In vitro evaluation of the susceptibility of bacterial biofilms to hecogenin acetate.

Biofilms are a bacterial resistance strategy through which microorganisms organize themselves in the form of a colony fixed to a surface that is protected by a polymer matrix. Infectious diseases that result in biofilm formation have been considered a relevant public health problem due to the potential to increase patient morbidity and mortality, in addition to increasing the burden on health services. Such pathologies are treated with the use of antimicrobial drugs, the indiscriminate use of which has contributed to the process of bacterial resistance, demanding the need to invest in new alternatives to combat them. Based on this, the present work aimed to evaluate the anti-biofilm formation and eradication capacity of Hecogenin Acetate, a steroidal sapogenin of natural origin with important antibacterial properties. For this, we used strains of Streptococcus mutans INCQS 00,446 (ATCC 25,175), Enterococcus faecalis INCQS 00,018 (ATCC 14,506), Staphylococcus epidermidis INCQS 00,016 (ATCC 12,228), Staphylococcus aureus ATCC 25,923, Pseudomonas aeruginosa ATCC 9027 and Escherichia coli ATCC 259,223. The formation, formation inhibition and treatment assays were carried out in microdilution plates and revealed using the crystal violet method. Readings were carried out using absorbance at wavelengths of 492 nm. All tests were performed in triplicate and statistical analyzes were performed using Graphpad Prism v.5.0 software. It was observed that the bacterial strains used have a relevant capacity for biofilm formation, with the Gram positive ones identified in the present study as the best former. In the results of the analyzes with bacterial biofilm, it was identified that Hecogenin Acetate had a relevant antibiofilm capacity, and could therefore serve as a basis for further research into the development of new antimicrobial drugs.

Evaluation of the antibacterial activity of hecogenin acetate and its inhibitory potential of NorA and MepA efflux pumps from Staphylococcus aureus.

Antimicrobial drugs are of great importance in the control of bacterial infections. Its indiscriminate use contributes to the consolidation of bacterial resistance. Its applicability is due to its secondary metabolites, such as saponins, which are compounds with relevant antibacterial action. Hecogenin acetate is a saponin present in plants of the agave genus with analgesic, antioxidant, antinociceptive, cardioactive, anticancer, antifungal and antimicrobial activity. The present work aimed to identify the antibacterial activity of hecogenin acetate against strains of E. coli, P. aeruginosa and S. aureus and to investigate the NorA and MepA efflux pump inhibitory activity of S. aureus strains. The Minimum Inhibitory Concentration was evaluated by broth microdilution. The Antibiotic Activity Modifier effect and the assessment of efflux pump inhibition were evaluated by microdilution with sub-inhibitory concentrations. Hecogenin acetate showed minimal inhibitory concentration without significant relevance. In the evaluation of the potentiating activity of the antibiotic action, a greater antagonistic behavior is noticed. In the analyzes performed with the efflux pump, it was noticed that the hecogenin acetate does not interfere in the efflux pump mechanism of the analyzed bacteria.

Potentiation of Antibiotic Action and Efflux Pump Inhibitory Effect on Staphylococcus aureus Strains by Solasodine.

A worrisome fact is the increase in microbial resistance, which has as its main cause the indiscriminate use of antibiotics. Scientific studies have investigated bioactive compounds such as steroidal sapogenins, in the perspective of new beneficial alternatives for the control of bacterial resistance. Therefore, the objective of this work was to verify the antibacterial activity as well as the modifying action of antibiotics associated with solasodine and its ability to inhibit the efflux pump mechanism in strains of Staphylococcus aureus. Tests were performed to verify the minimum inhibitory concentration (MIC). In addition, the action-modifying potential of antibiotics and the inhibitory capacity of the efflux pump NorA and MepA through synergistic effects on the antibiotic and ethidium bromide were evaluated. Solasodine showed significant results for the standard bacteria with an MIC of 512 µg/mL, and when associated with the antibiotics gentamicin and nofloxacin for the multidrug-resistant bacteria S. aureus 10, Escherichia coli 06, and Pseudomonas aeruginosa 24, it showed a 50% reduction in MIC. The association of solasodine with the antibiotic ciprofloxacin against S. aureus K2068 (MepA) showed synergism, with a reduction in the MIC of the antibiotic from 64 µg/mL to 40 µg/mL, and also a reduction in the MIC when the antibiotic was used in conjunction with the efflux pump inhibitors. Solasodine may be acting on the mechanism of action of the antibiotic, as it has shown a potentiating effect when associated with antibiotics, inducing a reduction in the MIC against Gram-positive and Gram-negative bacteria. Therefore, this study demonstrated significant results for the potentiating action of solasodine when associated with antibiotics of clinical importance.

