Methanogenic communities and methane emissions from enrichments of Brazilian Amazonia soils under land-use change.

Amazonian forest conversion into agricultural and livestock areas is considered one of the activities that contribute most to the emission of greenhouse gases, including methane. Biogenic methane production is mainly performed by methanogenic Archaea, which underscores the importance of understanding the drivers shaping microbial communities involved in the methane cycling and changes in methane metabolism. Here, we aimed to investigate the composition and structure of bacterial and archaeal communities in tropical soils in response to land-use changes, emphasizing the methanogenic communities. We collected soil samples from primary forest, pasture, and secondary forest of the Amazonian region and used a strategy based on the enrichment of the methanogenic community with three different methanogenic substrates followed by measurements of methane emission, quantification of mcrA gene copies by qPCR, and total 16 S rRNA gene sequencing (metataxonomics). We observed variations in the structure of bacterial and archaeal communities of soils under different uses. The richness of methanogenic communities was higher in pasture than forest soils and this richness remained during the incubation period, and as a consequence, the enrichment induced earlier methane emission in pastures-derived samples. Furthermore, pastures enrichments exhibited methanogenic archaea networks more complex than primary and secondary forests. In conclusion, pastures harbor a richer and more responsive methanogenic community than forest samples, suggesting that conversion of forest areas to pasture may boost methane emission.

Government strategies to ensure the human right to adequate and healthy food facing the Covid-19 pandemic in Brazil. / Estratégias governamentais para a garantia do direito humano à alimentação adequada e saudável no enfrentamento à pandemia de Covid-19 no Brasil.

The Covid-19 pandemic revealed a concrete and immediate threat to food and nutrition security (FNS), especially for vulnerable groups. This study aimed to identify government strategies implemented in Brazil to provide the Human Right to Adequate and Healthy Food in high social vulnerability contexts during the Covid-19 pandemic. A cross-sectional study was carried out, with analysis of official documents published between March 20 and July 30, 2020, by the Federal Government, Federal District, Brazilian states, and capitals, focusing on measures to ensure availability and physical or financial access to food. Strategies implemented mainly involve food distribution and minimum income assurance. The following were implemented: Basic Emergency Income (Federal Government); Food Acquisition Program (PAA), and emergency financial aid (states); emergency food donation programs (states and municipalities). Existing measures were adapted to the pandemic, such as the National School Food Program (PNAE), the National Food Acquisition Program (PAA), and the distribution of food and staple food baskets. While essential, these strategies have limited scope and are insufficient to ensure FNS.

A pandemia de Covid-19 revelou a existência de ameaça concreta e imediata à segurança alimentar e nutricional (SAN), em especial de grupos vulnerabilizados. O estudo buscou identificar as estratégias governamentais implementadas no Brasil para prover o Direito Humano à Alimentação Adequada e Saudável em contextos de elevada vulnerabilidade social frente à Covid-19. Foi realizado um estudo transversal, com análise de documentos oficiais publicados entre 20 de março e 30 de julho de 2020 pela União, Distrito Federal, estados e capitais brasileiras, com foco em medidas que assegurem disponibilidade e acesso físico ou financeiro a alimentos. As estratégias implementadas envolvem fundamentalmente distribuição de alimentos e garantia de renda mínima. Foram instituídas: Renda Básica Emergencial (União); Programa de Aquisição de Alimentos (PAA) e auxílio financeiro emergencial (estados); programas de doação emergencial de alimentos (estados e municípios). Medidas existentes foram adaptadas frente à pandemia, como o Programa Nacional de Alimentação Escolar (PNAE), o Programa de Aquisição de Alimentos (PAA) nacional, a distribuição de alimentos e de cestas básicas. Embora importantes, essas estratégias têm alcance limitado e são insuficientes para assegurar a SAN.

Fontes de Apoio Social em contextos de pobreza: o que dizem as comunidades rurais? / Sources of Social Support in contexts of poverty: what do rural communities say?

