Short-term responses of littoral phytoplankton in a large shallow subtropical lake.

The littoral zone is an essential compartment for lake biota because of its high productivity and diversity. Moreover, phytoplankton is expected to have non-equilibrium dynamics on it. The study's aimed to explore phytoplankton in the littoral zone of a shallow lake over a short-term scale. Daily sampling was conducted for 25 consecutive summer days in 2016, at two marginal points of a continuously warm, polymictic, and oligo-mesotrophic subtropical lake (Lake Mangueira, Brazil). Cyanobacteria and Chlorophyta contributed 86% of total biomass. We observed high variability in phytoplankton structure, with species turnover over diel cycles. Redundancy analysis indicated spatial differentiation for phytoplankton structure in relation to abiotic conditions. Nutrient dynamics and humic substances were significant drivers for phytoplankton variability. Phytoplankton was positively correlated with SRP and negatively with humic substances. Our results showed a non- equilibrium state for the littoral phytoplankton of Lake Mangueira, given the high variability of abiotic conditions, even at short distances. Due to its high temporal and spatial variability, the littoralzone seems to contribute to the recruitment and maintenance of phytoplankton biodiversity in shallow lakes. Further studies should consider the functional attributes of species and the complex biological interactions of phytoplankton and macrophytes along the littoral zone.

Aspects related to biofilm production and antifungal susceptibility of clinically relevant yeasts of the genus Trichosporon.

Trichosporonosis corresponds to a systemic fungal disease that leads to high mortality rates and is frequently associated with medical devices. It affects immunosuppressed patients in particular and is strongly linked to acquired human immunodeficiency, organ and tissue transplants, and malignant hematologic diseases such as leukemia and lymphomas. Trichosporon infections have been increasingly reported worldwide; however, little information is available either about their characteristics or the causative microorganism. Thus, the aims of the present study were: to investigate 59 yeasts of the genus Trichosporon by verifying the biofilm formation capacity of isolates; to analyze the susceptibility patterns of planktonic cells against the antifungals fluconazole, itraconazole, amphotericin-B, voriconazole, and caspofungin by comparing European Committee for Antimicrobial Susceptibility Testing (EUCAST) broth microdilution technique with the commercial method Etest; and to assess the susceptibility patterns of biofilm cells (sessile) against the same antifungals through broth microdilution. The ability to form biofilm on the surface of polystyrene plates was noted for all isolates, and 54.3% of samples were considered strong producers. Comparison between the antifungal susceptibility techniques evidenced that Etest showed higher and discordant minimum inhibitory concentrations (MICs) from those obtained by the microdilution method, especially for fluconazole, itraconazole, and caspofungin. Considering the susceptibility of biofilms, most species had high MIC50 and MIC90 against the tested antifungals, showing 4-to-66-fold higher concentrations for amphotericin B and 2-to-33-fold greater concentrations for caspofungin. These results highlight the importance of further studies with Trichosporon spp. for comparison between laboratory findings and in vivo response, considering both the susceptibility tests and the behavior of biofilm cells against drugs.

This study investigated 59 isolates of the medically important yeast Trichosporon in relation to their ability to form biofilms and the susceptibility of biofilms to antifungal agents. All isolates were able to produce biofilms and biofilms showed lower antifungal susceptibility.

Comparing the phenotypic, genotypic, and proteomic identification of Trichosporon species: A globally emerging yeast of medical importance.

Trichosporon spp. are widely distributed in the nature, comprising species that inhabit different ecological niches and can be found in the water, soil, and body surface of animals and humans. Such microorganisms have been classically associated with superficial infections; however, in the last decades, they have also been related to disseminated infections in immunocompromised patients, behaving as opportunistic agents, which demands rapid and accurate species identification for efficient therapy. Concordance level between the traditional phenotypic method and the molecular technique (gold standard) in the identification of all 59 Trichosporon samples was 59.3%. Identification concordance between MALDI-TOF spectrometry and the molecular technique was 71.2%. No isolate of environmental origin was identifiable by MALDI-TOF mass spectrometry (MS), and 100% of such environmental isolates were discordant for IGS region sequencing and phenotypic characterization. Both comparisons evidenced greatest concordance in the identification of T. asahii. The species T. debeurmannianum, T. dermatis, T. venhuisii and T. insectorum were not properly identified by both MALDI-TOF MS and the phenotypic technique. MALDI-TOF MS, in particular, seems to be appropriate to investigate yeasts of the genus Trichosporon; however, database updates are still necessary, especially for species that are not common in the clinical routine. With the aim of helping understand the aspects involved in early and accurate diagnosis of infections caused by this opportunistic agent, the present study compared the phenotypic, molecular (IGS region) and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon which had clinical and environmental origin and were kept in a mycology collection.

