From HIV to Mpox: Socio-discursive Analysis of Communicable Diseases, Stigma, and Pathologization in Sexual Minorities in Brazil.

Discrimination and stigma are significant barriers to healthcare for the LGBTQIAPN+ community, necessitating a deeper analysis of their sociocultural causes. There is a notable gap in the literature regarding the understanding of socio-discursive representations and their impact on the stigmatization and pathologization of sexual minorities in the context of communicable diseases. This study aims to discuss the understanding of the sociodiscursive aspects of the health-disease process, particularly in stigmatized infectious diseases affecting the LGBTQIAPN+ community. The focus is on examining how news articles, or the set of analyzed texts (corpus), shape these perceptions. We conducted documentary research with a qualitative and discursive approach using news articles retrieved from Google NewsⓇ about diseases affecting the LGBTQIAPN+ population from 2011 to 2022. The analysis was based on critical discourse analysis, processed using MAXQDA and IRAMUTEQ software. The identified representations predominantly align with biomedical ideology, manifesting in a discourse that normalizes and medicalizes (normative-curative discourse), and notable for its pathologizing and stigmatizing nature. Six classes were found: Ethical professional dilemmas facing stigma, infection and contamination of the LGBT+ population, prejudice and discrimination in the form of information, stigma related to sexual behavior/orientation, Vulnerability and stigma related to infectious diseases, and strategies for minimizing health risk/stigma for the LGBT+ public. The most relevant analytical categories were related to infectious diseases and sexual identity. These themes were identified, indicating that media representations reinforce stigma and maintain unequal health practices (verticalization) for the LGBT+ community. Understanding these patterns within a broader historical context is crucial for promoting health education and strategies that challenge internalized prejudice. The need to reformulate cultural norms and develop health information and education policies is urgent. These policies should be led by professionals with a comprehensive and humanized vision, addressing the diverse needs of the LGBT+ population.

Spatial analysis for bovine viral diarrhea virus and bovine herpesvirus type 1 infections in the state of Paraíba, northeastern Brazil.

BACKGROUND: Bovine Viral Diarrhea Virus (BVDV) and Bovine Herpesvirus type 1 (BoHV-1) cause reproductive problems in cattle and restrictions on international trade in animals worldwide. Both infections were detected in cattle herds in the Paraíba state, Northeastern Brazil, however, the spatial distribution and geographic identification of positive herds for these viruses has never been examined. Therefore, the aim of this study was to describe the spatial pattern of apparent prevalence estimate and to identify spatial clustering of positive herds of BVDV and BoHV-1 infections in cattle herds from the state of Paraíba, Northeastern Brazil. RESULTS: The herd-level prevalence for BVDV and BoHV-1 infections in Paraíba were, respectively, 65.5% (95% CI: 61.1-69.7) and 87.8% (95% CI: 84.5-90.5). The average apparent within-herd prevalence of BVDV was 31.8% and of BoHV-1 was 62.4%. The predicted prevalence was highest (0.42-0.75) for BVDV in the west, north and eastern part of Sertão and in the central and eastern part of Agreste/Zona da Mata. For BoHV-1, the highest predicted prevalence (0.74-0.97) was in some local areas across Sertão and throughout the eastern part of Agreste/Zona da Mata. Six significant clusters were detected for BVDV, a primary cluster covering the eastern Sertão region, with 11 herds, radius of 24.10 km and risk relative (RR) of 2.21 (P <  0.001) and five smaller significant clusters, involving one or two herds in Agreste/Zona da Mata region with a high RR. A significant clustering of BoHV-1 positive herds (P <  0.001) was detected in Agreste/Zona da Mata region with a radius of 77.17 km and a RR of 1.27, with 103 cases. Consistency was found between kriging and SatScan results for identification of risk areas for BVDV and BoHV-1 infections. CONCLUSIONS: The clusters detected contemplated different areas of the state, with BVDV cluster located in the Sertão and BoHV-1 in Agreste/Zona da Mata stratum. Through the risk mapping, it was possible to identify the areas in which the risk is significantly elevated, coincided with areas where there are borders with other states and in which there is a high movement of animals.

Expansive Spinal Cord Injury After Autologous Olfactory Mucosal Transplantation: Case Report and Systematic Review.

