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Chromobacterium violaceum is commonly found in soil and freshwater within tropical and subtropical regions. Although not a common occurrence, this bacterium has the potential to cause severe diseases in humans and animals, such as liver and lung abscesses and septicemia. Herein we report the synthesis of novel N-acyl homoserine lactones (HSLs) to evaluate their effectiveness as antiquorum sensing (anti-QS) agents in C. violaceum. The HSLs were prepared through three synthetic approaches, where hexanoic acid, decanoic acid, 6-decynoic acid, or 2-hexadecynoic acid (2-HDA) was treated with commercially available l-homoserine lactone (HSL) hydrobromide in either dichloromethane or tetrahydrofuran in the presence of EDC and DMAP. The effectiveness of HSLs as anti-QS agents was assessed through susceptibility tests and violacein quantification. The most effective anti-QS inhibitor among all N-acyl-HSLs tested was the N-(2-hexadecynoyl)-l-homoserine lactone (HSL 4). Further experimental approaches, such as quantification of acyl-homoserine lactones and biofilm inhibitory tests, were carried out to determine the effect of HSL 4 on these QS-dependent mechanisms. These experiments showed that HSL 4 was highly effective at inhibiting the production of HSLs and biofilm in C. violaceum at 0.25, 0.50, and 1 mg/mL. In addition, the cytotoxicity activity was evaluated against Vero cells to determine the selectivity of HSL 4 as a nontraditional antibacterial agent. HSL 4 was not toxic against Vero cells at concentrations ranging from 0.0039 to 1 mg/mL. Molecular docking experiments were conducted to study the interactions between novel HSLs and CviR (PDB ID 3QP5), a receptor that plays a significant role in C. violaceum QS. In silico studies indicate that HSL 4 exhibits better interactions with Leu 72 and Gln 95 of the CviR binding pocket when compared to the other analogs. These results validate previous in vitro studies, such as susceptibility tests and violacein production assays. The findings above indicate that novel acetylenic HSLs may potentially be agents that combat bacterial communication and biofilm formation. However, further investigation is necessary to expand the spectrum of bacterial strains capable of resisting antibiotics through QS and evaluate the compounds' cytotoxicity in other cell lines.

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BACKGROUND: Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes. The aim of this study was to devise a system to standardize the classification and reporting of inguinal lymph node dissection perioperative complications by creating a worldwide collaborative, the complications and adverse events in lymphadenectomy of the inguinal area (CALI) group. METHODS: A modified 3-round Delphi consensus approach surveyed a worldwide group of experts in inguinal lymph node dissection for melanoma, penile and vulval cancer. The group of experts included general surgeons, urologists and oncologists (gynaecological and surgical). The survey assessed expert agreement on inguinal lymph node dissection perioperative complications. Panel interrater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. RESULTS: Forty-seven experienced consultants were enrolled: 26 (55.3%) urologists, 11 (23.4%) surgical oncologists, 6 (12.8%) general surgeons and 4 (8.5%) gynaecology oncologists. Based on their expertise, 31 (66%), 10 (21.3%) and 22 (46.8%) of the participants treat penile cancer, vulval cancer and melanoma using inguinal lymph node dissection respectively; 89.4% (42 of 47) agreed with the definitions and inclusion as part of the inguinal lymph node dissection intraoperative complication group, while 93.6% (44 of 47) agreed that postoperative complications should be subclassified into five macrocategories. Unanimous agreement (100%, 37 of 37) was achieved with the final standardized classification system for reporting inguinal lymph node dissection complications in melanoma, vulval cancer and penile cancer. CONCLUSION: The complications and adverse events in lymphadenectomy of the inguinal area classification system has been developed as a tool to standardize the assessment and reporting of complications during inguinal lymph node dissection for the treatment of melanoma, vulval and penile cancer.

