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The caterpillar Anticarsia gemmatalis (Lepidoptera: Noctuidae) is a prevalent pest in soybean plantations, managed using both natural and synthetic chemical products. However, the emergence of resistance in some populations emphasizes the need to explore alternative insecticides. Flupyradifurone, a neurotoxic insecticide, has not been previously used for controlling A. gemmatalis. This study evaluated the potential of flupyradifurone in the management of A. gemmatalis. Initially, the toxicity and anti-feeding effects, as well as histopathological and cytotoxic impacts, of flupyradifurone on A. gemmatalis were evaluated. Subsequently, the indirect effects of flupyradifurone on the midgut and fat body of the predator Podisus nigrispinus (Hemiptera: Pentatomidae) were verified. The results indicate the susceptibility of caterpillars to flupyradifurone, with an LC50 of 5.10 g L-1. Furthermore, the insecticide adversely affects survival, induces an anti-feeding response, and inflicts damage on the midgut of the caterpillars. However, flupyradifurone also leads to side effects in the predator P. nigrispinus through indirect intoxication of the caterpillars, including midgut and fat body damage. While flupyradifurone demonstrates toxicity to A. gemmatalis, suggesting its potential for the chemical control of this pest, the indirect negative effects on the predator indicate the need for its controlled use in integrated pest management programs with the insecticide and the predator.

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In the original publication [...].

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This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher's exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

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ABSTRACT This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher's exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

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OBJECTIVES: The present study investigated the anti-depressive-like (anti-immobility) effect of a lectin from Moringa oleifera seeds (WSMoL) in mice. METHODS: To evaluate an acute effect, the animals were treated with WSMoL (1, 2, and 4 mg/kg, i.p.) 30 min before the tail suspension test (TST). To investigate the involvement of monoaminergic and nitrergic signaling, the mice were pre-treated with selective antagonists. The role of the WSMoL carbohydrate-recognizing domain (CRD) was verified using previous blockage with casein (0.5 mg/mL). The subacute anti-immobility effect was also evaluated by administering WSMoL (1, 2, and 4 mg/kg, i.p.) once a day for 7 d. Finally, an open field test (OFT) was performed to identify possible interferences of WSMoL on animal locomotory behavior. RESULTS: WSMoL reduced the immobility time of mice in the TST at all doses, and combined treatment with fluoxetine (5 mg/kg, i.p.) and WSMoL (1 mg/kg) was also effective. The CRD appeared to be involved in the anti-immobility effect since the solution of WSMoL (4 mg/kg) pre-incubated with casein showed no activity. The lectin effect was prevented by the pre-treatment of mice with ketanserin, yohimbine, and SCH 23390, thereby demonstrating the involvement of monoaminergic pathways. In contrast, pre-treatment with L-NAME, aminoguanidine, and L-arginine did not interfere with lectin action. WSMoL exhibited a subacute effect in the TST, thereby reducing immobility time and increasing agitation time even on the seventh day. OFT data revealed that the anti-immobility effect was not caused by interference with locomotor behavior. CONCLUSION: WSMoL elicits an anti-depressant-like effect that is dependent on monoaminergic signaling.

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After the wide oil spill reached the northeast of Brazil, the resurgence of oil was recorded and to evaluate this oil in detail, two samples collected in the state of Pernambuco in 2019 and 2021 were submitted to multiple analytical techniques. For both, we have found similar saturated biomarkers and triaromatic steroid ratios, implying that they are from the same spilled source. The n-alkanes, isoprenoids, and cycloalkanes were almost completely degraded due to evaporation, photooxidation, and/or biodegradation processes. The preferential loss of less alkylated PAHs than the more alkylated ones suggests that biodegradation was the most active process. This hypothesis is reinforced by the formation of mono and dicarboxylic acids assessed by GC × GC-TOFMS and ESI(-) FT-ICR MS high-resolution techniques. Furthermore, based on the ESI(-) FT-ICR MS results, three new ratios were proposed to evaluate the progress of the biodegradation process over time: Ox>2/O, SOx/SO, and SOx/N.

