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Species of Haemogregarina are blood parasites known to parasitise vertebrate hosts, including fishes (Haemogregarina sensu lato) and freshwater turtles (Haemogregarina sensu stricto). Their vectors, include gnathiid isopods and leeches, respectively. In turtles, Haemogregarina balli has the best-characterized life cycle in the genus. However, no studies in Brazil have suggested a possible vector for any species of Haemogregarina from freshwater turtles. Therefore, in the present study, we provide insights into a leech vector based on specimens found feeding on two species of freshwater turtles, Podocnemis unifilis and Podocnemis expansa, using morphological and molecular data. In 2017 and 2019, freshwater turtles were collected in Goiás State, Brazil. Hosts were inspected for ectoparasites and leeches were collected from two specimens of P. expansa and nine specimens of P. unifilis. Leeches were subsequently identified as members of the genus Unoculubranchiobdella. Leech histological slides revealed haemogregarine-like structures, similar to post-sporogonic merogony, found near the gills and within the posterior sucker. Molecular analysis of the haemeogregarines resulted in the identification of three species of Haemogregarina: Haemogregarina embaubali, Haemogregarina goianensis, and Haemogregarina brasiliana. Therefore, our findings, based on morphology and DNA data suggest leeches of the genus Unoculubranchiondella as vectors for at least three species of Haemogregarina from Brazilian turtles.

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Hepatozoon spp. are the most common haemoparasites reported from reptiles around the world, however, only six species have been described infecting crocodilians. In Brazil, Hepatozoon caimani Carini, 1909 is currently the only recognized species from the caiman hosts. This study provides new data on the diversity of species of Hepatozoon infecting Caiman crocodilus (Linnaeus) using molecular data and phylogenetic analysis, with additional support of morphological data of developmental stages from host blood and tissue. Forty-four individuals were collected and screened for haemogregarines, and blood and tissue samples were analysed by light microscopy with 31 (70.45%) infected. Hepatozoon spp. blood developmental stages included immature and mature gamonts with or without cytoplasmic vacuoles and free gamonts. Additionally, merogonic developmental stages were found in the liver and spleen of infected hosts. Based on the morphological and molecular data, this study identified two possible different species of Hepatozoon, being one of them the H. caimani with intragenotypic divergence.

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Haemogregarine (Apicomplexa: Adeleorina) parasites are considered to be the most common and widespread haemoparasites in reptiles. The genus Hepatozoon (Apicomplexa: Adeleorina: Hepatozoidae) can be found parasitizing a broad range of species and, in reptiles, they infect mainly peripheral blood erythrocytes. The present study detected and characterized a haemogregarine isolated from the lizard species, Ameiva ameiva, collected from the municipality of Capanema, Pará state, north Brazil. Blood smears and imprints from lungs, brain, heart, kidney, liver, bone marrow and spleen were observed using light microscopy and the parasite was genetically identified by molecular analysis. Morphological, morphometric and molecular data were obtained. Parasite gamonts were found in 49.5% (55/111) of the blood smears from A. ameiva, and were characterized as oval, averaging 12.0 ± 0.8 × 5.9 ± 0.6 µm2 in size, which displaced the nuclei of parasitized monocytes laterally. Parasite forms resembling immature gamonts were observed in the spleen and bone marrow of the lizards. Furthermore, phylogenetic analyses of 18S rRNA sequences did not reveal gene similarity with other Hepatozoon spp. sequences from reptiles. Thus, morphological and molecular analyses have identified a new species of Hepatozoon parasite, Hepatozoon lainsoni sp. nov., which infects monocytes of the A. ameiva lizard.