Factors associated with neonatal death among adolescent mothers / Fatores associados ao óbito neonatal de mães adolescentes

Abstract Objectives: to analyze factors associated with neonatal death among adolescent mothers. Methods: randomized hospital-based cross-sectional study in a tertiary institution,, data from the Sistema de Informação sobre Nascidos Vivos (Sinasc), (Live Birth Information System), Sistema de Informação sobre Mortalidade (SIM) (Mortality Information System), and medical records. The study population was comprised of 1,341 adolescents aged 10-19 who had assisted childbirth at the institution between 2012 to 2016. The independent variables were sociodemographic characteristics, care, prenatal, childbirth, birth, and newborn's hospitalization, as well as the baby's characteristics. Logistic regression analysis was carried out to assess the association between neonatal death and explanatory variables. Results: the factors associated with death were from the countryside or other States (OR=2.68; CI95% =1.24-5.81), Apgar scores lower than 7 in the 1st (OR= 9.52; CI95% = 4.15-21.81) and the 5th (OR=4.17; CI95%=1.53-11.34) minutes of life; and birth weight less than 999g (OR=13.37; CI95% =3, 64-49.04) and between 1,500 to 2,499g (OR=3.43; CI95%=1.37-8.58). Conclusions: apgar and low birth weight were associated with the neonatal death among adolescent mothers, as well as the fact they come from the countryside and other States. These findings show, in addition to classic risks, potential difficulties for adolescents in having access to healthcare services in their hometown. To reduce the risks, there is a need for restructuring the maternal and child healthcare network and ensure a social protection network for these girls.

Resumo Objetivos: analisar fatores associados ao óbito neonatal de mães adolescentes. Métodos: estudo transversal de base hospitalar em instituição terciária, randomizado, com dados do Sistema de Informação sobre Nascidos Vivos (Sinasc), Sistema de Informação sobre Mortalidade (SIM) e de prontuários. A população do estudo compreendeu 1.341 adolescentes de 10 a 19 anos assistidos durante o parto na instituição entre 2012 a 2016. As variáveis independentes foram características sociodemográficas, assistenciais, relacionadas ao pré-natal, parto, nascimento e internamento do recém-nascido, além das características do bebê. Realizou-se análise de regressão logística para avaliar a associação entre óbito neonatal e variáveis explanatórias. Resultados: os fatores associados ao óbito foram municípios do interior e outros estados (OR=2,68; IC95%=1,24-5,81), índices de apgar menor que sete no 1º(OR=9,52; IC95%=4,15-21,81) e no 5º(OR=4,17; IC95%=1,53-11,34) minutos de vida e peso ao nascer menor que 999g (OR=13,37; IC95%= 3,64-49,04) e entre 1500 a 2499g (OR=3,43; IC95%= 1,37-8,58). Conclusões: o apgar e o baixo peso ao nascer se associaram ao óbito neonatal de mães adolescentes além da procedência de municípios do interior e outros estados. Estes achados mostram além de riscos clássicos, potenciais dificuldade das adolescentes em dispor de assistência nos seus lugares de residência. Para reduzir os riscos há necessidade de reorganizar a rede assistencial materno-infantil e garantir uma rede de proteção social a estas meninas.

Antibacterial and modulatory activities of ß-cyclodextrin complexed with (+)-ß-citronellol against multidrug-resistant strains.