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Introdução: O uso do biomarcador procalcitonina (PCT) de forma racionalizada pode contribuir para reduzir o uso excessivo de antimicrobianos, poupar recursos e qualificar o cuidado com o paciente. Objetivo: Avaliar a eficácia da PCT na redução do tempo de tratamento com antimicrobianos e o impacto financeiro e factibilidade da incorporação desta tecnologia a partir de cenários simulados em um hospital de pequeno porte e média complexidade. Material e Métodos: Revisão da literatura, a partir da base de dados Pubmed seguida de análise de custo em quatro cenários simulados, comparando o PCR com a PCT. Foram incluídos ensaios clínicos randomizados e revisões sistemáticas cuja intervenção consistia no uso de PCT para guiar o tempo de tratamento com antimicrobianos. A seleção e extração dos dados foi realizada por quatro revisores independentes. A análise de custo foi realizada por meio de cenários simulados com os antimicrobianos de maior impacto na instituição totalizando doze terapias analisadas, a partir de dados de custos efetivamente desembolsados. Resultados: Foram selecionados 8 artigos para a análise final. A PCT possibilitou redução significativa de tempo de tratamento, redução de mortalidade, tempo de internação, eventos adversos e custos. A simulação de custo demonstrou que o cenário com PCT foi mais econômico para 67% das terapias analisadas, chegando à uma economia de até R$567,86 por tratamento, no caso da terapia combinada com meropenem, vancomicina e polimixina. Conclusão: A terapia guiada pela PCT reduz tempo de tratamento, internação e mortalidade apresentando impacto considerável na redução dos custos diretos, sendo factível a sua incorporação no cenário analisado

Introduction: The use of the procalcitonin (PCT) biomarker in a rationalized manner can contribute to reducing the excessive usage of antimicrobial, saving resources and improving patient care. Objective: To evaluate the effectiveness of PCT in reducing antimicrobial treatment time and the financial impact and feasibility of incorporating this technology based on simulated scenarios in a small and medium-complexity hospital. Material and Methods: Literature review, based on the Pubmed database followed by cost analysis in four simulated scenarios, comparing PCR with PCT test. Randomized clinical trials and systematic reviews whose intervention consisted of the use of PCT to guide the duration of antimicrobial treatment were included. Data selection and extraction was carried out by four independent reviewers. The cost analysis was carried out through simulated scenarios with the twelve therapies with the greatest impact on the institution, based on data of costs actually disbursed. Results: The final analysis included 8 articles. PCT resulted in significant reduction of duration of antibiotic treatment, reduction in mortality, length of stay, adverse events and costs. The cost simulation demonstrated that the PCT scenario was more economical for 67% of therapies analyzed, reaching savings up to R$567.86 per treatment, in the case of combined therapy with meropenem, vancomycin and polymyxin.Conclusion: PCT-guided therapy reduces treatment duration, hospitalization and mortality, presenting a considerable impact on reducing direct costs, making it feasible to incorporate it into the analyzed scenario.

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Resumo A pandemia do novo coronavírus suscita discussões sobre saúde relacionadas à proteção da vida por meio de medidas preventivas e de contenção da covid-19, sob orientação da Organização Mundial da Saúde. No Brasil, o debate perpassa os marcadores de classe, raça, gênero e etnia, expondo as vulnerabilidades a que determinados povos são submetidos historicamente, para além da ação do vírus Sars-CoV-2. Este artigo apresenta uma pesquisa documental de cunho qualitativo, acerca dos sentidos produzidos sobre a saúde da população indígena diante da pandemia da covid-19, com enfoque nas notícias publicadas no site da Articulação dos Povos Indígenas do Brasil, entre março e setembro de 2020. As 65 notícias foram organizadas em três eixos: Ações do Governo e órgãos oficiais; Questão territorial; e Organização política e resistência indígena, e analisadas com base no referencial teórico dos estudos decoloniais. Os resultados apontaram para um aumento das violações de direito dos povos originários por parte da gestão atual do governo federal, através do acirramento das crises ambientais, da morosidade e ausência de políticas públicas emergenciais contra a covid-19, evidenciando, também, a resistência destes povos, por meio de uma luta ancestral que valoriza os saberes e práticas tradicionais no cuidado em saúde.