OBJECTIVE: To present strategies for managing tumor mass formation and their corresponding postoperative outcomes. METHODS: We conducted a systematic literature review following the guidelines and protocol of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the PubMed and EMBASE databases, screened titles and abstracts, and further evaluated full-text publications to select relevant studies. Additionally, a narrative review of other pertinent articles on PubMed was performed. Case reports, cohort studies, and clinical trials were included. Animal studies were excluded. RESULTS: Of 6 patients enrolled in this study, most had American Spinal Injury Association Impairment Scale grade A (66.7%) following intramedullary injury, and 1 patient had American Spinal Injury Association Impairment Scale grade D (16.65%). The discovery time of the intramedullary mass formation ranged from approximately 5 to 14 years. Surgical intervention was performed in most cases (66.7%), with improvement reported in 3 of the surgical cases (75%). The majority of cases (83.3%) involved cervical lesions, while only 1 case (16.7%) involved a thoracic lesion. CONCLUSIONS: Due to the scarcity of described cases, there is no specific treatment for this tumor. Although our patient remained stable after conservative treatment, other studies have shown improvement in symptoms after mass resection. It is essential that the management of this complication be researched further due to the variety of clinical characteristics presented.

Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia.

Introduction: The clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to estimate overall survival (OS) and event-free survival (EFS) in an onco-hematology treatment center in Brazil, reports the main clinical-laboratory characteristics of patients at diagnosis, verify the frequency of treatment-related adverse effects and the main causes of death. Material and methods: Retrospective analysis involving patients diagnosed with ALL, treated with the protocol of the Brazilian Group for Treatment of Leukemias in Childhood (GBTLI), between 2010 and 2020 was carried out; the outcomes (relapse, deaths, development of new neoplasms) were analyzed SPSS® software was used for the statistical analyses, and the p-value was considered significant when less than 0.05 for all analyses. Results: 109 patients were included in the study; the median age was 5 years, with a slight predominance of males. Sixty-six patients were classified as high-risk (HR) group and 43 patients were classified as low-risk (LR) group. After 5 years of diagnosis, the OS was 71.5%, and the EFS was 65%. No statistical difference was found between the HR and LR groups for OS and EFS, while leukocyte counts were statistically associated with the outcome of death (p = 0.028). Among the patients, 28 (25.6%) died due to infection accounting 46.4% of death causes. Among the 34 patients with unfavorable outcomes (death and/or relapse), 32 had no research for the minimal residual disease at the end of remission induction, and 25 were not investigated for the presence of chromosomal abnormalities. The most reported complications and treatment-related adverse effects were increased liver transaminases (85.9%), airway infection (79.4%), oral mucositis (67.2%), febrile neutropenia (64.4%), and diarrhea (36.4%). Conclusions: The rates of OS and EFS obtained in this cohort are similar to those obtained in the few previous similar studies in Brazil and lower than those carried out in developed countries. The unavailability of prognostic tests may have hindered risk stratification and influenced the results obtained.

Herd and animal level prevalences and risk factors for Neospora caninum infection in cattle in the state of Paraíba, northeastern Brazil.

Bovine neosporosis is a globally important disease, causing abortions and significant economic losses. In Brazil, studies on neosporosis in cattle are few and based on limited samples and/or from limited areas. We aimed to determine the herd and animal levels seroprevalence and associated factors for Neospora caninum infections in cattle from the state of Paraíba, Northeastern Brazil, using a planned sampling. Herds (n = 434) and cows aged ≥24 months (n = 1891) were randomly selected, and serum samples were tested with the immunofluorescence antibody test (IFAT) using as cut-off point the antibody titer 200. Herd-level and animal-level seroprevalences were 17.8% (95% CI = 14.3%-21.8%) and 18.1% (95% CI = 14.7%-22.1%), respectively. The factors associated with N. caninum infection were farm located in the Sertão mesoregion (Prevalence ratio [PR] = 2.37), mixed production (PR = 1.64), herd size of 34-111 animals (PR = 3.50) and herd size >111 animals (PR = 6.14). The results indicate high N. caninum circulation in the bovine population of the state of Paraíba, semiarid of Brazil, mainly in the Sertão mesoregion, where the highest apparent herd and animal-level prevalences of positive herds were identified. Control strategies should be adopted to mitigate the impact of disease on cattle production, as well as it's suggested the encouragement of conducting surveys in wildlife from Caatinga biome, mainly canids, to provide information on the importance of these animals on the epidemiology of bovine neosporosis.

Herd-level based seroprevalence and associated factors for Toxoplasma gondii in cows in the state of Paraíba, Northeastern Brazil.