Esse artigo tem como objetivo compreender as fontes de apoio social utilizadas pelos moradores de comunidades rurais nas regiões Nordeste, Norte e Sul do Brasil, analisadas como estratégias de enfrentamento às situações de opressão decorrentes da pobreza. Foram realizados 14 grupos focais, analisados em quatro dimensões: apoio familiar, apoio comunitário, apoio religioso e apoio institucional, com a utilização do software Atlas ti 5.2. Os resultados apontam que a família é o apoio diante de situações de angustia e privações decorrentes dos contextos de pobreza, reiterando a sua função no suporte emocional e na segurança material. O apoio comunitário se relaciona também ao apoio emocional e à partilha dos bens disponíveis, com poucas referências às lutas comunitárias. A espiritualidade, analisada como apoio religioso, é um campo de consolo existencial que se amplia a partir da precarização do apoio institucional. Esse apoio institucional, advindo das políticas públicas de saúde, educação e assistência social, apareceu na realidade dessas comunidades, no entanto com algumas dificuldades de funcionamento. Estudar o apoio social em comunidades rurais pobres busca superar os estudos que identificam a pobreza apenas como ausência, carência ou limitações, esquecendo a existência de espaços de potencialidades e enfrentamento.

This article aims to understand the sources of the social support used by residents of rural communities in the Northeast, North, and South regions of Brazil, analyzed as strategies to confront situations of oppression resulting from poverty. A total of 14 focus groups were analyzed in four dimensions: family support, community support, religious support, and institutional support using the Atlas software 5.2. The results indicate that the family is supportive of situations of distress and deprivation arising from the contexts of poverty, reiterating its role in emotional support and material security. Community support also relates to emotional support and the sharing of available assets, with few references to community struggles. Spirituality, analyzed as religious support, is a field of existential consolation that expands from the precariousness of institutional support. This institutional support, coming from the public policies of health, education, and social assistance, has appeared in the reality of these communities, but with some difficulties in functioning. Studying social support in poor rural communities seeks to overcome studies that identify poverty only as an absence, lack, or limitations, forgetting the existence of spaces of potentialities and coping

Estratégias governamentais para a garantia do direito humano à alimentação adequada e saudável no enfrentamento à pandemia de Covid-19 no Brasil / Government strategies to ensure the human right to adequate and healthy food facing the Covid-19 pandemic in Brazil

Resumo A pandemia de Covid-19 revelou a existência de ameaça concreta e imediata à segurança alimentar e nutricional (SAN), em especial de grupos vulnerabilizados. O estudo buscou identificar as estratégias governamentais implementadas no Brasil para prover o Direito Humano à Alimentação Adequada e Saudável em contextos de elevada vulnerabilidade social frente à Covid-19. Foi realizado um estudo transversal, com análise de documentos oficiais publicados entre 20 de março e 30 de julho de 2020 pela União, Distrito Federal, estados e capitais brasileiras, com foco em medidas que assegurem disponibilidade e acesso físico ou financeiro a alimentos. As estratégias implementadas envolvem fundamentalmente distribuição de alimentos e garantia de renda mínima. Foram instituídas: Renda Básica Emergencial (União); Programa de Aquisição de Alimentos (PAA) e auxílio financeiro emergencial (estados); programas de doação emergencial de alimentos (estados e municípios). Medidas existentes foram adaptadas frente à pandemia, como o Programa Nacional de Alimentação Escolar (PNAE), o Programa de Aquisição de Alimentos (PAA) nacional, a distribuição de alimentos e de cestas básicas. Embora importantes, essas estratégias têm alcance limitado e são insuficientes para assegurar a SAN.

Abstract The Covid-19 pandemic revealed a concrete and immediate threat to food and nutrition security (FNS), especially for vulnerable groups. This study aimed to identify government strategies implemented in Brazil to provide the Human Right to Adequate and Healthy Food in high social vulnerability contexts during the Covid-19 pandemic. A cross-sectional study was carried out, with analysis of official documents published between March 20 and July 30, 2020, by the Federal Government, Federal District, Brazilian states, and capitals, focusing on measures to ensure availability and physical or financial access to food. Strategies implemented mainly involve food distribution and minimum income assurance. The following were implemented: Basic Emergency Income (Federal Government); Food Acquisition Program (PAA), and emergency financial aid (states); emergency food donation programs (states and municipalities). Existing measures were adapted to the pandemic, such as the National School Food Program (PNAE), the National Food Acquisition Program (PAA), and the distribution of food and staple food baskets. While essential, these strategies have limited scope and are insufficient to ensure FNS.

Performance of family health teams for tackling chronic diseases in a state of the Amazon.

