Second-generation ethanol production by Wickerhamomyces anomalus strain adapted to furfural, 5-hydroxymethylfurfural (HMF), and high osmotic pressure.

The aims of this work were to improve cell tolerance towards high concentrations of furfural and 5-hydroxymethylfurfural (HMF) of an osmotolerant strain of Wickerhamomyces anomalus by means of evolutionary engineering, and to determine its ethanol production under stress conditions. Cells were grown in the presence of furfural, HMF, either isolated or in combination, and under high osmotic pressure conditions. The most toxic condition for the parental strain was the combination of both furans, under which it was unable to grow and to produce ethanol. However, the tolerant adapted strain achieved a yield of ethanol of 0.43 g g-1glucose in the presence of furfural and HMF, showing an alcohol dehydrogenase activity of 0.68 mU mg protein-1. For this strain, osmotic pressure, did not affect its growth rate. These results suggest that W. anomalus WA-HF5.5strain shows potential to be used in second-generation ethanol production systems.

Detection of hormones in surface and drinking water in Brazil by LC-ESI-MS/MS and ecotoxicological assessment with Daphnia magna.

The growing use of pharmaceutical drug is mainly due to several diseases in human and in animal husbandry. As these drugs are discharged into waterways via wastewater, they cause a major impact on the environment. Many of these drugs are hormones; in which even at low concentrations can alter metabolic and physiological functions in many organisms. Hormones were found in surface water, groundwater, soil, and sediment at concentrations from nanograms to milligrams per liter of volume--quantities known to cause changes in the endocrine system of aquatic organisms. This study aimed to develop a methodology for hormone detection (estriol, estrone, 17ß-estradiol, 17α-ethinylestradiol, progesterone, and testosterone) on surface and treated water samples. Sample toxicity was assessed by ecotoxicology tests using Daphnia magna. A liquid chromatograph coupled to a mass spectrometer with an electrospray ionization source (LC-ESI-MS/MS) was used for the analysis. The results showed that samples were contaminated by the hormones estriol, estrone, progesterone, 17ß-estradiol, and 17α-ethinylestradiol during the sampling period, and the highest concentrations measured were 90, 28, 26, 137, and 194 ng · L(-1), respectively. This indicates the inflow of sewage containing these hormones at some points in the Piracicaba River in the State of Sao Paulo-Brazil. Results indicated little toxicity of the hormone estriol in D. magna, indicating that chronic studies with this microcrustacean are necessary.

Ecotoxicity and environmental risk assessment of larvicides used in the control of Aedes aegypti to Daphnia magna (Crustacea, Cladocera).

Dengue transmitted by mosquitoes of the genus Aedes, species aegypti, is a major public health concern in Brazil. The chemical control of the mosquito larvae has been performed with the larvicide temephos since 1967. However, vector resistance was reported to temephos in several Brazilian states, and the Ministry of Health ordered the replacement of this larvicide by diflubenzuron (DFB), an inhibitor of chitin synthesis. Both insecticides are diluted in water with larvae and are able to reach aquatic environments in which they subsequently adversely damage nontarget organisms. The aims of this study were to (1) determine the acute toxicity (EC50) and environmental risk (RQ) of DFB and temephos to the microcrustacean Daphnia magna, and (2) evaluate the chronic toxicity (no-observed-effect concentration [NOEC] and lowest-observed-effect concentration [LOEC]) of these larvicides to D. magna. The experiments were performed according to a completely randomized design. The estimated 48-h EC50 of temephos was 0.15 µg/L (lower limit = 0.1 and upper limit = 0.2 µg/L) and the 48-h EC50 of DFB was 0.06 µg/L (lower limit = 0.03 and upper limit = 0.1 µg/L). RQ values were 4.166.7 to DFB and 6.666.6 to temephos. NOEC and LOEC values were respectively 2.5 and 5 ng/L for DFB, and respectively 6.2 and 12.5 ng/L for temephos. Thus, temephos and DFB are classified as highly toxic to Daphnia magna and pose a high environmental risk to this species. Mortality of D. magna was observed at concentrations lower than those used in the field to control A. aegypti larvae.

"Dementia Doesn't Mean That Life Doesn't Have More Wonderful Things Ahead": A Qualitative Study Evaluating a Canadian Dementia Support Services Program.