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AbstractExplaining diversity in tropical forests remains a challenge in community ecology. Theory tells us that species differences can stabilize communities by reducing competition, while species similarities can promote diversity by reducing fitness differences and thus prolonging the time to competitive exclusion. Combined, these processes may lead to clustering of species such that species are niche differentiated across clusters and share a niche within each cluster. Here, we characterize this partial niche differentiation in a tropical forest in Panama by measuring spatial clustering of woody plants and relating these clusters to local soil conditions. We find that species were spatially clustered and the clusters were associated with specific concentrations of soil nutrients, reflecting the existence of nutrient niches. Species were almost twice as likely to recruit in their own nutrient niche. A decision tree algorithm showed that local soil conditions correctly predicted the niche of the trees with up to 85% accuracy. Iron, zinc, phosphorus, manganese, and soil pH were among the best predictors of species clusters.

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BACKGROUND: Leptospirosis represents a One Health issue, affecting humans and animals. This study investigated pathogenic leptospires in small wild rodents in São Paulo, Brazil. METHODS: Kidney samples from 164 rodents underwent qPCR testing, targeting pathogenic Leptospira spp. RESULTS: Thirty-five animals (21.34%) tested positive, including five rodent species: Akodon montensis (2/21; 9.5%), Necromys lasiurus (1/4; 25%), Oligoryzomys nigripes (24/92; 26.1%), Oligoryzomys flavescens (5/26; 19.2%), and Sooretamys angouya (3/14; 21.4%). Botucatu municipality exhibited the highest prevalence, with 42.5% (20/47) of the animals testing positive. CONCLUSIONS: The presence of Leptospira spp. in wild rodents suggests they may be chronic carriers, contaminating the environment.

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Objetivo: analisar o perfil sociodemográfico e comparar as diferenças das características de mulheres com alterações citológicas de alto grau em um serviço da atenção secundária. Método: estudo transversal retrospectivo de 2017 a 2021 realizado em 160 prontuários (CAAE 51800621.3.0000.5240). Resultados: predominaram mulheres com média de idade 40,7 anos, escolaridade abaixo do ensino médio, tiveram um a três filhos, não utilizavam preservativos e anticoncepcionais, não tabagistas e com alterações citopatológicas alto grau. As características com maiores percentuais para lesões citopatológicas de alto grau foram mulheres com quatro ou mais gestações, idade do parto menor ou igual a 18 anos, coitarca menor ou igual a 15 anos e tabagistas. Conclusão: serviços da rede de atenção, especialmente da atenção primária à saúde, devem capacitar permanentemente os profissionais visando cumprimento de fluxos assistenciais preconizadas pelas recomendações das diretrizes brasileiras de rastreamento da neoplasia cérvico-uterina atentando ao perfil encontrado de mulheres encaminhadas a atenção secundária.(AU)

Objective: analyzes the sociodemographic profile and compare the differences in the characteristics of women with high-grade cytological alterations in a secondary care service. Method: retrospective cross-sectional study from 2017 to 2021 carried out in 160 medical records (CAAE 51800621.3.0000.5240). Results: women predominated with a mean age of 40.7 years, education below high school, had one to three children, did not use condoms and contraceptives, non-smokers and with high-grade cytopathological alterations. The characteristics with the highest percentages for high-grade cytopathological lesions were women with four or more pregnancies, age at birth less than or equal to 18 years, coitarche less than or equal to 15 years, and smokers. Conclusion: services of the care network, especially primary health care, should permanently train professionals in order to comply with the care flows recommended by the recommendations of the Brazilian guidelines for screening cervical uterine neoplasia, paying attention to the profile found of women referred to secondary care.(AU)

Objetivo: analizar el perfil sociodemográfico y comparar las diferencias en las características de mujeres con alteraciones citológicas de alto grado en un servicio de segundo nivel de atención. Método: estudio transversal retrospectivo de 2017 a 2021 realizado en 160 historias clínicas (CAAE 51800621.3.0000.5240). Resultados: predominaron las mujeres con edad media de 40,7 años, escolaridad inferior a la secundaria, con uno a tres hijos, no usuarias de preservativo y anticonceptivos, no fumadoras y con alteraciones citopatológicas de alto grado. Las características con mayor porcentaje de lesiones citopatológicas de alto grado fueron mujeres con cuatro o más embarazos, edad al nacer menor o igual a 18 años, coitarquia menor o igual a 15 años y fumadoras. Conclusión: servicios de la red de atención, especialmente la atención primaria a la salud, deben capacitar permanentemente a los profesionales para cumplir con los flujos de atención recomendados por las recomendaciones de las directrices brasileñas para el tamizaje de la neoplasia cérvico-uterina, prestando atención al perfil encontrado de las mujeres referidas atención secundaria.(AU)

