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Introduction. Proper management of multidrug-resistant tuberculosis is a prioritized strategy for tuberculosis control worldwide. Objective. To evaluate differences concerning demographic and clinical characteristics and programmatic indicators of Buenaventura patient cohort with confirmed diagnosis of multidrug-resistant tuberculosis, compared to those of the other municipalities from Valle del Cauca, Colombia, 2013-2016. Materials and methods. We conducted an analytical cohort study to compare records of patients older than 15 years with multidrug-resistant tuberculosis included in the Programa de Tuberculosis de Buenaventura (with para-aminosalicylic acid) versus the other municipalities of Valle del Cauca (without para-aminosalicylic). Results. Ninety-nine cases were recorded with a median age of 40 years (IQR = 26 - 53); in Buenaventura, 56% of the patients were women, while in the other municipalities, men predominated with 67%; 95% had health insurance. The most common comorbidity was diabetes (14%). Adverse reactions to antituberculosis medications in Buenaventura were 1.3 times more frequent than in the other municipalities (OR = 2.3; 95% CI = 0.993 - 5.568; p = 0.04). In Buenaventura, the mortality rate was 5% compared to the 15% reported in the other municipalities. Treatment failures were not reported in Buenaventura, but 35% did not continue with the follow-up. Treatment success was higher in Buenaventura (56 %). Conclusion. A strengthened program in Buenaventura presented better programmatic results than those from the other municipalities of Valle del Cauca. Access to molecular tests, availability of shortened treatments, and continuous monitoring to identify adverse reactions to antituberculosis medications are routes for all other control programs.

Introducción. El manejo adecuado de la tuberculosis multirresistente es una estrategia priorizada para el control de la tuberculosis en el mundo. Objetivo. Evaluar las diferencias entre las características demográficas y clínicas, y los indicadores programáticos de los pacientes con diagnóstico confirmado de tuberculosis pulmonar resistente a rifampicina o multirresistente en Buenaventura, frente a la cohorte de los demás municipios del Valle del Cauca entre 2013 y 2016. Materiales y métodos. Se desarrolló un estudio analítico de cohortes para comparar los registros de pacientes mayores de 15 años con tuberculosis multirresistente, del Programa de Tuberculosis de Buenaventura (con ácido paraaminosalicílico), frente a los demás municipios del Valle del Cauca (sin ácido paraaminosalicílico). Resultados. Se registraron 99 casos con una mediana de edad de 40 años (RIC = 26- 53); en Buenaventura, el 56 % eran mujeres; en los demás municipios, predominaron los hombres (67 %); el 95 % de los evaluados tenía aseguramiento en salud. La comorbilidad más frecuente fue diabetes (14 %). Las reacciones adversas a medicamentos antituberculosos en Buenaventura fueron 1,3 veces más frecuentes que en los demás municipios (OR = 2,3; IC95 %: 0,993 - 5,568; p = 0,04). En Buenaventura falleció el 5 % de los casos frente al 15 % reportado en los demás municipios. No hubo fracasos con el tratamiento en Buenaventura, pero se reportó un 35 % de pérdida del seguimiento. El éxito del tratamiento fue mayor en Buenaventura en el 56 %. Conclusión. El programa fortalecido de Buenaventura presentó mejores resultados programáticos que los demás municipios del Valle del Cauca. El acceso a pruebas moleculares, la disponibilidad de tratamientos acortados y el seguimiento continuo para identificar reacciones adversas a medicamentos antituberculosos son un derrotero para todos los programas de control.

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Children and adolescents with physical disabilities have motor and social-emotional challenges that interfere with their health-related quality of life and put them at greater risk of developing secondary conditions. Moreover, services that provide them therapies are more likely to be restricted, especially for the low-income population. There must be broader actions towards health promotion, offering not only means for physical habilitation and rehabilitation but for social and emotional improvements as well. This goal is attainable by adaptive sports and recreational activities where physical conditioning is accompanied by an improvement in self-esteem and social benefits. With the COVID-19 pandemic and social isolation, children and adolescents with physical disabilities were even further deprived of assistance. Our aim was to report the efforts of a non-governmental sports organization in maintaining physical and psychological care through virtual consultations and to analyze the perceptions of those affected by the process. Level of evidence IV; case series .