Background: Community support programs can improve quality of life for people living with dementia and their care partners. Important to the successful implementation of such programs is close engagement with end-users to gain a better understanding of their needs. This study describes the perspectives of people living with dementia, care partners, and health-care providers on the First Link® dementia support program provided by the Alzheimer Society of British Columbia (ASBC). Methods: Following a large-scale survey (N=1,164), semi-structured interviews were conducted with participants to explore in greater detail the different needs and themes that emerged from the first phase of the study. The interviews explored: 1) experiences with the program; 2) future planning; 3) meaning of independence; and 4) impact of the program on emotional and physical well-being. Results: A total of 48 participants were interviewed in this study. Knowledge and education were key factors that helped participants manage the impact of dementia. Learning about dementia, the experiences of others, strategies on how to manage symptoms, what to plan for in the future, and how to access different services in the community, was tied to increased feelings of confidence and comfort, and decreased stress. Participants also provided suggestions for improvement of the First Link® dementia program such as further embedding the program into the patient journey, providing more services in remote areas, providing education for health-care providers, and increasing awareness of the program. Conclusion: By emphasizing the lived experiences and needs of those living with dementia and their caregivers, this work will inform future research-based program evaluations globally and, in turn, improve the existing services to support people living with-and impacted by-dementia.

The Secretome of Phanerochaete chrysosporium and Trametes versicolor Grown in Microcrystalline Cellulose and Use of the Enzymes for Hydrolysis of Lignocellulosic Materials.

The ability of white-rot fungi to degrade polysaccharides in lignified plant cell walls makes them a suitable reservoir for CAZyme prospects. However, to date, CAZymes from these species are barely studied, which limits their use in the set of choices for biomass conversion in modern biorefineries. The current work joined secretome studies of two representative white-rot fungi, Phanerochaete chrysosporium and Trametes versicolor, with expression analysis of cellobiohydrolase (CBH) genes, and use of the secretomes to evaluate enzymatic conversion of simple and complex sugarcane-derived substrates. Avicel was used to induce secretion of high levels of CBHs in the extracellular medium. A total of 56 and 58 proteins were identified in cultures of P. chrysosporium and T. versicolor, respectively, with 78-86% of these proteins corresponding to plant cell wall degrading enzymes (cellulolytic, hemicellulolytic, pectinolytic, esterase, and auxiliary activity). CBHI predominated among the plant cell wall degrading enzymes, corresponding to 47 and 34% of the detected proteins in P. chrysosporium and T. versicolor, respectively, which confirms that Avicel is an efficient CBH inducer in white-rot fungi. The induction by Avicel of genes encoding CBHs (cel) was supported by high expression levels of cel7D and cel7C in P. chrysosporium and T. versicolor, respectively. Both white-rot fungi secretomes enabled hydrolysis experiments at 10 FPU/g substrate, despite the varied proportions of CBHs and other enzymes present in each case. When low recalcitrance sugarcane pith was used as a substrate, P. chrysosporium and T. versicolor secretomes performed similarly to Cellic® CTec2. However, the white-rot fungi secretomes were less efficient than Cellic® CTec2 during hydrolysis of more recalcitrant substrates, such as acid or alkaline sulfite-pretreated sugarcane bagasse, likely because Cellic® CTec2 contains an excess of CBHs compared with the white-rot fungi secretomes. General comparison of the white-rot fungi secretomes highlighted T. versicolor enzymes for providing high glucan conversions, even at lower proportion of CBHs, probably because the other enzymes present in this secretome and CBHs lacking carbohydrate-binding modules compensate for problems associated with unproductive binding to lignin.

Prevalence and trends of mental disorders requiring inpatient care in the city of Porto Alegre: a citywide study including all inpatient admissions due to mental disorders in the public system from 2013-2017.

OBJECTIVES: To investigate the 5-year prevalence of patients admitted to public inpatient care units due to a mental disorder, stratifying them by age group and diagnosis, and to assess trends of admissions over this time period in Porto Alegre. METHODS: All admissions to the public mental health care system regulated by the city-owned electronic system Administração Geral dos Hospitais (AGHOS) were included in the analysis. The total population size was obtained by estimations of Fundação de Economia e Estatística (FEE). General information about 5-year prevalence of inpatient admissions, time-series trends e prevalence by age groups and diagnosis were presented. RESULTS: There were 32,608 admissions over the 5-year period analyzed. The overall prevalence of patients was 1.62% among the total population, 0.01% among children, 1.12% among adolescents, 2.28% among adults and 0.93% among the elderly. The most common diagnosis was drug-related, followed by mood, alcohol-related and psychotic disorders. There was a linear trend showing an increase in the number of admissions from 2013 to the midst of 2014, which dropped in 2015. CONCLUSIONS: Admissions due to mental disorders are relatively common, mainly among adults and related to drug use and mood disorders. Time trends varied slightly over the 5 years. Prevalence rates in real-world settings might be useful for policymakers interested in planning the public mental health system in large Brazilian cities.