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Polyamine (PA) spermidine (SPD) plays a crucial role in aging. Since SPD accumulates in glial cells, particularly in Müller retinal cells (MCs), the expression of the SPD-synthesizing enzyme spermidine synthase (SpdS) in Müller glia and age-dependent SpdS activity are not known. We used immunocytochemistry, Western blot (WB), and image analysis on rat retinae at postnatal days 3, 21, and 120. The anti-glutamine synthetase (GS) antibody was used to identify glial cells. In the neonatal retina (postnatal day 3 (P3)), SpdS was expressed in almost all progenitor cells in the neuroblast. However, by day 21 (P21), the SpdS label was pronouncedly expressed in multiple neurons, while GS labels were observed only in radial Müller glial cells. During early cell adulthood, at postnatal day 120 (P120), SpdS was observed solely in ganglion cells and a few other neurons. Western blot and semi-quantitative analyses of SpdS labeling showed a dramatic decrease in SpdS at P21 and P120 compared to P3. In conclusion, the redistribution of SpdS with aging indicates that SPD is first synthesized in all progenitor cells and then later in neurons, but not in glia. However, MCs take up and accumulate SPD, regardless of the age-associated decrease in SPD synthesis in neurons.

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Plants provide a wide array of compounds that can be explored for potential anticancer properties. Siphonochilone, a furanoterpene that represents one of the main components of the African plant Siphonochilus aethiopicus, shows numerous health benefits. However, to date, its antiproliferative properties have not been tested. The aim of this study was to analyze the cytotoxic effects of siphonochilone on a panel of cancer cell lines and its underlying mechanism of action. Our results demonstrated that siphonochilone exhibited significant cytotoxic effects on pancreatic, breast, lung, colon, and liver cancer cell lines showing a IC50 ranging from 22 to 124 µM at 72 h of treatment and highlighting its cytotoxic effect against MCF7 and PANC1 breast and pancreas cancer cell lines (22.03 and 39.03 µM, respectively). Cell death in these tumor lines was mediated by apoptosis by the mitochondrial pathway, as evidenced by siphonochilone-induced depolarization of the mitochondrial membrane potential. In addition, siphonochilone treatment involves the generation of reactive oxygen species that may contribute to apoptosis induction. In this work, we described for the first time the cytotoxic properties of siphonochilone and provided data about the molecular processes of cell death. Although future studies will be necessary, our results support the interest in this molecule in relation to their clinical application in cancer, and especially in breast and pancreatic cancer.

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The Airway section of the Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) present the Guidelines for the integral management of difficult airway in adult patients. This document provides recommendations based on current scientific evidence, theoretical-educational tools and implementation tools, mainly cognitive aids, applicable to the treatment of the airway in the field of anesthesiology, critical care, emergencies and prehospital medicine. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations and optimization in the progression of the application of strategies to preserve adequate alveolar oxygenation in order to improve safety and quality of care.

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A new eusdesmane sesquiterpenoid, characterized as 3,5,8a-trimethyl-8-oxo-4,4a,5,6,7,8,8a,9-octahydronaphtho[2,3-b]furan-5-yl acetate (1), has been isolated from the rhizomes of the South African variety of wild ginger (Siphonochilus aethiopicus (Schweinf) B. L. Burtt). The compound was obtained by silica gel column chromatography. Its structure was elucidated by nuclear magnetic resonance spectroscopy (NMR) and mass-spectrometric (MS) analyses, including 1D-, 2D-NMR, and HR-LCMS. We also investigated the cytotoxic effect of 1 on a panel of cancer cell lines, human breast, pancreas, lung, colon, and central nervous system cancer lines. The data are not encouraging since its antitumor effect is poor. Nonetheless, the discovery of new molecules may provide a source of new compounds with important biological effects applicable to the field of medicine.

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A mathematical concept, n-tuples are originally applied to medicinal chemistry, especially with the creation of scaffold diversity inspired by the hybridisation of different commercial drugs with cytarabine, a synthetic arabinonucleoside derived from two marine natural products, spongouridine and spongothymidine. The new methodology explores the virtual chemical-factorial combination of different commercial drugs (immunosuppressant, antibiotic, antiemetic, anti-inflammatory, and anticancer) with the anticancer drug cytarabine. Real chemical combinations were designed and synthesised for 8-duples, obtaining a small representative library of interesting organic molecules to be biologically tested as proof of concept. The synthesised library contains classical molecular properties regarding the Lipinski rules and/or beyond rules of five (bRo5) and is represented by the covalent combination of the anticancer drug cytarabine with ibuprofen, flurbiprofen, folic acid, sulfasalazine, ciprofloxacin, bortezomib, and methotrexate. The insertion of specific nomenclature could be implemented into artificial intelligence algorithms in order to enhance the efficiency of drug-hunting programs. The novel methodology has proven useful for the straightforward synthesis of most of the theoretically proposed duples and, in principle, could be extended to any other central drug.