The present study compared the phenotypic, genotypic, and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon. MALDI-TOF MS, in particular, seems to be appropriate to investigate this yeasts when compared to a molecular technique (gold standard).

Nasal colonization with methicillin-resistant Staphylococcus aureus among elderly living in nursing homes in Brazil: risk factors and molecular epidemiology.

BACKGROUND: Methicillin-resistant Staphylococcus aureus poses a threat to elderly living in nursing homes. Studies focusing on the epidemiology of colonization may help in the design of infection control strategies. OBJECTIVE: To identify factors associated with MRSA colonization and the dissemination of clones among nursing home residents. METHODS: Nasal swabs were collected from 300 persons from nine nursing homes in the city of Bauru, Brazil. Resistance to methicillin was identified through amplification of the mecA gene. Strain typing (Pulsed-Field Gel Electrophoresis) and characterization of the Staphylococcal Chromosome Cassette (SCC) mec was performed. Univariate and multivariable models were used to identify predictors of overall S. aureus and MRSA carriage. RESULTS: Rates of S. aureus and MRSA colonization were 17.7 and 3.7%, respectively. Age and recent admission to a hospital were independently associated with colonization with S. aureus. MRSA colonization was associated with living in small (< 15 residents) and medium-sized (15-49 residents) facilities, as well as with recent hospitalization. Most MRSA strains carried SCCmec types II or IV, and there was evidence of clonal spread within and among different facilities. CONCLUSIONS: MRSA may be introduced in nursing homes form hospitals or arise from the community setting. Screening for asymptomatic colonization may identify persons with greater risk for infection, and is advised for residents discharged from acute care hospitals.

Toxigenic profile of methicillin-sensitive and resistant Staphylococcus aureus isolated from special groups.

BACKGROUND: Staphylococcus aureus is characterized by its pathogenicity and high prevalence, causing disease in both healthy and immunocompromised individuals due to its easy dissemination. This fact is aggravated by the widespread dissemination of S. aureus carrying toxigenic genes. The objective of this study was to determine the toxigenic profile of methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in patients with purulent skin and/or soft tissue infections seen at the Dermatology Department of the University Hospital of the Botucatu Medical School, asymptomatic adults older than 60 years living in nursing homes, and prison inmates of the Avaré Detention Center. METHODS: PCR was used for the detection of the mecA gene, enterotoxin genes (sea, seb, and sec), exfoliative toxins A and B (eta and etb), toxic shock syndrome toxin 1 (tst), panton-valentine leukocidin (lukS-PV and lukF-PV), and alpha- and delta-hemolysins or cytotoxins (hla and hld). RESULTS: The results showed a significant prevalence of toxigenic genes among S. aureus isolates from asymptomatic individuals, with the observation of a higher prevalence of cytotoxin genes. However, the panton-valentine leukocidin gene was only detected in MSSA isolated from patients with skin infections and the tst gene was exclusively found in MSSA isolated from prison inmates. CONCLUSIONS: The present study demonstrated a significant prevalence of toxigenic genes in MSSA and MRSA strains isolated from asymptomatic S. aureus carriers. There was a higher prevalence of cytotoxin genes.

Adaptation and psychometric assessment of the instrument "Partners of Adults with Type 1 Diabetes Distress Scale" in a Brazilian population.