Crianças e adolescentes com deficiência física apresentam desafios motores e socioemocionais que interferem na qualidade de vida relacionada à saúde e os colocam em maior risco de desenvolver doenças secundárias. Além disso, estão mais sujeitos a restrições de serviços adequados que ofereçam terapias, principalmente para a população de baixa renda social. Torna-se necessário oferecer ações voltadas para a promoção da saúde em um sentido mais amplo, oferecendo não só meios de habilitação e reabilitação física, mas também de ganhos sociais e emocionais. Este objetivo pode ser atingido com esportes adaptados e atividades recreativas nos quais o condicionamento físico é acompanhado por ganhos em autoestima e benefícios sociais. Com a pandemia de COVID-19 e o isolamento social, crianças e adolescentes com deficiência física ficaram ainda mais privados de assistência. Relatamos aqui o esforço de uma organização não-governamental esportiva em manter o atendimento físico e psicológico por meio de consultas virtuais, e avaliamos as percepções das partes interessadas no processo. Nível de evidência IV; série de casos .

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ABSTRACT Children and adolescents with physical disabilities have motor and social-emotional challenges that interfere with their health-related quality of life and put them at greater risk of developing secondary conditions. Moreover, services that provide them therapies are more likely to be restricted, especially for the low-income population. There must be broader actions towards health promotion, offering not only means for physical habilitation and rehabilitation but for social and emotional improvements as well. This goal is attainable by adaptive sports and recreational activities where physical conditioning is accompanied by an improvement in self-esteem and social benefits. With the COVID-19 pandemic and social isolation, children and adolescents with physical disabilities were even further deprived of assistance. Our aim was to report the efforts of a non-governmental sports organization in maintaining physical and psychological care through virtual consultations and to analyze the perceptions of those affected by the process. Level of evidence IV; case series .

RESUMO Crianças e adolescentes com deficiência física apresentam desafios motores e socioemocionais que interferem na qualidade de vida relacionada à saúde e os colocam em maior risco de desenvolver doenças secundárias. Além disso, estão mais sujeitos a restrições de serviços adequados que ofereçam terapias, principalmente para a população de baixa renda social. Torna-se necessário oferecer ações voltadas para a promoção da saúde em um sentido mais amplo, oferecendo não só meios de habilitação e reabilitação física, mas também de ganhos sociais e emocionais. Este objetivo pode ser atingido com esportes adaptados e atividades recreativas nos quais o condicionamento físico é acompanhado por ganhos em autoestima e benefícios sociais. Com a pandemia de COVID-19 e o isolamento social, crianças e adolescentes com deficiência física ficaram ainda mais privados de assistência. Relatamos aqui o esforço de uma organização não-governamental esportiva em manter o atendimento físico e psicológico por meio de consultas virtuais, e avaliamos as percepções das partes interessadas no processo. Nível de evidência IV; série de casos .

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Usually, stability conditions of excavation slopes are evaluated by means of kinematic analysis and geomechanical classification systems. However, field surveys are concentrated at the slope toe and information about the upper and internal portions of rock masses are not taken into account. In order to tackle with these issues multisources data were integrated. The studies were carried out in a marble quarry located in one of the largest Brazilian poles of dimension stones. Results have shown that drone images actually help in the structural characterization of rock masses because they allow to classify variable degrees of fracturing and to identify structural domains in the entire slope face. In addition, the number of discontinuities interpreted from drone images was much larger than that determined by scanline survey methods. This demonstrates that the subsampling of classical survey methods may significantly affect slope stability assessment. Results have also shown that the intensive use of explosives as a method for rock dismantling was an important mechanism of fracture generation. The electrical resistivity tomography method coupled with the other survey methods employed in this work, proved an important tool for rock mass characterization and quarry exploitation, since it allowed identifying and assessing subsurface fractured zone.