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Among the most harmful tumors detected in the human body, such as breast, colon, brain or pancreas, breast (BC) and colorectal cancer (CRC) are the first and third most frequent cancer worldwide, respectively. The current existing chemotherapeutic treatments present serious side effects due to their intravenous administration can induce cytotoxicity in healthy cells. Thus, new treatment methods based on drug-loaded polymeric nanofibers (NFs) have gained significant potential for their use in localized cancer chemotherapy. Here, a deep in vitro comparative analysis between maslinic acid (MA) and a tyramine-maslinic acid (TMA) derivative is initially performed. This analysis includes a proliferation, and a cell cycle assay, and a genotoxicity, antiangiogenic and apoptosis study. Then, the TMA derivative has been incorporated into electrospun polymeric NFs obtaining an implantable dressing material with antitumor activity. Two types of patches containing TMA-loaded polymeric NFs of poly(caprolactone) (PCL), and a mixture of polylactic acid/poly(4-vinylpyridine) (PLA/PVP) were fabricated by the electrospinning technique. The characterization of the drug-loaded NFs showed an encapsulation capacity of 0.027 mg TMA/mg PCL and 0.024 mg TMA/mg PLA/PVP. Then, the cytotoxic activity of both polymeric systems was tested in CRC (T84), BC (MCF-7) and a no tumor (L929) cell lines exposed to TMA-loaded NFs and blank NFs for 48 h. Moreover, cell cycle assay, genotoxicity, angiogenesis and apoptosis tests were carried out to study the mechanism of action of TMA. Blank NFs showed no-toxicity in all cell lines tested and both drug-loaded NFs significantly reduced cell proliferation (relative proliferation of ≈44 % and ≈25 % respectively). Therefore, TMA was less genotoxic than maslinic acid (MA), and reduced VEGFA expression in MCF-7 cells (1.32 and 2.12-fold for MA and TMA respectively). These results showed that TMA-loaded NFs could constitute a promising biocompatible and biodegradable nanoplatform for the local treatment of solid tumors such as CRC or BC.

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Foraging is a behavioural process and, therefore, individual behaviour and diet are theorized to covary. However, few comparisons of individual behaviour type and diet exist in the wild. We tested whether behaviour type and diet covary in a protected population of Atlantic cod, Gadus morhua. Working in a no-take marine reserve, we could collect data on natural behavioural variation and diet choice with minimal anthropogenic disturbance. We inferred behaviour using acoustic telemetry and diet from stable isotope compositions (expressed as δ13 C and δ15 N values). We further investigated whether behaviour and diet could have survival costs. We found cod with shorter diel vertical migration distances fed at higher trophic levels. Cod δ13 C and δ15 N values scaled positively with body size. Neither behaviour nor diet predicted survival, indicating phenotypic diversity is maintained without survival costs for cod in a protected ecosystem. The links between diet and diel vertical migration highlight that future work is needed to understand whether the shifts in this behaviour during environmental change (e.g. fishing or climate), could lead to trophic cascades.

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Knowledge of biodiversity is unevenly distributed across the Tree of Life. In the long run, such disparity in awareness unbalances our understanding of life on Earth, influencing policy decisions and the allocation of research and conservation funding. We investigated how humans accumulate knowledge of biodiversity by searching for consistent relationships between scientific (number of publications) and societal (number of views in Wikipedia) interest, and species-level morphological, ecological, and sociocultural factors. Across a random selection of 3019 species spanning 29 Phyla/Divisions, we show that sociocultural factors are the most important correlates of scientific and societal interest in biodiversity, including the fact that a species is useful or harmful to humans, has a common name, and is listed in the International Union for Conservation of Nature Red List. Furthermore, large-bodied, broadly distributed, and taxonomically unique species receive more scientific and societal attention, whereas colorfulness and phylogenetic proximity to humans correlate exclusively with societal attention. These results highlight a favoritism toward limited branches of the Tree of Life, and that scientific and societal priorities in biodiversity research broadly align. This suggests that we may be missing out on key species in our research and conservation agenda simply because they are not on our cultural radar.