The most common cause of death worldwide is noncommunicable diseases. A cross-sectional study was conducted to evaluate the adequacy of the work process among family health teams and compare differences in regional adequacy in the state of Tocantins, in the Amazonian Region, Brazil. Categorical principal components analysis was used, and scores of each principal component extracted in the analysis were compared among health regions in Tocantins. A post hoc analysis was performed to compare the heath region pairs. The adequacy of family health teams' work process was evaluated with respect to the Strategic Action Plan to Tackle NCDs. The results showed that the family health teams performed actions according to the Strategic Action Plan to Tackle NCDs. However, overall, the adequacy percentages of these actions according to the axes of the Plan are very uneven in Tocantins, with large variations among health regions. The family health teams in the Bico do Papagaio (Region 1), Médio Norte Araguaia (Region 2), Cantão (Region 4) and Capim Dourado (Region 5) regions have adequacy percentages ≥ 50% with the Strategic Action Plan to Tackle NCDs, whereas all other regions have percentages <50%. Health teams perform surveillance actions, health promotion, and comprehensive care for NCDs in accordance with the guidelines of the Strategic Action Plan to Tackle NCDs. The challenge of NCDs in primary care requires a care model that is tailored to users' needs and has the power to reduce premature mortality and its determinants.

Mangrove soil as a source for novel xylanase and amylase as determined by cultivation-dependent and cultivation-independent methods.

Xylanase and α-amylase enzymes participate in the degradation of organic matter, acting in hemicellulose and starch mineralization, respectively, and are in high demand for industrial use. Mangroves represent a promising source for bioprospecting enzymes due to their unique characteristics, such as fluctuations in oxic/anoxic conditions and salinity. In this context, the present work aimed to bioprospect xylanases from mangrove soil using cultivation-dependent and cultivation-independent methods. Through screening from a metagenomic library, three potentially xylanolytic clones were obtained and sequenced, and reads were assembled into contigs and annotated. The contig MgrBr135 was affiliated with the Planctomycetaceae family and was one of 30 ORFs selected for subcloning that demonstrated only amylase activity. Through the cultivation method, 38 bacterial isolates with xylanolytic activity were isolated. Isolate 11 showed an enzymatic index of 10.9 using the plate assay method. Isolate 39 achieved an enzyme activity of 0.43 U/mL using the colorimetric method with 3,5-dinitrosalicylic acid. Isolate 39 produced xylanase on culture medium with salinity ranging from 1.25 to 5%. Partial 16S rRNA gene sequencing identified isolates in the Bacillus and Paenibacillus genera. The results of this study highlight the importance of mangroves as an enzyme source and show that bacterial groups can be used for starch and hemicellulose degradation.

Evaluation of the primary care for chronic diseases in the high coverage context of the Family Health Strategy.

BACKGROUND: This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil. METHODS: The data source contained information on the infrastructure of the 233 Primary Health Units and on the work process of 266 health teams. The Principal Component Analysis for Categorical Data technique and the McNemar chi-squared statistical test for comparing paired samples were used, and a significance level of 5% with a 95% Confidence Interval was used. RESULTS: The analysis identified a low proportion of dispensing of medications for the treatment of chronic disease in both cycles. There was a significant increase in seasonal influenza vaccination, in the number of sterilization, procedure, dressings and inhalation rooms. There was a small but significant reduction in the materials for cervical cancer screening, although they are available in almost 90.0% of the PHUs. More than 70.0% of the health teams carried out additional health education activities, encouraged physical activity, registered schoolchildren with health needs for monitoring, evaluated user satisfaction and user referral. CONCLUSIONS: The findings of this study highlighted the improvement of the structure of the Primary Health Units, but identified a low provision of medicines to treat chronic diseases. The health promotion was performed as the main work process tool of family health teams, but it was little focused on intersectoral actions and on actions with the population in the area or on the empowerment of users through self-management support for chronic diseases. Furthermore, it is critical that the Family Health Strategy in Tocantins be organized and focused on the care of chronic diseases to improve and adapt itself to a primary chronic care model.

Saúde do homem: identificação e análise dos fatores relacionados à procura, ou não, dos serviços de atenção primária / Men's health: identification and analysis of factors related to the demand for primary care services