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Sanitary landfills are a well-planned engineering work for final disposal of municipal solid waste in order to minimize the environmental impacts in soil and groundwater. Therefore, several control systems are installed such as liners and leachate and biogas collectors. However, the establishment of landfill in vulnerable areas, the inadequate operations, and failures in collectors and liner systems can cause subsurface contamination. The discovery of eventual leachate leakage usually is based on chemical analyses of groundwater using monitoring wells; which may not be representative in spatial terms. This work involves a geophysical monitoring of the leachate percolation in a landfill waste cell closed in 2014, in which geomembrane boreholes and aquifer contamination have been proved. The DC resistivity method was applied by means of electrical resistivity tomography (ERT) in order to detect eventual contrasts in electrical properties. Twelve ERT lines have been carried out in a steady mesh during three years of study (2016, 2017, and 2018). The results of 2016 allowed a clear contrast between zones of leachate percolation into the aquifer and the natural environment. The comparative analyses of the three-year monitoring results reveal a gradual increase in resistivity values in the areas of leachate percolation. The absence of replacement of biodegradable organic matter after 2014 conditions the gradual decrease of leachate salinity. In this sense, the increase in resistivity is an indicator of the tendency for chemical stabilization of the organic waste and existence of natural attenuation processes.

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Biooil produced via biomass pyrolysis includes an aqueous-acidic phase and a dense and rich organic phase. The aqueous phase has a low heating value and is considered a waste stream. In this study fractional condensation was employed to separate the liquid product of birch bark pyrolysis into an aqueous pyrolysis condensate (APC) and a dense biooil fraction. The APC contained high amounts (~100 g/kg) of acidic acid (AA) and was investigated for anaerobic digestion (AD). The AA in the APC could be converted to biogas, however, it contained elevated concentrations of microbial inhibitors (24 g/kg total phenolics). The inhibiting effect could be mitigated by acclimatization of the microbial population, which in turn converted some of the additional organics. The production of methane further improved with the addition of biochar to adsorb some of the inhibitors. The results imply that a waste product can be converted into a potential energy carrier.

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RESUMO Necrochorume é um efluente gerado a partir da decomposição de corpos. Em cemitérios, a principal causa de poluição subsuperficial é a sua percolação, que altera significativamente o solo, impedindo-o de realizar suas funções naturais. Particularmente no Brasil, pela falta de planejamento consequente do histórico cultural, os cemitérios se localizam totalmente integrados à malha urbana, representando um problema de saúde pública. O risco de contaminação está associado à presença de elementos, como compostos nitrogenados, metais pesados, vírus e bactérias, com riscos inerentes à saúde humana. Na literatura, esses contaminantes têm sido constantemente identificados no ambiente geológico a partir de resultados analíticos de água e solo quando comparados a uma área não impactada. A presente pesquisa objetivou investigar eventuais alterações no meio físico subsuperficial do cemitério municipal da cidade de Rio Claro, São Paulo, por meio dos resultados analíticos dos poços, apoiados por dados obtidos da técnica geofísica da sondagem elétrica vertical (SEV). Os resultados apontaram boa correlação com a evolução espacial e temporal da ocupação do cemitério ao longo de sua história.

ABSTRACT Putrefative liquid is an effluent generated from the decomposition of bodies. In cemeteries, the leading cause of subsurface pollution is the liquefaction products percolation, which substantially alter the physical-chemical and biological characteristics of the soil. In Brazil, due to the lack of consistent planning due to cultural history, cemeteries are fully integrated into urban areas, which can be a public health problem. The risk of contamination is associated with the presence of elements such as nitrogen compounds, heavy metals, viruses and bacteria, with risks to human health. In the literature, these contaminants have been consistently identified in the geological environment through analytical results of water and soil compared to non affected areas. This research aimed to investigate possible changes in the subsurface physical environment of the Rio Claro city (São Paulo, Brazil) municipal cemetery, through the analytical results of the wells, supported by data obtained from the geophysical technique of vertical electrical sounding (VES). The results showed good correlation with the spatial and temporal evolution of the occupation of the cemetery throughout its history.