The present study aimed to investigate the antibacterial and modulatory activities of (+)-ß-citronellol (ßCT), ß-cyclodextrin (ß-CD), and their complex ßCT/ß-CD and characterize them using infrared spectroscopy. Infrared spectra were recorded in the 750-4000 cm-1 region. The antibacterial effects of these compounds and their modulatory-antibiotic activities were determined using the minimum inhibitory concentration (MIC) test. Signatures of these pure compounds were detected in the infrared spectrum of the ßCT/ß-CD complex. The MIC of the ßCT/ß-CD complex against the tested strains was found to be 1024 µg/mL. The antagonistic and synergistic effects of these compounds were also observed using the modulation tests. ßCT or ß-CD alone did not exhibit any direct antibacterial activity. However, the ßCT/ß-CD complex in combination with gentamicin showed a synergistic effect against E. coli.

Cases of leprosy notified in the municipality of Parnaíba, state of Piauí, Brazil, 2007-2016

This study aimed to describe the epidemiological and clinical characteristics of leprosy cases reported in the municipality of Parnaíba, State of Piauí. This was a cross-sectional study of leprosy cases, living in Parnaíba, State of Piauí, reported to the National System of Notifiable Diseases (SINAN), from 2007 to 2016. There were 582 cases of leprosy with hyperendemic detection in the general population in 2008, 2009 and 2016; and under < 15 years of age in 2008, 2014 and 2016, with a predominance of females (53.1%), brown (62.2%), aged 20-64 years (74.7%), complete and incomplete elementary school (56.4%), housewives (20.7%), living in the urban area (87.1%), reported by primary care (69.2%). The most frequent clinical and therapeutic findings were: multibacillary operational classification (53.8%); clinical forms: undetermined (30.6%) and virchowian (24.3%); single lesion (34.8%); no affected nerves (86.7%); degree of disability zero (70.6%); bacilloscopy not performed (26.7%); therapeutic regimen 12 doses (53.7%) and no reaction (70.8%). Regarding the mode of input, predominated new case (88.8%); mode of output, cure (87.9%) and detection mode: spontaneous demand (45.8%). Out of 2,106 registered contacts, 60.6% were examined. Leprosy is endemic to Parnaíba, State of Piauí. It is noteworthy that the hyperendemic detection rates occurred during years when there was intensification of active search for contacts and cases in the population.

Cervical cancer and quality of life: an integrative review / Câncer do colo do útero e qualidade de vida: uma revisão integrativa

Objective: To analyze the publications regarding the quality of life of women with cervical cancer. Method: This is an integrative review performed in the indexed LILACS, MEDLINE and SCIELO databases. The descriptors "Quality of Life" AND "Cervical Neoplasms", "Quality of Life" AND "Woman's Health" and "Woman's Health" AND "Cervical Neoplasms" were used, in which articles published in the period from 2010-2018 that met the inclusion criteria were selected. Results: The research resulted in three articles in Lilacs, three in Medline, and five in Scielo, totaling 11 articles. The research used three questionnaires, such as EORTC QLQ-C30, WHOQOL-bref, and FACT-Cx. These instruments are the most widely used today to measure the quality of life and health conditions in broad aspects. It was observed that cervical cancer positively affects women's quality of life in social and emotional aspects. Conclusion: Quality of life, although with a positive evaluation, should encourage the formulation of public health policies aimed at improving this target audience's quality of life. The discovery of the disease brings several fears, including the thought of death. In addition, it has a physical and psychological impact on these women's lives.