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Understanding population dynamics, movements, and fishing mortality is critical to establish effective shark conservation measures across international boundaries in the ocean. There are few survival and dispersal estimates of juveniles of oceanic shark species in the North Atlantic despite it being one of the most fished regions in the world. Here we provide estimates of dispersal, survival, and proportion of fishing mortality in the North Atlantic for two threatened oceanic sharks: the blue shark (Prionace glauca) and the shortfin mako shark (Isurus oxyrinchus). Our results are based on multi-event models applied to tag-recovery data of 700 blue sharks and 132 shortfin makos tagged over a decade. A total of 60 blue sharks (8.57% of tagged) and 30 makos (22.73%) were recovered by the longline fishery between 2009 and 2017. Tag-reporting rate (percentage of returned information when a tagged shark was caught) was estimated to be high (0.794 ± 0.232 SE). Mean annual survival, as predicted from the models, was higher for blue shark (0.835 ± 0.040 SE) than for shortfin mako (0.618 ± 0.189 SE). Models predicted that fishing caused more than a half of total mortality in the study area for both species (0.576 ± 0.209), and more than a third of tagged individuals dispersed from the study area permanently (0.359 ± 0.073). Our findings, focused mainly on juveniles from oceanic areas, contribute to a better understanding of shark population dynamics in the North Atlantic and highlight the need for further conservation measures for both blue shark and shortfin mako, such as implementing efficient bycatch mitigation measures and static/dynamic time-area closures in the open ocean.

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Marine organisms have gained considerable biotechnological interest in recent years due to their wide variety of bioactive compounds with potential applications. Mycosporine-like amino acids (MAAs) are UV-absorbing secondary metabolites with antioxidant and photoprotective capacity, mainly found in organisms living under stress conditions (e.g., cyanobacteria, red algae, or lichens). In this work, five MAAs were isolated from two red macroalgae (Pyropia columbina and Gelidium corneum) and one marine lichen (Lichina pygmaea) by high-performance countercurrent chromatography (HPCCC). The selected biphasic solvent system consisted of ethanol, acetonitrile, saturated ammonium sulphate solution, and water (1:1:0.5:1; v:v:v:v). The HPCCC process for P. columbina and G. corneum consisted of eight separation cycles (1 g and 200 mg of extract per cycle, respectively), whereas three cycles were performed for of L. pygmaea (1.2 g extract per cycle). The separation process resulted in fractions enriched with palythine (2.3 mg), asterina-330 (3.3 mg), shinorine (14.8 mg), porphyra-334 (203.5 mg) and mycosporine-serinol (46.6 mg), which were subsequently desalted by using precipitation with methanol and permeation on a Sephadex G-10 column. Target molecules were identified by HPLC, MS, and NMR.

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Polyamines (PAs) in the nervous system has a key role in regeneration and aging. Therefore, we investigated age-related changes in the expression of PA spermidine (SPD) in the rat retina. Fluorescent immunocytochemistry was used to evaluate the accumulation of SPD in retinae from rats of postnatal days 3, 21, and 120. Glial cells were identified using glutamine synthetase (GS), whereas DAPI, a marker of cell nuclei, was used to differentiate between retinal layers. SPD localization in the retina was strikingly different between neonates and adults. In the neonatal retina (postnatal day 3-P3), SPD is strongly expressed in practically all cell types, including radial glia and neurons. SPD staining showed strong co-localization with the glial marker GS in Müller Cells (MCs) in the outer neuroblast layer. In the weaning period (postnatal day 21-P21), the SPD label was strongly expressed in all MCs, but not in neurons. In early adulthood (postnatal day 120-P120), SPD was localized in MCs only and was co-localized with the glial marker GS. A decline in the expression of PAs in neurons was observed with age while glial cells accumulated SPD after the differentiation stage (P21) and during aging in MC cellular endfoot compartments.