Abstract The pandemic of the new coronavirus enables discussions about health related to protecting life by adopting covid-19 prevention and contention measures, based on the World's Health Organization guidance. In Brazil, the debate involves issues of class, race, gender, and ethnicity, exposing vulnerabilities to which certain peoples are historically submitted beyond the action of the Sars-CoV-2 virus. This article presents qualitative documental research about the meanings produced regarding the health of indigenous peoples in face of the covid-19 pandemic focusing on news reports published in the site of the Articulação dos Povos Indígenas do Brasil between March and September of 2020. The 65 publications were organized in three categories: Actions from official departments and government; Territorial issue; and Political organization and indigenous resistance, and analyzed based in theories of decolonial studies. The results point to an increase of violations of the indigenous peoples' rights by the current executive office of the federal government, by aggravating environmental crisis, the morosity and absence of emergency public policies against covid-19, also evidencing the resistance of these peoples by an ancient struggle that values knowledge and traditional healthcare practices.

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Introdução: Compreender o modo como o ensino da Saúde Coletiva (SC) tem sido inserido nos currículos da fonoaudiologia é fundamental para o entendimento dos desafios da formação de profissionais para o Sistema Único de Saúde (SUS). Objetivo: Analisar as mudanças curriculares no ensino da SC ocorridas em um curso de Fonoaudiologia na região nordeste, desde sua criação ao momento atual. Método: A coleta dos dados compreendeu a análise documental dos Projetos Políticos Pedagógicos, planos de estágio e planos de ensino do Curso de graduação em Fonoaudiologia, desde sua criação até o momento atual. Resultados: Os resultados referem que houve mudanças, mesmo que mínimas, na inserção do ensino da SC na fonoaudiologia no curso estudado com o decorrer dos anos. A principal delas foi a ampliação dos componentes curriculares que abordavam o Campo da SC, que avançaram deum componente isolado na metade do curso, para um eixo horizontal, composto de componentes que vão do primeiro ao último ano do curso. Conclusão: Apesar das lacunas foi possível observar o caminho que a graduação em fonoaudiologia tem seguido, abandonando aos poucos o modelo hospital cêntrico e se aproximando da integralidade prezada pelo SUS e do que é preconizado pelas Diretrizes Curriculares de Fonoaudiologia.

Introduction: It is essential to understand how public health teaching has been included in speech-language-hearing curricula to address the challenges of training professionals for the Unified Health System.Objective: To analyze cu rricular changes in public health teaching in a speech-language-hearing undergraduate program in Northeastern Brazil from its creation to the present. Method: Data were collected with documentary analysis of pedagogical frameworks, internship plans, and lesson plans in a speech-language-hearing program from its creation to the present. Results: The results demonstrate that changes, though slight ones, have taken place over the years in the public health teaching in the speech-language-hearing program approached in this study. The main change was the increase in public health curricular components, advancing from one component alone halfway through the program to a horizontal approach with components offered from the first to the last year of the program. Conclusion: Despite the gaps, the speech-language-hearing undergraduate program is progressively shifting from a hospital-centered model toward the comprehensive approach valued by the Unified Health System and expected in the Speech-Language-Hearing Curricular Guidelines.

Introducción: Comprender cómo se ha insertado la enseñanza de la Salud Pública (SP) en los planes de estudio de logopedia es fundamental para comprender los desafíos de la formación de profesionales para el Sistema Único de Salud (SUS). Objetivo: Analizar los cambios curriculares en la educación de la SP que se han producido en un curso de Patología del Habla y Lenguaje en la noreste región, desde su creación hasta el momento actual. Método: La recolección de datos comprendió análisis documental de Proyectos Políticos Pedagógicos, planes de pasantía y planes de enseñanza de la Carrera de Licenciatura en Patología del Habla y Lenguaje, desde su creación hasta la actualidad. Resultados:Los resultados indican que hubo cambios, aunque mínimos, en la inserción de la enseñanza de SP en logopedia en el curso estudiado a lo largo de los años. El principal fue la ampliación de los componentes curriculares que abordaban el Campo de la SP, que pasó de un componente aislado en la mitad del curso, a un eje horizontal, compuesto por componentes que van desde el primer hasta el último año del curso. Conclusión: A pesar de las brechas, se pudo observar el camino que ha seguido la graduación en logopedia, abandonando paulatinamente el modelo hospitalario y acercándose a la integralidad valorada por el SUS y lo recomendado por las Directrices Curriculares Nacionales de Fonoaudiología.