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The aim was to identify constraining and enabling factors related to the organization of health care networks that influence access to oral cancer diagnosis and treatment. A case study in the "Metropolitan I" health region using data collected from health information systems and 26 semi-structured interviews with health managers and professionals. The data were analyzed using descriptive statistics and strategic conduct analysis, drawing on the theory of structuration proposed by Giddens. The findings reveal that coverage of oral health care in primary care services is generally low and prioritizes specific groups and urgent cases, hampering access to oral cancer diagnosis. While the presence of a network of secondary care services in the municipalities that make up the health region facilitates diagnosis, there are major barriers to treatment. Informal partnerships established with dental schools play an important role in diagnosis, but do not receive funding. The regulation of appointments for diagnosis was not restrictive. In contrast, the regulation of referrals for treatment lacked transparency, was subject to long delays, and shortage of places. Despite advances, constraining factors related to structure and the actions of agents involved in the care process persist, hampering the timely diagnosis and treatment of oral cancer.

O objetivo foi identificar os fatores facilitadores e coercitivos da organização da rede de atenção à saúde que intervêm sobre o acesso ao diagnóstico e tratamento do câncer bucal. Um estudo de caso da região de saúde Metropolitana I do estado do Rio de Janeiro, com coleta de dados em sistemas de informação e 26 entrevistas com gestores e profissionais. A análise dos dados foi realizada por meio das técnicas de estatística descritiva e análise temática, à luz da Teoria da Estruturação de Giddens. Identificou-se baixa cobertura de saúde bucal na atenção básica, com priorização do acesso a grupos prioritários e urgências, dificultando o acesso ao diagnóstico do câncer bucal neste nível de atenção. A presença da rede secundária em todos os municípios da região facilita o diagnóstico, porém há limites para o acesso ao tratamento. Faculdades de odontologia atuam no diagnóstico como rede informal, ação importante, mas não financiada. A regulação para o diagnóstico não foi restritiva, mas para o tratamento a regulação foi considerada pouco transparente e demorada, com falta de vagas. Apesar dos avanços, persistem fatores coercitivos estruturais e nas ações dos agentes que restringem diagnóstico e tratamento oportuno do câncer bucal.

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During a parasite survey in Brazilian amphibians from São Paulo state, Brazil, Gorgoderina parvicava Travassos, 1922 was found in the urinary bladder (11 adult worms) and (five juvenile worms) in the kidneys of the pepper-frog Leptodactylus labyrinthicus (Spix, 1824). Parasites were examined by microscopy and 28S rDNA and COI gene were sequenced and analyzed for the molecular study. The phylogenetic reconstructions resulted in identical topologies with highly supported values in the nodes in most clades using Maximum likelihood and Bayesian inference methods and positioned G. parvicava in the subclade formed by species of subfamily Gorgoderinae parasitizing the urinary bladder of amphibians. Molecular phylogenetic data showed that this species is related to other species of Gorgoderina. In addition, new molecular data and the analyses of genetic distances provide extra comparative data, which can be applied in further investigations on the taxonomic status and the diversity among Gorgoderina spp. and host-parasite relationships.

