Associação entre as condições de nascimento e a densidade mineral óssea de adultos das coortes de nascimentos de 1982 e 1993 de Pelotas, Rio Grande do Sul, Brasil / Association between birth conditions and bone mineral density in adults from the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil / Asociación entre las condiciones de nacimiento y la densidad mineral ósea de adultos de las cohortes de nacimiento de 1982 y 1993 en Pelotas, Rio Grande do Sul, Brasil

Resumo: Este estudo avaliou a associação do peso ao nascer, idade gestacional e crescimento intrauterino com a densidade mineral óssea (DMO) aos 22 e 30 anos, nas coortes de nascimentos de 1982 e 1993 de Pelotas, Rio Grande do Sul, Brasil. A DMO foi medida por absorciometria por raios X com dupla energia (DXA), a associação foi avaliada usando análise de variância e a regressão linear múltipla para o controle de confundimento por: sexo, renda familiar ao nascer, tabagismo materno na gestação, escolaridade materna, cor da pele materna e índice de massa corporal pré-gestacional. Foi testado se a gordura corporal na vida adulta era mediadora da associação analisada, por meio da G-computation Formula. Foram avaliados 6.803 participantes das coortes de 1982 e 1993, aos 30 e 22 anos, respectivamente. O peso ao nascer teve associação com a DMO em todos os sítios, com maior diferença no colo femoral. Os nascidos com menos de 2.000g apresentaram, em média, -0,036g/cm2 (IC95%: -0,064; -0,008) de DMO no colo femoral em comparação àqueles com mais de 3.500g. Aqueles com escore-z de crescimento intrauterino com pelo menos 1,28 desvio padrão abaixo da média apresentaram, em média, -0,013g/cm2 (IC95%: -0,024; -0,002) de DMO na coluna lombar, em relação aos com escore-z acima da média. A análise de mediação mostrou que gordura corporal na idade adulta não mediou a associação. As condições de nascimento foram associadas com a densidade mineral óssea na vida adulta, e a identificação dos fatores precoces relacionados à perda de DMO é essencial devido à inversão demográfica em progresso em países de média e baixa renda.

Abstract: This study assessed the association of birth weight, gestational age, and intrauterine growth with bone mineral density (BMD) at 22 and 30 years of age in the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil. BMD was measured by dual-energy X-ray absorptiometry (DXA) and the association was assessed using analysis of variance. Multiple linear regression was used to control for confounding factors: sex; household income at birth; maternal smoking during pregnancy; maternal schooling; maternal ethnicity/skin color; and pre-pregnancy body mass index. The study tested whether body fat in adulthood was a mediator of the association analyzed, using the G-computation Formula. A total of 6,803 participants from the 1982 and 1993 cohorts were evaluated at 30 and 22 years of age, respectively. Birth weight was associated with BMD at all sites, with a greater difference at the femoral neck. Individuals born weighing less than 2,000g had on average -0.036g/cm2 (95%CI: -0.064; -0.008) of BMD in the femoral neck than individuals weighing more than 3,500g. Individuals with an intrauterine growth z-score at least 1.28 standard deviation below the mean had an average of -0.013g/cm2 (95%CI: -0.024; -0.002) of BMD in the lumbar spine compared with individuals with an above-average z-score. The mediation analysis showed that body fat in adulthood did not mediate the association. Birth conditions have been associated with BMD in adulthood and the identification of early factors related to bone loss is essential due to the demographic inversion that has been taking place in low- and middle-income countries.

Resumen: Este estudio evaluó la asociación del peso al nacer, la edad gestacional y el crecimiento intrauterino con la densidad mineral ósea (DMO) a los 22 y 30 años de edad, en las Cohortes de Nacimiento de 1982 y 1993 de Pelotas, Rio Grande do Sul, Brasil. La DMO se midió mediante absorciometría de rayos X de doble emisión (DXA), y la asociación se evaluó mediante ANOVA y regresión lineal múltiple para controlar la confusión por sexo, ingresos familiares al nacer, tabaquismo materno durante el embarazo, escolaridad materna, color de piel materno e índice de masa corporal antes del embarazo. Se comprobó si la grasa corporal en la edad adulta era un mediador de la asociación analizada, utilizando G-computation Formula. Se evaluaron 6.803 participantes de las cohortes 82 y 93, de 30 y 22 años, respectivamente. El peso al nacer se asoció con la DMO en todos los sitios, con la mayor diferencia en el cuello femoral. Los nacidos con un peso inferior a 2.000g tuvieron una media de -0,036g/cm2 (IC95%: -0,064; -0,008) de DMO en el cuello femoral, que aquellos con más de 3.500g. Aquellos con una puntuación z de crecimiento intrauterino de al menos 1,28 desviaciones estándar por debajo de la media presentaron un promedio de -0,013g/cm2 (IC95%: -0,024; -0,002) de DMO en la columna lumbar, con relación a aquellos con un puntaje z superior a la media. El análisis de mediación mostró que la grasa corporal en la edad adulta no medió la asociación. Las condiciones de nacimiento se asociaron con la DMO en la edad adulta, y la identificación temprana de factores relacionados con la pérdida de DMO es esencial debido a la inversión demográfica que ha estado ocurriendo en los países de ingresos medios y bajos.