Biological pretreatment of sugarcane bagasse with basidiomycetes producing varied patterns of biodegradation.

This work evaluated sugarcane bagasse pretreatment with wood-decay fungi, producing varied patterns of biodegradation. The overall mass balance of sugars released after pretreatment and enzymatic hydrolysis indicated that a selective white-rot was necessary to provide glucose yields similar to the ones observed from leading physico-chemical pretreatment technologies. The selective white-rot Ceriporiopsis subvermispora was selective for lignin degradation in the lignocellulosic material, preserved most of the glucan fraction, and increased the cellulose digestibility of biotreated material. Glucose mass balances indicated that of the potential glucose of untreated bagasse, 47% was recovered as sugar-rich syrup after C. subvermispora biotreatment for 60days followed by enzymatic digestion of the pretreated material.

[Bone Fractures in a Neonatal Intensive Care Unit]. / Fraturas Ãìsseas em uma Unidade de Cuidados Intensivos Neonatais.

INTRODUCTION: Fractures during the neonatal period are rare. Some fractures, especially long bones, may occur during birth. Moreover, neonates hospitalized in the Neonatal Intensive Care Unit have an increased risk of fractures for several reasons. OBJECTIVE: To evaluate the incidence and characterize fractures in newborns admitted in a tertiary Neonatal Intensive Care Unit. MATERIAL AND METHODS: A retrospective analysis of the newborns admitted to the Neonatal Intensive Care Unit with a diagnosis at discharge of one or more bone fractures from January 1996 to June 2013. RESULTS: Eighty neonates had one or more fractures. In 76 (95%) infants the fractures were attributed to birth injury. The most common fracture was the clavicle fracture in 60 (79%) neonates, followed by skull fracture in 6 (8%). In two (2.5%) neonates, extremely low birth weight infants, fractures were interpreted as resulting from osteopenia of prematurity. Both had multiple fractures, and one of them with several ribs. CONCLUSION: A change in obstetric practices allied to improvement premature neonateâÄôs care contributed to the decreased incidence of fractures in neonatal period. But in premature infants the diagnosis may be underestimated, given the high risk of fracture that these infants present.

Introdução: As fraturas ósseas são raras durante o período neonatal. Algumas das fraturas, sobretudo as de ossos longos, podem ocorrer durante o parto. Por outro lado, os recém-nascidos internados em Unidades de Cuidados Intensivos Neonatais têm um risco aumentado de fraturas ósseas por várias razões.Objetivo: Avaliar a incidência e caracterizar as fraturas ósseas nos recém-nascidos internados numa Unidade de Cuidados Intensivos Neonatais nível III.Material e Métodos: Análise retrospetiva dos recém-nascidos internados na Unidade de Cuidados Intensivos Neonatais com o diagnóstico na alta de uma ou mais fraturas ósseas, entre janeiro de 1996 a junho de 2013.Resultados: Oitenta recém-nascidos apresentaram uma ou mais fraturas ósseas. Em 76 (95%) recém-nascidos, as fraturas foram atribuídas a traumatismo do parto. A fratura mais comum foi da clavícula em 60 (79%) recém-nascidos, seguida da fratura craniana em 6 (8%) recém-nascidos. Em dois (2,5%) recém-nascidos, prematuros de extremo baixo peso, as fraturas foram interpretadas como decorrentes de osteopenia da prematuridade. Ambos apresentaram fraturas múltiplas, um dos quais de várias costelas.Conclusão: Uma mudança das práticas obstétricas, aliada à melhoria dos cuidados prestados ao recém-nascido prematuro contribuíram para a diminuição da incidência de fraturas ósseas no período neonatal. Contudo nos recém-nascidos prematuros o seu diagnóstico pode estar subestimado, dado o elevado risco de desenvolvimento de fratura que estes recém-nascidos apresentam.

Prevalence and trends of mental disorders requiring inpatient care in the city of Porto Alegre: a citywide study including all inpatient admissions due to mental disorders in the public system from 2013-2017 / Prevalência e tendências temporais de transtornos mentais necessitando de tratamento de internação na cidade de Porto Alegre: um estudo de toda a cidade incluindo todas as internações por motivo de saúde mental no sistema público de 2013-2017