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About 20 valid species of the genus Rhabdias are known in the Neotropical region. The present study aimed to describe two new species of Rhabdias parasitizing the lungs of Leptodactylus macrosternum and Leptodactylus podicipinus from Brazil. Distinctive characteristics between these species are numerous and based on body size, size of the buccal capsule, shape and size of the oesophagus, and position of the vulva. Molecular data based on ribosomal genes 28S and ITS region and mitochondrial COI of the two species are presented. Molecular analysis and comparison of the partial mitochondrial COI sequence of Rhabdias matogrossensis n. sp. and Rhabdias guaianensis n. sp. revealed a genetic divergence between these new species and the sequences of Rhabdias spp. previously deposited in GenBank. In the phylogenetic analysis, R. matogrossensis n. sp. was grouped with R. breviensis species complex, and R. guaianensis n. sp. was grouped as a sister group of R. cf. stenochepala. This study contributes to improving the diversity of known species of Rhabdias described in Brazilian anurans.

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PURPOSE: Brazilian anurans are considered the most diverse and species rich around the world. Although in recent years there has been a strong focus on research related to this group of animals, their parasites have not received the same attention. Thus, this study aimed to provide morphological and molecular data on haemogregarines biodiversity infecting Brazilian anurans. METHODS: During 2020, 116 anurans were collected from four Brazilian States and their blood and fragment of organs were screened for haemogregarine parasites. RESULTS: From the total, seven (6.03%) animals were found infected with species of Hepatozoon and Dactylosoma. Based on the morphological and molecular analysis, four anurans were found infected with Hepatozoon latrensis. The phylogenetic analysis has shown the isolates from this study grouping with the Brazilian anuran Hepatozoon clade, also with gene similarity ranging from 99.70 to 100% to H. latrensis isolates available on GenBank. Furthermore, three specimens (Trachycephalus typhonius, Leptodactylus latrans, and Rhinella diptycha) were infected with the same species of Dactylosoma (100% genetic similarity), with a genetic similarity of 98.56% to Dactylosoma piperis the only other species described in Brazil. In support of the molecular data, different morphological characters were observed in the blood smears as compared to D. piperis, suggesting that the species of Dactylosoma from the present study infecting three different species of Brazilian anurans is an undescribed species. CONCLUSION: Thus, this study increases the knowledge of Brazilian anuran blood parasites and demonstrates the importance of using integrative approaches for the diagnosis of haemoparasites.

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PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is associated with a poor prognosis. Multianalyte signatures, including liquid biopsy and traditional clinical variables, have shown promise for improving prognostication in other solid tumors but have not yet been rigorously assessed for PDAC. MATERIALS AND METHODS: We performed a prospective cohort study of patients with newly diagnosed locally advanced pancreatic cancer (LAPC) or metastatic PDAC (mPDAC) who were planned to undergo systemic therapy. We collected peripheral blood before systemic therapy and assessed circulating tumor cells (CTCs), cell-free DNA concentration (cfDNA), and circulating tumor KRAS (ctKRAS)-variant allele fraction (VAF). Association of variables with overall survival (OS) was assessed in univariate and multivariate survival analysis, and comparisons were made between models containing liquid biopsy variables combined with traditional clinical prognostic variables versus models containing traditional clinical prognostic variables alone. RESULTS: One hundred four patients, 40 with LAPC and 64 with mPDAC, were enrolled. CTCs, cfDNA concentration, and ctKRAS VAF were all significantly higher in patients with mPDAC than patients with LAPC. ctKRAS VAF (cube root; 0.05 unit increments; hazard ratio, 1.11; 95% CI, 1.03 to 1.21; P = .01), and CTCs ≥ 1/mL (hazard ratio, 2.22; 95% CI, 1.34 to 3.69; P = .002) were significantly associated with worse OS in multivariate analysis while cfDNA concentration was not. A model selected by backward selection containing traditional clinical variables plus liquid biopsy variables had better discrimination of OS compared with a model containing traditional clinical variables alone (optimism-corrected Harrell's C-statistic 0.725 v 0.681). CONCLUSION: A multianalyte prognostic signature containing CTCs, ctKRAS, and cfDNA concentration outperformed a model containing traditional clinical variables alone suggesting that CTCs, ctKRAS, and cfDNA provide prognostic information complementary to traditional clinical variables in advanced PDAC.