Objectives: To adapt the instrument "Partners of Adults with Type 1 Diabetes Distress Scale" (Partner-DDS) into Brazilian culture, and to evaluate the psychometric characteristics of the adapted version. Methods: All the cultural adaptation steps of the measure's instruments were followed. The psychometric properties such as reliability (stability by test-retest; internal consistency), and convergent construct validity were performed. Results: Of all 72 partners, 69.4% were male, mean age: 42.69 ± 14.09 years, mean of marriage duration: 14.74 ± 12.41 years, and mean schooling: 11.81 ± 3.91 years.The internal consistency of the instrument (Cronbach Alpha) was 0.90. The intra-class coefficient (stability) was 0.80 (0.72-0.84). The Spearman coefficient (convergent construct validity) between the Partner-DDS scale and the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) was 0.4273 (p < 0.0002). Conclusions: The steps of the instruments' cultural adaptation were appropriately performed. The Brazilian version of the Partner- DDS scale demonstrates reliable psychometric properties for being used in POPWT1D distress evaluation in Brazil. Innovation: The cultural adaptation of Partner-DDS scale into Brazilian Portuguese is a helpful innovation to assess the emotional burden in POPWT1D. This tool could be used to provide education and psychological support for this population.

Emotional burden and care of adults with type 1 diabetes during the COVID-19 pandemic in Brazilian regions.

AIMS: This study investigated the emotional burden in persons with type 1 diabetes (PWT1D) during the COVID-19 pandemic in Brazilian regions and evaluated which COVID-19, sociodemographic/clinical characteristics are related to it. METHODS: In a cross-sectional study, T1D adults completed a web-based survey from May to July 2020. We collected sociodemographic/clinical data, and participants answered COVID-19 related questions. Diabetes burnout was evaluated by Diabetes burnout scale. Type 1 Diabetes scale assessed Diabetes Distress and PHQ-8 measured depressive symptoms. RESULTS: DD and DS levels were similar in all Brazilian regions. DB was higher in Central-West/North/Northeast. Higher DB was associated with females, lower-income, higher HbA1c, and shorter time since T1D diagnosis. Predictors of experiencing higher levels of DD included: difficulty access to safe places to exercise, participants without a partner, male gender, young age, and higher HbA1c. Higher depressive symptoms were associated with difficulty to access diabetes supplies, and higher HbA1c (p < 0.05). CONCLUSIONS: The mean levels of DB, DD, and DS were high in all Brazilian regions. A great number of PWT1D had their diabetes care impaired and relied on family as their main support during the pandemic. The subgroups identified at risk should be prioritized in mental health support.

Development and validation of a scale to measure diabetes burnout.

INTRODUCTION: The aim of this study is to establish reliability and validity of the Diabetes Burnout Scale (DBS) among adults with type 1 diabetes (T1D). METHODS: We used a multi-stage, mixed methods approach to developing the DBS. First, the research team identified twenty-eight candidate items through a review of the literature and 117 qualitative narratives from adults living with T1D. Next, items were revised based on the expert (n = 20) and individual with T1D (n = 10) feedback. The resulting 18-item DBS measure along with validated measures of diabetes distress, depressive symptoms, and questions related to diabetes outcomes (i.e., last reported hemoglobin A1c [HbA1c] and Time-in-Range [TiR]) were completed by 1099 adults with T1D across the U.S. The sample was randomly divided into two subsets (n1 = 561, n2 = 538) for exploratory and confirmatory factor analyses (EFA/CFA) to determine the underlying structure of the DBS. Regression analyses examined the relationships of the DBS with self-reported glycemic control and socio-demographic characteristics. RESULTS: Based on the EFA three factors are identified and the DBS demonstrated strong internal consistency with Cronbach alphas (≥0.80). The validation and confirmatory analysis for the structure of the DBS provided consistent results with EFA. Higher burnout (overall DBS) was positively associated with diabetes distress (b = 0.74; p < 0.01) and depressive symptoms (b = 0.61; p < 0.01). Overall DBS, however was the strongest predictor for poorer HbA1c (r2 = 0.19; p < 0.01) and lower TiR (r2 = 0.17; p < 0.01) compared to diabetes distress and depressive symptoms. CONCLUSION: The 12-item DBS is a reliable and valid scale to measure diabetes burnout in adults with diabetes. The results provide a weak to strong degree of association between the validated DBS scale, T1-DDS and PHQ-8. The DBS can contribute to advancement of diabetes science by measuring diabetes burnout and informing clinical interventions to improve psychosocial care in individuals with diabetes.

Cross-national comparison of psychosocial well-being and diabetes outcomes in adults with type 1 diabetes during the COVID-19 pandemic in US, Brazil, and Iran.