Analisar as publicações referentes à qualidade de vida das mulheres acometidas pelo câncer cervical. Trata-se de uma revisão integrativa realizada nas bases de dados indexadas LILACS, MEDLINE e SCIELO. Utilizou-se os descritores "Qualidade de vida" AND "Neoplasias do colo do útero", "Qualidade de vida" AND "Saúde da Mulher" e "Saúde da Mulher" AND "Neoplasias do colo do útero", na qual foram selecionados artigos publicados no período de 2010-2018 que atendessem aos critérios de inclusão. A pesquisa resultou em três artigos na Lilacs, três na Medline e cinco na Scielo, totalizando 11 artigos. As pesquisas utilizaram três questionários, tais como: EORTC QLQ-C30, WHOQOL-bref e FACT-Cx. Esses instrumentos são os mais utilizados na atualidade para mensurar a qualidade de vida e as condições de saúde em amplos aspectos. Observou-se que o câncer cervical afeta positivamente a qualidade de vida das mulheres nos aspectos sociais e emocionais. A qualidade de vida embora com a avaliação positiva nas mulheres deva ser incentivada à formulação de políticas públicas de saúde que visem à melhora da qualidade de vida desse público-alvo. A descoberta da doença traz vários receios, entre eles, o pensamento de morte que repercute de forma física e psicológica na vida dessas mulheres.

GC/MS analysis and antimicrobial activity of the Piper mikanianum (Kunth) Steud. essential oil.

The Piper mikanianum species were investigated by the antimicrobial potential and chemical composition. Chemical analysis was performed by gas chromatography coupled to mass spectrometry (GC/MS). The Minimum Inhibitory Concentration (MIC) as well as the 50% Inhibitory Concentration against Candida strains were determined by microdilution. The effect of the drug-oil combination was also evaluated to verify possible synergism. The Minimum Fungicidal Concentration (MFC) was evaluated by subculturing the microdilution in Petri dishes and the anti-pleomorphism potential of the oil was tested in humid chambers. Chemical analysis revealed safrol as the major compound. The results from the intrinsic activity evaluation of the oil did not reveal a clinical importance, however, it presented a synergistic effect when associated with gentamicin against the multidrug resistant E. coli strain and when associated with fluconazole against fungal strains. Moreover, the oil possessed a fungistatic effect. Total inhibition of filamentous structures occurred in both Candida species in the anti-virulence test. The P. mikanianum essential oil showed a potentiating activity of drugs for which resistance exists and an inhibitory effect of one of the main virulence factors of the Candida genus, morphological transition, which has been previously shown to be responsible for causing invasive infections in human tissues.

Mídias sociais como fonte de conhecimento para o processo de parto normal / Los medios sociales como fuente de conocimientos para el proceso de parto normal / Social media as a source of knowledge for the process of normal delivery

RESUMO Objetivo: verificar o conhecimento adquirido pelas gestantes para o processo de parto normal através das mídias sociais e a influência sobre a experiência do parto. Metodologia: estudo qualitativo com 12 puérperas de um hospital filantrópico, na cidade de Recife-PE. Foram realizadas entrevistas individuais, entre dezembro de 2018 e fevereiro de 2019, e foi utilizada a metodologia de análise de conteúdo. Resultados: após análise, emergiram duas categorias: Uso da mídia social como suporte de informações durante a gestação, e Expectativa para o parto vaginal através do conhecimento adquirido versus a realidade da experiência do parto vaginal. Conclusão: em resposta ao déficit de educação em saúde, as mídias sociais ganharam espaço como principal fonte de informações e esclarecimento de dúvidas a respeito do parto. Os profissionais da saúde, conhecendo as fontes de informação utilizadas pelas gestantes, podem contribuir com as orientações e indicação de fontes seguras e com conteúdo de qualidade.

RESUMEN: Objetivo: verificar los conocimientos adquiridos por las embarazadas para el proceso de parto normal a través de los medios sociales y la influencia sobre la experiencia del parto. Metodología: estudio cualitativo realizado con 12 puérperas de un hospital filantrópico en la ciudad de Recife-PE. Se realizaron entrevistas individuales entre diciembre de 2018 y febrero de 2019 y se utilizó la metodología del análisis de contenido. Resultados: luego del análisis surgieron dos categorías: Uso de los medios sociales como soporte de información durante el embarazo, y Expectativa con respecto al parto vaginal a través del conocimiento adquirido versus la realidad de la experiencia del parto vaginal. Conclusión: en respuesta al déficit de educación en salud, los medios sociales ganaron espacio como fuente principal de información y aclaración de dudas con respecto al parto. Al conocer qué fuentes de información emplearon las embarazadas, los profesionales de la salud pueden contribuir con pautas orientadoras y con la indicación de fuentes seguras y que aporten contenido de calidad.