Abstract Objectives To investigate the 5-year prevalence of patients admitted to public inpatient care units due to a mental disorder, stratifying them by age group and diagnosis, and to assess trends of admissions over this time period in Porto Alegre. Methods All admissions to the public mental health care system regulated by the city-owned electronic system Administração Geral dos Hospitais (AGHOS) were included in the analysis. The total population size was obtained by estimations of Fundação de Economia e Estatística (FEE). General information about 5-year prevalence of inpatient admissions, time-series trends e prevalence by age groups and diagnosis were presented. Results There were 32,608 admissions over the 5-year period analyzed. The overall prevalence of patients was 1.62% among the total population, 0.01% among children, 1.12% among adolescents, 2.28% among adults and 0.93% among the elderly. The most common diagnosis was drug-related, followed by mood, alcohol-related and psychotic disorders. There was a linear trend showing an increase in the number of admissions from 2013 to the midst of 2014, which dropped in 2015. Conclusions Admissions due to mental disorders are relatively common, mainly among adults and related to drug use and mood disorders. Time trends varied slightly over the 5 years. Prevalence rates in real-world settings might be useful for policymakers interested in planning the public mental health system in large Brazilian cities.

Resumo Objetivos Investigar a prevalência de 5 anos de pacientes internados no sistema público de saúde por motivo de saúde mental, estratificando-os por grupo etário e diagnóstico, e avaliar tendências temporais nas admissões nesse período em Porto Alegre. Métodos Todas as admissões no sistema público de saúde mental reguladas pelo sistema eletrônico da cidade, denominado Administração Geral dos Hospitais (AGHOS), foram incluídos na análise. A população total foi obtida a partir de estimativas da Fundação de Economia e Estatística (FEE). Informações gerais sobre a prevalência de 5 anos de admissões, tendências das séries temporais e prevalência por grupo etário e por diagnóstico foram apresentadas. Resultados Ocorreram 32.608 admissões no período de 5 anos analisado. A prevalência global de pacientes foi de 1,62% na população total, 0,01% em crianças, 1,12% em adolescentes, 2,28% em adultos e 0,93% em idosos. Os diagnósticos mais comuns foram relacionados ao uso de drogas, seguidos de transtornos de humor, relacionados ao álcool e transtornos psicóticos. Houve uma tendência linear mostrando um aumento no número de admissões de 2013 a meados de 2014, que caíram em 2015. Conclusões Admissões por transtornos mentais são relativamente comuns, principalmente entre adultos e relacionados ao uso de drogas e transtornos de humor. Tendências lineares variaram levemente nos últimos 5 anos. Estimativas de prevalência no mundo real podem ser úteis para formuladores de políticas interessados em planejar o sistema público de saúde mental em grandes cidades brasileiras.

[Congenital myotonic dystrophy in a Neonatal Intensive Care Unit: case series]. / Distrofa miotónica congénita en una Unidad de Cuidados Intensivos Neonatales: serie de casos.

Steinert myotonic dystrophy is a multisystemic disease, autosomal dominant, with a wide spectrum of severity and clinical manifestations. The most severe form is one that manifests in the neonatal period, called congenital myotonic dystrophy. This condition is distinguished by overall hypotonia at birth and respiratory function compromise. Complications are frequent, mainly psychomotor development delay, growth failure, food difficulties and constipation. It is associated with a poor prognosis, with an overall mortality of up to 50% of severely affected children. We present five patients with congenital myotonic dystrophy in order to describe clinical manifestations, diagnosis, treatment and prognosis. Existing data in the literature on psychomotor development, complications and prognosis of survivors with congenital myotonic dystrophy are scarce. In our case studies, we have found significant chronic psychomotor limitations.

5-Hydroxymethylfurfural induces ADH7 and ARI1 expression in tolerant industrial Saccharomyces cerevisiae strain P6H9 during bioethanol production.

The aims of this work were to obtain, by evolutionary engineering, an industrial strain of Saccharomyces cerevisiae tolerant to high concentrations of HMF and to determine the expression levels of genes previously described as responsible for this tolerance. Cells were grown under anaerobic and oxygen limited conditions, in the presence of glucose or sucrose as carbon sources. P6H9 strain presented high expression levels for genes ADH7 and ARI1 in presence of HMF. This tolerant strain also showed higher ethanol productivity, biomass formation and alcohol dehydrogenase activity comparing to sensitive strains. Results suggest that S. cerevisiae P6H9 strain presents potential to be used for second-generation ethanol production.