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The potential of plant lectins (carbohydrate-binding proteins) for the treatment of neurological disorders such as anxiety and depression has started to be reported in the last few years. Schinus terebinthifolia leaves contain a lectin called SteLL, which has displayed antimicrobial, immunomodulatory, antitumor, and analgesic activities. However, the effects of SteLL on the Central Nervous System (CNS) have not yet been determined. In this study, we investigated the in vivo anxiolytic effect of SteLL in mice using the open field (OF) and elevated plus maze (EPM) tests. In the OF, SteLL (1, 2, and 4 mg/kg, i.p.) did not interfere with the number of crossings but significantly reduced the number of rearings. In the EPM, SteLL 4 mg/kg and the combination SteLL (1 mg/kg) plus diazepam (1 mg/kg) significantly increased the time spent in the open arms while reducing the time spent in the closed arms. The anxiolytic effect of SteLL did not seem to be dependent on the carbohydrate-binding domain of the lectin. Nevertheless, the SteLL effect in the EPM was reversed by the pretreatment with the pharmacological antagonists of the α2-adrenoceptor, 5-HT2A/2C serotonin receptor, and the D1 dopamine receptor. Overall, our results suggest that the anxiolytic effect of SteLL is dependent on the monoaminergic signaling cascade.

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The aim of the present study was to investigate the effects of PDT using the photosensitizer 5-aminoulevulinic acid (5-ALA) in oral squamous cell carcinoma (OSCC) behavior, mainly regarding its role on the cancer stem cell (CSC) phenotypes and in maintenance of the stem cell properties. Two OSCC cell lines were used and divided in the groups: Control, 5-ALA, LED 6 J/cm2 and PDT. MTT and Neutral red assays were used to access cellular viability, cell migration was evaluated by the wound healing assay. The stem cell phenotype was analyzed by flow cytometry to evaluate the CD44high/ESAhigh, CD44high/ESAlow and CD44low populations, by the clonogenic and tumor sphere formation assays as well as by RT-qPCR. The presence of Protoporphyrin IX in each CSC fraction was evaluated by flow cytometry. The OSCC cell lines showed a significant decrease in cell viability and migration after PDT. The percentage of CD44high/ESAhigh cells decreased after PDT, which was associated with an increase in the CD44low cells and with a functional decrease in the colony and sphere formation capacity. CD44high/ESAhigh cells showed increased PpIX, which contributed for their greater sensitivity to PDT. INV gene increased significantly after PDT, indicating cellular differentiation. Altogether, our results demonstrate that 5-ALA mediated PDT decreases not only the fraction of oral CSC but also their functional capabilities, inducing their differentiation.

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Plasmodium vivax blood-stage invasion into reticulocyte is critical for parasite development. Thus, validation of novel parasite invasion ligands is essential for malaria vaccine development. Recently, we demonstrated that EBP2, a Duffy binding protein (DBP) paralog, is antigenically distinct from DBP and could not be functionally inhibited by anti-DBP antibodies. Here, we took advantage of a small outbreak of P.vivax malaria, located in a non-malarious area of Brazil, to investigate for the first time IgM/IgG antibodies against EBP2 and DEKnull-2 (an engineering DBPII vaccine) among individuals who had their first and brief exposure to P.vivax (16 cases and 22 non-cases). Our experimental approach included 4 cross sectional surveys at 3-month interval (12-month follow-up). The results demonstrated that while a brief initial P.vivax infection was not efficient to induce IgM/ IgG antibodies to either EBP2 or DEKnull-2, IgG antibodies against DEKnull-2 (but not EBP2) were boosted by recurrent blood-stage infections following treatment. Of interest, in most recurrent P. vivax infections (4 out of 6 patients) DEKnull-2 IgG antibodies were sustained for 6 to 12 months. Polymorphisms in the ebp2 gene does not seem to explain EBP2 low immunogenicity as the ebp2 allele associated with the P.vivax outbreak presented high identity to the original EBP2 isolate used as recombinant protein. Although EBP2 antibodies were barely detectable after a primary episode of P.vivax infection, EBP2 was highly recognized by serum IgG from long-term malaria-exposed Amazonians (range from 35 to 92% according to previous malaria episodes). Taken together, the results showed that individuals with a single and brief exposure to P.vivax infection develop very low anti-EBP2 antibodies, which tend to increase after long-term malaria exposure. Finally, the findings highlighted the potential of DEKnull-2 as a vaccine candidate, as in non-immune individuals anti-DEKnull-2 IgG antibodies were boosted even after a brief exposure to P.vivax blood stages.