We aimed to determine the herd and animal levels seroprevalence and associated factors for Toxoplasma gondii infections in cattle from the state of Paraíba, Northeastern Brazil. Herds (n = 434) and cows aged ≥ 24 months (n = 1,895) were randomly selected, and serum samples were tested with the immunofluorescence antibody test (IFAT) using as cutoff of 64. Of the 434 farms investigated, 197 had at least one seropositive cow (prevalence of 49.0%; 95% CI = 44.3%-53.8%), and the prevalence at animal level was 18.0% (95% CI = 5.3%-21.1%). The antibody titers ranged from 64 to 1024, with the most frequent titers being 64 (10.8%) and 128 (3.7%). The risk factors identified were property located in Sertão region (odds ratio [OR] = 3.07), property located in Agreste/Zona da Mata regions (OR = 2.00), animal purchasing (OR = 2.68), herd size of 34-111 animals (OR = 2.91) and herd size > 111 animals (OR = 6.97). The results suggest the wide distribution of T. gondii infections in cattle throughout the state of Paraíba, and the risk factors identified are not possible to correct.

Computational modeling of the bHLH domain of the transcription factor TWIST1 and R118C, S144R and K145E mutants.

BACKGROUND: Human TWIST1 is a highly conserved member of the regulatory basic helix-loop-helix (bHLH) transcription factors. TWIST1 forms homo- or heterodimers with E-box proteins, such as E2A (isoforms E12 and E47), MYOD and HAND2. Haploinsufficiency germ-line mutations of the twist1 gene in humans are the main cause of Saethre-Chotzen syndrome (SCS), which is characterized by limb abnormalities and premature fusion of cranial sutures. Because of the importance of TWIST1 in the regulation of embryonic development and its relationship with SCS, along with the lack of an experimentally solved 3D structure, we performed comparative modeling for the TWIST1 bHLH region arranged into wild-type homodimers and heterodimers with E47. In addition, three mutations that promote DNA binding failure (R118C, S144R and K145E) were studied on the TWIST1 monomer. We also explored the behavior of the mutant forms in aqueous solution using molecular dynamics (MD) simulations, focusing on the structural changes of the wild-type versus mutant dimers. RESULTS: The solvent-accessible surface area of the homodimers was smaller on wild-type dimers, which indicates that the cleft between the monomers remained more open on the mutant homodimers. RMSD and RMSF analyses indicated that mutated dimers presented values that were higher than those for the wild-type dimers. For a more careful investigation, the monomer was subdivided into four regions: basic, helix I, loop and helix II. The basic domain presented a higher flexibility in all of the parameters that were analyzed, and the mutant dimer basic domains presented values that were higher than the wild-type dimers. The essential dynamic analysis also indicated a higher collective motion for the basic domain. CONCLUSIONS: Our results suggest the mutations studied turned the dimers into more unstable structures with a wider cleft, which may be a reason for the loss of DNA binding capacity observed for in vitro circumstances.

Professional Safety in the daily life of primary health care: grounded theory.

OBJECTIVE: to understand Professional Safety in daily life in Primary Health Care. METHODS: this is a study on the Grounded Theory method and the Symbolic Interactionism theoretical framework with 82 health professionals. RESULTS: it presents the category "Professional Safety in Daily Life in Primary Health Care: a Grounded Theory" and two subcategories determining and conditioning Professional Safety in PHC: professional training, infrastructure, support and technical responsibility; Professional Safety: physical protection, psychological support, distress and feelings reveal the (un)safe conditions. Professional Safety is mentioned in several dimensions that include professionals' knowledge, decision-making skills, the practice of the profession and what regulates it, the structure and organization of the Unified Health System and services, permanent education. It presents the context of primary care and the factors that impact an (unsafe) work. FINAL CONSIDERATIONS: this study contributes to reflect on Professional Safety to strengthen safety culture in Primary Health Care.

Professional safety constructs in the context of Primary Health Care.

OBJECTIVES: to identify scientific production on safety-related aspects/characteristics in the performance of Primary Health Care professionals for professional safety constructs. METHODS: integrative literature review in the BDENF, IBECS, LILACS, MEDLINE databases. RESULTS: the corpus of this review refers to 16 articles that highlighted work overload, work process, insufficient human resources, precarious work environment conditions, lack of continuing education, team relationship and with users, evidencing that they are factors that possibly compromise health care and professional safety for best practices. FINAL CONSIDERATIONS: to know the factors that impact in the scope of professional safety allows to subsidize interventions that guarantee best practices. This study originally contributes to the formulation of Primary Health Care professional safety constructs.