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This study investigated the effect of seasonality on the Cyanobacteria community in two tropical eutrophic reservoirs in northeastern Brazil. Monthly samplings were conducted in the sub-surface of reservoirs. The following abiotic variables were analyzed: apparent color, turbidity, conductivity, alkalinity, calcium, magnesium, sodium, potassium, sulfate, total phosphorous, ammonia, nitrate, nitrite, chlorides, total hardness and chlorophyll-a, according to APHA (2012). Cyanobacteria density was quantified through biomass. Data were analyzed using one-way ANOVA and Redundancy Analysis (RDA). Higher mean values of Cyanobacteria biomass occurred in the dry (9.9mm3 L-1) and rainy (19.0mm3 L-1) season in Jucazinho and Carpina reservoirs, respectively, especially Planktothrix agardhii, Cylindrospermopsis raciborskii and Geiterinema amphibium, which occurred in 100% of the samples. RDA analysis revealed that the variables nitrite, ammonia, conductivity, calcium, sulfate, chlorides and alkalinity influenced most the Cyanobacteria community in both reservoirs. High trophic state index was observed throughout the year. Seasonality affected both biotic and abiotic variables.

Este estudo investigou o efeito da sazonalidade sobre a comunidade de cianobactérias em dois reservatórios eutróficos tropicais no nordeste do Brasil. Mensalmente, amostras foram coletadas na subsuperfície dos reservatórios. Foram analisados os seguintes fatores abióticos: cor aparente, turbidez, condutividade, alcalinidade, cálcio, magnésio, sódio, potássio, sulfato, fósforo total, amônia, nitrato, nitrito, cloretos, dureza total e clorofila-a, de acordo com APHA (2012). A densidade de cianobactérias foi quantificada por meio de sua biomassa. Os dados foram analisados usando Anova (one-way) e Análise de Redundância (RDA). Maiores valores médios de biomassa de cianobactérias ocorreram na estação seca (9,9 mm3 L-1) e chuvosa (19,0 mm3 L-1) nos reservatórios de Jucazinho e Carpina, respectivamente, especialmente Planktothrix agardhii, Cylindrospermopsis raciborskii e Geitlerinema amphibium que ocorreram em 100% das amostras. A análise de RDA revelou que os parâmetros nitrito, amônia, condutividade, cálcio, sulfato, cloretos e alcalinidade foram mais influentes na comunidade de Cyanobacteria em ambos os reservatórios. Elevado índice de estado trófico foi detectado durante todo o ano. A sazonalidade exerceu influência tanto nas variáveis bióticas como abióticas.

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This study investigated the water quality in an urban eutrophic reservoir in Northeastern Brazil, considering the influence of seasonality. Monthly, samples were collected in the sub-surface reservoir. The following abiotic variables were analyzed: temperature, pH, dissolved oxygen, apparent color, turbidity, conductivity, fluoride, total nitrogen, chlorides, total dissolved solids, total hardness, iron, copper, manganese, aluminum, chlorophyll-a and phaeophytin. Total and thermotolerant coliforms were analyzed according to APHA (2012). Cyanobacteria density was quantified through its biomass. The data were analyzed using one- way ANOVA and Pearson correlation test. Higher values mean phytoplankton biomass (26.3mm3.L-1) occurred in the dry season, especially Planktothrix agardhii and Geiterinema amphibium, which occurred in 100% of samples. High trophic state index was detected throughout the year. Seasonality exerted some influence on both biotic and abiotc variables, leading to changes in water quality of the reservoir.

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A água subterrânea é um importante recurso ao abastecimento público, principalmente para comunidades periféricas em grandes cidades ou pequenos municípios, onde a instalação ou prolongamento de sistemas de distribuição são economicamente inviáveis. Estudos voltados à análise da vulnerabilidade de aquíferos são relevantes para subsídio a políticas públicas em saneamento básico e preservação ambiental. Este estudo contou com o cadastro de 23 poços rasos localizados no município de Caçapava do Sul (RS), onde foram realizadas medidas de resistividade elétrica e cargabilidade por meio de geofísica, e medidas diretas de condutividade hidráulica e sólidos totais dissolvidos. A análise estatística dos dados demonstrou diversos graus de correlação entre parâmetros, basicamente condicionados a fatores geológicos como porosidade, permeabilidade e sólidos totais dissolvidos.

