RESUMO

Human visceral leishmaniasis is a major public health problem in the Amazon. Thus, we analyzed the spatial distribution of this disease and its relationship with epidemiological, socioeconomic, and environmental variables in the Carajás Integration Region, Pará state, from 2011 to 2020. Epidemiological data for this ecological study were obtained from the State Public Health Secretariat, environmental data were obtained from the National Space Research Institute, and socioeconomic data were obtained from the Brazilian Geography and Statistics Institute. ArcGIS 10.5.1 software was used for classifying land use and cover and for the Kernel and Moran spatial analyses. It was observed in 685 confirmed cases that the epidemiological profile followed the national pattern of the disease occurrence, with a high prevalence in children who were not school-aged. The disease had a non-homogeneous distribution with clusters related to different human activities, such as urbanization, ranching, and mining. A spatial dependence between the disease prevalence and socioeconomic indicators was observed. The municipalities presented gradients of case densities associated with a direct relationship between areas with cases and deforestation. The disease is developing due to risk factors such as establishment and maintenance related to the non-sustainable development model implemented in the region, pointing to the need for its revision.

RESUMO

Spheroids are 3D spherical cell aggregates, which, cultivated in vitro, behave differently than regular monolayer cellular cultures. Cancer spheroids share many characteristics with in vivo solid tumors, making them a powerful tool in cancer research. The use of cancer spheroids makes it possible to identify the potential of new anticancer pharmacological targets, leading them to be widely used in preclinical oncology research. 3D in vitro models allow the study in detail of many important aspects of the cellular transformation process, such as cell morphology, gene expression, cell-cell and cell-ECM interactions, angiogenesis, and vasculogenic mimicry.In this chapter, the importance of studies using spheroids for current cancer research is described, focusing on vasculogenic mimicry, its morphological structure, and the different methods used in the formation of spheroids. The main method uses agarose to produce the molds for the cancer spheroids, is known as the non-adherent hydrogel micro-mold method, and is being covered in more detail below.

Assuntos

RESUMO

As indústrias de leite e derivados devem ofertar produtos inócuos aos consumidores e, para isso, a adoção de boas práticas de fabricação (BPF) é imprescindível. O objetivo deste estudo foi verificar e classificar o atendimento às Boas Práticas de Fabricação em indústrias de leite e derivados registradas no Serviço de Inspeção Municipal de Campo Grande, região Centro-Oeste de Mato Grosso do Sul. Foram avaliadas uma unidade de beneficiamento de leite e derivados e três queijarias, a partir de um checklist elaborado com base na Portaria nº 368/1997, na Instrução Normativa nº 77/2018 e no Decreto nº 9.013/2017, alterado pelo Decreto nº 10.468/2020. Os dados obtidos no checklist foram tabulados e analisados por meio de frequência absoluta e relativa. A classificação das indústrias e dos itens avaliados foi feita de acordo com a RDC nº 275/2002. A adequação média às BPF foi de 61,8% e todos os estabelecimentos pesquisados foram classificados como regulares. Classificaram-se como bons os itens área interna (78,5%), sala de beneficiamento (87,5%), abastecimento de água (100%) e manipuladores (90%). Apenas os itens recepção do leite e higienização dos utensílios foram classificados como regulares. Os itens área externa (40%), laboratório condições gerais (25%), análises laboratoriais (42,8%), câmara fria (40%) e documentação e registros (40%) foram classificados como deficientes. Nenhum dos estabelecimentos sob fiscalização avaliados atendeu completamente as exigências da legislação e as indústrias que apresentaram itens classificados como deficientes e regulares revelaram problemas que podem representar um risco à segurança dos alimentos.

The milk and milk derivatives industries must offer innocuous products to consumers and for this, the adoption of good manufacturing practices (GMP) is essential. The objective of this study was to verify and classify the attendance to Good Manufacturing Practices in milk and milk derivatives industries registered in the Municipal Inspection Service of Campo Grande, in the Midwest region of Mato Grosso do Sul. A processing unit of milk and milk derivatives and three cheese factories were evaluated through a checklist prepared based on Ordinance no368/1997, Normative Instruction no 77/2018, and Decree no 9.013 /2017, amended by Decree no 10.468 /2020. The data obtained in the checklist were tabulated and analyzed using absolute and relative frequency. The items and industries classification was made according to resolution DRC 275/2002. The mean adequacy to GMP was 61.8% and all evaluated establishments were classified as regular. The items internal area (78.5%), beneficiation room (87.5%), water supply (100%), and handlers (90%) were classified as good. Only the items milk reception and utensils cleaning were classified as regular. The items external area (40%), laboratory general conditions (25%), laboratory analysis (42.8%), cold room (40%), and documentation and records (40%) were classified as disabled. None of the evaluated establishments under inspection fully met the legislation requirements and the industries that showed items classified as deficient and regular revealed problems that may represent a risk to food safety.