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Cosmocerca spp. are common nematode parasites of amphibians. We provide herein molecular data for two species of Cosmocerca and describe a new species, Cosmocerca albopunctata n. sp., using light microscopy and molecular data (cytochrome c oxidase subunit 1 - COI mtDNA). Cosmocerca albopunctata n. sp. can be easily distinguished from other congeneric species by the combination of characteristics such as body size, length of spicules and gubernaculum, and the arrangements and number of caudal papillae (7 + 1:1 + 1:6). The phylogenetic results based on the partial COI mtDNA sequences clustered the new species in a monophyletic clade along with the other sequences of Cosmocerca spp. Therefore, our results contribute to the knowledge about the species diversity and genetic data for Cosmocerca spp. in the Neotropical region.

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This article aims to analyze the perspective of managers and professionals about the performance of the Mobile Emergency Care Service (SAMU) in the Grande ABC region. This is a qualitative case study based on the formulation of a theoretical-logical model of intervention and semi-structured interviews. The Theoretical-Logical Model translated the dimensions of SAMU analysis: regulation, care and management. The regulation process was understood as a strategic space where the judgment of the patient's need and the ambulance dispatch time have the potential to influence the outcomes of the cases transported. In health care, the main themes that emerged were investment in the qualification of the team and in telemedicine with the perspective of improving the quality of care and making the diagnosis more accurate. In management, challenges such as integrating SAMU with tertiary centers, improving the information system, and monitoring and evaluation were highlighted aiming to qualify the regulatory processes by aligning them with the objectives proposed in the health policy. The set of data analyzed reinforces the capacity of the SAMU in emergency care in the region; however, the intervention needs to overcome important challenges in order to improve the prognosis of the cases transported.

Este artigo tem como objetivo analisar a perspectiva de gestores e profissionais sobre o desempenho do SAMU na região do Grande ABC. Trata-se de estudo de caso, de abordagem qualitativa, baseado na formulação de modelo teórico-lógico da intervenção e entrevistas semiestruturadas. O Modelo teórico-lógico traduziu as dimensões de análise do SAMU: regulação, assistência e gestão. O processo de regulação foi entendido como espaço estratégico onde o julgamento da necessidade do paciente e o tempo de despacho da ambulância tem potencial de influenciar nos desfechos dos casos transportados. Na assistência os principais temas que emergiram foram investimento na qualificação da equipe e em telemedicina com a perspectiva de melhorar a qualidade do cuidado e tornar o diagnóstico mais preciso. No âmbito da gestão desafios como integração do SAMU com centros terciários, aperfeiçoamento do sistema de informação e monitoramento e avaliação foram destacados visando qualificar os processos regulatórios alinhando-os aos objetivos propostos na política de saúde. O conjunto de dados analisados reforça a capacidade do SAMU na atenção de urgência na região, no entanto a intervenção precisa superar importantes desafios em busca de melhor prognóstico entre os casos transportados.

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Although Brazil is a hotspot for snake species, there is a lack of information on the biodiversity of haemoparasites infecting these hosts. Thus, the present study aimed to bring new insights on the diversity of species of Hepatozoon (Apicomplexa: Adeleorina: Hepatozoidae) infecting Brazilian snakes from the Midwest and Southeast regions. The snakes were captured from 2018 to 2020 from the states of Mato Grosso, Mato Grosso do Sul, Goiás, and São Paulo. Three to five blood smears were made and the remaining blood sample was stored for further molecular analysis. Moreover, histopathological slides of the organs were stained with haematoxylin-eosin. Regarding molecular diagnosis, PCR was performed targeting different regions of the 18S rRNA gene of apicomplexan parasites. From the 13 free-living snakes screened, ten (76.92%) were found infected with Hepatozoon spp. Based on morphological and morphometric tools, five different morphotypes of species of Hepatozoon gamonts were detected. Molecular data and phylogenetic analysis support the morphological data, identifying five species of Hepatozoon from snakes, of which three species belong to previously described species, Hepatozoon cevapii, Hepatozoon cuestensis, and Hepatozoon quagliattus, with a genetic similarity of 100% (based on the 18S rRNA genetic marker). The present study identifies and describes two new species of Hepatozoon, Hepatozoon annulatum sp. nov. infecting the snake Leptodeira annulata and Hepatozoon trigeminum sp. nov. infecting the snake Oxyrhopus trigeminus. Thus, based on morphological and molecular data the present study provides new insights on haemogregarine diversity infecting Brazilian snakes from the Midwest and Southeast regions.