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BACKGROUND: Several factors impact the preservation of renal function after partial nephrectomy. Warm ischemia time is the main modifiable surgical factor. Renorrhaphy represents the key of hemostasia, but it is associated with increase of warm ischemia time and complications. The aim of this study was to describe our initial surgical experience with a new surgical technique for sutureless partial nephrectomy, based on the application of our own developed renal-sutureless-device-RSD. METHODS: Between 2020-2021, 10 patients diagnosed with renal cell carcinoma stage cT1a-b cN0M0 with an exophytic component were operated using renal-sutureless-device-RSD. Surgical technique of sutureless partial nephrectomy with renal-sutureless-device-RSD is described in a step-by-step fashion. Clinical data was collected in a dedicated database. Presurgical, intraoperative, postoperative variables, pathology and functional results were evaluated. Medians and ranges of values for selected variables were reported as descriptive statistics. RESULTS: Partial nephrectomy was carried out with the use of renal-sutureless-device-RSD without renorrhaphy in all cases (70%cT1a-30%cT1b). Median tumor size was 3.15 cm (IQR: 2.5-4.5). R.E.N.A.L Score had a range between 4a-10. Median surgical time was 97.5 minutes (IQR 75-105). Renal artery clamping was only required in 4 cases, with a median warm ischemia time of 12.5 minutes (IQR 10-15). No blood transfusion, intraoperative and postoperative complications were noted. Free-of-disease margin rate achieved was 90%. Median length of stay was 2 days (IQR 2-2). Laboratory data on hemoglobin and hematocrit levels, as well as renal function tests, remained stable after partial nephrectomy. CONCLUSIONS: Our initial experience suggests that a sutureless PN using the RSD device is feasible and safe. Further investigation is needed to determine the clinical benefit of this technique.

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A series of dithienylethene (DTE) photoswitches with aza-heteroaromatic cationic moieties is synthesized. The switches are characterized regarding their photochemical and photophysical properties in acetonitrile and in water. The efficiency of the switching and the photostationary state composition depend on the degree of π-conjugation of the heteroaromatic systems. Thus, DTEs with acridinium-derived moieties have very low quantum yields for the ring-closing process, which is in contrast to switches with pyridinium and quinolinium moieties. All switches emit fluorescence in their open forms. The involved electronic transitions are traced back to an integrative picture including the DTE core and the cationic arms. The emission can be fine-tuned by the π-conjugation of the heteroaromatic cations, reaching the red spectral region for DTEs with acridinium moieties. On ring-closing of the DTEs the fluorescence is not observable anymore. Theoretical calculations point to rather low-lying energy levels of the highly conjugated ring-closed DTEs, which would originate near-infrared emission (> 1200 nm). The latter is predicted to be very weak due to the concurrent non-radiative deactivation, according to the energy-gap law. In essence, an ON-OFF fluorescence switching as the result of the electrocyclic ring-closing reaction is observed.

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The one-pot reaction of a chiral aldehyde, p-methoxyaniline or p-fluoroaniline, and triethylborane produces the corresponding alkylated chiral amine with high yields and diastereoisomeric ratios. Stereocontrol is induced by the presence of a heteroatom in the α-position to the aldehyde. In the case of alkylation of imines derived from chiral aliphatic amines, good yields and moderate to high diastereoselectivity are obtained: yields are significantly better when the preformed imine is used in the reaction with triethyl borane, and diastereoselectivity of the reactions largely depends on the structure of the chiral aliphatic amine. The methodology is successfully applied to the synthesis of romneine, a natural benzylisoquinoline.