Analysis of annexin-A1 in the macrophages and apoptotic cells of patients with cutaneous leishmaniasis

Abstract INTRODUCTION This study aimed to determine the number of macrophages and apoptotic cells and perform annexin-A1 detection in patients with leishmaniasis. METHODS Patients with Leishmania infection were admitted to Júlio Müller University Hospital. RESULTS The number of apoptotic cells was higher in the exudative granulomatous reaction. The exudative cellular reaction displayed higher levels of annexin-A1 detection in macrophages and apoptotic cells. The correlation between annexin-A1 detection in apoptotic cells and macrophages was observed in exudative necrotic reaction and exudative necrotic-granulomatous reaction. CONCLUSIONS: Our data demonstrate the relevance of annexin-A1 in the regulation of apoptosis and phagocytosis in leishmaniasis.

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort / Condição socioeconômica e índice de massa corporal em modelos de curso de vida: coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil / Estatus socioeconómico e índice de masa corporal en modelos de ciclo vital: cohorte de nacimientos de 1993 en Pelotas, Rio Grande do Sul, Brasil

Abstract: This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Resumo: O artigo busca avaliar a relação entre condição socioeconômica ao longo da vida e índice de massa corporal (IMC) aos 22 anos de idade, de acordo com as hipóteses geradas pelos modelos de acúmulo de riscos, período crítico e mobilidade social. Este é um estudo prospectivo de base populacional, na coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil. Os modelos de acúmulo de riscos, período crítico e mobilidade social foram testados em relação a um model saturado, e comparados através de um teste F parcial. Após escolher o melhor modelo, a análise de regressão linear foi realizada para determinar os coeficientes de regressão, brutos e ajustados, da associação entre a condição socioeconômica ao longo da vida e o IMC aos 22 anos. A amostra consistia em 3.292 indivíduos (53,3% mulheres). Foram identificados efeitos de dose-resposta em homens e mulheres, embora os efeitos fossem opostos. Entre os homens, um aumento na pontuação baixa no modelo de acúmulo de condição socioeconômica levou a um IMC médio mais baixo aos 22 anos de idade; enquanto isso, nas mulheres, um aumento na pontuação baixa no modelo de acúmulo de condição socioeconômica levou a um aumento no IMC aos 22 anos de idade.

Resumen: El objetivo de este artículo es evaluar la relación entre el estatus socioeconómico a lo largo del ciclo vital y el índice de masa corporal (IMC) con 22 años de edad, según las hipótesis generadas por riesgo de acumulación, período crítico y modelos de movilidad social. Se trata de un estudio prospectivo de base poblacional con la cohorte de nacimiento de 1993 en Pelotas, Rio Grande do Sul, Brasil. Se probaron tanto el riesgo de acumulación, como el período crítico y modelos de movilidad social, en relación con un modelo saturado y comparado mediante un F-test parcial. Tras haber elegido el mejor modelo, se llevó a cabo una regresión lineal para determinar los coeficientes de asociación crudos y ajustados entre estatus socioeconómico, a lo largo del ciclo vital, e IMC a los 22 años de edad. La muestra estuvo compuesta por 3.292 individuos (53,3% mujeres). Se encontraron efectos dosis-respuesta para ambos hombres y mujeres, a pesar de que los efectos fueron opuestos. Entre hombres, el aumento en la puntación del modelo de acumulación en el estatus socioeconómico bajo condujo a un promedio más bajo de IMC a los 22 años de edad, mientras que, entre mujeres, el aumento en la puntuación del modelo de acumulación en el estatus socioeconómico bajo provocó un incremento en el IMC a los 22 años de edad.