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This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.

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ABSTRACT: This study aims to evaluate the ratio of the number of cases of family violence and violence by a known person, over the four surveys that took place in 2006, 2007, 2009, and 2011, within the population treated in the Brazilian health services, according to demographic and socioeconomic characteristics. Data from the Vigilância de Violências e Acidentes survey was used. The variables age, victim sex, aggressor sex, race, and schooling level were considered in the analysis. This study pointed out decreasing trend in the number of violence-related care within the older age group. The number of familial violence-related care per victim sex was higher for male victims when the aggressor was female, and conversely, it was higher for female victims when the aggressor was male. The number of violence-related care was mostly higher in non-White people than in White. People with low schooling levels showed the highest ratio of the number of violence-related care.

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Myxosporidiosis is an infectious disease caused by myxozoans of the Phylum Cnidaria, Class Myxosporea, and Order Bivalvulida, considered a common parasite in fresh and saltwater fishes that parasitize many organs, especially gills. In the present study, 49 specimens of fishes belonging to eight genera: Tetragonopterus, Leporinus, Myleus, Pirinampus, Rhapiodon, Pygocentrus, Ageneiosus, and Serrasalmus were collected and blood smears were made, fixed with absolute methanol, and stained with Giemsa 10% to survey hemoparasites. However, myxospores were found in the circulating blood of five (10.20%) fishes belonging to genus Tetragonopterus, Myleus, and Pygocentrus. Two morphological types of Myxobolus spp. were identified in all the five fish specimens analyzed. Usually, investigations on myxozoans in fish are carried out with the search for plasmodia or cysts in the fish organs and observation of the cavity of organs. Nevertheless, this study highlights the importance of also examining the blood of these animals, since these parasites can cause severe pathogenic diseases in fish. Thus, the blood analyses can proportionate preventive sanitary control for commercial fish avoiding economic loss.

A mixosporidiose é considerada uma doença infecciosa causada por mixozoários pertentences ao Filo Cnidaria, Classe Myxosporea e Ordem Bivalvulida, considerados parasitos comuns de peixes de água doce e salgada, parasitando vários órgãos, principalmente as brânquias. No presente estudo, 49 espécimes de peixes pertencentes a oito gêneros: Tetragonopterus, Leporinus, Myleus, Pirinampus, Rhapiodon, Pygocentrus, Ageneiosus and Serrasalmus foram coletados e extensões sanguíneas foram feitas com a finalidade de encontrar hemoparasitos. Entretanto, mixoesporos foram observados em cinco (10.20%) espécimes de peixes, pertencentes aos gêneros Tetragonopterus, Myleus e Pygocentrus. Dois morfotipos de Myxobolus spp. foram identificados parasitando esses peixes. Normalmente, as investigações sobre mixozoários em peixes é realizada com a procura de plasmódios ou cistos nos órgãos dos peixes e observação da cavidade de órgãos. Porém, esse trabalho ressalta a importância de se examinar também o sangue desses animais, já que esses parasitos podem ocasionar patogenias severas em peixes. Sendo assim, a análise sanguínea pode proporcionar controle sanatório preventivo para peixes comerciais e evitar perdas econômicas.