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The effects of marine reserves on the life history and demography of the protected populations are well-established, typically increasing population density and body size. However, little is known about how marine reserves may alter the behavior of the populations that are the target of protection. In theory, marine reserves can relax selection on spatial behavioral phenotypes that were previously targeted by the fishery and also drive selection in favor of less mobile individuals. In this study, we used acoustic telemetry to monitor the individual spatial behavior of 566 Atlantic cod (Gadus morhua Linnaeus, 1758) moving within a marine reserve and a control site in southern Norway, starting 1 year before the implementation of the marine reserve and lasting up to 9 years after. Following a before-after-control-impact approach, we investigated changes in (1) survival, (2) selection acting on behavioral traits, and (3) mean behavioral phenotypes, after the implementation of the marine reserve. We focused on three behavioral traits commonly used to describe the mobility of aquatic animals: home range size, depth position, and diel vertical migration range. Survival increased after reserve implementation, but contrary to our expectations, it subsequently decreased to preprotection levels after just 3 years. Further, we found no significance in selection patterns acting on any of the three behavioral traits after reserve implementation. Although some changes related to water column use (the tendency to occupy deeper waters) were observed in the marine reserve after 9 years, they cannot unequivocally be attributed to protection. Our results show that survival and behavioral responses to marine reserves in some cases may be more complex than previously anticipated and highlight the need for appropriately scaled management experiments and more integrated approaches to understand the effects of marine protected areas on harvested aquatic species.

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Methicillin-resistant Staphylococcus aureus is a pathogen responsible for skin and wound infections, pneumonia, and bloodstream infections. Serious attention is needed because Methicillin-resistant S. aureus is also resistant to many other commonly used antibiotics. This study explores the potential of vinyl halogenated fatty acids as antibacterial agents. Specifically, the total synthesis of vinyl halogenated fatty acids was performed to investigate their antibacterial activity against clinical isolates of methicillin-resistant S. aureus. The novel synthesis of the vinyl halogenated fatty acids was carried out by treating either 2-dodecynoic acid or 2-hexadecynoic acid with an allyl halide and 5 mol% of bis(benzonitrile)palladium (II) chloride as catalyst. Our results demonstrate that vinyl halogenated fatty acids displayed significant antibacterial activity against clinical isolates of methicillin-resistant S. aureus and low cytotoxicity against eukaryotic Vero Cells. Moreover, it was demonstrated that vinyl brominated fatty acids could disrupt the S. aureus plasma membrane and inhibit the expression of the norB gene.

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The ocean is a key component of the Earth's dynamics, providing a great variety of ecosystem services to humans. Yet, human activities are globally changing its structure and major components, including marine biodiversity. In this context, the United Nations has proclaimed a Decade of Ocean Science for Sustainable Development to tackle the scientific challenges necessary for a sustainable use of the ocean by means of the Sustainable Development Goal 14 (SDG14). Here, we review how Acoustic animal Tracking, a widely distributed methodology of tracking marine biodiversity with electronic devices, can provide a roadmap for implementing the major Actions to achieve the SDG14. We show that acoustic tracking can be used to reduce and monitor the effects of marine pollution including noise, light, and plastic pollution. Acoustic tracking can be effectively used to monitor the responses of marine biodiversity to human-made infrastructures and habitat restoration, as well as to determine the effects of hypoxia, ocean warming, and acidification. Acoustic tracking has been historically used to inform fisheries management, the design of marine protected areas, and the detection of essential habitats, rendering this technique particularly attractive to achieve the sustainable fishing and spatial protection target goals of the SDG14. Finally, acoustic tracking can contribute to end illegal, unreported, and unregulated fishing by providing tools to monitor marine biodiversity against poachers and promote the development of Small Islands Developing States and developing countries. To fully benefit from acoustic tracking supporting the SDG14 Targets, trans-boundary collaborative efforts through tracking networks are required to promote ocean information sharing and ocean literacy. We therefore propose acoustic tracking and tracking networks as relevant contributors to tackle the scientific challenges that are necessary for a sustainable use of the ocean promoted by the United Nations.