ABSTRACT Objective: To check the knowledge acquired by pregnant women through social media about the normal delivery process and the influence on the delivery experience. Method: A qualitative study with 12 puerperal women from a philanthropic hospital, in the city of Recife-PE. Individual interviews were conducted between December 2018 and February 2019, and the methodology of content analysis was used. Results: Two categories emerged after analysis: The use of social media as information sources during pregnancy, and Expectation towards vaginal delivery with the acquired knowledge versus the reality of the vaginal delivery experience. Conclusion: In response to the health education deficit, social media gained ground as the main source of information and clarification of pieces of doubt about childbirth. Health professionals, knowing the sources of information used by pregnant women, can contribute with the guidance and indication of safe sources with quality content.

Evaluation of the antibacterial and modulatory potential of α-bisabolol, ß-cyclodextrin and α-bisabolol/ß-cyclodextrin complex.

The present study aimed to evaluate the antibacterial and modulatory potential of α-bisabolol, ß-cyclodextrin and α-bisabolol/ß-cyclodextrin complex. The minimum inhibitory concentration was determined through the broth microdilution technique using the bacterial strains: Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. The drugs norfloxacin, imipenem and gentamicin were used in the tests, and the compounds α-bisabolol and ß-cyclodextrin; all the compounds were diluted in DMSO. To obtain the minimum inhibitory concentration (MIC) a serial microdilution of the substances in volumes corresponding to the sub-inhibitory concentration (MIC/8), and microdilution with the antibiotic until the penultimate well were performed. The results showed that ß-cyclodextrin did not present synergistic effects when combined with the antibiotics. It was found that α-bisabolol presented a synergistic effect against S. aureus, when combined with the antibiotic norfloxacin. Moreover, α-bisabolol presented synergism against E. coli when combined with gentamicin. The results of this study show that α-bisabolol presents a modulatory synergistic effect for some antibiotics, as gentamicin, and this is an interesting result against multidrug resistant bacteria (MDR). By other side, the complexation of α-bisabolol with ß-cyclodextrin apparently reduces the modulatory effect, maybe due the polarity enhancement of the polarity of α-bisabolol, affecting the interaction of this compound with the cell membrane bilayer. However, more studies are necessary to demonstrate or not these interactions.

Seasonal variation of Brazilian red propolis: Antibacterial activity, synergistic effect and phytochemical screening.

The aim of this study was to investigate the effect of the dry and rainy season on the antibacterial activity and chemical composition of the Brazilian red propolis. The samples were collected in rainy (RP-PER) and dry (RP-PED) seasons and analyzed by HPLC-DAD. The extracts were tested alone and in association with antibiotics against Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. The HPLC analysis identified luteolin and quercetin as the main compounds. Seasonal variation was observed according to concentrations of the compounds. The MIC values against E. coli ranged from 128 µg/mL to 512 µg/mL (EC 06 and EC ATCC). The red propolis showed MIC values of 512 µg/mL against both strains of P. aeruginosa used in our study (PA03 and PA24) and against strains of Gram-positive bacteria S. aureus the MICs ranged from 64 µg/mL to ≥1024 µg/mL (SA10). A synergistic effect was observed when we combined the RP-PED with gentamicin against all the strains tested. When we combined the RP-PED with Imipenem, we only observed synergistic effect against P. aeruginosa. According to our synergistic activity results, the utilization of red propolis collected in the drier periods can be used as an adjuvant against multiresistant bacterial infections.