Assuntos

RESUMO

INTRODUCTION: Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities. METHODOLOGY: A descriptive, cross-sectional, and ecological study was conducted using data from the Malaria Epidemiological Surveillance System of the municipalities of Cametá and Tucuruí, PA, Brazil, from 2014 to 2018; the Brazilian Institute of Geography and Statistics; and the National Registry of Health Institutions of the Ministry of Health. Statistical and spatial analyses of epidemiological, laboratory and public health service coverage variables were performed using the Bioestat 5.0 and ArcGis 10.5 software. RESULTS: 11,381 Malaria cases were reported in the two municipalities. The highest percentage of case notifications was reported in brown-skinned men aged from 19 and 59 years, and who had primary education levels. The predominant occupations were farming and livestock in Cametá and domestic activity in Tucuruí. The most common diagnostic examination used was a thick blood smear, and Plasmodium vivax was the species most often encountered. The percentage of primary care coverage increased during the study period. The spatial distribution of the disease was not homogeneous, and there were clusters of cases with different densities in Cametá and Tucuruí. CONCLUSIONS: Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, thus reflecting health inequities.

Assuntos

RESUMO

Objetivo: O estudo objetiva descrever a relação de Enfermeiros Obstétricos e Doulas na assistência ao trabalho de parto e parto. Métodos: Estudo qualitativo, descritivo e prospectivo, realizado no Centro de Parto Normal localizado em Castanhal, com sete Enfermeiras Obstétricas e três Doulas. Os dados foram coletados entre dezembro/2017 e maio/2018, por meio de entrevista semiestruturada e Análise de Conteúdo de Bardin. Resultados: Emergiram as seguintes categorias: Assistência holística à gestante; A Enfermagem Obstétrica e as Doulas: o desafio no entrecruzar de práticas; Associação de práticas na assistência ao parto normal. Conclusão: Apesar dos relatos evidenciados de conflitos entre as Doulas e as Enfermeiras Obstétricas, é possível identificar uma boa relação na associação de práticas proporcionando benefícios à parturiente. (AU)

Objective: The study aims to describe the relationship between Obstetric Nurses and Doulas in assisting labor and delivery. Methods: A qualitative, descriptive and prospective study, carried out with seven Obstetric Nurses and three Doulas. Data were collected between Dec 2017 to May 2018, through a semi-structured interview and Bardin Content Analysis. Results: The speeches were classified into the following categories: Holistic care for pregnant women; Obstetric Nursing and Doulas: the challenge in the intertwining of practices; Association of practices in assisting normal delivery. Conclusion: Despite the evidences of conflicts between the Doulas and the Obstetric Nurses, it is possible to identify a good relation in the association of practices providing benefits to the parturient. (AU)

Objetivo: El estudio objetivó describir la relación de Enfermeros Obstétricos y Doulas en la asistencia al trabajo de parto y parto. Métodos: Estudio cualitativo, descriptivo y prospectivo, realizado en el Centro de Parto Normal ubicado en Castanhal, con siete Enfermeras Obstétricas y tres Doulas. Los datos fueron recolectados entre diciembre/2017 y mayo/2018, por medio de entrevista semiestructurada y Análisis de Contenido de Bardin. Resultados: Se plantearon las siguientes categorías: Asistencia holística a la gestante; La Enfermería Obstétrica y las Doulas: el desafío en el entrecruzar de prácticas; Asociación de prácticas en la asistencia al parto normal. Conclusion: A pesar de los relatos evidenciados de conflictos entre las Doulas y las Enfermeras Obstétricas, es posible identificar una buena relación en la asociación de prácticas proporcionando beneficios a la parturienta. (AU)