Groundwater is an important resource for the public supply, mainly for the attendance of peripheral communities in large cities or small cities, where the installation or prolongation of distribution systems is economically unfeasible. Studies related to the vulnerability analysis in aquifers are important for subsiding public policies in basic sanitation and environmental preservation. This study was supported by the cadaster of 23 shallow wells localized in Caçapava do Sul (RS). Measurements of electric resistivity and chargeability were performed by geophysical methods, direct measures of hydraulic conductivity and total dissolved solids. The data statistics analysis demonstrated several degrees among parameters, conditioned to geological factors as porosity, permeability and total dissolved solids.

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OBJECTIVE: To assess whether there has been any improvement in the quality and quantity of randomized controlled trials (RCTs) in nationally published journals through the application of standardized and validated scores. METHODS: We electronically selected all RCTs published in the two indexed Brazilian journals that focus on orthopedics, over the period 2000-2009: Acta Ortopédica Brasileira (AOB) and Revista Brasileira de Ortopedia (RBO). These RCTs were identified and scored by two independent researchers in accordance with the Jadad scale and the Cochrane Bone, Joint and Muscle Trauma Group score. The studies selected were grouped as follows: 1) publication period (2000-2004 or 2004-2009); 2) journal of publication (AOB or RBO). RESULTS: Twenty-two papers were selected: 10 from AOB and 12 from RBO. No statistically significant differences were found between the proportions (nRCT/nTotal of published papers) of RCTs published in the two journals (p = 0.458), or in the Jadad score (p = 0.722) and Cochrane score (p = 0.630). CONCLUSION: The relative quality and quantity of RCTs in the journals analyzed were similar. There was a trend towards improvement of quality, but there was no increase in the number of RCTs between the two periods analyzed.

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OBJETIVO: Verificar se houve melhora da qualidade e quantidade dos ensaios clínicos randomizados (ECRs) publicados na literatura nacional, por meio da aplicação de escores estruturados e validados na literatura. MÉTODOS: Selecionamos, eletronicamente, todas as edições das duas revistas indexadas e de escopo ortopédico da literatura nacional - Acta Ortopédica Brasileira (AOB) e Revista Brasileira de Ortopedia (RBO), no período de 2000-2009, todos os ECRs publicados. Dois pesquisadores independentes identificaram e pontuaram os ECRs de acordo com as escalas de JADAD e do grupo de trauma musculoesquelético da Colaboração Cochrane. Os trabalhos selecionados foram agrupados: 1) pelo período de publicação 2000-2004 e 2004-2009; 2) periódico de publicação (AOB e RBO). RESULTADOS: Vinte e dois trabalhos foram selecionados, sendo10 da AOB e 12 da RBO. Não houve diferença entre o número proporcional (nECR/nTotal de trabalhos publicados) de ensaios clínicos randomizados publicados nos dois periódicos (p = 0,458), assim como para os escores de JADAD (p = 0,722) e da Colaboração Cochrane (p = 0,630). CONCLUSÃO: A qualidade e quantidade relativa de ensaios clínicos randomizados nos periódicos analisados foi semelhante. Há uma tendência de melhora da qualidade; contudo, não há acréscimo da quantidade de ensaios clínicos randomizados nos dois períodos analisados.

OBJECTIVE: To assess whether there was an improvement in the quality and quantity of randomized controlled trials (RCTs) in nationally published journals through an application of standardized and validated scores. METHODS: We selected, electronically, for the period of 2000-2009, all RCTs published at the two indexed, orthopaedics-focused Brazilian journals: Acta Ortopédica Brasileira(AOB) and Revista Brasileira de Ortopedia (RBO). These RCTs were identified and scored by two independent researchers according to the JADAD scale and Cochrane Bone, Joint and Muscle Trauma Group score. The selected studies were grouped: 1) by publication period (2000-2004 and 2004-2009); 2) journal of publication (AOB and RBO). RESULTS: Twenty-two papers were selected, 10 from AOB and 12 from RBO. No statistically significant differences were found between the proportion (nRCT/nTotal of published papers) of RCTs published in the two journals (p=0.458), as well as for the JADAD score (p=0.722) and Cochrane score (p=0.630). CONCLUSION: The quality and quantity of randomized clinical trials in the period was similar in the journals analyzed. There is a trend of improvement of quality, yet there was no increase in the number of randomized clinical trials in both periods.