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P2X7R is a purinergic receptor with broad expression throughout the body, especially in immune system cells. P2X7R activation causes inflammatory mediators to release, including interleukin-1ß (IL-1ß), the processing and release of which are critically dependent on this ion channel activation. P2X7R's therapeutic potential augments the discovery of new antagonistic compounds. Thus, we investigated whether the Eugenia sulcata essential oil could block P2X7R activity. The essential oil (ESO) dose-dependently inhibited ATP-promoted PI uptake and IL-1ß release with an IC50 of 113.3 ± 3.7 ng/mL and 274 ± 91 ng/mL, respectively, and the essential oil nanoemulsion (ESON) improved the ESO inhibitory effect with an IC50 of 81.4 ± 7.2 ng/mL and 62 ± 2 ng/mL, respectively. ESO and ESON reversed the carrageenan-activated peritonitis in mice, and ESON exhibited an efficacy higher than ESO. The majority substance from essential oil, ß-caryophyllene, impaired the ATP-evoked PI uptake and IL-1ß release with an IC50 value of 26 ± 0.007 ng/mL and 97 ± 0.012 ng/mL, respectively. Additionally, ß-caryophyllene reduced carrageenan-induced peritonitis, and the molecular modeling and computational simulation predicted the intermolecular interactions in the P2X7R situs. In silico, results indicated ß-caryophyllene as a potent allosteric P2X7R antagonist, although this substance may present toxic effects for humans. These data confirm the nanoemulsion of essential oil from E. sulcata as a promisor biotechnology strategy for impaired P2X7R functions and the inflammatory response.

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Introdução: Experiências de formação interprofissional no âmbito dos Núcleos Ampliados de Saúde da Família - Atenção Básica (NASF-AB) podem representar uma importante estratégia de contraposição à fragmentação do trabalho em saúde e, consequentemente, do cuidado, favorecendo a uma atuação em saúde mais eficiente, a partir das necessidades de saúde da comunidade. Objetivo: Discutir a experiência de formação interdisciplinar e interprofissional em saúde de um estudante de Fonoaudiologia vivenciada em um estágio curricular no contexto de um NASF-AB em Salvador, Bahia, Brasil. Descrição: As atividades dos estudantes foram organizadas em 5 frentes de trabalho, a saber: 1. Discussão de casos com profissionais com vistas à atualização do Planejamento Terapêutico Singular; 2. Grupos educativos voltados à prevenção; 3. Atendimentos individuais; 4. Programa Saúde na Escola; e 5. Intervenção pedagógica com profissionais. Considerações finais: A experiência de formação interprofissional no contexto do NASF-AB permitiu o desenvolvimento de competências colaborativas para o trabalho em equipe interprofissional, como a comunicação interprofissional, a clarificação de papéis, e a responsabilidade e trabalho em equipe, fundamentais para o alcance da integralidade do cuidado em saúde. Ademais, permitiu refletir sobre os limites da formação essencialmente clínica e fragmentada que hegemoniza a Fonoaudiologia no Brasil, bem como sobre sua insuficiente inserção na Atenção Primária em Saúde. Durante a experiência, outras reflexões foram suscitadas e permitiram a compreensão de conceitos importantes através da articulação teórico-prática possibilitada pela vivência em campo.

Introduction: Interprofessional training experiences in the context of the Extended Family Health and Basic Care Center (NASF-AB) may be an important strategy to counteract health work - and consequently health care - fragmentation, favoring a more effective health practice based on the community's health needs. Objective: To discuss an interdisciplinary and interprofessional health training experience of a speech-language-hearing student, which took place as a required internship at an NASF-AB in Salvador, Bahia, Brazil. Description: The students' activities were organized into 5 focuses of effort, namely: 1. Case discussions with professionals aiming to update the Unique Therapeutic Project; 2. Educational groups focused on prevention; 3. Individual attention; 4. School Health Program; and 5. Pedagogical intervention with professionals. Final considerations: The interprofessional training experience at the NASF-AB helped develop collaborative competencies for interprofessional teamwork, such as interprofessional communication, role clarification, teamwork, and responsibility, which are essential to provide comprehensive health care. It also helped reflect on the limitations of the hegemonic, essentially clinical, fragmented speech-language-hearing training in Brazil, as well as this professional's insufficient inclusion in primary health care. During the experience, other considerations arose and helped understand important concepts combining the theory and practice experience in the field.