BACKGROUND: The COVID-19 pandemic is a global public health emergency, which presents wide-ranging negative impacts on individuals with diabetes. To examine psychosocial well-being and diabetes outcomes in individuals with type 1 diabetes during the COVID-19 pandemic, and investigate how these factors vary in different countries. METHODS: Between April and June 2020 we employed a cross national comparative research study in the United States (US), Brazil, and Iran to collect data from 1788 adults with type 1 diabetes using web-based survey. Study participants answered questions relevant to diabetes distress, diabetes burnout, depressive symptoms, COVID-19 related changes, and socio-demographic characteristics. They also reported their last Hemoglobin A1c (HbA1c) and daily Time-in-Range (TiR) blood glucose. We analyzed data using comparative tests (Chi-square, Kruskal-Wallis and McNemar test), logistic and linear regression adjusted for fixed effects. RESULTS: There were significant changes prior and during the pandemic regarding access to diabetes care, diabetes supplies and medications, healthy food and safe places to exercise in all countries (p < 0.05). Participants in Iran experienced higher levels of diabetes distress (57.1%), diabetes burnout (50%), and depressive symptoms (60.9%), followed by Brazil and US (p < 0.0001). US participants reported better glycemic control (HbA1c = 6.97%, T1R = 69.64%) compared to Brazil (HbA1c = 7.94%, T1R = 51.95%) and Iran (HbA1c = 7.47%, T1R = 51.53%) (p < 0.0001). There were also significant relationships between psychosocial well-being, diabetes outcomes, socio-demographic data, and COVID-19 related challenges in overall sample (p < 0.05). CONCLUSIONS: Regardless of differences among US, Brazil, and Iran, our findings revealed that different countries may experience similar challenges related to the COVID-19 pandemic which can impact negatively diabetes outcomes and psychosocial well-being in individuals with type 1 diabetes. Countries need to consider modifiable variables associated with poor diabetes outcomes and sub optimal psychosocial well-being and target vulnerable population using significant socio-demographic variables.

From adrenarche to aging of adrenal zona reticularis: precocious female adrenopause onset.

OBJECTIVE: Adaptive changes in DHEA and sulfated-DHEA (DHEAS) production from adrenal zona reticularis (ZR) have been observed in normal and pathological conditions. Here we used three different cohorts to assess timing differences in DHEAS blood level changes and characterize the relationship between early blood DHEAS reduction and cell number changes in women ZR. MATERIALS AND METHODS: DHEAS plasma samples (n = 463) were analyzed in 166 healthy prepubertal girls before pubarche (<9 years) and 324 serum samples from 268 adult females (31.9-83.8 years) without conditions affecting steroidogenesis. Guided by DHEAS blood levels reduction rate, we selected the age range for ZR cell counting using DHEA/DHEAS and phosphatase and tensin homolog (PTEN), tumor suppressor and cell stress marker, immunostaining, and hematoxylin stained nuclei of 14 post-mortem adrenal glands. RESULTS: We confirmed that overweight girls exhibited higher and earlier DHEAS levels and no difference was found compared with the average European and South American girls with a similar body mass index (BMI). Adrenopause onset threshold (AOT) defined as DHEAS blood levels <2040 nmol/L was identified in >35% of the females >40 years old and associated with significantly reduced ZR cell number (based on PTEN and hematoxylin signals). ZR cell loss may in part account for lower DHEA/DHEAS expression, but most cells remain alive with lower DHEA/DHEAS biosynthesis. CONCLUSION: The timely relation between significant reduction of blood DHEAS levels and decreased ZR cell number at the beginning of the 40s suggests that adrenopause is an additional burden for a significant number of middle-aged women, and may become an emergent problem associated with further sex steroids reduction during the menopausal transition.

Severe Maternal Morbidity: post-traumatic suffering and social support.