Percepção da imagem corporal e tolerância alimentar de pacientes submetidos à cirurgia bariátrica e metabólica em um hospital do Sul de Minas Gerais / Perception of body image and food tolerance of patients undergoing bariatric and metabolic surgery at a hospital of the South of Minas Gerais

Introdução: os pacientes submetidos à cirurgia bariátrica e metabólica apresentam melhoras clínicas significativas; porém, podem desenvolver intolerâncias alimentares e problemas emocionais, como distúrbios da imagem corporal, alterações no sistema gastrointestinal e, consequentemente, a rápida perda de peso, que acarretam mudanças importantes na vida destes pacientes. Objetivo: identificar a tolerância alimentar e a percepção da imagem corporal de pacientes submetidos à cirurgia bariátrica e metabólica. Método: trata-se de um estudo prospectivo transversal de abordagem quantitativa, realizado com 36 pacientes que realizam acompanhamento no Programa de Cirurgia Bariátrica e Metabólica do Hospital de Clínicas de Itajubá, Minas Gerais (MG). Os dados clínicos e antropométricos foram obtidos em prontuários; a tolerância alimentar foi avaliada por meio do questionário de avaliação da qualidade da alimentação e tolerância alimentar,(14) e a imagem corporal da escala de silhuetas corporais(18) e Body Shape Questionnaire-34,(15) nas consultas de pós-operatório de acordo com o protocolo do serviço. A análise dos dados foi realizada através do software Bioestat® v5.0, por meio da estatística descritiva (média ± desvio padrão e porcentagem). Resultados: 36 pacientes foram avaliados, sendo 75% do sexo feminino; 97,2% apresentaram intolerância alimentar, sendo os alimentos menos tolerados massas (50,0%), carne vermelha (35,3%), pão (27,3%) e arroz (22,2%). Quanto à percepção da imagem corporal, 56% dos participantes apresentaram algum nível de distorção da imagem corporal e 83,3% destes desejavam diminuir a silhueta. Conclusão: identificou-se elevada frequência de intolerâncias a alimentos específicos após a cirurgia bariátrica e metabólica, uma distorção importante da imagem corporal e avaliação negativa da autoimagem. (AU)

Introduction: patients undergoing bariatric and metabolic surgery show significant clinical improvements; however, they can develop food intolerances and emotional problems, such as body image disorders, changes in the gastrointestinal system and, consequently, rapid weight loss, cause important changes in the lives of these patients. Objective: to identify food tolerance and body image perception in patients undergoing bariatric and metabolic surgery. Method: this is a prospective crosssectional study with a quantitative approach, carried out with 36 patients who are being followed up in the Bariatric and Metabolic Surgery Program of Hospital de Clínicas de Itajubá, Minas Gerais (MG). Clinical and anthropometric data were obtained from medical records; the food tolerance assessed through the questionnaire to assess the quality of food and food tolerance,(14) and the body image of the body silhouettes scale(18) and Body Shape Questionnaire-34,(15) in the postoperative consultations of according to the service protocol. Data analysis was performed using the Bioestat® software v5.0, using descriptive statistics (mean ± standard deviation and percentage). Results: 36 patients were evaluated, 75% of whom were female; 97.2% had food intolerance, with less tolerated food being pasta (50.0%), red meat (35.3%), bread (27.3%) and rice (22.2%). Regarding the perception of body image, 56% of participants showed some level of distortion of body image and 83.3% of these wished to decrease the silhouette. Conclusion: a high frequency of intolerances to specific foods was identified after bariatric and metabolic surgery, an important distortion of body image and a negative assessment of self-image.(AU)

Comportamento suicida: o perfil epidemiológico das lesões autoprovocadas no Estado de Goiás / Suicidal behavior: the epidemiological profile of self-harm in the State of Goiás

Conhecer o perfil epidemiológico das lesões autoprovocadas é importante para subsidiar a construção e o fortalecimento de políticas públicas para seu enfrentamento. Com este objetivo, foi realizado um estudo descritivo com base nos dados das Fichas de Notificação de Violência Interpessoal e Autoprovocada registradas no Sistema de Agravos de Notificação (SINAN) o qual aponta alta subnotificação (do total de municípios notificantes, 10% constam apenas um registro) e municípios silenciosos em Goiás (dos 246 municípios, 111 encontram-se silenciosos). A faixa etária com maior prevalência é de 20 a 39 anos (48%). Violência de repetição foi observada em 36% das notificações. Envenenamento, objeto perfurocortante e enforcamento foram nesta ordem os meios mais utilizados. Conclui-se que em Goiás houve um acréscimo das notificações de lesão autoprovocadas, sendo as mulheres e adultos jovens as principais vítimas. Contudo as subnotificações são ainda um entrave para a vigilância em saúde e para melhor identificação do comportamento suicida, ainda sim essas informações podem contribuir para sensibilização dos profissionais de saúde quanto à detecção oportuna deste comportamento e devida atenção