Introducción: Las experiencias de formación interprofesional en el contexto de los Núcleos de Apoyo a la Salud de la Familia (NASF) pueden representar una importante estrategia para contrarrestar la fragmentación del trabajo en salud y, en consecuencia, de la atención, favoreciendo una acción de salud más eficiente, basada sobre las necesidades de salud de la comunidad. Objetivo: Discutir la experiencia de formación interdisciplinaria e interprofesional en salud de un estudiante de Patología del Habla y el Lenguaje con experiencia en una pasantía curricular en el contexto de un NASF en Salvador, Bahía, Brasil. Descripción: Las actividades de los estudiantes se organizaron en 5 frentes de trabajo, a saber: 1. Planificación terapéutica singular; 2. Grupos educativos enfocados a la prevención; 3. Asistencia individual; 4. Programa de salud en la escuela; y 5. Intervención pedagógica con profesionales. Consideraciones finales: La experiencia de la formación interprofesional en el contexto de NASF permitió el desarrollo de habilidades colaborativas para el trabajo en equipo interprofesional, como la comunicación interprofesional, el esclarecimiento de roles y la responsabilidad y el trabajo en equipo, fundamentales para lograr la integralidad. Además, permitió reflexionar sobre la actual formación esencialmente clínica de la Logopedia en Brasil, así como sobre su insuficiente inserción en la Atención Primaria de Salud. Durante la experiencia, se plantearon otras reflexiones que permitieron la comprensión de conceptos importantes a través de la práctica teórico-práctica, articulación posibilitada por la experiencia en el campo.

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Introduction: Tetralogy of Fallot (TOF) is a cyanotic congenital heart disease that has an incidence of sudden cardiac death of 0.2% per year, being arrhythmias the main cause of its occurrence. Objective: To compare characteristics of TOF patients referred for electrophysiological study (EPS) against those that were not (No-EPS). Method: Retrospective cohort with 215 patients (57.2% men; age = 29 ± 4) with corrected TOF (median of three years, ranging from 0.33 to 51) that underwent EPS between 2009-2020. The primary outcome was composed of death, implantable cardiac defibrillator (ICD) requirement and hospitalization. Results: Pre-syncope (EPS = 4.7%, No-EPS = 0%; p = 0.004), syncope (EPS = 7.1%, No-EPS = 1.7%; p = 0.056) and palpitations (EPS = 31%, No-EPS = 5.8%; p < 0.001) were symptoms that justified electrophysiological investigation. ICD was implanted in 24% of EPS and 0.6% of No-EPS (p=0.001). Twenty-six percent of the EPS group presented non-sustained ventricular tachycardia, while 0% in No-EPS (p = 0.012). The EPS group had more atrial fibrillation or atrial Flutter (35.7% vs. 6.9%; p < 0.001). The EPS patients had a wider QRS duration than the no-EPS group (171.12 ± 29.52 ms vs. 147 ± 29.77 ms; p < 0.001). Also, 26.2% of EPS performed ablation to correct macroreentrant atrial tachycardias. The incidence of primary outcome (death + ICD requirement + hospitalization) was higher in patients in the EPS group compared to the No-EPS group (p = 0.001). However, the total of seven deaths occurred during the clinical follow-up, but without differences between the groups (EPS = 4.7% vs. No-EPS = 2.8%; p = 0.480). Conclusion: EPS group had a profile of greater risk, more complex heart disease, and a greater occurrence of the primary outcome when compared to the No-EPS group.

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Malaria remains a major public health problem worldwide, and Plasmodium vivax is the most widely distributed malaria parasite. Naturally acquired binding inhibitory antibodies (BIAbs) to region II of the Duffy binding protein (DBPII), a P. vivax ligand that is critical for reticulocyte invasion, are associated with a reduced risk of clinical malaria. Owing to methodological issues in evaluating antibodies that inhibit the DBPII-DARC interaction, a limited number of studies have investigated DBPII BIAbs in P. vivax-exposed populations. Based on the assumption that individuals with a consistent BIAb response are characterized by strain-transcending immune responses, we hypothesized that detecting broadly reactive DBPII antibodies would indicate the presence of BIAb response. By taking advantage of an engineered DBPII immunogen targeting conserved DBPII neutralizing epitopes (DEKnull-2), we standardized a multiplex flow cytometry-based serological assay to detect broadly neutralizing IgG antibodies. For this study, a standard in vitro cytoadherence assay with COS-7 cells expressing DBPII was used to test for DBPII BIAb response in long-term P. vivax-exposed Amazonian individuals. Taken together, the results demonstrate that this DBPII-based multiplex assay facilitates identifying DBPII BIAb carriers. Of relevance, the ability of the multiplex assay to identify BIAb responders was highly accurate when the positivity for all antigens was considered. In conclusion, the standardized DBPII-based flow cytometric assay confirmed that DBPII-BIAb activity was associated with the breadth rather than the magnitude of anti-DBPII antibodies. Altogether, our results suggest that multiplex detection of broadly DBPII-reactive antibodies facilitates preliminary screening of BIAb responders.