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Myxosporidiosis is an infectious disease caused by myxozoans of the Phylum Cnidaria, Class Myxosporea, and Order Bivalvulida, considered a common parasite in fresh and saltwater fishes that parasitize many organs, especially gills. In the present study, 49 specimens of fishes belonging to eight genera: Tetragonopterus, Leporinus, Myleus, Pirinampus, Rhapiodon, Pygocentrus, Ageneiosus, and Serrasalmus were collected and blood smears were made, fixed with absolute methanol, and stained with Giemsa 10% to survey hemoparasites. However, myxospores were found in the circulating blood of five (10.20%) fishes belonging to genus Tetragonopterus, Myleus, and Pygocentrus. Two morphological types of Myxobolus spp. were identified in all the five fish specimens analyzed. Usually, investigations on myxozoans in fish are carried out with the search for plasmodia or cysts in the fish organs and observation of the cavity of organs. Nevertheless, this study highlights the importance of also examining the blood of these animals, since these parasites can cause severe pathogenic diseases in fish. Thus, the blood analyses can proportionate preventive sanitary control for commercial fish avoiding economic loss.(AU)

A mixosporidiose é considerada uma doença infecciosa causada por mixozoários pertentences ao Filo Cnidaria, Classe Myxosporea e Ordem Bivalvulida, considerados parasitos comuns de peixes de água doce e salgada, parasitando vários órgãos, principalmente as brânquias. No presente estudo, 49 espécimes de peixes pertencentes a oito gêneros: Tetragonopterus, Leporinus, Myleus, Pirinampus, Rhapiodon, Pygocentrus, Ageneiosus and Serrasalmus foram coletados e extensões sanguíneas foram feitas com a finalidade de encontrar hemoparasitos. Entretanto, mixoesporos foram observados em cinco (10.20%) espécimes de peixes, pertencentes aos gêneros Tetragonopterus, Myleus e Pygocentrus. Dois morfotipos de Myxobolus spp. foram identificados parasitando esses peixes. Normalmente, as investigações sobre mixozoários em peixes é realizada com a procura de plasmódios ou cistos nos órgãos dos peixes e observação da cavidade de órgãos. Porém, esse trabalho ressalta a importância de se examinar também o sangue desses animais, já que esses parasitos podem ocasionar patogenias severas em peixes. Sendo assim, a análise sanguínea pode proporcionar controle sanatório preventivo para peixes comerciais e evitar perdas econômicas.(AU)

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Descreve as redes assistenciais sua formulação teórica e implementação no Brasil, apresenta o SAMU. Mostra a história, a função e as tipologias de hospitais. comenta sobre as estratégias de diferentes países para atender ás urgências de forma integrada

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RESUMO

In keeping with the process of institutionalization of evaluation of primary healthcare in Brazil, we developed the Evaluative Matrix of the Longitudinal Bond (MAVIL in Portuguese), a simple and concise evaluative tool. MAVIL is structured according to three dimensions in the concept of longitudinal bond: Dimension 1 - recognition of the basic health unit (UBS in Portuguese) as a regular source of care, Dimension 2 - healthcare worker/patient interpersonal relationship, and Dimension 3 - continuity of information. The instrument consists of a structured set of 12 criteria, 20 indicators and respective questions, and verification items submitted to various validation stages. The current article presents the statistical validation of the MAVIL application in two UBS in a health territory in order to support future applications and also verify the instrument's capacity to capture differences in the longitudinal bond profile between UBS. The method included the following definitions: sample design, choice of the metric, descriptive data analysis, and comparative test of means, through application of the test of normality and nonparametric statistic. As results, the sample by strata, together with option of totaling the points from the MAVIL items as the metric, allowed describing the longitudinal bond profile for three cross-sections: territory and UBS A and B. To verify the capacity of MAVIL to capture differences in the longitudinal bond profile, we tested the hypothesis of the data's normality with the Kolmogorov-Smirnov test. Having rejected the hypothesis of normality, we opted for the Wilcoxon nonparametric test to compare the UBS. Dimension 1 and Dimension 2 showed similar profiles, but there was a significant difference for Dimension 3, attesting to the sensitivity of MAVIL.