Motor development of older adults: comparative study of gender and age group / Desenvolvimento motor de idosos: estudo comparativo de sexo e faixa etária

Abstract Introduction: Aging in motor development is represented by a retrogenesis process that refers to gradual losses in motor components. Intrinsic and extrinsic factors can influence this process. Objective: The aimed of this study was to evaluate and compare the motor development of older adults considering the gender and age group. Method: A total of 218 healthy older adults aged 60-79 years old were included. Four groups were formed according to gender and age group: G1 (n=64) - female, 60-69 years old; G2 (n=45) - female, 70-79 years old; G3 (n=66) - male, 60-69 years old; G4 (n=43) - male, 70-79 years old. The Motor Scale for Older Adults (MSOA) was used. Statistical analysis was performed using Kruskal Wallis and Dunn post hoc test. Results: Most of the older adults presented Motor Development within the normal range. The group of older women of 70-79 years old presented low mean values ( x ¯=87.7, SD=12.4), being statistically different when compared to the others groups. The areas: Global Coordination (p=0.001), Balance (p=0.001) and Body Scheme (p=0.012), presented significant statistical differences between the groups. In this analysis, women reached lower scores in most of the evaluated areas. Conclusion: The older women with more advanced age presented major impairment in motor development when compared to older men and older women with 60-69 years old.

Resumo Introdução: No desenvolvimento motor, o envelhecimento é representado pela retrogênese, processo que se refere às perdas gradativas nos componentes motores. Fatores intrínsecos e extrínsecos podem influenciar este processo. Objetivo: Avaliar e comparar o desenvolvimento motor de idosos considerando o sexo e a faixa etária. Método: Foram avaliados 218 idosos hígidos com idade entre 60 e 79 anos estratificados por sexo e faixa etária, constituindo quatro grupos: G1(n=64) - sexo feminino, 60-69 anos; G2 (n=45) - sexo feminino, 70-79 anos; G3 (n=66) - sexo masculino, 60-69 anos; G4 (n=43) - sexo masculino, 70-79 anos. O instrumento utilizado para coleta dos dados foi a Escala Motora para Terceira Idade (EMTI). Na análise estatística, empregou-se teste H de Kruskal Wallis e post hoc Dunn. Resultados: Observou-se que a maioria dos idosos apresentou desenvolvimento motor dentro da normalidade. O grupo do sexo feminino, 70-79 anos, foi o que apresentou valores médios inferiores ( x ¯=87,7; DP=12,4), sendo diferente estatisticamente quando comparado os grupos. Nas áreas motoras, diferenças estatísticas significantes foram encontradas entre os grupos na Coordenação Global (p=0,001), Equilíbrio (p=0,001) e Esquema Corporal (p=0,012); nesta análise, as mulheres alcançaram pontuações inferiores aos homens na maioria das áreas avaliadas. Conclusão: As mulheres idosas com idade mais avançada apresentaram maior comprometimento no desenvolvimento motor quando comparadas aos homens idosos e mulheres idosas mais jovens.

Programa Mais Médicos e sua repercussão na mídia: o que informar e para quem? / Programa Mais Médicos and its repercussion in the media: what should be informed and for whom? / Programa Mais Médicos y su repercusión en los medios de comunicación: qué y para quién informar?

O Programa Mais Médicos (PMM) foi instituído no Brasil no ano de 2013. Desde então, vem sendo debatida pela sociedade a questão de sua viabilidade, seus resultados e sua continuidade. O objetivo deste artigo é identificar e analisar a produtividade discursiva midiática, no período de maio de 2013 a julho de 2014, sobre o PMM. Foi feito um estudo exploratório e documental em uma revista semanal de grande circulação no Brasil (IstoÉ), através da busca de reportagens no seu sítio virtual, com descritores relacionados ao Programa, em que foram selecionadas 34 reportagens em 31 edições a partir do mês anterior à publicação da medida provisória que instituiu o PMM. A revista destacou a chegada de profissionais estrangeiros, os atos xenofóbicos empreendidos pela classe médica e a proteção corporativista da categoria. O PMM contribui grandemente para a melhoria da saúde da população e o atendimento de suas necessidades, porém reproduz a centralidade médica, desconsiderando que outros profissionais de saúde também têm sua atuação dificultada em áreas negligenciadas pelo Estado.(AU)

The PMM ­ Programa Mais Médicos [More Doctors Program] was established in Brazil in 2013. Since it was announced, the question of its viability, results and continuity has been debated by the Brazilian society. The aim of this article is to identify and analyze the media discursive productivity in the first year (May 2013 to July 2014) of the PMM. An exploratory and documentary study of articles published in a weekly magazine of great circulation in Brazil (IstoÉ) was developed by means of a search for reports on its virtual site with descriptors related to the Program and 34 articles were selected in 31 editions from one month before the setting up of PMM by "medida provisória". The magazine noticed the arrival of foreign professionals, the xenophobic acts committed by Brazilian medical associations, and the category's corporative protection. The PMM contributes greatly to improve the health of the population and to satisfy its needs, but it reproduces the medical centrality, disregarding that the work of other health professionals have also been complicated in areas neglected by the State.(AU)