Knowing the epidemiological profile of self-harm is important to support the construction and strengthening of public policies to cope with it. With this objective in mind, a descriptive study was carried out based on data from the Interpersonal and Self-Evoked Violence Notification Sheets registered with SINAN, which points to high underreporting (of the total of notifying municipalities, 10% included only one registry) and silent municipalities in Goiás (of the 246 municipalities, 111 are silent). The prevalent age group is 20 to 39 years (48%). Repetitive violence was observed in 36% of notifications. Poisoning, sharps and hanging were the most used means in this order. It is concluded that in Goiás there was an increase in self-harm reports, with women and young adults being the main victims. However underreporting is still an obstacle to health surveillance and to better identify suicidal behavior, notwithstanding these informations can contribute for health professionals to be aware of the timely detection of this behavior and due attention

A contação de histórias no instagram como tecnologia leve em tempos pesados de pandemia / La narración de historias em instagram como tecnología ligera en tiempos de pandemia intensa / Storytelling on instagram as a light technology in heavy pandemic times

Resumo O artigo objetiva analisar as contribuições da contação de histórias para a saúde mental no contexto da pandemia de Covid-19. Trata-se de uma pesquisa-intervenção que posiciona o recurso das histórias como uma tecnologia leve em saúde, comprometida em reduzir distâncias, criar pontes entre as pessoas através do investimento na produção de vínculos e acolhimento. A contação de histórias articula literatura e psicologia, faz parte da caixa de ferramentas necessárias para a ativação de forças psíquicas expressivas dos afetos no cenário atual. O banco de dados da pesquisa pode ser designado como banco de histórias que passam por um processo de curadoria, sendo essa uma metodologia fundamental para o encadeamento de temas abordados nas histórias e a postagem das mesmas no Instagram do projeto. As histórias videogravadas foram analisadas a partir dos núcleos semânticos contexto-afeto-texto, com destaque para os conteúdos de memória e morte; e práticas de mutualidade em cuidado. A reação dos/as seguidores/as do Instagram expressam mensagens afetuosas aos/as contadores/as.

Resumen El artículo tiene como objetivo analizar las contribuciones de la narración a la salud mental en el contexto de la pandemia Covid-19. Se trata de una investigación-intervención que posiciona el recurso de las historias como una tecnología ligera en salud, comprometida con la reducción de distancias, creando puentes entre las personas a través de la inversión en la producción de vínculos y la acogida. La narración de cuenteros articula la literatura y la psicología, es parte de la caja de herramientas necesarias para la activación de las fuerzas psíquicas expresivas de los afectos en el escenario actual. La base de datos de investigación puede designarse como un banco de historias que se someten a un proceso curatorial, que es una metodología fundamental para vincular los temas tratados en las historias y publicarlos en el Instagram del proyecto. Se analizaron relatos videograbados a partir de los núcleos semánticos contexto-afecto-texto; con énfasis en los contenidos de la memoria y la muerte; y prácticas de cuidado mutuo en el cuidado. La reacción de los/las seguidores/as de Instagram expresan mensajes afectuosos a los/las cuenteros/as.

Abstract This article aims to analyze the contributions of the storytelling to mental health in the context of the Covid-19 pandemic. It is an intervention-research that places this story device as light health technology. It is committed to reduce distances, create bridges between people through investment in bonding and welcoming. Storytelling articulates literature and psychology, and is part of the toolbox that is necessary for the activation of expressive psychic forces of affections in the current scenario. The research database can be designated as a bank of stories that undergo a curatorial process, which is a fundamental methodology for linking topics covered in the stories and posting them on the project's Instagram. The videotaped stories were analyzed from mutual-care practices and the context-affection-text semantic nuclei, with emphasis on the contents of memory and death. The reactions of Instagram followers express affectionate messages to the storytellers.

Analysis of macrophage subtypes and annexin A1 expression in lesions of patients with cutaneous leishmaniasis