Avaliação comparativa da modulação de antibióticos, frente às cepas bacterianas de Escherichia coli, Staphylococcus aureus / Evaluación comparativa de la modulación de antibióticos frente a cepas bacterianas de Escherichia Coli, Staphylococcus / Comparative Evaluation of the Modulation of Antibiotic-Activity against Strains of Escherichia coli and Staphylococcus aureus

Introdução: Combinações múltiplas de drogas estão sendo utilizadas no combate à disseminação de bactérias patogênicas resistentes a antibióticos. No entanto, a utilização incorreta desses antibióticos fez com que algumas bactérias sejam selecionadas, deixando apenas as resistentes aos agentes antimicrobianos, com o consequente surgimento de resistência aos antibióticos. Objetivos: Nesse contexto, avaliaram-se as atividades microbiológicas dos antibióticos claritromicina, gentamicina, ciprofloxacino e imipenem, além de comparar as atividades da associação entre esses fármacos, frente às cepas bacterianas de Escherichia coli e Staphylococcus aureus. Materiais e Métodos: A Concentração Inibitória Mínima (CIM) foi realizada pelo método de microdiluição em caldo para cada uma das amostras selecionadas. Posteriormente, com base nos valores das cims, foi avaliado o efeito antimicrobiano da combinação das drogas pelo método de modulação. Resultados: A associação demonstrou efeitos sinérgicos frente às linhagens testadas, sugerindo-se que a associação dos antibióticos testados aumenta o seu potencial antimicrobiano. Conclusão: Nesse sentido, o uso de antibióticos em combinação pode ser realizado mediante investigações posteriores que comprovem a segurança de seu uso.

Introducción: Actualmente, se está utilizando la combinación de múltiples drogas en la lucha contra la propagación de bacterias patógenas resistentes a los antibióticos. Sin embargo, el uso inadecuado de estos antibióticos ha causado que algunas bacterias se seleccionen, con la consiguiente aparición de resistencia a los antibióticos. Objetivo: Se evaluó la actividad microbiológica de los antibióticos claritromicina, gentamicina, ciprofloxacino e imipenem, y se comparó la actividad sinérgica de estos fármacos, frente a las cepas bacterianas de Escherichia coli y Staphylococcus aureus. Materiales y Métodos: Se determinó la Concentración Mínima Inhibitoria (CMI) por el método de microdilución en caldo para cada una de las muestras seleccionadas y se evaluó el efecto antimicrobiano de la combinación de fármacos por el método de modulación. Resultados: La combinación mostró efectos sinérgicos frente a las cepas ensayadas, lo que sugiere que la asociación de los antibióticos ensayados aumenta su potencial antimicrobiano. Conclusión: Se puede utilizar antibióticos en combinación; sin embargo, se requiere realizar investigaciones adicionales que demuestren ser seguros para su utilización.

Introduction: Combining multiple drugs is an strategy used to combat the dissemination of pathogenic and drug resistant bacteria. However, the misuse of these drugs against bacteria have caused the selection of more resistant specimens called multidrug-resistant bacteria. Objective: In this work we evaluated the antibiotic activity of claritromicin, gentamicin, ciprofloxacin and imipenen, alone or associating one by one, against strains of Escherichia coli and Staphylococcus aureus. Material and methods: The minimal inhibitory concentration (mic) was performed using the microdilution assay. Based in the mic values, the antibiotic effect of the drugs alone and in association were determined. Results: The association between the drugs demonstrated the synergism against the bacterial strains. Conclusion: The use of the combined antibiotic-therapy can be positively performed, but additional studies have to be conducted first for proving that its use is safe.

Seasonal Variation and Frequency Distribution of Ectoparasites in Crossbreed Cattle in Southeastern Brazil.