OBJECTIVE: To assess the relationship of post-traumatic stress symptoms and the perception of social support in women submitted to Severe Maternal Morbidity (SMM). METHOD: A prospective cohort study, with 549 women from public hospitals. The Impact of Events and Social Support scales were used. RESULTS: Women with SMM were from the State countryside (p=0.046), with low schooling (p=0.039) and did not work (p<0.001). They presented higher consumption of alcoholic beverages (p<0.001), did not perform prenatal (p<0.001), and were older (28.15 ± 28 years). Women with SMM had higher mean values of avoidance behavior (24.32, SD: 4.16), intrusive thinking (18.28, SD: 3.80), lower social support (0.11, SD: 0.001) with large effect size and lower social support satisfaction (0.69; SD: 0.19), with small effect size. CONCLUSION: SMM is a differential and negative factor for women's mental health, and social support can favor their coping.

Bacterioplankton Activity in a Meso-eutrophic Subtropical Coastal Lagoon.

The aim of this study was to investigate whether the bacterioplankton activity in the meso-eutrophic Conceição Lagoon would increase significantly under allochthonous inputs of inorganic nutrients and organic carbon. Abundance and biomass of bacterioplankton were evaluated under three treatments: light (14 h light/10 h dark), complete darkness (dark-control), and nutrient (C + N + P-dark, 100 : 10 : 1) enrichments during 72 h. Nutrient enrichments promoted a significant increase in abundance (maximum of 19.0 ×109 cells·L-1 in the first 32 hours) and biomass of the heterotrophic bacterioplankton, which induced the formation of large clusters. Bacterial biomass remained constant in the non-enriched incubations (dark-control and light). Bacterial growth rates were significantly higher after nutrient additions (1.35 d-1), followed by control (0.79 d-1), and light (0.63 d-1) treatments, which were statistically equal (p > 0.05). Bacterial production rates were also significantly higher under nutrient additions (1.28 d-1), compared to the control and light (0.50 d-1 and 0.44 d-1, respectively), demonstrating that bacterial growth and production in this meso-eutrophic lagoon are under an immediate "bottom-up" regulation, followed by a potential top-down effect. These facts reinforce the urgency on improving the local wastewater management plan in order to prevent further expansion of anoxic waters.

Small hospitals matter: insights from the emergence and spread of vancomycin-resistant enterococci in 2 public hospitals in inner Brazil.

Although vancomycin-resistant enterococci (VRE) are reported in Brazil since 1996, data on their impact over settings of different complexity are scarce. We performed a study aimed at identifying determinants of VRE emergence and spread in a public hospital consortium (comprising 2 hospitals, with 318 and 57 beds) in inner Brazil. Molecular typing and case-control studies (addressing predictors of acquisition or clonality) were performed. Among 122 authocthonous isolates, 106 were Enterococcus faecium (22 clones), and 16, Enterococcus faecalis (5 clones). Incidence was greater in the small-sized hospital, and a previous admission to this hospital was associated with greater risk of VRE colonization or infection during admission to the larger one. Overall risk factors included comorbidities, procedures, and antimicrobials (piperacillin-tazobactam, cefepime, and imipenem). Risk factors varied among different hospitals, species, and clones. Our findings demonstrate that VRE can spread within low-complexity facilities and from these to larger hospitals.

Ansiedade e Depressão na Morbidade Materna Grave e Near Miss / Anxiety and depression in severe maternal morbidity and near miss

RESUMO Com o objetivo de verificar a prevalência da ansiedade e depressão em mulheres com morbidade materna grave (near miss), foi realizado estudo de coorte transversal, com 549 mulheres. Para tanto, foram utilizados o Inventário de Beck de Depressão (BDI) e o Inventário de Ansiedade (BAI). Na análise estatística, aplicaram-se o teste do qui-quadrado de Pearson e o U-Mann-Whitney, além de Razões de Chances brutas e seus Intervalos com 95% de confiança. Houve maior prevalência e maior chance de desenvolver a ansiedade e depressão na MMG/NM, bem como a relação positiva e significativa entre ambos. Considera-se a associação do ponto de vista psicológico, como um fator grave e impactante na saúde mental da mulher.

ABSTRACT To verify the prevalence of anxiety and depression in women with severe maternal morbidity (near miss), a cross-sectional cohort study was conducted, with 549 women. The Beck Depression Inventory (BDI) and the Anxiety Inventory (BAI) were used. For the statistical analysis, the Pearson chi-square test and the U-Mann-Whitney test besides Odds Ratio and their 95% confidence intervals. There was a higher prevalence and a greater chance of developing anxiety and depression in the SAMM/NM, as well as the positive and significant relationship between both. We consider association from the psychological point of view as a serious and shocking factor in the mental health of women.