NF-kappaB Is Involved in the Regulation of EMT Genes in Breast Cancer Cells.

The metastatic process in breast cancer is related to the expression of the epithelial-to-mesenchymal transition transcription factors (EMT-TFs) SNAIL, SLUG, SIP1 and TWIST1. EMT-TFs and nuclear factor-κB (NF-κB) activation have been associated with aggressiveness and metastatic potential in carcinomas. Here, we sought to examine the role of NF-κB in the aggressive properties and regulation of EMT-TFs in human breast cancer cells. Blocking NF-κB/p65 activity by reducing its transcript and protein levels (through siRNA-strategy and dehydroxymethylepoxyquinomicin [DHMEQ] treatment) in the aggressive MDA-MB-231 and HCC-1954 cell lines resulted in decreased invasiveness and migration, a downregulation of SLUG, SIP1, TWIST1, MMP11 and N-cadherin transcripts and an upregulation of E-cadherin transcripts. No significant changes were observed in the less aggressive cell line MCF-7. Bioinformatics tools identified several NF-κB binding sites along the promoters of SNAIL, SLUG, SIP1 and TWIST1 genes. Through chromatin immunoprecipitation and luciferase reporter assays, the NF-κB/p65 binding on TWIST1, SLUG and SIP1 promoter regions was confirmed. Thus, we suggest that NF-κB directly regulates the transcription of EMT-TF genes in breast cancer. Our findings may contribute to a greater understanding of the metastatic process of this neoplasia and highlight NF-κB as a potential target for breast cancer treatment.

Professional Safety in the daily life of primary health care: grounded theory / Seguridad Profesional en la vida diaria de la atención primaria de salud: una teoría fundamentada / Segurança do Profissional no cotidiano da atenção primária à saúde: uma teoria fundamentada nos dados

ABSTRACT Objective: to understand Professional Safety in daily life in Primary Health Care. Methods: this is a study on the Grounded Theory method and the Symbolic Interactionism theoretical framework with 82 health professionals. Results: it presents the category "Professional Safety in Daily Life in Primary Health Care: a Grounded Theory" and two subcategories determining and conditioning Professional Safety in PHC: professional training, infrastructure, support and technical responsibility; Professional Safety: physical protection, psychological support, distress and feelings reveal the (un)safe conditions. Professional Safety is mentioned in several dimensions that include professionals' knowledge, decision-making skills, the practice of the profession and what regulates it, the structure and organization of the Unified Health System and services, permanent education. It presents the context of primary care and the factors that impact an (unsafe) work. Final considerations: this study contributes to reflect on Professional Safety to strengthen safety culture in Primary Health Care.

RESUMEN Objetivo: comprender la Seguridad del Profesional que trabaja en la vida diaria de la Atención Primaria de Salud. Métodos: estudio utilizando el método de la Teoría Fundamentada y el marco teórico del Interaccionismo Simbólico con 82 profesionales de la salud. Resultados: presenta la categoría "Seguridad Profesional en la Vida Diaria de la Atención Primaria de Salud: una Teoría Fundamentada" y dos subcategorías Determinantes y Condicionadores de la Seguridad Profesional en la APS: formación profesional, infraestructura, soporte y responsabilidad técnica; Seguridad profesional: la protección física, el apoyo psicológico, el sufrimiento y los sentimientos revelan las condiciones (in)seguras. La Seguridad Profesional se menciona en varias dimensiones que incluyen el conocimiento del profesional, la capacidad de decisión, el ejercicio de la profesión y lo que la regula, la estructura y organización del Sistema Único de Salud y los servicios, la educación permanente. Presenta el contexto de la atención primaria y los factores que impactan el desempeño inseguro. Consideraciones finales: este estudio contribuye a la reflexión sobre Seguridad Profesional para fortalecer la cultura de seguridad en Atención Primaria de Salud.