Assuntos

RESUMO

INTRODUCTION: COVID-19 is a severe respiratory syndrome caused by the SARS-CoV-2 virus. In Brazil the highest infection rates are associated with socially vulnerable populations. This study therefore sought to analyze the spatial distribution of the disease and its relation with geographic, socioeconomic and public health policy characteristics associated with quilombola communities in Salvaterra municipality, state of Pará, for the period of March to September, 2020. METHODOLOGY: This cross-sectional and ecological study used data from the Disease Notification System and the National Registry of Health Establishments of the Ministry of Health, the Income Transfer Registry of the Ministry of Citizenship and the 2010 census of the Brazilian Institute of Geography and Statistics. Statistical and spatial analysis of the data was done through percentages of cases and Flow and Kernel map techniques. RESULTS: Seventy-five notified cases of COVID-19 distributed among 7 quilombola communities in the municipality were analyzed. The epidemiological profile followed a national trend, with a higher percentage of cases among persons who were female, adults with low schooling levels, working as family farmers and with an outcome ending in recovery. The spatial distribution of the disease was not homogenous and showed clusters of cases and high incidence rates, especially in communities close to the municipal seat or to highways. CONCLUSIONS: The use of data analysis techniques was satisfactory for providing an understanding of the socioeconomic production of the disease in the areas studied. Accordingly, the need for intensifying epidemiological survey actions in the quilombola communities of the municipality is emphasized.

Assuntos

RESUMO

Estudo descritivo/quantitativo realizado no período de novembro e dezembro de 2015. A coleta de dados se deu com 22 institucionalizados por meio da aplicação das escalas de Katz e Lawton & Brody. Constatou-se predomínio da independência para AVD (81,8%) na escala de Katz, divergindo da escala de Lawton & Brody, que evidenciou grau moderadamente dependente (81,8%) para atividades instrumentais de vida diária. Haja vista os dados, observa-se que o grau de funcionalidade exige maior atenção visando à qualidade de vida no envelhecimento.

Descriptive/quantitative study accomplished between November and December of 2015. The data collection has been made with 22 institutionalized people by applying of Katz and Lawton & Brody scales. As became evident the independence to Activities of Daily Living (ADL) (81,8%) in Katz scale diverging of Lawton & Brody scale that showed low function, dependent (81,8%) to Activities Of Daily Living (IADL). Considering the data of functionality degree observed that it requires greater attention aiming aging quality.

Estudio descriptivo/cuantitativo cumplido entre noviembre y diciembre de 2015. Los datos fueron recolectados con 22 institucionalizado mediante la aplicación de las escalas de Katz y Lawton y Brody.  Observado predominio de la independencia de las AVD (81,8%) en la escala de Katz que divergen de Lawton y Brody escala que mostraron moderadamente grado dependiente (81,8%) para AIVD. En vista de los datos se observa que el grado de funcionalidad requiere mayor atención que buscan calidad en el envejecimiento.

Assuntos

RESUMO

Ganciclovir (GCV) is the first therapeutic choice for prevention and treatment of active cytomegalovirus (CMV) infection in solid organ transplant recipients in Bahia state, Brazil. Prolonged and repeated GCV therapy may result in drug-resistant virus, associated with progressive and disseminated disease. We present a case report of a young male kidney recipient, who was CMV-seronegative with a CMV-seropositive donor (D(+)/R(-)), and who developed clinical GCV resistance, confirmed by mutation in viral UL97 phosphotransferase responsible for GCV activation. Under prophylactic therapy with intravenous GCV for 6 weeks post-transplantation, he developed severe anaemia and hepatic enzyme increases, probably due to drug side effects. At this moment, the drug was discontinued and he started to be monitored by pp65 antigen test. At week 10 post-transplantation, he presented fever, myalgia, thrombocytopenia and neutropaenia, with a positive CMV antigen test. During treatment with intravenous GCV, antigenaemia assay demonstrated a higher number of positive cells, requiring GCV at higher doses. Pre-emptive therapy lasted for 31 days and he started the maintenance therapy with oral GCV. However, antigenaemia assay demonstrated an extremely high number of positive cells, and he was rehospitalized and prescribed intravenous GCV. Severe leukopaenia led to GCV interruption, but immunosuppressive dose reduction helped to control the active CMV infection. GCV-resistant CMV infection resulted in increased morbidity, rehospitalization episodes and increased costs; therefore, implementation of resistance diagnostic tests in the transplantation routine is of great importance. We documented the first case of GCV-resistant CMV infection due to the L595S mutation in UL97 phosphotransferase gene in a kidney recipient from Bahia state, Brazil.

Assuntos