Urgent Considerations on the Relationship Between the Advance of Covid-19 in Indigenous Territories in Brazil and the Impacts of Monoepistemic Public Policies.

This paper seeks to deal with the advance of Covid-19 in indigenous territories in Brazil, whether urban or rural. To do so, we have gone through a general analysis of the Brazilian government's indigenous policies, comparing bulletins and data from the Special Secretariat of Indigenous Health-Secretaria Especial de Saúde Indígena, an agency linked to the Ministry of Health, as well as data from the Articulation of Indigenous Peoples of Brazil, the main Brazilian indigenous political movement. Furthermore, we systematize strategies that have been developed and executed by some indigenous peoples in Brazil, undertaken by an exploratory analysis of manifestations of indigenous leaders on the internet, along with actions in the legal sphere, as well as, actions in the indigenous territory. Finally, the monoepistemic character of public policies on the issue is problematized.

Toxoplasmosis outbreak in Brazil, 2006 - Revisited.

Waterborne outbreaks of human toxoplasmosis can have great magnitude due to the number of persons infected while smaller-scale outbreaks are also possible. This is a study based on a historical database investigating a toxoplasmosis outbreak occurred in 2006 in a residential community in São Luís, in the Brazilian state of Maranhão. Ninety of the 110 residents, employees and domestic helping persons had blood samples collected and tested. The diagnosis of toxoplasmosis was established by quantification of anti-Toxoplasma gondii immunoglobulin M and immunoglobulin G antibodies using enzyme immunoassay. The subjects were classified as past infection, acute/recent infection or seronegatives. The definition of acute infection was based on the presence of indicative symptoms and immunoglobulin M positivity. There were 33 cases of acute infection. The outbreak was concluded to be waterborne: consumption of faucet-mount filtered water was indicated as risk factor. We discuss the challenges of investigating waterborne toxoplasmosis outbreaks.

Avaliação odontológica de pacientes em unidade de terapia intensiva (UTI) pediátrica / Evaluación odontológica de pacientes en una unidad de cuidados intensivos (UCI) pediátrica / Dental assessment of patients in paediatric intensive care unit (ICT)

Resumo Introdução e Objetivo: Há necessidade de trabalhos envolvendo crianças submetidas à abordagem odontológica em ambiente hospitalar para relatar as características clínicas das crianças atendidas pelo Serviço de Odontologia da Unidade de Terapia Intensiva Pediátrica (UTIPed) de um hospital de referência do Sistema Único de Saúde (SUS). Registrar das condições bucais das crianças e tratamentos realizados pela equipe de profissionais em Odontologia. Materiais e métodos: estudo descritivo retrospectivo, através de resgate de prontuários e os resultados foram tabulados e analisados por meio de diferença percentual. A amostra foi composta por 145 pacientes de 0 a 15 anos de idade atendidos e acompanhados pelo serviço de Odontologia da UTIPed no período de setembro 2016 a novembro 2017. Os pacientes foram analisados quanto gênero, idade, motivo da internação, nível de consciência, condição das vias aéreas, processos patológicos na cavidade bucal, procedimentos odontológicos realizados, material de higiene bucal utilizado e presença de PAV. Resultados: Os pacientes encontravam-se na faixa etária de menor que 1 ano até 17 anos, sendo mais frequente o sexo feminino (54,48%). Em relação à procedência 94 (64,23%) eram pacientes internos do Hospital Universitário e 51 (35,77%) foram transferidos de outros hospitais. Ao avaliarmos as condições de saúde bucal, 45,83% dos pacientes apresentavam higiene bucal satisfatória, 45,14% regular e 9,03% deficiente. Em relação às condições da mucosa bucal, apenas 5,52% dos pacientes apresentaram alterações, destas, 3,45% já se encontravam no momento da admissão. Conclusão: Verificou-se que as crianças hospitalizadas em UTI Pediátrica podem apresentar alterações em mucosa bucal desde o momento da admissão, sendo mandatória a presença constante do Cirurgião-dentista na equipe da UTI para tratar e proporcionar uma maior adesão aos cuidados bucais a estes pacientes.

Abstract Introduction and Objective: There is need for papers involving children undergoing dental approach in hospital environment to report the clinical characteristics of the children attended by the Pediatric Intensive Care Unit Dentistry Service of a reference hospital of the Unified Health System (SUS) To record the oral conditions of the children and treatments performed by the team of professionals in Dentistry. Materials and methods: retrospective descriptive study, through retrieval of medical records and results were tabulated and analyzed by means of percentage difference. The sample consisted of 145 patients from 0 to 15 years of age attended and followed up by the UTIPed Dentistry service from September 2016 to November 2017. Patients were analyzed for gender, age, reason for hospitalization, level of consciousness, condition of the airways, pathological processes in the oral cavity, dental procedures performed, oral hygiene material used and presence of PAV. Results: Patients were in the age range of less than 1 year up to 17 years, with females being more frequent (54.48%). Regarding the origin 94 (64.23) were internal patients of the University Hospital and 51 (35.77%) were transferred from other hospitals. When we evaluated the oral health conditions, 45.83% of the patients presented satisfactory oral hygiene, 45.14% regular and 9.03% deficient. Regarding oral mucosa conditions, only 5.52% of the patients presented alterations, of which, 3.45% were already on admission. Conclusion: It was verified that the children hospitalized in Pediatric ICU may present changes in the oral mucosa from the moment of admission, being mandatory the constant presence of the dentist in the ICU team to treat and provide a greater adherence to the oral care of these patients.