Severe Maternal Morbidity: post-traumatic suffering and social support / Morbilidad Materna Grave: estrés postraumático y soporte social / Morbidade Materna Grave: estresse pós-traumático e suporte social

ABSTRACT Objective: To assess the relationship of post-traumatic stress symptoms and the perception of social support in women submitted to Severe Maternal Morbidity (SMM). Method: A prospective cohort study, with 549 women from public hospitals. The Impact of Events and Social Support scales were used. Results: Women with SMM were from the State countryside (p=0.046), with low schooling (p=0.039) and did not work (p<0.001). They presented higher consumption of alcoholic beverages (p<0.001), did not perform prenatal (p<0.001), and were older (28.15 ± 28 years). Women with SMM had higher mean values of avoidance behavior (24.32, SD: 4.16), intrusive thinking (18.28, SD: 3.80), lower social support (0.11, SD: 0.001) with large effect size and lower social support satisfaction (0.69; SD: 0.19), with small effect size. Conclusion: SMM is a differential and negative factor for women's mental health, and social support can favor their coping.

RESUMEN Objetivo: Evaluar la relación de síntomas de estrés postraumático y la percepción del soporte social en mujeres sometidas a la Morbilidad Materna Grave (MMG). Método: Estudio de corte prospectivo, con 549 mujeres de hospitales públicos. Se utilizaron las escalas de Impacto de Eventos y de Soporte Social. Resultados: las mujeres con MMG provenían del interior del estado (p = 0,046), con baja escolaridad (p = 0,039) y no trabajaban (p <0,001). En el caso de las bebidas alcohólicas (p <0,001), no realizaron prenatal (p <0,001), y eran mayores (28,15 ± 28 años). Las mujeres expuestas a la MMG tuvieron promedios más altos de comportamiento de esquiva (24,32, DP: 4,16), pensamiento intrusivo (18,28, DP: 3,80), menor soporte social (0,11, DP: 0,001) con tamaño de efecto grande y menor satisfacción del soporte social (0,69, DP: 0,19) con tamaño de efecto pequeño. Conclusión: La MMG es un factor diferencial y negativo para la salud mental de las mujeres, y el apoyo social puede favorecer su enfrentamiento.

RESUMO Objetivo: Avaliar a relação de sintomas de estresse pós-traumático e a percepção do suporte social em mulheres submetidas à Morbidade Materna Grave (MMG). Método: Estudo de coorte prospectivo, com 549 mulheres de hospitais públicos. Foram utilizadas as escalas de Impacto de Eventos e de Suporte Social. Resultados: Mulheres com MMG eram oriundas do interior do estado (p=0,046), com baixa escolaridade (p=0,039) e não trabalhavam (p<0,001). Apresentavam maior consumo de bebidas alcoólicas (p<0,001), não realizaram pré-natal (p<0,001), e eram mais velhas (28,15±28 anos). As mulheres com MMG tiveram maiores médias de comportamento de esquiva (24,32; DP: 4,16), pensamento intrusivo (18,28; DP: 3,80), menor suporte social (0,11; DP: 0,001) com tamanho de efeito grande e menor satisfação do suporte social (0,69; DP: 0,19), com tamanho de efeito pequeno. Conclusão: A MMG é um fator diferencial e negativo para a saúde mental das mulheres, e o apoio social pode favorecer o seu enfrentamento.

A depressão pós-parto em mulheres que sobreviveram à morbidade materna grave / Postpartum depression in women who survived severe maternal morbidity