El PMM ­ Programa Mais Médicos [Programa Más Médicos] se estableció en Brasil en 2013. Desde su origen, su viabilidad, resultados y continuidad han sido objeto de debate por la sociedad brasileña. Este artículo tiene el objetivo de identificar y analizar la productividad discursiva mediática, en el primer año (mayo de 2013 a junio de 2014) del PMM. Un estudio exploratorio y documental en una revista semanal de gran circulación en Brasil (IstoÉ) fue llevado a cabo, a través de la búsqueda de reportajes en su sitio virtual, con descriptores relacionados al Programa y se seleccionaron 34 reportajes en 31 ediciones a partir del mes anterior a la publicación de la "medida provisória" que ha establecido el PMM. El periódico destaca la llegada de profesionales extranjeros, los actos de xenofobia practicados por entidades médicas, y la protección corporativista de la categoría. El PMM contribuye en gran medida a mejora de la salud de la población y a atención médica de sus necesidades, pero reproduce la centralidad médica, sin tener en cuenta otros profesionales de la salud que también tienen su desempeño obstaculizado en áreas desatendidas por el Estado.(AU)

[Salmonella gastroenteritis in children]. / Gastrenterite a Salmonella em idade pediátrica.

INTRODUCTION: The gastroenteritis (GE) by Salmonella is an important cause of disease in childhood. In Portugal an average of 456 cases per year are notified, 82% of which before the age of fifteen. AIM OF THE STUDY: Clinical and laboratorial characterization of the pediatric population with GE by Salmonella admitted in a level two hospital. MATERIAL AND METHODS: Retrospective study of patients admitted in the Emergency Room between 2005 and 2009 with Salmonella isolation in coproculture. RESULTS: In 8195 admissions by GE, 218 (2.66%) cases of Salmonella GE were identified. The most frequently isolated serotypes were S. enteritidis (49.1%) and S. typhimurium (29.8%). The studied population was mostly rural (83%) with median of age of 36 months. It was registered a predominance of S. enteritidis (63.6%, p < 0.01) above 36 months and of S. typhimurium under this age (75.3%, p < 0.01). As for the annual distribution, 166 (76%) cases occurred between May and October. It was noticed an association between S. enteritidis and the summer (52.3%, p < 0.01), and between S. typhimurium and the spring (35.4%, p < 0.01). Among the food items potentially involved in the infection, eggs and non-potable water were the most mentioned. A number of 182 (83.5%) children were hospitalized, of which one with septic shock and another with secondary bacteraemia, both with good clinical evolution. CONCLUSION: The authors observed the high prevalence of Salmonella GE within the context of a rural population, as well as a high admission rate. It is to detach the potential association between the serotypes and specific food items, the prevalence in the hottest seasons of the year and its distribution by age groups.

Ocorrência de diclofenaco e naproxeno em água superficial no município de Três Lagoas (MS) e a influência da temperatura da água na detecção desses anti-inflamatórios / Occurence of diclofenac and naproxen in surface water in the Três Lagoas (MS) city and water temperature influence in the detection of these anti-inflammatories

RESUMO Os objetivos deste trabalho foram avaliar a presença e a concentração dos anti-inflamatórios diclofenaco e naproxeno em um córrego urbano localizado no município de Três de Lagoas, Mato Grosso do Sul, que recebe efluente de uma estação de tratamento de esgoto; e verificar a influência da temperatura da água na ocorrência dos fármacos em águas superficiais. Foi realizado monitoramento dos anti-inflamatórios e dos parâmetros temperatura, pH e oxigênio dissolvido na água durante 12 meses consecutivos (outubro de 2008 a setembro de 2009). Foram coletadas amostras de água mensalmente em seis pontos, representando diferentes seções do córrego. As amostras foram submetidas ao processo de extração em fase sólida e analisadas por cromatografia líquida de alta eficiência. Para verificar a influência da temperatura da água na ocorrência dos anti-inflamatórios diclofenaco e naproxeno nos ambientes aquáticos, utilizou-se um modelo de regressão logística do Statistical Analysis System versão 9.0. Os anti-inflamatórios diclofenaco e naproxeno foram detectados nos diferentes pontos monitorados no Córrego da Onça. Os demais parâmetros avaliados neste estudo foram comparados com os padrões de qualidade de água estabelecidos pela Resolução CONAMA nº 357/2005. A maior concentração do diclofenaco foi detectada no ponto localizado à jusante da estação de tratamento de esgoto do município, enquanto a maior concentração de naproxeno foi registrada na foz do córrego. A temperatura da água influencia de forma inversamente proporcional a ocorrência dos dois anti-inflamatórios no córrego, ou seja, quanto maior a temperatura do corpo hídrico, menor a probabilidade de detecção dos fármacos diclofenaco e naproxeno.