RESUMO Objetivo: compreender a Segurança do Profissional em atuação no cotidiano da atenção primária à saúde. Métodos: estudo sob o método da Teoria Fundamentada nos Dados e do referencial teórico do Interacionismo Simbólico com 82 profissionais de saúde. Resultados: apresenta a categoria Segurança do Profissional no Cotidiano da Atenção Primária à Saúde: uma Teoria Fundamentada nos Dados e duas subcategorias Determinantes e condicionantes da Segurança do Profissional na APS: formação profissional, infraestrutura, apoio e responsabilidade técnica; Segurança do Profissional: proteção física, apoio psicológico, sofrimento e sentimentos revelam as condições (in)seguras. A Segurança do Profissional é referida em várias dimensões que passam pelo conhecimento do profissional, as competências para tomada de decisão, o exercício da profissão e o que a regulamenta, a estrutura e organização do Sistema Único de Saúde e dos serviços, a educação permanente. Apresenta o contexto da atenção primária e os fatores que impactam na atuação in(segura). Considerações finais: este estudo contribui com a reflexão sobre a Segurança do Profissional a fim de fortalecer a cultura de segurança na Atenção Primária à Saúde.

Herd-level seroprevalence and associated risk factors for bovine cysticercosis in the State of Paraíba, Northeastern Brazil.

This study focused on estimating the herd-level and animal-level prevalences, and identifying risk factors associated with bovine cysticercosis in the State of Paraíba, Northeastern Brazil. The state was divided into three sampling strata: Sertao, Borborema and Zona da Mata/Agreste. For each sampling stratum, herd-level and animal-level prevalences were estimated by a two-stage sampling survey. First, a pre-established number of herds (primary sampling units) were randomly selected; second, within each herd a pre-established number of cows aged ≥24months were systematically selected (secondary sampling units). Ten animals were sampled in herds with up to 99 cows aged over 24 months; 15 animals were sampled in herds with 100 or more cows aged over 24 months; and all animals were sampled in those with up to 10 cows aged over 24 months. In total, 2382 animals were sampled from 474 herds. Serological diagnosis was initially performed by the indirect ELISA, and positive sera were confirmed by immunoblot. A herd was deemed positive if it included at least one positive animal in herds of up to 29 females, and two positive animals in herds with more than 29 females. The herd-level prevalence in the State of Paraíba was 10.8% (95% CI=8.1%-14.1%), 10.3% (95% CI=6.4%-16.1%) in the region of Sertão, 6.9% (95% CI=3.9%-12.1%) in Borborema, and 13.8% (95% CI=9.3%-20.2%) in Agreste/Zona da Mata. The animal-level prevalence was 2.3% (95% CI=1.6%-3.3%) in the State of Paraíba, 1.4% (95% CI=0.8%-2.5%) in Sertão, 3.6% (95% CI=1.7%-7.4%) in Borborema, and 3.2% (95% CI=1.9%-5.4%) in Agreste/Zona da Mata. The risk factors identified were as follows: animal purchasing (OR=2.19) and presence of flooded pastures (OR=1.99). Our findings suggest that bovine cysticercosis herd-level seroprevalence in the State of Paraíba, Northeastern Brazil, is high, and support the idea that prevention measures should be applied at herd level and farmers should restrict the access of their cattle to flooded pastures.

Herd-level spatial cluster analysis of bovine cysticercosis in the state of Paraíba, northeastern Brazil.

The aim of this survey was to identify spatial clustering of bovine cysticercosis-positive herds in the state of Paraíba. The state was divided into three sampling groups: sampling stratum 1 (Sertão mesoregion), sampling stratum 2 (Borborema mesoregion) and sampling stratum 3 (Zona da Mata and Agreste mesoregions), and 2382 cows aging ≥ 24 months from 474 farms were sampled. Serological diagnoses of bovine cysticercosis were initially done by means of indirect ELISA, and positive serum samples were confirmed by a immunoblot test. Herds were deemed positive for cysticercosis if they presented at least one positive animal in herds of up to 29 females, and two positive animals in herds with more than 29 females. The spatial clustering was assessed using the Cuzick-Edwards k-nearest neighbor method and spatial scan statistics. A significant clustering of positive herds was detected in the southern part of the Borborema mesoregion. Given that serological tests for bovine cysticercosis are not widely available, and also that replacement and maintenance of herds through animal purchases is common in the region, it can be concluded that prevention measures should be applied at herd level.

Kinetic parameters of red pepper waste as biomass to solid biofuel.

This work aimed to study the kinetic of thermal degradation of red pepper waste as solid biofuel to bioenergy production. The thermal degradation experiments were conducted at three heating rates, 5°C/min, 7.5°C/min and 10°C/min in a thermogravimetric analyzer and oxidative atmosphere. The kinetic analysis was carried out applying the isoconversional model of Ozawa-Flynn-Wall. The activation energy was considerate low and varied 29.49-147.25k J/mol. The enthalpies revealed the energy difference between the reagent and the activated complex agreed with activation energies, the values of the pre-exponential factor indicated empirical first order reactions, Gibbs free energy varied from 71.77 kJ/mol to 207.03 kJ/mol and the changes of entropies had negative values, indicating that the degree of disorder of products formed through bond dissociations was lower than initial reactants. The calorific value was 19.5 MJ/kg, considered a relevant result for bioenergy production.