Consonante com o processo de institucionalização da avaliação da atenção primária no Brasil, foi desenvolvida a Matriz Avaliativa do Vínculo Longitudinal (MAVIL), instrumental avaliativo simples e conciso. A MAVIL estrutura-se a partir das três dimensões do conceito de vínculo longitudinal: Dimensão 1 - reconhecimento da unidade básica de saúde (UBS) como fonte regular de cuidados, Dimensão 2 - relação interpessoal profissional/paciente e Dimensão 3 - continuidade da Informação. Consiste em um conjunto estruturado de 12 critérios, 20 indicadores e respectivas questões e itens de verificação, submetido a várias etapas de validação. O presente artigo apresenta a validação estatística da aplicação MAVIL em duas UBS de um território de saúde a fim de respaldar as futuras aplicações e averiguar também a capacidade do instrumento para captar diferenças no perfil do vínculo longitudinal entre UBS. O método consistiu nas seguintes definições: desenho da amostra, escolha da métrica, análise descritiva dos dados e teste comparativo de médias, por meio da aplicação do teste de normalidade e de estatística não paramétrica. Como resultados: a amostra por estrato, junto à opção da soma dos pontos dos itens da MAVIL como métrica, possibilitou descrever o perfil do vínculo longitudinal para os três recortes: território e UBS A e B. Para verificar a capacidade da MAVIL em captar diferença no perfil de vínculo longitudinal, testou-se a hipótese da normalidade dos dados a partir do teste de Kolmogorov-Smirnov. Rejeitada a hipótese da normalidade, optou-se pelo teste não paramétrico de Wilcoxon para comparar as UBS. Para Dimensão 1 e Dimensão 2, constatou-se a semelhança de perfil, contudo, para Dimensão 3, houve diferença significativa, atestando a sensibilidade da MAVIL.

En consonancia con el proceso de institucionalización de la evaluación de la atención primaria en Brasil, se desarrolló la Matriz Evaluativa del Vínculo Longitudinal (MAVIL), un instrumento evaluativo simple y conciso. MAVIL se estructura a partir de las tres dimensiones del concepto de vínculo longitudinal: Dimensión 1 - reconocimiento de la unidad básica de salud (UBS) como fuente regular de cuidados, Dimensión 2 - relación interpersonal profesional/paciente y Dimensión 3 - continuidad de la información. Consiste en un conjunto estructurado de 12 criterios, 20 indicadores y sus respectivas cuestiones e ítems de verificación, sometido a varias etapas de validación. Este artículo presenta la validación estadística de la aplicación MAVIL en dos UBS de una zona con servicios de salud, con el fin de respaldar sus futuras aplicaciones y también averiguar la capacidad de la herramienta para captar diferencias en el perfil del vínculo longitudinal entre UBS. El método consistió en las siguientes definiciones: diseño de la muestra, elección del sistema de medición, análisis descriptivo de los datos y test comparativo de medias, a través de la aplicación del test de normalidad y de estadística no paramétrica. Como resultados: muestra por estrato, junto a la opción de suma de los puntos de los ítems de la MAVIL como sistema de medición, posibilitó describir el perfil del vínculo longitudinal para las tres secciones elegidas: territorio, UBS A y B. Para verificar la capacidad de la MAVIL en captar la diferencia en el perfil de vínculo longitudinal se probó la hipótesis de la normalidad de los datos, a partir del test de Kolmogorov-Smirnov. Rechazada la hipótesis de la normalidad, se optó por la prueba no paramétrica de Wilcoxon para comparar las UBS. En Dimensión 1 y Dimensión 2 se constató la semejanza de perfil, sin embargo, en la Dimensión 3 hubo una diferencia significativa, constatando la sensibilidad de la MAVIL.

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