ABSTRACT The aims of this study were to evaluate the presence and concentration of the anti-inflammatory drugs diclofenac and naproxen in an urban stream located in Três Lagoas, Mato Grosso do Sul, Brazil, that receives effluent from a wastewater treatment plant; and to evaluate the influence of water temperature in the occurrence of these drugs into surface waters. Monitoring of both anti-inflammatory and the parameters temperature, pH and dissolved oxygen was held in this water body during 12 consecutive months (October 2008 to September 2009). Water samples were collected monthly at six points representing different sections of the stream. The samples were subjected to solid phase extraction procedure and analyzed by high performance liquid chromatography. To check the influence of water temperature on the occurrence of the anti-inflammatory drugs diclofenac and naproxen in aquatic environments, it was used a logistic model of regression, the Statistical Analysis System version 9.0. The anti-inflammatory drugs diclofenac and naproxen were detected at different points in the Stream of Onça. The other parameters evaluated in this study were compared with the water quality standards established by the CONAMA Resolution 357/2005. The highest concentration of diclofenac was detected in the point located downstream of the wastewater treatment plant of the city, while the largest concentration of naproxen was recorded at the mouth of the stream. The water temperature influence, in an inversely proportional way, the occurrence of both anti-inflammatory in the stream, the higher the temperature the lower the water body probability of detection of drug diclofenac and naproxen.

Comparison of serological and parasitological methods for cutaneous leishmaniasis diagnosis in the state of Paraná, Brazil.

We evaluated the effectiveness of serological and parasitological methods for cutaneous leishmaniasis (CL) diagnosis in patients from the central region of Paraná state, southern Brazil. Five groups were compared: clinical diagnosis, parasitological diagnosis, communicants, inhabitants of a non-endemic area and carriers of other etiologies. Two antigens were prepared from promastigotes of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis for indirect immunofluorescence assay, ELISA and immunoblotting. The parasitological approaches detected 79.3% of the patients with a clinical diagnosis; the parasites were identified by PCR as L. (V.) braziliensis. Serological methods showed 95% sensitivity for homologous antigens. Immunoblotting revealed specific proteins for diagnosis of CL and detected 96.6% of the patients when L. (V.) braziliensis was used as an antigen, and 83.3% with L. (L.) amazonensis. This study demonstrated the importance of differential diagnosis for leishmaniasis; the association of two or more indirect methods increased diagnosis sensitivity.

Psiquiatria no século XXI: transformações a partir da integração com a Atenção Primária pelo matriciamento / Psychiatry in the 21th century: changes from the integration with Primary Health Care through matrix support

A lacuna de cuidados em Saúde Mental (SM) é um problema mundial. A Atenção Primária à Saúde (APS) é a base para estruturação da rede assistencial integral que o solucione. Sua integração com a Psiquiatria é parte deste desafio. Partindo da pergunta norteadora "Como vem sendo desenvolvida a inserção da APS no cuidado em Saúde Mental através da integração com a Psiquiatria pelo Matriciamento?", este artigo analisa a participação da Psiquiatria na organização da assistência em saúde mental centrada na APS, dentro de um modelo integral de cuidado em saúde. Foi utilizada metodologia qualitativa baseada na problematização da integração do Psiquiatra com as equipes da Estratégia de Saúde da Família no processo de matriciamento, sistematizam-se as experiências e conhecimento desenvolvidos pelos autores nos projetos do Laboratório Interdisciplinar de Pesquisa em APS da Universidade do Estado do Rio de Janeiro. A partir dos referenciais conceituais dos Cuidados Colaborativos, Apoio Matricial, Matriciamento e Cuidado Integral, e da caracterização das demandas clínicas de SM mais frequentes na APS, discutem-se as repercussões destes na estruturação do cuidado em SM, na formação médica e na transformação da Psiquiatria. Conclui-se que a APS é um novo campo de atuação da Psiquiatria trazendo desafios importantes para a formação e a assistência em SM...

The gap in Mental Health Care is a worldwide problem. Primary Health Care (PHC) is the framework basis for providing integrated care. Integrating Psychiatry into PHC is fundamental to solve this problem. Based on the issue of how integration of PHC into Mental Health Care is being developed with matrix support from psychiatrists, this paper investigates the role of Psychiatry in the organization of PHC, within a health comprehensive model approach. Problem-based analysis was used to systematize the knowledge and experiences gained by the authors during the execution of several research projects developed at the Laboratory of Interdisciplinary Research in Primary Health Care (LIPAPS) of Rio de Janeiro State University. Conceptual references such as Comprehensive Care, Collaborative Care and the Brazilian Model of Matrix Support Teams, as well as the most frequent Mental Health demands in PHC are reviewed, while discussing their influence on mental health care, medical education and changes imposed on Psychiatry. In conclusion, PHC may be considered as a new scenario for Psychiatry that raises important challenges related to mental health education and services...