Identificar e analisar os fatores que dificultam a procura dos serviços de Atenção Primária relatados pela população masculina. Trata-se de um estudo descritivo com abordagem quantitativa. As informações foram coletadas por meio de aplicação de questionário estruturado com perguntas objetivas e subjetivas para 384 homens com idade entre 18 e 59 anos. Identificou-se a participação majoritária (33,85%) de indivíduos com idade entre 18 e 24 anos. A visão dos entrevistados acerca de sua saúde e gênero foi de que o homem é mais resistente, forte e invulnerável. Os principais motivos impeditivos relacionados a não procura dos serviços de Atenção Primária foram: preferência por se automedicar, falta de tempo, e desconforto dentro da Unidade Básica de Saúde. A entrada dos homens no sistema de saúde, no ano anterior à pesquisa, ocorreu principalmente pela atenção ambulatorial e hospitalar de média e alta complexidade (62,2%). Para a adoção da Atenção Primária como porta de entrada dos homens no Sistema Único de saúde, é preciso mudar a visão de que os serviços de saúde têm como único propósito tratar as doenças. Essa sensibilização deve começar mediante conhecimento sobre as características sociais, econômicas e culturais dos homens que receberão a atenção à saúde, além do preparo da equipe de saúde e gestores, seguido pelo acolhimento e busca ativa dessa população.

This study aims at identifying and analyzing the factors that hinder the demand for Primary Care services reported by the male population. It is a descriptive study with a quantitative approach. The information was collected through the application of a structured questionnaire with objective and subjective questions, applied to 384 men aged between 18 and 59 years. It could be observed that most participants (33.85%) were aged between 18 and 24 years. The view of the interviewees about their health and gender was that men are more resilient, stronger and invulnerable. The main impediments regarding their not seeking primary care services were: preference for self-medication, lack of time, and discomfort with the Basic Health Unit. The entry of men into the health system in the year prior to the survey occurred mainly by outpatient and hospital care of medium and high complexity (62.2%). For the adoption of Primary Care Service as the entry point for men in the Unified Health System, it is necessary to change the behavior of the male population in relation to their own health. It is necessary to change the view that health services have the sole purpose of treating diseases. This awareness should begin with knowledge about the social, economic and cultural characteristics of men who will receive health care, as well as the preparation of the health team and managers, followed by the reception and active search of that population.

Entre a transição institucional e a transição nutricional: descortinando a trajetória da nutrição em saúde pública à atenção nutricional no Sistema Único de Saúde / Between the institutional transition and the nutritional transition: unveiling the path of nutrition in public health to nutrition care in the Unified Health System

O propósito deste estudo foi analisar a trajetória institucional da área de alimentação e nutrição do Ministério da Saúde, buscando identificar possíveis avanços, resistências e impasses para a organização da Atenção Nutricional no Sistema Único de Saúde (SUS) a partir da gestão federal. Para o desenvolvimento da pesquisa, partimos da perspectiva construcionista de produção de conhecimento e de contribuições da Teoria Ator-Rede para construir uma trilha de estudo que incluiu: um trajeto de exploração de documentos institucionais do Ministério da Saúde e de atos legislativos emitidos no âmbito federal, além de bibliografia já produzida por outros autores acerca do tema em questão; e um trajeto com sujeitos, com a realização de entrevistas semiestruturadas com informantes-chave que vivenciaram ou acompanharam a trajetória institucional da área de alimentação e nutrição do Ministério da Saúde após a extinção do Instituto Nacional de Alimentação e Nutrição (INAN) em 1997 e até a publicação da segunda versão da Política Nacional de Alimentação e Nutrição (PNAN) em 2011. Na análise, buscou-se descortinar as condições de possibilidades nos tempos políticos da gestão federal em que se propuseram e/ou se desenvolveram programas e políticas de alimentação e nutrição a serem implantados nos serviços de saúde pública (antes de 1988) e na rede de serviços do SUS. Apresentam-se as características destes programas e políticas apontando continuidades, rupturas, semelhanças e diferenças, bem como suas repercussões na trajetória institucional da área no Ministério da Saúde. Por fim, discutem-se perspectivas da implementação da diretriz da PNAN sobre organização da atenção nutricional no SUS

The purpose of this study was to analyze the institutional trajectory of the food and nutrition area in the Ministry of Health, seeking to identify possible advances, resistance and impasses for the organization of Nutrition Assistance in the Unified Health System (SUS) from the federal administration. For the development of the research, we started with the constructionist perspective of knowledge production and the contributions of the Actor-Network Theory to build a study trail that included: a route of exploration of institutional documents of the Ministry of Health and of legislative acts issued at the federal level , besides bibliography already produced by other authors on the subject in question; with semi-structured interviews with key informants who lived or followed the institutional trajectory of the food and nutrition area of the Ministry of Health after the end of the National Institute of Food and Nutrition (INAN) in 1997 and until the publication of the second version of the National Food and Nutrition Policy (PNAN) in 2011. In the analysis, we sought to uncover the conditions of possibilities in the political times of federal management in which food and nutrition programs and policies were proposed and / or developed. to be implemented in the public health services (before 1988) and in SUS's service network. We present the characteristics of these programs and policies, pointing out continuities, ruptures, similarities and differences, as weel as its repercussions on the institutional trajectory of the area in the Ministry of Health. Finaly, perspectives of the implementation of the PNAN guideline on the organization of nutricional care in the SUS are discussed