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A criação e implantação do Programa Mais Médicos (PMM), a partir de 2013, têm estimulado a realização de um conjunto de pesquisas sobre os diversos eixos temáticos ­ provimento médico, formação e supervisão acadêmica e melhoria da infraestrutura da Atenção Básica. Os estudos também abordam as discussões políticas em torno dos objetivos e das estratégias de implementação do programa, inclusive a contratação de médicos estrangeiros, aspecto polêmico que gerou a redefinição do PMM na conjuntura mais recente, com sua substituição pelo Programa Mais Médicos para o Brasil (PMMB). Este artigo apresenta os resultados de uma revisão da literatura sobre o programa, publicada nos últimos cinco anos, tratando de atualizar um mapeamento da produção científica sobre o PMM que cobriu o período de 2013 a 2016. O levantamento dos artigos mais recentes foi feito em duas bases de dados ­ Biblioteca Virtual em Saúde (BVS) e Plataforma de Periódicos Capes ­ tendo sido selecionados 135 artigos, que foram classificados e analisados segundo sua distribuição temporal, tipo de estudo e temas e subtemas abordados. Os resultados evidenciam a manutenção do interesse da comunidade científica da área de saúde pública/saúde coletiva em acompanhar e avaliar o processo de implementação desse programa, devido a sua importância estratégica no processo de fortalecimento e melhoria da qualidade da Atenção Básica de Saúde no Sistema Único de Saúde (SUS). Nessa perspectiva, são apontados os avanços e as dificuldades enfrentadas pelos gestores e profissionais envolvidos no processo de implantação, contribuindo, assim, para o aprofundamento do debate em torno das estratégias a serem acionadas e aperfeiçoadas.

Created and implemented in 2013, the Mais Médicos Program (PMM) has stimulated research on various thematic axes ­ medical provision, academic education and advisement, and improvement of Primary Care infrastructure. Studies also address the political discussions on the objectives and implementation strategies of the Program, including the hiring of foreign doctors, a controversial aspect that led to its redefinition in the most recent juncture and replacement by the Mais Médicos Program for Brazil (PMMB). This integrative review focuses on the literature produced about the program, published in the last five years, for a updated mapping of the scientific production on PMM which covered the period from 2013 to 2016. Literature search was carried out in the Virtual Health Library (VHL) and Periódicos Capes Platform databases, returning 135 articles that were selected, classified, and analyzed according to year of publication, type of study, and themes and subthemes addressed. Results show a recurring interest of the public health / collective health scientific community in monitoring and evaluating PMM's implementation process, due to its strategic importance in the process of strengthening and improving the quality of SUS Primary Health Care. In this regard, they point out advancements and the difficulties faced by managers and professionals involved in the implementation process, thus furthering the debate on the strategies to be put into practice and improved.

La creación e implementación del Programa Más Médicos (PMM) a partir de 2013 ha promovido un conjunto de estudios e investigaciones sobre los diversos ejes temáticos ­provisión médica, formación académica y supervisión, y mejoramiento de la infraestructura de la Atención Primaria. Los estudios también plantean discusiones políticas sobre los objetivos y estrategias de implementación del programa, incluida la contratación de médicos extranjeros, aspecto controvertido que llevó a la redefinición del PMM en la coyuntura más reciente, con su sustitución por el Programa Más Médicos para Brasil (PMMB). Este artículo presenta los resultados de una revisión de la literatura sobre el programa, publicada en los últimos cinco años, y trata de actualizar con un mapeo de la producción científica sobre el PMM que abarcó el período 2013-2016. Se realizó una búsqueda de los artículos más recientes en dos bases de datos ­Biblioteca Virtual en Salud (BVS) y Plataforma de Periódicos Capes ­, lo que resultó en la selección, clasificación y análisis de 135 artículos según su distribución temporal, tipo de estudio, temas y subtemas abordados. Los resultados muestran que el interés de la comunidad científica del área de salud pública/salud colectiva se mantuvo en el seguimiento y evaluación del proceso de implementación de este Programa, por su importancia estratégica en el proceso de fortalecimiento y mejora de la calidad de la Atención Primaria de Salud en el Sistema Único de Salud (SUS). Desde esta perspectiva, se señalan los avances y dificultades enfrentados por los gestores y profesionales involucrados en el proceso de implementación, contribuyendo con un debate enfocado en las estrategias que deben ser impulsadas y perfeccionadas.

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