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Estudos geofísicos em áreas impactadas por derivados de petróleo descrevem anomalias tanto de baixa quanto de elevada resistividade, confirmada como fase contaminante por meio de análises químicas. Esta aparente contradição pode refletir processos de degradação, associada ao tempo de residência de contaminantes no meio, por meio da geração de subprodutos que alteram as propriedades físicas do meio, principalmente pela dissolução mineral por ação de ácidos orgânicos e pela neoformação de minerais de óxidos e hidróxidos de ferro. Este trabalho apresenta resultados da aplicação do método de eletrorresistividade e polarização induzida em uma área industrial contaminada por benzeno, tolueno, xileno, 1,2 dicloroetano e sais inorgânicos, em processo de atenuação natural. Os resultados indicam a neoformação mineral no centro e nas adjacências da área contaminada, conforme sugerem as alterações apontadas nos parâmetros físicos medidos.

Geophysical studies in impacted areas by petroleum products may be described by anomalies of both low and high resistivity, confirmed as contaminant by chemical analyses. This apparent contradiction can reflect processes of contaminants degradation, directly associated with its residence time in the soil, through the generation of by-products that change the physical properties of the soil and groundwater, principally for the mineral dissolution by action of organic acids and by neoformation minerals of oxides and hydroxides minerals. This paper presents the application of electrical resistivity and induced polarization methods in a contaminated industrial area for benzene, toluene, xylene, 1,2 dichloroethene and inorganic salts, in natural attenuation process. The results indicated the mineral neoformation in the center and adjacencies of contaminated area, as it suggested the alterations in physical parameters measured.

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In 2001, Buenaventura, Colombia, the rate of smear-positive pulmonary tuberculosis was of 66 per 100,000 inhabitants. The poor control of the tuberculosis in this city during the last 10 years and the inadequate use of first-line anti-tuberculosis drugs was an opportune situation for the development of high resistance to these drugs. Two surveys of initial resistance to first-line antituberculosis drugs were conducted in new cases of pulmonary TB, in the city of Buenaventura--the first from August 1, of 1997 to January 31 of 1998 and the second from November 15, of 2000 to November 15, 2001. The method of multiple proportions was used to determine drug susceptibility. Mycobacterium tuberculosis was isolated in 93% and 55% of the new cases of lung TB during each respective period. The initial resistance to at least one drug was 25% (9/36) and 32% (23/72), respectively. The initial multi-drug resistance (defined as resistance to at least isoniazid and rifampicin) was 6% for both surveys. This demonstrates the dissemination of multidrug-resistant bacilli and shows the need for surveillance of resistance to antituberculosis drugs in control of the disease, particularly in those areas where the TB control program has been erratically applied. In areas where multi-drug resistant TB occurs, the control strategy should be enhanced with the careful introduction of second-line drugs.

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La tasa de notificación de tuberculosis pulmonar bacilífera en 2001 en Buenaventura, Colombia, fue de 66 por 100.000 habitantes. El pobre control de la tuberculosis en este municipio durante los últimos 10 años y el uso inadecuado de medicamentos de primera línea hace sospechar una elevada resistencia a estas drogas antituberculosas. En este artículo se presentan y discuten los resultados de dos encuestas de resistencia inicial a drogas antituberculosas de primera línea en personas con tuberculosis pulmonar realizadas en Buenaventura entre el 1° de agosto de 1997 y el 31 de enero de 1998, y entre el 15 de noviembre de 2000 y el 15 de noviembre de 2001, con un intervalo de dos años y nueve meses. En las dos encuestas se utilizó el método de proporciones múltiples. Se logró aislar Mycobacterium tuberculosis en 93% y 55% de los casos nuevos de tuberculosis pulmonar diagnosticados en cada uno de los periodos estudiados. La resistencia inicial a cualquier medicamento antituberculoso fue de 25% (9/36) y 32% (23/72) en la primera y segunda encuesta, respectivamente. La multirresistencia inicial (definida como resistencia, al menos, a isoniacida y rifampicina) fue de 6% en ambas encuestas. Este porcentaje de resistencia encontrado demuestra la diseminación de cepas multirresistentes y destaca a la vigilancia epidemiológica de la resistencia a drogas antituberculosas como un componente esencial en el control de la enfermedad, por lo menos, en las zonas en las que el programa ha sido errático en el pasado. De esta manera, se podrán identificar las áreas en las que la estrategia DOTS deba ser reforzada con el uso de drogas de segunda línea (DOTS-plus).