Distrofa miotónica congénita en una Unidad de Cuidados Intensivos Neonatales: serie de casos / Congenital myotonic dystrophy in a Neonatal Intensive Care Unit: case series

La distrofia miotónica de Steinert es una enfermedad multisistémica, autosómica dominante, con un amplio espectro de gravedad y manifestaciones clínicas. La forma más grave es aquella que se manifesta en el periodo neonatal, llamada distrofa miotónica congénita. Se destaca la hipotonía global al nacer y el compromiso de la función respiratoria. Las complicaciones son frecuentes, principalmente, retraso del desarrollo psicomotor, del crecimiento pondoestatural, difcultades alimentarias y constipación. Se asocia a un mal pronóstico, con una mortalidad global de hasta un 50% de los niños gravemente afectados. Presentamos cinco casos de distrofa miotónica congénita con el objetivo de describir manifestaciones clínicas, métodos diagnósticos, tratamiento y pronóstico. Los datos existentes en la literatura sobre el desarrollo psicomotor, complicaciones y pronóstico de los supervivientes con distrofa miotónica congénita son pocos. En nuestra serie de casos, las limitaciones psicomotoras presentadas son signifcativas.

Steinert myotonic dystrophy is a multisystemic disease, autosomal dominant, with a wide spectrum of severity and clinical manifestations. The most severe form is one that manifests in the neonatal period, called congenital myotonic dystrophy. This condition is distinguished by overall hypotonia at birth and respiratory function compromise. Complications are frequent, mainly psychomotor development delay, growth failure, food diffculties and constipation. It is associated with a poor prognosis, with an overall mortality of up to 50% of severely affected children. We present fve patients with congenital myotonic dystrophy in order to describe clinical manifestations, diagnosis, treatment and prognosis. Existing data in the literature on psychomotor development, complications and prognosis of survivors withcongenital myotonic dystrophy are scarce. In our case studies, we have found signifcant chronic psychomotor limitations.

A new focus of cutaneous leishmaniasis in the central area of Paraná State, southern Brazil.

We report a new endemic zone of cutaneous leishmaniasis (CL) in the central area of the State of Paraná (Municipality of Prudentópolis), in southern Brazil. This region was not previously considered endemic for CL, and this work constitutes the first report of CL endemicity there. Leishmaniasis was confirmed by smear, culture, and ELISA. Parasites were isolated and identified by random amplification of polymorphic DNA (PCR-RAPD). Phylogeographical analysis, based on two different criteria, was able to distinguish between RAPD profiles from different geographical regions. In total, 100 patients were diagnosed with leishmaniasis by culture and serology methods. The reported incidence rate was 4.32%. Of the 100 patients, 92% of the patients had single lesions, and 79.98% of these lesions were located on their limbs. The fact that 61% of patients were male rural workers points to an extradomiciliar type of transmission. In houses where human leishmaniasis was diagnosed, 29% of the dogs presented anti-Leishmania antibodies. A total of 1663 phlebotomines, representing 5 species, were captured in the studied area with CDC-like light minitraps. Lutzomyia intermedia s.l. was the most prevalent species (94.40%). The isolated parasites were grouped with Leishmania (V.) braziliensis. The epidemiological implications are discussed in the present article.

Comparison of serological and parasitological methods for cutaneous leishmaniasis diagnosis in the state of Paraná, Brazil

We evaluated the effectiveness of serological and parasitological methods for cutaneous leishmaniasis (CL) diagnosis in patients from the central region of Paraná state, southern Brazil. Five groups were compared: clinical diagnosis, parasitological diagnosis, communicants, inhabitants of a non-endemic area and carriers of other etiologies. Two antigens were prepared from promastigotes of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis for indirect immunofluorescence assay, ELISA and immunoblotting. The parasitological approaches detected 79.3 percent of the patients with a clinical diagnosis; the parasites were identified by PCR as L. (V.) braziliensis. Serological methods showed 95 percent sensitivity for homologous antigens. Immunoblotting revealed specific proteins for diagnosis of CL and detected 96.6 percent of the patients when L. (V.) braziliensis was used as an antigen, and 83.3 percent with L. (L.) amazonensis. This study demonstrated the importance of differential diagnosis for leishmaniasis; the association of two or more indirect methods increased diagnosis sensitivity.