A Política Nacional de alimentação e Nutrição e seu diálogo com a Política Nacional de Segurança alimentar e Nutricional / The national food and nutrition policy and its dialogue with the national food and nutrition security policy

A alimentação é um dos determinantes e condicionantes da saúde e um direito inerente a todas as pessoas. As consequências da insegurança alimentar e nutricional da população, a exemplo da obesidade, desnutrição e carências nutricionais específicas, recaem sobre o setor saúde e têm feito com que, historicamente, este tenha incorporado a responsabilidade de políticas e programas de alimentação e nutrição no Brasil. Porém, a garantia da Segurança Alimentar e Nutricional exige uma conjunção de políticas públicas, dentre as quais a Política Nacional de Alimentação e Nutrição do SUS tem papel fundamental. O artigo objetiva contribuir com o debate sobre intersetorialidade e promoção da saúde a partir da apresentação da Política Nacional de Alimentação e Nutrição e discussão do seu papel enquanto interlocutora entre o Sistema Único de Saúde e a Política e Sistema Nacional de Segurança Alimentar e Nutricional. Essa perspectiva sugere fortemente a conjunção de esforços para a promoção da saúde e de SAN, com vistas a potencializar agendas desenvolvidas em diferentes setores e acompanhadas por diferentes conselhos de políticas públicas, que não se articulam, permitindo uma melhor atuação do governo e da sociedade civil sobre os determinantes da saúde e da alimentação.

Food is one of the determinants and conditions of health and an inherent right of all people. The consequences of food and nutrition insecurity in the population, such as obesity, malnutrition and specific nutritional deficiencies, impact the health sector and have historically meant that it has assumed the responsibility for food and nutrition programs and policies in Brazil. However, ensuring food and nutrition security requires a combination of public policies, among which the National Food and Nutrition Policy of the Unified Health System (SUS) plays a fundamental role. This paper seeks to contribute to the debate on intersectoriality and health promotion based on presenting the National Food and Nutrition Policy and discussing its role as interface between the SUS and the National Food and Nutrition Security Policy and System. This perspective strongly suggests the combination of efforts to promote health and food and nutrition security in order to optimize initiatives developed in different sectors and accompanied by different policy councils that are not interrelated, enabling enhanced government and civil society action on the determinants of health and nutrition.

[The national food and nutrition policy and its dialogue with the national food and nutrition security policy]. / A Política Nacional de alimentação e Nutrição e seu diálogo com a Política Nacional de Segurança alimentar e Nutricional.

Food is one of the determinants and conditions of health and an inherent right of all people. The consequences of food and nutrition insecurity in the population, such as obesity, malnutrition and specific nutritional deficiencies, impact the health sector and have historically meant that it has assumed the responsibility for food and nutrition programs and policies in Brazil. However, ensuring food and nutrition security requires a combination of public policies, among which the National Food and Nutrition Policy of the Unified Health System (SUS) plays a fundamental role. This paper seeks to contribute to the debate on intersectoriality and health promotion based on presenting the National Food and Nutrition Policy and discussing its role as interface between the SUS and the National Food and Nutrition Security Policy and System. This perspective strongly suggests the combination of efforts to promote health and food and nutrition security in order to optimize initiatives developed in different sectors and accompanied by different policy councils that are not interrelated, enabling enhanced government and civil society action on the determinants of health and nutrition.

