficiente considerar os aspectos econômicos da tomada de decisão na esfera da família; há uma necessidade de se revisar a teoria da Segunda Transição Demográfica, especialmente no que concerne à migração e à mortalidade e suas relações com a família; e a necessidade de uma integração maior entre estudos demográficos, gêneros e teorias feministas.

Frente a los cambios en las familias y a las preocupaciones académicas presentes en el estudio de tales cambios, merecen atención la recogida de datos y la estructura teórica utilizadas en las investigaciones sobre familias. El propósito de este artículo es presentar algunas contribuciones internacionales importantes para el ámbito de los estudios de la familia y señalar algunos desafíos y preguntas todavía sin respuesta para una futura investigación en Brasil. Los tres temas principales serían los siguientes: cambios en el concepto de familia; perspectivas femeninas, sobre todo las de las madres de familia, en el mercado laboral (ingresos, oportunidades de trabajo, preferencias en la contratación, etc.), y de forma más específica, la discusión sobre la mujer trabajadora, cambiando su foco para el de la familia trabajadora; y la influencia de los temas arriba mencionados sobre las perspectivas de los niños. Al final del artículo refuerzo algunas investigaciones anteriores al sugerir mejoras en proyectos de recogida de datos. Por la lado teórico, subrayo la importancia de tres puntos: no basta considerar el aspecto económico de la acción social sobre cómo las personas toman decisiones en el esfera familiar; es necesario revisar el enfoque de la Segunda Transición Demográfica, especialmente en lo que concierne a la migración y a la mortalidad y su relación con la familia; también es necesario integrar más los estudios demográficos, el género y las perspectivas feministas.