Resumo Introdução A morbidade materna grave é cada vez mais conhecida como um indicador útil de segurança e de qualidade do cuidado materno e pode afetar a saúde mental da mãe. Objetivo Avaliar a relação entre a morbidade materna grave (near miss) e os sintomas da depressão pós-parto. Método Estudo descritivo de coorte prospectivo. A amostra foi constituída por 549 mulheres puérperas em duas maternidades públicas do Estado de Sergipe. Foi aplicada a Edinburgh Postnatal Depression Scale (EPDS) para identificar os sintomas de depressão no pós-natal. Para a análise estatística, aplicaram-se os testes do Qui-quadrado, de U-Mann-Whitney e o coeficiente de correlação de postos de Spearman, e considerou-se o nível de significância de α ≤ 0,05%. Resultados 156 (56%) das mães expostas à MMG/NM e 45 (17%) das não expostas revelaram forte associação com depressão pós-parto e maior chance (ORC: 24,0; IC95%: 7,23-79,7) de desenvolvê-la. Conclusão A MMG/NM tem impacto negativo na saúde mental da mulher e eleva a sua vulnerabilidade para a doença mental. É fundamental para a qualidade da assistência materno-infantil a implantação de políticas públicas que assegurem prevenção e estratégias de enfrentamento.

Abstract Background Severe maternal morbidity is increasingly known as a useful indicator of the safety and quality of maternal care, and may affect the mother´s mental health. Objective To evaluate the relationship between severe maternal morbidity (near miss) and symptoms of postpartum depression. Method Descriptive study of prospective cohort. The sample consisted of a total of 549 puerperal women from two public maternity hospitals in the state of Sergipe. We applied the Edinburgh Postnatal Depression Scale (EPDS) to identify the prevalence of postpartum depression. The statistical analysis was performed using chi-square test of U-Mann-Whitney and the Spearman rank correlation coefficient, with significance level of α ≤ 0.05%. Results 156 (56%) of the mothers exposed to severe maternal obesity, and 45 (17%) of the non-exposed mothers showed a strong association and greater chance (ORC: 24.0; 95% CI: 7.23-79.7) to develop postpartum depression. Conclusion Severe maternal morbidity has a negative impact on women's mental health, and increases the vulnerability to mental illness. It is fundamental for the quality of maternal and child care to implement public policies that ensure prevention and coping strategies.

Eficácia do álcool etílico e quaternário de amônio na desinfecção de equipamentos médicos hospitalares / Efficacy of ethyl alcohol and quaternary ammonium in hospital medical equipment disinfection / Eficacia del alcohol etílico y cuaternario de amonio en la desinfección de equipos médicos hospitalarios

Justificativa e Objetivos: Os ambientes hospitalares podem albergar microrganismos patogênicos e oportunistas, sendo o processo de limpeza e desinfecção importante para o controle das Infecções relacionadas à Assistência à Saúde (IRAS). Assim, o objetivo deste trabalho foi avaliar a eficácia do álcool etílico e do quaternário de amônio no processo de desinfecção de equipamentos médicos hospitalares previamente contaminados com Staphylococcus aureus (S. aureus). Métodos: descontaminação de 10 equipamentos médicos hospitalares contaminados com uma suspensão de S. aureus ATCC 25923. A descontaminação ocorreu com álcool etílico nas concentrações de 46,2%, 70% e 99% e com o quaternário de amônio de 1ª e de 5ª geração. Após a descontaminação, foram colhidas amostras da superfície dos equipamentos para cultura bacteriana. Resultados: foi verificado crescimento bacteriano em 80% dos equipamentos descontaminados com álcool 46,2% e 99%. Não houve crescimento bacteriano na superfície dos equipamentos descontaminados com álcool 70% e quaternários de amônio. Conclusão: os processos de desinfecção com álcool 70% e quaternário de amônio de 1ª e 5ª geração foram eficazes no controle do S. aureus, comprovando a ação efetiva destes produtos na desinfecção dos equipamentos médicos hospitalares.(AU)

Background and Objectives: Hospital environments may harbor pathogenic and opportunistic microorganisms, and the cleaning and disinfection process is important for the control of Health Care Related Infections (IRAS). Thus, the objective of this work to evaluate compare the efficacy of ethyl alcohol and quaternary ammonium in the disinfection of hospital medical equipment against Staphylococcus aureus (S. aureus). Methods: decontamination of 10 hospital medical equipment contaminated with a suspension of S. aureus ATCC 25923. The decontamination occurred with ethyl alcohol at concentrations of 46.2%, 70% and 99% and with the quaternary ammonium of 1st generation and 5th generation. After the decontamination, samples were harvested from the surface of the equipment for bacterial culture. Results: bacterial growth was verified in 80% of the equipment decontaminated with alcohol 46.2% and 99%. There was no bacterial growth on the surface of equipment decontaminated with alcohol 70% and quaternary ammonium. Conclusions: the disinfection processes with alcohol 70% and quaternary ammonium 1st and 5th generation were effective in the control of S. aureus, proving the effectiveness of these products in the disinfection of hospital medical equipment.(AU)