Acolhimento humanizado em um posto de saúde urbano no Distrito Federal, Brasil / Humanized user embracement in an urban health center of the Distrito Federal, Brazil

O acolhimento compreende desde a recepção do usuário no sistema de saúde e a responsabilização integral de suas necessidades até a atenção resolutiva aos seus problemas. Baseia-se na escuta qualificada de todos os pacientes e na construção de vínculos entre os profissionais e a comunidade, buscando uma postura capaz de acolher e estabelecer respostas mais adequadas aos usuários. Este estudo objetiva contribuir para a reflexão dos profissionais do Posto de Saúde Urbano 01 do Riacho Fundo II / DF (PSU01) acerca do acolhimento humanizado, de acordo com as diretrizes da Política Nacional de Humanização (PNH). Trata-se de uma pesquisa descritivo-exploratória, de caráter observacional e transversal, com abordagem qualitativa. Os sujeitos da pesquisa foram 20 profissionais que trabalhavam na unidade de saúde e 30 usuários, escolhidos aleatoriamente. Para a coleta de dados, foram utilizados questionários estruturados, elaborados pelos pesquisadores. Com base nesses dados, foram escolhidos alguns temas disparadores para a realização de um grupo focal. Utilizando a metodologia de Bardin, após análise dos discursos, elaboraram-se as seguintes categorias: acolhimento; falhas na gestão e questão social; visão imediatista e desconhecimento do usuário; vínculo. Observou-se que alguns fatores são entraves para a implementação, de fato, do acolhimento no PSU 01, tais como: quantidade insuficiente e a rotatividade de profissionais, infraestrutura inadequada (relacionada à ambiência), pouco treinamento destinado às equipes e carência de materiais. Além disso, foi evidenciado o quanto os profissionais sentem-se desvalorizados, muitas vezes, pela própria comunidade e pelos meios de comunicação em massa. Propôs-se a confecção de um banner explicando as verdadeiras atribuições de uma unidade básica de saúde, diferenciando-a de uma unidade de pronto atendimento, a fim de facilitar a relação entre profissionais de saúde e usuários.

User embracement ranges from the reception of users in the health system, and full responsibility for their needs, to the attention to solving their problems. It is based on qualified listening to all patients and in building links between professionals and the community, seeking a posture capable of receiving and establishing more adequate responses to users. This study aims to contribute to the reflection of the professionals from Urban Health Center No. 01 (UHC01) of Riacho Fundo II / DF, about humanized reception, in accordance with the guidelines of the National Humanization Policy (NHP). This is a descriptive-exploratory study, observational and crosssectional, with a qualitative approach. The subjects were 20 professionals working at the health center, and 30 users, randomly chosen. Data was collected via structured questionnaires, prepared by the researchers. Based on the data, some triggering themes were chosen for conducting a focus group. Using the Bardin method, after discourse analysis, the following categories were drafted: embracement; failures in social management and issues; immediacy perspective and ignorance of the user; bonding. It was observed that some factors are, in fact, obstacles to the implementation of embracement in the UHC01, such as: staff insufficiency and turnover, inadequate infrastructure (related to the environment), insufficient training for the teams, and lack of materials. Furthermore, it was emphasized how much professionals often feel undervalued by the community itself and by the means of mass communication. Researchers proposed the construction of a banner explaining the real tasks of a basic health center, distinguishing it from an emergency unit, in order to facilitate the relationship between health professionals and users.

Simultaneous follow-up of mouse colon lesions by colonoscopy and endoluminal ultrasound biomicroscopy.