Resumen Introducción y Objetivo: Es necesario trabajos que impliquen enfoque dental en ambiente de hospital para relatar las características clínicas de los niños atendidos por el Servicio de Odontología de la Unidad de Cuidados Intensivos Pediátrica de un hospital de referencia del Sistema Único de Salud (SUS). Registrar las condiciones bucales de los niños y tratamientos realizados por el equipo de profesionales en Odontología. Materiales y métodos: estudio descriptivo retrospectivo, a través de historias clínicas; los resultados fueron tabulados y analizados por medio de diferencia porcentual. La muestra fue compuesta por 145 pacientes de 0 a 15 años de edad atendidos y acompañados por el servicio de Odontología de la UTIPed en el período de septiembre de 2016 a noviembre de 2017. Los datos fueron analizados de acuerdo con el género, edad, motivo de la internación, nivel de conciencia, condición de las vías aéreas, procesos patológicos en la cavidad bucal, procedimientos odontológicos realizados, instrumentos de higiene bucal utilizado y presencia de pneumonía associada a la ventilación mecánica. Resultados: Los pacientes se encontraban en el grupo de edad de menos de 1 año hasta 17 años, siendo más frecuente el sexo femenino (54,48). En relación a la procedencia 94 (64,23%) eran pacientes internos del Hospital Universitario y 51 (35,77%) fueron transferidos de otros hospitales. Al evaluar las condiciones de salud bucal, el 45,83% de los pacientes presentaban higiene bucal satisfactoria, el 45,14% regular y el 9,03% deficiente. En cuanto a las condiciones de la mucosa bucal, sólo el 5,52% de los pacientes presentaron alteraciones, de ellas, el 3,45% ya se encontraban en el momento de la admisión. Conclusión: Se verificó que los niños hospitalizados em la UTIPed pueden presentar alteraciones en mucosa bucal desde el momento de la admisión, siendo obligatoria la presencia constante del Cirujano-dentista en el equipo de la UTI para tratar y proporcionar una mayor adhesión a los cuidados bucales a estos pacientes.

Anti-inflammatory and anti-edematogenic action of the Croton campestris A. St.-Hil (Euphorbiaceae) essential oil and the compound ß-caryophyllene in in vivo models.

BACKGROUND: Inflammation makes up a set of vascularized tissue reactions acting in the defense of the body against harmful stimuli. Natural products are a lower cost alternative with better benefit, often used in popular medicine in the treatment of inflammatory processes. Several species from the genus Croton have scientifically proven anti-inflammatory action. PURPOSE: This study aims to analyze the chemical composition of the Croton campestris A. St.-Hil essential oil (EOCC), derived from fresh leaves, as well as to evaluate the anti-inflammatory potential and the possible mechanisms of action of the EOCC and its constituent ß-caryophyllene. METHODS: The assays were performed in in vivo models of acute and chronic inflammation. Initially, the chemical composition of the EOCC was determined and its oral toxicity was evaluated, followed by the evaluation of its topical antiedematogenic effect through acute and chronic ear edema induced by Croton oil. For the systemic verification of an anti-inflammatory action, the abdominal contortions, formalin test, paw edema induced by carrageenan, dextran, histamine and arachidonic acid models, as well as a peritonitis test, vascular permeability and granuloma assays were performed. RESULTS: The evaluation of the essential oil chemical composition revealed the presence of ß-caryophyllene (15.91%), 1,8-cineol (16.98%) and germacrene-D (14.51%) as its main constituents. The EOCC had no relevant clinical toxicity on oral administration, with an LD50 of more than 5000 mg/kg. The tested substances showed anti-inflammatory action in the abdominal contortions, paw edema induced by carrageenan, dextran, histamine and arachidonic acid models, the formalin test, peritonitis test and vascular permeability; however, ß-caryophyllene had no significant effect on the granuloma assay. This suggests as a hypothesis that both substances tested showed significant influence on the arachidonic acid and histamine pathway reducing edema in these models. CONCLUSION: The tested substances have a clinically safe profile, additionally the EOCC and ß-caryophyllene presented relevant anti-inflammatory activity. This study supports the hypothesis that ß-caryophyllene, in association with other constituents present in the EOCC such as 1,8-cineole, contributed to the anti-inflammatory effect observed, in addition to suggesting that one of the mechanisms of action probably involves the inhibition of cytokines with the involvement of the arachidonic acid and histamine pathways.