TDAH hackathon: inovação em saúde: app para auxiliar pacientes com transtorno de déficit de atenção e hiperatividade para a adesão ao tratamento / ADHD hackathon: health innovation: app to assist patients with attention deficit disorder and hyperactivity to treatment adherence

Este artigo apresenta o processo de ideação e prototipação de um aplicativo para auxílio de pacientes com TDAH no autogerenciamento de hábitos diários para uma maior adesão ao tratamento e no gerenciamento de tempo, agregando assim muito valor à sociedade. Este processo foi proposto na primeira edição do evento "Experiência HCPA ­ TDAH Hackathon". O método usado foi a pesquisa de campo com pacientes com TDAH e validação de hipóteses. Justifica-se pela necessidade de uma ferramenta confiável, permitindo que os pacientes com TDAH possam centralizar as ações em apenas um aplicativo no celular: seus compromissos, lembretes de medicação e gerenciamento de tempo, entre outras facilidades, sendo o meio mais viável e efetivo para a adesão ao tratamento. (AU)

This article presents the process of ideation and prototyping of an application to helppatients with ADHD in self-management of daily habits to a greater adherence to treatment and time management, thus adding a lot of value to society. This process was proposed in the first edition of the HCPA Experience ­ ADHD Hackathon event. The method used was field research of patients with ADHD and validation of hypotheses. The need for a reliable tool is justified, where ADHD patients will be able to centralize their appointments, medication reminders, time management, among other facilities in just one mobile application, being the most viable and effective means of adhering to treatment. (AU)

Atuação cotidiana no Sistema Único de Saúde em sua terceira década / Práctica diaria en el Sistema Unico de Salud en su tercera década / Daily practice in the Brazilian Unified Health System in its third decade

RESUMO Objetivo compreender a atuação cotidiana no Sistema Único de Saúde (SUS), em sua terceira década, sob a ótica dos profissionais da Atenção Primária à Saúde (APS). Método pesquisa qualitativa, ancorada na Teoria Fundamentada nos Dados e no Interacionismo Simbólico, com 82 profissionais de saúde que atuam na APS. Teve como fonte de evidências a entrevista aberta individual e memorandos. A coleta de dados ocorreu entre abril de 2017 e março de 2018, em 14 unidades de APS de três municípios pertencentes às regiões sanitárias distintas de Minas Gerais. Resultados a atuação cotidiana no SUS é apresentada pelos profissionais da APS e perpassa pela compreensão que tem do SUS, do trabalho na APS e sua implicação na atuação profissional; pelo impacto da gestão; o contexto atual do SUS e sua influência na assistência (in)segura. Conclusões e implicações para a prática: fatores que ocasionam insegurança ao profissional podem comprometer a qualidade da assistência e as boas práticas, contribuindo para reflexões de profissionais, gestores e usuários sobre a relevância da proatividade na participação popular para que mudanças ocorram frente ao contexto da APS possibilitando ao profissional mais segurança em suas ações e melhorias na qualidade da atenção à saúde.

RESUMEN Objetivo comprender el desempeño diario en el Sistema Único de Salud (SUS), en su tercera década, desde la perspectiva de los profesionales de Atención Primaria de Salud (APS). Método investigación cualitativa, anclada en la teoría fundamentada y el marco teórico del interaccionismo simbólico con 82 profesionales de la salud que trabajan en APS. La fuente de evidencia fue la entrevista individual abierta y los memorandos. La recopilación de datos tuvo lugar entre abril de 2017 y marzo de 2018, en 14 unidades de APS en tres municipios pertenecientes a diferentes regiones de salud de Minas Gerais. Resultados el desempeño diario en el SUS es presentado por los profesionales de la APS e impregna su comprensión del SUS, el trabajo en la APS y su implicación en el desempeño profesional; el impacto de la gestión; El contexto actual del SUS y su influencia en la atención (des) segura. Conclusiones e implicaciones para la práctica: los factores que causan inseguridad al profesional pueden comprometer la calidad de la atención y las buenas prácticas. Contribuir a reflexiones de profesionales, gerentes y usuarios sobre la relevancia de la proactividad en la participación popular para que los cambios ocurran en el contexto de la APS permitiendo al profesional más seguridad en sus acciones y mejoras en la calidad de la atención médica.