AIM: To evaluate the potential use of colonoscopy and endoluminal ultrasonic biomicroscopy (eUBM) to track the progression of mouse colonic lesions. METHODS: Ten mice were treated with a single azoxymethane intraperitoneal injection (week 1) followed by seven days of a dextran sulfate sodium treatment in their drinking water (week 2) to induce inflammation-associated colon tumors. eUBM was performed simultaneously with colonoscopy at weeks 13, 17-20 and 21. A 3.6-F diameter 40 MHz mini-probe catheter was used for eUBM imaging. The ultrasound mini-probe catheter was inserted into the accessory channel of a pediatric flexible bronchofiberscope, allowing simultaneous acquisition of colonoscopic and eUBM images. During image acquisition, the mice were anesthetized with isoflurane and kept in a supine position over a stainless steel heated surgical waterbed at 37 °C. Both eUBM and colonoscopic images were captured and stored when a lesion was detected by colonoscopy or when the eUBM image revealed a modified colon wall anatomy. During the procedure, the colon was irrigated with water that was injected through a flush port on the mini-probe catheter and that acted as the ultrasound coupling medium between the transducer and the colon wall. Once the acquisition of the last eUBM/colonoscopy section for each animal was completed, the colons were fixed, paraffin-embedded, and stained with hematoxylin and eosin. Colon images acquired at the first time-point for each mouse were compared with subsequent eUBM/colonoscopic images of the same sites obtained in the following acquisitions to evaluate lesion progression. RESULTS: All 10 mice had eUBM and colonoscopic images acquired at week 13 (the first time-point). Two animals died immediately after the first imaging acquisition and, consequently, only 8 mice were subjected to the second eUBM/colonoscopy imaging acquisition (at the second time-point). Due to the advanced stage of colonic tumorigenesis, 5 animals died after the second time-point image acquisition, and thus, only three were subjected to the third eUBM/colonoscopy imaging acquisition (the third time-point). eUBM was able to detect the four layers in healthy segments of colon: the mucosa (the first hyperechoic layer moving away from the mini-probe axis), followed by the muscularis mucosae (hypoechoic), the submucosa (the second hyperechoic layer) and the muscularis externa (the second hypoechoic layer). Hypoechoic regions between the mucosa and the muscularis externa layers represented lymphoid infiltrates, as confirmed by the corresponding histological images. Pedunculated tumors were represented by hyperechoic masses in the mucosa layer. Among the lesions that decreased in size between the first and third time-points, one of the lesions changed from a mucosal hyperplasia with ulceration at the top to a mucosal hyperplasia with lymphoid infiltrate and, finally, to small signs of mucosal hyperplasia and lymphoid infiltrate. In this case, while lesion regression and modification were observable in the eUBM images, colonoscopy was only able to detect the lesion at the first and second time-points, without the capacity to demonstrate the presence of lymphoid infiltrate. Regarding the lesions that increased in size, one of them started as a small elevation in the mucosa layer and progressed to a pedunculated tumor. In this case, while eUBM imaging revealed the lesion at the first time-point, colonoscopy was only able to detect it at the second time-point. All colonic lesions (tumors, lymphoid infiltrate and mucosal thickening) were identified by eUBM, while colonoscopy identified just 76% of them. Colonoscopy identified all of the colonic tumors but failed to diagnose lymphoid infiltrates and increased mucosal thickness and failed to differentiate lymphoid infiltrates from small adenomas. During the observation period, most of the lesions (approximately 67%) increased in size, approximately 14% remained unchanged, and 19% regressed. CONCLUSION: Combining eUBM with colonoscopy improves the diagnosis and the follow-up of mouse colonic lesions, adding transmural assessment of the bowel wall.

In vivo endoluminal ultrasound biomicroscopic imaging in a mouse model of colorectal cancer.

RATIONALE AND OBJECTIVES: The gold-standard tool for colorectal cancer detection is colonoscopy, but it provides only mucosal surface visualization. Ultrasound biomicroscopy allows a clear delineation of the epithelium and adjacent colonic layers. The aim of this study was to design a system to generate endoluminal ultrasound biomicroscopic images of the mouse colon, in vivo, in an animal model of inflammation-associated colon cancer. MATERIALS AND METHODS: Thirteen mice (Mus musculus) were used. A 40-MHz miniprobe catheter was inserted into the accessory channel of a pediatric flexible bronchofiberscope. Control mice (n = 3) and mice treated with azoxymethane and dextran sulfate sodium (n = 10) were subjected to simultaneous endoluminal ultrasound biomicroscopy and white-light colonoscopy. The diagnosis obtained with endoluminal ultrasound biomicroscopy and colonoscopy was compared and confirmed by postmortem histopathology. RESULTS: Endoluminal ultrasound biomicroscopic images showed all layers of the normal colon and revealed lesions such as lymphoid hyperplasias and colon tumors. Additionally, endoluminal ultrasound biomicroscopy was able to detect two cases of mucosa layer thickening, confirmed by histology. Compared to histologic results, the sensitivities of endoluminal ultrasound biomicroscopy and colonoscopy were 0.95 and 0.83, respectively, and both methods achieved specificities of 1.0. CONCLUSIONS: Endoluminal ultrasound biomicroscopy can be used, in addition to colonoscopy, as a diagnostic method for colonic lesions. Moreover, experimental endoluminal ultrasound biomicroscopy in mouse models is feasible and might be used to further develop research on the differentiation between benign and malignant colonic diseases.

Indices of body fat distribution for assessment of lipodysthrophy in people living with HIV/AIDS.

