Avaliação quantitativa da cobertura assistencial médica básica e especializada no município de Caratinga ­ MG / Quantitative assessment of basic and specialized medical assistance coverage in the city of Caratinga -MG

Avaliou-se o quantitativo inerente à cobertura assistencial médica, básica e especializada do município de Caratinga-MG, no período de setembro de 2014 a agosto de 2015. Estudo observacional transversal. Os elementos referenciados foram avaliados por meio de dados secundários do sistema de informação ambulatorial SIA/SUS, referente às 23 equipes da Estratégia Saúde da Família, agregados no seguinte perfil de pacientes: menores de 01 ano, 01 a 04, 05 a 14, 15 a 44, 45 a 59 anos e de 60 anos ou mais. Posteriormente foram avaliados os encaminhamentos aos atendimentos especializados, sendo submetidos a uma análise de parâmetros, de acordo com a Portaria 1101/02 do Ministério da Saúde. Os dados foram calculados através das frequências absolutas e relativas, média e desvio-padrão. Na avaliação para a média e desvio-padrão os resultados apontaram para um superávit nas consultas médicas básicas para os pacientes acima de 60 anos (m=905,4 e dp=347,4), e um déficit no cumprimento dos parâmetros nas consultas médicas básicas das demais faixas etárias: menores de 01 ano (m=101,4 e dp=50,4), 01 a 04 anos (m=191,4 e dp=54,3), 05 a 14 anos (m=375,8 e dp=93,7) e 15 a 59 anos (m=2.200 e dp=533,7). Os encaminhamentos aos atendimentos especializados também apresentaram déficit (m=380,2 e dp=234,2). A cobertura assistencial de consulta médica básica e de encaminhamento ao atendimento especializado no município de Caratinga-MG apresentou um percentual inferior aos parâmetros preconizados pelo Ministério da Saúde, com atendimento em apenas uma faixa etária.

The quantitative of medical, basic and specialized health care coverage was evaluated in the city of Caratinga-MG from September 2014 to August 2015. It is an observational research. The referenced elements were evaluated through secondary data from the outpatient information system - SIA / SUS referring to the 23 teams of the Family Health Strategy, aggregated in the following patients profile: under 1 year, from 01 to 04 years, from 05 to 14 years, 15 to 44 years, 45 to 59 years and 60 years or more. Subsequently, the referrals to the specialized services were evaluated, being submitted to a parameter analysis, in accordance with Ministry of Health Ordinance 1101/02. Data were calculated through the absolute and relative frequencies, mean and standard deviation. In the evaluation for the mean and standard deviation the results pointed to a surplus in basic medical appointments for patients over 60 years (m = 905.4 and dp = 347.4), and a deficit in compliance with the parameters in the basic medical visits (M = 101.4 and dp = 50.4), 01 to 04 years (m = 191.4 and dp = 54.3), 05 to 14 years (m = 375, 8 and dp = 93.7) and 15 to 59 years (m = 2,200 and dp = 533.7). Referrals to specialized care also presented a deficit of (m = 380.2 and dp = 234.2). The assistance coverage of basic medical consultation and referral to specialized care in the city of Caratinga-MG presented a percentage lower than the parameters recommended by the Ministry of Health.

Effects of N-terminus modifications on the conformation and permeation activities of the synthetic peptide L1A.

We investigate the effect of the N-terminus modification of the L1A, a synthetic octadecapeptide, on its helical content, affinity and lytic action in model membranes and on its hemolytic and antibacterial activities. L1A and its acetylated analog displayed a selective antibacterial activity to Gram-negative bacteria without being hemolytic. The covalently linked 2-aminobezoic acid to the N-terminus impaired the antibacterial efficacy and increased hemolysis. Despite their lower net charge (+2), N-terminus modifications resulted in enhanced affinity and improved lytic efficiency in anionic vesicles. The analogs also showed higher helical content and consequently higher amphipathicity in these vesicles. The conformational analysis by molecular dynamics simulations in 30 % of TFE/water showed that the hydrophobic faces of the peptides are in close contact with CF3 groups of TFE while the hydrophilic faces with water molecules. Due to the loss of the amino charge, the N-termini of the analogs are buried in TFE molecules. The analysis of the pair distribution functions, obtained for the center of mass of the charged groups, has evidenced that the state of the N-terminus has influenced the possibility of different ion-pairing. The higher complexity of the bacterial cells compared with anionic vesicles hampers to establish correlations structure-function for the analogs.

Interaction of a synthetic antimicrobial peptide with model membrane by fluorescence spectroscopy.

Static and time-resolved fluorescence of tryptophan and ortho-aminobenzoic acid was used to investigate the interaction of the synthetic antimicrobial peptide L1A (IDGLKAIWKKVADLLKNT-NH2) with POPC and POPC:POPG. N-acetylated (Ac-L1A) and N-terminus covalently bonded ortho-aminobenzoic acid (Abz-L1A-W8V) were also used. Static fluorescence and quenching by acrylamide showed that the peptides adsorption to the lipid bilayers was accompanied by spectral blue shift and by a decrease in fluorescence quenching, indicating that the peptides moved to a less polar environment probably buried in the lipidic phase of the vesicles. These results also suggest that the loss of the N-terminus charge allowed deeper fluorophore insertion in the bilayer. Despite the local character of spectroscopic information, conclusions can be drawn about the peptides as a whole. The dynamic behaviors of the peptides are such that the mean intensity lifetimes, the long correlation time and the residual anisotropy at long times increased when the peptides adsorb in lipid vesicles, being larger in anionic vesicles. From the steady-state increase in fluorescence intensity and anisotropy, we observed that the partition coefficient of peptides L1A and its Abz analog in both types of vesicles are higher than the acetylated analog; moreover, the affinity to the anionic vesicle is higher than to the zwitterionic.