In 2001, Buenaventura, Colombia, the rate of smear-positive pulmonary tuberculosis was of 66 per 100.000 inhabitants. The poor control of the tuberculosis in this city during the last 10 years and the inadequate use of first-line anti-tuberculosis drugs was an opportune situation for the development of high resistance to these drugs. Two surveys of initial resistance to first-line antituberculosis drugs were conducted in new cases of pulmonary TB, in the city of Buenaventura-the first from August 1, of 1997 to January 31 of 1998 and the second from November 15, of 2000 to November 15, 2001. The method of multiple proportions was used to determine drug susceptibility. Mycobacterium tuberculosis was isolated in 93% and 55% of the new cases of lung TB during each respective period. The initial resistance to at least one drug was 25% (9/ 36) and 32% (23/72), respectively. The initial multi-drug resistance (defined as resistance to at least isoniazid and rifampicin) was 6% for both surveys. This demonstrates the dissemination of multidrug-resistant bacilli and shows the need for surveillance of resistance to antituberculosis drugs in control of the disease, particularly in those areas where the TB control program has been erratically applied. In areas where multi-drug resistant TB occurs, the control strategy should be enhanced with the careful introduction of second-line drugs.

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O presente estudo teve como objetivo levantar a imagem corporal dos idosos internados no Servico de Geriatria do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da USP, avaliar a possibilidade de sua mudanca durante a internacao, enfocando as implicacoes do trabalho do fisioterapeuta e do psicólogo na auto-estima, na qualidade de vida do paciente e na própria atuacao da equipe. A amostra foi composta por 13 pacientes, de ambos os sexos, com idades entre 62 e 93 anos. Os instrumentos utilizados foram: avaliacao dos prontuários; procedimento de desenhos-estória com tema; ABIPEME; relatórios de avaliacao e atendimento fisioterápico. Foi realizada análise quantitativa e qualitativa, que teve como referencial teórico o enfoque psicanalítico. Observou-se que há uma discrepância entre a imagem corporal dos idosos e esquema corporal, refletindo uma dificuldade de "aceitacao/reconhecimento" do processo de envelhecimento. Pode-se concluir com o presente estudo que os pacientes, ao receberem tratamento adequado, que aborde a subjetividade, adquirem maior conscientizacao de si mesmos, deixando de idealizar imagens, prender-se ao passado e, consequentemente, abandonando estereótipos. Do ponto de vista emocional, após intervencao houve mudanca da percepcao da imagem corporal em 80 por cento dos casos e fisioterápica em 69 por cento, o que demonstra que a atuacao conjunta entre fisioterapia e psicologia é de fundamental importância na recuperacao global dos pacientes

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Os autores trataram 20 crianças, sem distinçäo de raça ou sexo, e idades variáveis desde um dia até 12 anos, acometidas de processos septicêmicos causados por bacilos Gram-negativos diversos, utilizando a Amicacina como antimicrobiano único. Em todos os casos o estudo de sensibilidade in vitro mostraram resistência a todos os antibióticos aminoglicosídios com exceçäo da Amicacina. a droga foi administrada por via intramuscular ou endovenosa, numa dose diária de 15 mg/Kg subdivididas em duas administraçöes. Nos casos em que foi usada também a via intratecal, em administraçöes diárias de 7 mg Foi obtido sucesso terapêutico em 16 casos (80%), e näo foi observada toxicdade hematológica, hepática ou renal. Estudos audiométricos näo puderam ser efetuados. Os resultados säo considerados excelentes, frente à gravidade da patologia em questäo, e o fato de muitos pacientes pertencerem às faixas etária mais baixas, aumentando com isto a severidade do prognóstico

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O autor apresenta uma análise de 126 ligaduras elásticas feitas em 54 pacientes, entre 19 e 56 anos de idade, no período de maio de 1979 a junho de 1980. É confirmada a simplicidade do método e analisados os sintomas pós-ligadura

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