Justificación y objetivos: Los ambientes hospitalarios pueden albergar microorganismos patógenos y oportunistas, siendo el proceso de limpieza y desinfección importante para el control de las Infecciones relacionadas a la Asistencia a la Salud (IRAS). Así, el objetivo de este trabajo evaluar comparar la eficacia del alcohol etílico y del cuaternario de amonio en el proceso de desinfección de equipos médicos hospitalarios previamente contaminados con Staphylococcus aureus (S. aureus). Métodos: la descontaminación de 10 equipos médicos hospitalarios contaminados con una suspensión de S. aureus ATCC 25923. La descontaminación ocurrió con alcohol etílico en las concentraciones de 46,2%, 70% y 99% y con el cuaternario de amonio de 1ª y de 5ª generación. Después de la descontaminación, se tomaron muestras de la superficie de los equipos para cultivo bacteriano. Resultados: se verificó crecimiento bacteriano en el 80% de los equipos descontaminados con alcohol 46,2% y 99%. No hubo crecimiento bacteriano en la superficie de los equipos descontaminados con alcohol 70% y cuaternarios de amonio. Conclusión: los procesos de desinfección con alcohol 70% y cuaternario de amonio de 1ª y 5ª generación fueron eficaces en el control del S. aureus, comprobando la acción efectiva de estos productos en la desinfección de los equipos médicos hospitalarios.(AU)

Caracterização dos usuários com esquizofrenia e outros transtornos psicóticos dos Centros de Atenção Psicossocial. / Characterization of the users with schizophrenia in Psychosocial Care Centers.

A rede de Saúde Mental de base comunitária no Brasil ampliou a oferta de serviços substitutivos para a população com doença mental grave. O objetivo deste estudo foi caracterizar o perfil do usuário com transtornos psicóticos nos Centros de Atenção Psicossocial do Estado de Sergipe (CAPS-SE). Foi conduzido um estudo descritivo, com análise quantitativa dos dados sociodemográficos e número de internação. Foram estudados 1.444 prontuários com diagnóstico de transtorno psicótico e encontraram-se 75,3% deles com diagnóstico de esquizofrenia e 24,7% com outros transtornos psicóticos. Os usuários com menos de 24 anos representavam 33% dos usuários, enquanto 54% estavam igualmente distribuídos nas faixas etárias de 25-35 e 35-46 anos. Dos sujeitos com diagnóstico de esquizofrenia, 79,9% eram do gênero masculino e 68%, feminino, mostrando relação significativa entre gênero e diagnóstico. A maioria absoluta dos sujeitos não tem profissão. Quanto ao número de internações, a diferença entre sujeitos diagnosticados como esquizofrênicos para os portadores de outros diagnósticos aponta predominância significativa do primeiro grupo na faixa com mais de seis internações. Conclui-se que entre os usuários dos CAPS é predominante o gênero masculino, com comprometimento importante também na dimensão profissional.

Community based network of Mental Health in Brazil increased the supply of substitute services for the population with grave mental disorders. The objective of this study was to characterize the profile of the user with psychotic disorders in Psychosocial Care Centers (PCC) in the state of Sergipe, Brazil. A descriptive study was carried out by means of a quantitative analysis of the sociodemographic and number of committal data. In this study, 1,444 patients? records with psychotic disorder diagnosis were analysed. It was revealed that 75.3% were diagnosed with schizophrenia and whereas 24.7% with other psychotic disorders. Users with less than 24 years represented 33% of the subjects, while 54% were equally distributed in the age groups 25-35 and 35-46 years. It was shown that among the users diagnosed with schizophrenia, 79.9% belonged to the male gender and 68.7% to the feminine gender. The absolute majority of the subjects have no occupation. Concerning the number of hospitalizations, the difference between subjects diagnosed with schizophrenia for patients with other diagnoses indicates significant predominance more than first group in the range of six admissions. It was concluded that among the users of the PPC with schizophrenia the male gender is prevalent, which also signals impairment towards the professional dimension.