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Acanthamoeba spp. are the causative agents of a sight-threatening infection of the cornea known as Acanthamoeba keratitis (AK). Amphotericin B - deoxycholate (AB) is used in the treatment of infectious keratitis, however, its topical administration has side effects as blepharitis, iritis, and painful instillation. In this context, the preheating of AB can decrease its toxicity by the formation of super aggregates (hAB). hAB associated with a thermoreversible in situ gelling ophthalmic system is a promising option due to the latter biocompatibility, low toxicity, and high residence time on the ocular surface. Our objective was to develop a topical ocular formulation of hAB for the treatment of AK. After heating at 70°C for 20 min, hAB was incorporated into a thermoreversible gelling system. The amebicidal activity of AB and hAB was evaluated against trophozoites and cysts of A. castellanii (ATCC 50492) and a regional clinical isolate (IC01). The results showed that the preheating of AB did not change the pharmacological action of the drug, with the amebicidal effect of AB and hAB under trophozoites and cysts of Acanthamoeba spp. The thermoreversible system remained stable, allowing the increase of drug retention time. For assessment of cytotoxicity, HUVEC (ATCC® CRL-1730) cells were challenged with AB and hAB for 48h. Cell viability was assessed, and hAB did not show cytotoxicity for HUVEC cells. As far as we know this was the first study that showed the preheated AB associated with a thermoreversible in situ gelling ophthalmic system as a promising system for topical ocular topical administration of hAB for AK therapy.

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To comprehensively understand the chemical changes over time of spilled oils subject to tropical climate conditions and the active weathering processes, a spill simulation experiment was conducted along 210 days with two distinct Brazilian oils (19 and 24 API) under irradiation and non-irradiation of sunlight. Isoprenoids and n-alkanes showed a great loss after 40 days for both oils under the two conditions due to evaporation. Diagnostic ratios of saturated biomarkers showed no changes, whereas the polycyclic aromatic hydrocarbons had a decreasing concentration under both conditions mainly due to evaporation. Furthermore, oxygenated polar compounds produced by photooxidation were investigated by ESI(-) FT-ICR MS and showed changes only for the oils exposed to sunlight irradiation. Based on the observed polar compositional changes, new parameters are suggested using heteroatom classes to estimate oil spill time under tropical conditions: NO3/NO2; NO3/(NO + NO2); ∑NOx/N1; (O4 + O3)/(O2 + O1); O4/(O2 + O1); and O3/O2.

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The Estuarine-Lagoon Complex of Iguape-Cananéia (ELCIC), a Marine Protected Area (MPA) in Brazil, was the focus of this study that aimed to relate external levels of exposure to contaminants to toxic effects on Gobioides broussonnetii fish. Different anthropogenic contaminants such as metals, polycyclic aromatic hydrocarbons (PAHs) and pharmaceuticals and personal care products (PPCPs) were analyzed in the sediments; and biochemical, histopathological and genotoxicity biomarkers evaluated in fish; in two different seasons at three sites of the estuarine region. Higher contamination of the sediments was observed near the main urban center (Iguape city - IG). Metal concentrations were considered low to moderate, while PAHs concentrations were considered low. The concentrations of PPCPs increased due to the anthropogenic presence and were higher near IG and the Cananéia Island (CI). Contributions from historical mining, agriculture, nautical activities, oil, sewage and waste disposal, biomass and fossil fuels combustion were identified. Higher concentrations of metals and PPCPs were observed during the cold-dry season, suggesting influences of the lower hydrodynamics during the season of lower precipitation. Higher PAHs concentrations occurred in the hot-rainy season, indicating influences of greater human presence in summer. In fish, biological responses followed the same spatial and seasonal pattern. More pronounced changes in antioxidant, biotransformation, histopathological and genotoxic biomarkers were observed in IG and CI. The multivariate analysis and the integrated biomarkers response index (IBR) also evidenced worse environmental conditions in these sites. This result can indicate a negative influence of anthropogenic activities on the contamination of sediments and on the biological responses of fish. This study presented the first ecotoxicological data for the species and suggested that these chronic exposures can cause adverse effects on this fish population. The data contribute to the understanding of local environmental quality and can be applied in the future to the environmental and social management of marine protected areas.