ABSTRACT Objective to understand the daily practice in the Brazilian Unified Health System, in its third decade, from the perspective of primary health care professionals (PHC). Method this qualitative research was anchored in the Grounded Theory and Symbolic Interactionism, with 82 health professionals working at PHC. It had as a source of evidence individual open interview and memoranda. Data collection occurred between April 2017 and March 2018 in 14 PHC units of three cities from different sanitary regions of Minas Gerais. Results the daily practice in the SUS is presented by PHC professionals and permeates their understanding of SUS, the work in PHC and its implication in professional practice; the impact of management; the current context of SUS and its influence on (un)safe care. Conclusions and implications for practice factors that cause insecurity to professionals may compromise the quality of care and good practice, contribute to reflections of professionals, managers and users on the relevance of proactivity in popular participation so that changes occur in the context of PHC, enabling professionals to be safer in their actions and improvements in the quality of health care.

Professional safety constructs in the context of Primary Health Care / Construcciones de seguridad profesional en el contexto de la Atención Primaria de Salud / Constructos da segurança do profissional no contexto da Atenção Primária à Saúde

ABSTRACT Objectives: to identify scientific production on safety-related aspects/characteristics in the performance of Primary Health Care professionals for professional safety constructs. Methods: integrative literature review in the BDENF, IBECS, LILACS, MEDLINE databases. Results: the corpus of this review refers to 16 articles that highlighted work overload, work process, insufficient human resources, precarious work environment conditions, lack of continuing education, team relationship and with users, evidencing that they are factors that possibly compromise health care and professional safety for best practices. Final Considerations: to know the factors that impact in the scope of professional safety allows to subsidize interventions that guarantee best practices. This study originally contributes to the formulation of Primary Health Care professional safety constructs.

RESUMEN Objetivos: identificar la producción científica sobre aspectos/características relacionadas con la seguridad en el desempeño de los profesionales de la Atención Primaria de Salud para construcciones sobre el tema de la seguridad del profesional. Métodos: revisión integradora de la literatura en las bases de datos BDENF, IBECS, LILACS, MEDLINE. Resultados: el corpus de esta revisión se refiere a 16 artículos que destacaron la sobrecarga de trabajo, el proceso de trabajo, los recursos humanos insuficientes, las malas condiciones del entorno laboral, la falta de educación permanente, la interrelación del equipo y el usuario, lo que demuestra que son factores que posiblemente comprometan la atención médica y la seguridad profesional para las buenas prácticas. Consideraciones finales: conocer los factores que impactan en la seguridad del profesional permite subsidiar intervenciones que garantizan buenas prácticas. Este estudio originalmente contribuyó a la formulación de las construcciones de seguridad profesional de la Atención Primaria de Salud.

RESUMO Objetivos: identificar a produção científica sobre os aspectos/características relacionadas à segurança na atuação dos profissionais da Atenção Primária à Saúde para constructos da temática Segurança do Profissional. Métodos: revisão integrativa da literatura nas bases de dados BDENF, IBECS, LILACS, MEDLINE. Resultados: o corpus desta revisão refere-se a 16 artigos que destacaram a sobrecarga de trabalho, processo de trabalho, recursos humanos insuficientes, condições precárias do ambiente de trabalho, falta de Educação Permanente, inter-relação em equipe e com usuários, evidenciando que são fatores que possivelmente comprometem a assistência à saúde e a Segurança do Profissional para boas práticas. Considerações Finais: conhecer os fatores que impactam no âmbito da Segurança dos Profissionais permite subsidiar intervenções que garantam as boas práticas. Este estudo contribui originalmente para formulação dos constructos da Segurança do Profissional da Atenção Primária à Saúde.

Molecular typing of dengue virus type 2 in Brazil.

Strain typing is a critical tool for molecular epidemiological analysis and can provide important information about the spread of dengue viruses. Here, we performed a molecular characterization of DEN-2 viruses isolated in Brazil during 1990-2000 from geographically and temporally distinct areas in order to investigate the genetic distribution of this serotype circulating in the country. Restriction site-specific polymerase chain reaction (RSS)-PCR presented the same pattern for all 52 Brazilian samples, showing the circulation of just one DEN-2 variant. Phylogenetic analysis using progressive pairwise alignments from 240-nucleotide sequences of the E/NS1 junction in 15 isolates showed that they belong to genotype III (Jamaica genotype).