BACKGROUND: Metabolic and morphological changes associated with excessive abdominal fat, after the introduction of Antiretroviral Therapy, increase the risk of cardiovascular disease in people living with HIV/AIDS(PLWHA). Accurate methods for body composition analysis are expensive and the use of anthropometric indices is an alternative. However the investigations about this subject in PLWHA are rare, making this research very important for clinical purpose and to advance scientific knowledge. The aim of this study is to correlate results of anthropometric indices of evaluation of body fat distribution with the results obtained by Dual-energy X-Ray Absorptiometry(DEXA), in people living with HIV/AIDS. METHODS: The sample was of 67 PLWHA(39 male and 28 female), aged 43.6±7.9 years. Body mass index, conicity index, waist/hip ratio, waist/height ratio and waist/thigh were calculated. Separated by sex, each index/ratio was plotted in a scatter chart with linear regression fit and their respective Pearson correlation coefficients. Analyses were performed using Prism statistical program and significance was set at 5%. RESULTS: The waist/height ratio presented the highest correlation coefficient, for both male (r=0.80, p<0.001) and female (r=0.87, p <001), while the lowest were in the waist/thigh also for both: male group (r=0.58, p<0.001) and female group (r=0.03, p=0.86). The other indices also showed significant positive correlation with DEXA. CONCLUSION: Anthropometric indices, especially waist/height ratio may be a good alternative way to be used for evaluating the distribution of fat in the abdominal region of adults living with HIV/ADIS.

Percepción de riesgo de infección por VIH entre adolescentes embarazadas en el Distrito Federal de Brasil / Perceived risk of HIV infection among pregnant teenagers in the federal district of Brazil

Se trata de un estudio transversal con el objetivo de analizar la percepción de riesgo de la infección por el VIH entre adolescentes embarazadas en el Distrito Federal, Brasil. Fueron entrevistadas 336 adolescentes gestantes de edades comprendidas entre 13 y 19 años, atendidas en el sistema público de salud del Distrito Federal, entre abril y noviembre de 2009. El Comité de Ética aprobó el estudio (Parecer No 33/2009). En el análisis estadístico se utilizó el test χ2. La mayoría de las entrevistadas estaban casadas/unión estable, con una iniciación sexual media de 14,9 años de edad, hicieron uso del preservativo en la primera y última relación sexual un 64,0 por ciento y un 14,9 por ciento respectivamente. El 33,3 por ciento de las adolescentes eran conscientes del riesgo de infección por VIH al quedarse embarazadas, recayendo la mayor percepción de riesgo (p=0,014) entre las que tuvieron más de un compañero sexual. No se observaron diferencias estadísticas entre la percepción de riesgo y las variables edad, estado civil, cohabitación, escolaridad, religión o frecuencia de uso del preservativo. En conclusión, fue baja la percepción de riesgo de infección por VIH de las adolescentes embarazadas del Distrito Federal.

This is a transversal study with the aim of analyzing the perception of risk of HIV infection among pregnant adolescents in the Federal District of Brazil. 336 pregnant adolescents between the ages of 13 and 19 who received prenatal care from the public hospital system between April and November 2009 were interviewed. The study was approved by the ethics committee (Opinion No. 33/2009). The Pearson χ2 test was used in the statistical analysis. Most interviewed were married/stable union with sexual initiation average 14.9 years old, made use of condoms in the frst and last sexual union 64.0 percent and 14.9 percent respectively. Around 33.3 percent of the adolescents perceived the risk of HIV infection upon becoming pregnant with the highest perception of risk (p=0.014) among those who had had more than one sexual partner. Statistical differences were not observed with the variables: age, marital status, cohabitation, educational level, religion or frequency of condom use. In conclusion, the perception of risk among pregnant adolescents in the Federal District was low.

Features of in vitro ultrasound biomicroscopic imaging and colonoscopy for detection of colon tumor in mice.

The present work tested the capability of ultrasound biomicroscopy (UBM), at 45 MHz, to provide cross-sectional images with appropriate resolution and contrast to detect tumors and determine their penetration depths on the colon of mice, Mus musculus (Linnaeus 1758), treated with carcinogen for colon tumor induction. B-mode images were obtained, in vitro, from each animal (13 treated and 4 untreated) colon opened longitudinally and immersed in saline solution at room temperature. Prior to UBM inspection, all animals were also examined by colonoscopy. The layers of normal colon identified by UBM are: mucosa (hyperechoic), muscularis mucosae (hypoechoic), submucosa (hyperechoic) and muscularis externa (hypoechoic). UBM images of colon lesions presented structures corresponding to tumors (hyperechoic), lymphoid hyperplasia (hypoechoic) and polypoid tumors (hyperechoic). Additionally, tumoral lesion invasion through the colon was also identified. When compared with histopathologic analysis, all colon lesions detected by UBM were confirmed, while colonoscopic findings had two false negatives.