The aims of this study were to evaluate the seasonal variation and frequency distribution of Rhipicephalus (Boophilus) microplus, Haematobia irritans, and Dermatobia hominis on crossbred heifers under field conditions in the northeast of Minas Gerais state, southeastern Brazil. From November 2007 to September 2009 (23 months), 40 heifers aged 16.6 ± 2.4 months were divided into groups A (1/4 Holstein × 3/4 Gir) and B (1/2 Holstein × 1/2 Gir) and had the monthly infestation estimated along with the climatic conditions. The mean maximum and minimum temperatures were 28.5 and 19°C, respectively. The ectoparasites were present on animals in all months of the year. The levels of ticks on the animals were low (3.0 ± 0.2 ticks/animal), with the highest density in midwinter. The temperature was the climatic factor that most influenced the tick levels. The population of H. irritans (13.9 ± 0.3 flies/animal) and D. hominis (1.5 ± 0.2 larvae/animal) on heifers was more influenced by rainfall and exhibited two population peaks during the year. 1/2 Holstein heifers harbored significantly more H. irritans and D. hominis than 1/4 Holstein heifers. The results are discussed considering the most appropriate periods to apply ectoparasiticides and the genetic make-up of the animals.

[The Family Health Strategy and hospital admissions of children under five years in Piauí State, Brazil]. / Estratégia Saúde da Família e internações hospitalares em menores de 5 anos no Piauí, Brasil.

Hospitalizations for some health conditions can be reduced by timely primary care with appropriate quality, especially in children. This study analyzed the trend in hospitalizations in children under five years of age in Piauí State, Brazil, from 2000 to 2010, according to groups of causes (ICD-10) and hospital admissions in 2010, based on the Brazilian List of Hospitalizations for Primary Care-Sensitive Conditions. The objectives were to identify changes in the hospital morbidity profile and to discuss their relationship to expansion of the Family Health Strategy (FHS) in the State. Piauí showed the highest proportional expansion of the FHS in Brazil, reaching an estimated coverage of 97.2% in 2010. From 2000 to 2010, there was a reduction in the hospitalization frequency and rates in children under five years, but the proportion of hospitalizations in the leading groups of causes persisted or increased during the decade. In 2010, 60% of hospitalizations in children under five years were for causes that are sensitive to primary care, especially infectious gastroenteritis, respiratory infections, and asthma.

Estratégia Saúde da Família e internações hospitalares em menores de 5 anos no Piauí, Brasil / The Family Health Strategy and hospital admissions of children under five years in Piauí State, Brazil

Internações hospitalares por algumas condições de saúde podem ser reduzidas por uma atenção primária oportuna e com qualidade, especialmente na população infantil. Analisou-se a evolução das internações hospitalares de menores de 5 anos no Piauí, Brasil, de 2000 a 2010, segundo grupos de causas (CID-10) e das internações de 2010, com base na lista brasileira de Internações por Condições Sensíveis à Atenção Primária. O objetivo foi identificar mudanças no perfil de morbidade hospitalar e discutir sua relação com a expansão da ESF no estado. O Piauí apresentou a maior expansão proporcional da ESF, alcançando a cobertura estimada de 97,2 por cento, em 2010. No período de 2000 a 2010, a frequência e as taxas de internações em menores de 5 anos foram reduzidas, porém, a proporção de hospitalizações nos principais grupos de causas se manteve ou aumentou, ao longo da década analisada. Em 2010, 60 por cento das internações em menores de 5 anos foram por causas sensíveis à atenção primária, em especial gastrenterites infecciosas, infecções respiratórias e asma.

Hospitalizations for some health conditions can be reduced by timely primary care with appropriate quality, especially in children. This study analyzed the trend in hospitalizations in children under five years of age in Piauí State, Brazil, from 2000 to 2010, according to groups of causes (ICD-10) and hospital admissions in 2010, based on the Brazilian List of Hospitalizations for Primary Care-Sensitive Conditions. The objectives were to identify changes in the hospital morbidity profile and to discuss their relationship to expansion of the Family Health Strategy (FHS) in the State. Piauí showed the highest proportional expansion of the FHS in Brazil, reaching an estimated coverage of 97.2 percent in 2010. From 2000 to 2010, there was a reduction in the hospitalization frequency and rates in children under five years, but the proportion of hospitalizations in the leading groups of causes persisted or increased during the decade. In 2010, 60 percent of hospitalizations in children under five years were for causes that are sensitive to primary care, especially infectious gastroenteritis, respiratory infections, and asthma.