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A pandemia da Covid-19 tem provocado uma série de movimentações em diversos âmbitos da sociedade contemporânea. Podem-se destacar as áreas da economia, da ciência, da saúde e da educação como as principais atingidas por conta de uma conjuntura complexa que se apresenta no Brasil. Considerando essa conjuntura, no âmbito da educação, diferentes estratégias têm sido utilizadas para que os prejuízos na formação de novos profissionais sejam amenizados. No campo da saúde, os profissionais da área, incluindo os fonoaudiólogos, têm se deparado com um contexto sanitário pouco conhecido, evidenciando fragilidades na atuação profissional oriundas, muitas vezes, do processo de formação desses sujeitos. Diante deste cenário, e dos desafios colocados pela conjuntura de pandemia da Covid-19, a presente comunicação busca, à luz da literatura, fomentar reflexões acerca de alguns elementos que podem contribuir na construção de novos caminhos possíveis na formação do fonoaudiólogo. Nesse sentido, são abordados no texto elementos a serem modificados nas práticas pedagógicas no pós-pandemia: adoção da EIP, do currículo integrado e das metodologias ativas de ensino-aprendizagem; fortalecimento da inserção do estudante de fonoaudiologia no contexto do SUS; a educação para a cidadania, com vistas à defesa da vida, do SUS e da ciência e, por fim, a valorização docente.

The Covid-19 pandemic has provoked a series of movements in different areas of contemporary society. It is possible to highlight the areas of economics, science, health and education as the main ones affected due to a complex conjuncture that presents itself in Brazil. Considering this conjuncture, in the scope of education, different strategies have been used so that the losses in the training of new professionals are mitigated. In the health field, professionals in the field, including speech therapists, have faced a little-known health context, showing weaknesses in their professional performance, often resulting from the training process of these subjects. In view of this scenario, and of the challenges imposed by the Covid-19 pandemic situation, this communication seeks, in the light of literature, to encourage reflections on some elements that can contribute to the construction of new possible paths in the training of speech-language therapists/audiologists. In this sense, the text addresses elements to be modified in pedagogical practices in the post-pandemic: adoption of IPE, the integrated curriculum and active teaching-learning methodologies; strengthening the insertion of the speech-language therapy/audiology student in the SUS context; education for citizenship, with a view to the defense of life, SUS and science and, finally, teacher appreciation.

La pandemia de Covid-19 ha provocado una serie de movimientos en diferentes áreas de la sociedad contemporánea. Es posible destacar las áreas de economía, ciencia, salud y educación como las principales afectadas debido a una coyuntura compleja que se presenta en Brasil. En esta coyuntura, en el ámbito de la educación, se han utilizado diferentes estrategias para mitigar las pérdidas en la formación de nuevos profesionales. En el campo de la salud, los profesionales en el campo, incluidos los terapeutas del habla, se han enfrentado a un contexto de salud poco conocido, evidenciando debilidades en su desempeño profesional, como resultado del proceso de capacitación de estos sujetos. En vista de este escenario, y de los desafíos planteados por la situación de pandemia de Covid-19, esta comunicación busca, a la luz de la literatura, alentar reflexiones sobre algunos elementos que pueden contribuir a la construcción de nuevos caminos posibles en la capacitación de los terapeutas del habla. En este sentido, el texto aborda elementos para ser modificados en las prácticas pedagógicas después de la pandemia: adopción de EIP, el plan de estudios integrado y metodologías activas de enseñanza-aprendizaje; fortalecer la inserción del estudiante de terapia del habla en el contexto del SUS; educación para la ciudadanía, con vistas a la defensa de la vida, del SUS y de la ciencia y, por último, la apreciación del profesorado.

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