Herd-level spatial cluster analysis of bovine cysticercosis in the state of Paraíba, northeastern Brazil / Análise de aglomerados espaciais no nível do rebanho de cisticercose bovina no Estado da Paraíba, Nordeste do Brasil

Abstract The aim of this survey was to identify spatial clustering of bovine cysticercosis-positive herds in the state of Paraíba. The state was divided into three sampling groups: sampling stratum 1 (Sertão mesoregion), sampling stratum 2 (Borborema mesoregion) and sampling stratum 3 (Zona da Mata and Agreste mesoregions), and 2382 cows aging ≥ 24 months from 474 farms were sampled. Serological diagnoses of bovine cysticercosis were initially done by means of indirect ELISA, and positive serum samples were confirmed by a immunoblot test. Herds were deemed positive for cysticercosis if they presented at least one positive animal in herds of up to 29 females, and two positive animals in herds with more than 29 females. The spatial clustering was assessed using the Cuzick-Edwards k-nearest neighbor method and spatial scan statistics. A significant clustering of positive herds was detected in the southern part of the Borborema mesoregion. Given that serological tests for bovine cysticercosis are not widely available, and also that replacement and maintenance of herds through animal purchases is common in the region, it can be concluded that prevention measures should be applied at herd level.

Resumo O objetivo deste estudo foi identificar agrupamentos espaciais de rebanhos positivos para cisticercose bovina no Estado da Paraíba. O estado foi dividido em três grupos amostrais: estrato amostral 1 (mesorregião do Sertão), estrato amostral 2 (mesorregião da Borborema), e estrato amostral 3 (mesorregiões da Zona da Mata e Agreste), e 2.382 vacas com idade ≥ 24 meses foram amostradas a partir de 474 propriedades. O diagnóstico sorológico da cisticercose bovina foi inicialmente realizado pelo ELISA indireto, e as amostras de soro positivas foram confirmadas por immunoblot. Um rebanho foi considerado positivo para cisticercose se apresentasse pelo menos um animal positivo em rebanhos de até 29 fêmeas, e dois animais positivos em rebanhos com mais de 29 fêmeas. Os agrupamentos espaciais foram avaliados com o uso da metodologia k-vizinhos mais próximos de Cuzick-Edwards e estatística espacial de varredura. Um agrupamento significativo de rebanhos positivos foi detectado na parte sul da mesorregião da Borborema. Tendo em vista que os testes sorológicos para diagnóstico de cisticercose bovina não são amplamente disponíveis, bem como é comum na região a reposição e manutenção dos rebanhos por compra de animais, conclui-se que medidas de prevenção devem ser aplicadas em nível de rebanho.

Comparação de dois índices de determinação do grau de trofia nas águas do Baixo Rio São José dos Dourados, São Paulo, Brasil / Comparison of two indexes of determination of the trophic state in the waters of Baixo São José dos Dourados, São Paulo, Brazil

RESUMO Estudo realizado no período de fevereiro de 2010 a janeiro de 2011, no Baixo São José dos Dourados (BSJD), inserido na Unidade de Gerenciamento de Recursos Hídricos 18 (UGRHI), com o intuito de determinar o grau de trofia da água por meio do cálculo do índice de estado trófico (IET). Os pontos de coletas contemplavam as entradas diretas e difusas no trecho represado do curso d'água (pontos 1 e 2), intermediário (3) e próximo de sua confluência com o Rio Paraná (ponto 4). As amostras coletadas foram superficiais, de meio e de aproximadamente 1 m acima do leito. Em laboratório, foram determinados a clorofila-a, o fósforo total e o ortofosfato; a transparência da água foi determinada no local da coleta. Após determinados os parâmetros necessários foi possível classificar as águas como sendo oligotróficas e ultraoligotróficas.

ABSTRACT This Study conducted from February 2010 to January 2011, in the Baixo São José dos Dourados (BSJD), in the Unidade de Gerenciamento de Recursos Hídricos (UGRHI) 18, in order to determine the trophic level of the water calculating the trophic state index (TSI) The points of collection were at the direct and diffuse inputs and dammed stretch of the watercourse (points 1 and 2), intermediate (3) and confluence with the Paraná River (point 4). The samples were superficial, medium and approximately 1 m above the riverbed. At the laboratory was determined chlorophyll-a, total phosphorus and orthophosphate, water transparency was determined at the collect place. After those parameters was possible to classify the waters as oligotrophic and ultraoligotrophic.