Anthelmintic resistance in a dairy cattle farm in the State of Minas Gerais.

Eighty-four half-blood Gir × Holstein (F1) calves aged six months who were naturally infected by gastrointestinal helminths and maintained in rotational grazing received different anthelmintic treatments. Group A received anthelmintics according to the usual management in the property (eight treatments, seven including a macrocyclic lactone agent). Group B received strategic treatment (ivermectin 3.15%) at the beginning and at the end of the rainy period. Eggs per gram of feces (EPG) counts and genus of larvae from fecal cultures were determined on a monthly basis from April 2002 to December 2003. There was no significant reduction (p > 0.05) in EPG counts in any group after anthelminthic treatment, and the larvae in fecal cultures observed were Cooperia, Haemonchus, Oesophagostomum and a few Trichostrongylus. Cooperia was the most prevalent genus in the first four months of the experiment and Haemonchus in the following months. In 2003, tracer calves were introduced onto the pastures monthly and they showed high nematode burden many times throughout the year, and Cooperia punctata and Haemonchus contortus were the main species identified. The results suggest that there is anthelminthic resistance in this farm, mainly to macrocyclic lactones, and the development of immunity by crossbred animals was vital to reduce nematode burden.

Anthelmintic resistance in a dairy cattle farm in the State of Minas Gerais / Resistência anti-helmíntica em uma propriedade de bovinos leiteiros em Minas Gerais

Eighty-four half-blood Gir × Holstein (F1) calves aged six months who were naturally infected by gastrointestinal helminths and maintained in rotational grazing received different anthelmintic treatments. Group A received anthelmintics according to the usual management in the property (eight treatments, seven including a macrocyclic lactone agent). Group B received strategic treatment (ivermectin 3.15 percent) at the beginning and at the end of the rainy period. Eggs per gram of feces (EPG) counts and genus of larvae from fecal cultures were determined on a monthly basis from April 2002 to December 2003. There was no significant reduction (p > 0.05) in EPG counts in any group after anthelminthic treatment, and the larvae in fecal cultures observed were Cooperia, Haemonchus, Oesophagostomum and a few Trichostrongylus. Cooperia was the most prevalent genus in the first four months of the experiment and Haemonchus in the following months. In 2003, tracer calves were introduced onto the pastures monthly and they showed high nematode burden many times throughout the year, and Cooperia punctata and Haemonchus contortus were the main species identified. The results suggest that there is anthelminthic resistance in this farm, mainly to macrocyclic lactones, and the development of immunity by crossbred animals was vital to reduce nematode burden.

Oitenta e quatro bezerras meio sangue Gir × holandês (F1) com seis meses de idade, naturalmente infectadas por helmintos gastrintestinais e mantidas em pastejo rotacionado receberam diferentes tratamentos anti-helmínticos. O grupo A recebeu anti-helmínticos segundo manejo empregado na propriedade (oito tratamentos, sete com produtos à base de lactonas macrocíclicas). O grupo B recebeu tratamento estratégico (ivermectina 3,15 por cento) no inicio e final de período chuvoso. Mensalmente, no período de abril de 2002 a dezembro de 2003, foram realizadas contagens de ovos por grama de fezes (OPG) e coproculturas. Não houve redução significativa (p > 0,05) nas contagens de OPG em nenhum dos grupos após os tratamentos anti-helmínticos, e as larvas encontradas na coprocultura foram Cooperia, Haemonchus, Oesophagostomum e poucos Trichostrongylus, com predominância de Cooperia nos quatro meses iniciais e Haemonchus nos meses seguintes. No ano de 2003, bezerros traçadores foram alocados mensalmente nos pastos, apresentando altas cargas parasitárias na maioria dos meses do ano, sendo as principais espécies identificadas: Cooperia punctata e Haemonchus contortus. Os resultados indicam que os nematódeos da fazenda apresentam resistência anti-helmíntica, principalmente às lactonas macrocíclicas, e o desenvolvimento de imunidade foi primordial para reduzir a carga parasitária dos animais mestiços.