Abstract INTRODUCTION: Cutaneous leishmaniasis is caused by protozoa of the genus Leishmania and transmission occurs through the bite of sandflies. It is an infectious disease, which affects skin and mucosa. The aim was to quantify the macrophages M1 and M2 and the annexin A1 expression in the skin lesions of patients with cutaneous leishmaniasis. METHODS: Skin biopsies from patients (n = 50) were analyzed and classified according to the lesion type as: exudative cellular reaction, exudative granulomatous reaction, exudative necrotic reaction, exudative necrotic-granulomatous reaction. Using the immunofluorescence technique, macrophages were identified by CD163 marker, differentiated by anti-MHCII and anti-CD206 antibodies, and annexin A1 expression was determined by arbitrary unit (a.u.) densitometry. RESULTS: In M1 macrophages, a greater expression of this protein was observed in the exudative cellular reaction type lesions (136.3 ± 2.6 a.u., assuming mean and standard derivation) when compared to the expression in the lesions of exudative granulomatous reaction, exudative necrotic reaction and exudative necrotic-granulomatous reaction patients (108.0 ± 2.3, 121.6 ± 3.2 and 124.7 ± 2.4 a.u., respectively). Regarding M2 macrophages, it was observed that patients with exudative cellular reaction lesion also had a higher expression of this protein (128.8 ± 2.6 a.u.), when compared to the expression in the lesions of exudative granulomatous reaction, exudative necrotic reaction and exudative necrotic-granulomatous reaction patients (105.6 ± 2, 113.9 ± 2.8, 114.3 ± 2.1 a.u., respectively). CONCLUSIONS: These data suggest that annexin A1 is assisting macrophages in the phagocytosis process of patients with exudative cellular reaction lesion type.

Factores psicosociales que influyen en el embarazo en adolescentes de un colegio de la provincia del Guayas / Psychosocial factors that influence teenage pregnancy in a school in the province of Guayas

Introducción.El embarazo en la adolescente es un tema actual y recurrente en nuestras sociedades, dado que es un fenómeno natural que está biológicamente disponible para prácticamente todas las adolescentes, considerado un problema de salud pública en Ecuador. Objetivo.Determinar los factores psicosocialesque influyen en el embarazo de las adolescentes de 12 a 17 años, del Colegio Fiscal Dr. José María Velasco Ibarra de la ciudad de Milagro, año 2016.Materiales y método.Se realizó un estudio de enfoque cuantitativo, diseño no experimental de tipo descriptivo, de corte transversal, en estudiantes de 12 a 17 años de edad, del que se obtuvo una muestra de 335 adolescentes que cumplieron con los criterios de selección. Resultados.El 31 % de las adolescentes pertenece a la edad de 16 años y la mayor parte vive en el sector urbano. El 63 % reconoce las características de las tres etapas de la adolescencia; el 92 % conoce sobre el desarrollo de todos los órganos de la reproducción y los cambios físicos que se producen en ellos; el 69,55 % resalta que las características que primero identifican en su grupo de pares es la amistad y aceptación. El 85 % señaló que vive en un hogar funcional. Conclusiones. Los factores psicosociales que influyen en el embarazo en la adolescencia son los cambios físicos relacionados con el crecimiento, cambio corporal y a la maduración sexual; siendo en la adolescencia intermedia el desarrollo cognitivo han demostrado la característica de tener un pensamiento más reflectivo.

Adolescent pregnancy is a current and recurrent theme in our societies given that it is a natural phenomenon that is biologically available for practically all adolescents, considered a public health problem in Ecuador. Objective.Determine the psychosocial factors that influence the pregnancy of adolescents aged 12 to 17 years, from the tax school Dr. José María Velasco Ibarra from the city of Milagro, 2016. Materials and Method.A quantitative, non-experimental descriptive, cross-sectional study was carried out in 12 to 17-year-old students, from which a sample of 335 adolescents who met the selection criteria was obtained. Results.31 % of adolescents belong to the age of 16 and most of these live in the urban sector. 63 % recognize the characteristics of the three stages of adolescence; 92 % know about the development of all the organs of reproduction and the physical changes that occur in them; 69,55 % emphasize that the characteristics that they first identify in their peer group are friendship and acceptance. 85% said they live in a functional home. Conclusions.The psychosocial factors that influence adolescent pregnancy are the physical changes related to growth, body change and sexual maturation; Being in the middle adolescence the cognitive development have demonstrated the characteristic of having a more reflective thought.

First autochthonous case of canine visceral leishmaniasis in Rondônia, Brazil, a region with no history of visceral leishmaniasis

Abstract This report describes the first autochthonous case of canine visceral leishmaniasis in Rondônia, northern Brazil. A canine resident of the municipality of Cacoal, with clinical signs and symptoms of visceral leishmaniasis, was treated by a veterinarian. Samples were analyzed by a reference laboratory. Dual-path platform (DPP) assay, indirect immunofluorescence technique (IIT), enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), isolation in a culture medium, and direct parasitological analysis were performed. DPP assay, IIT, and ELISA revealed positive results for Leishmania; PCR identified the species as Leishmania infantum. Based on the clinical presentation and test results, canine visceral leishmaniasis was diagnosed.

Factores asociados para el procedimiento de administración de medicamentos mediante el sistema de dosis unitaria / Associated factors for the procedure of administration of medicines through the system of unitary dose

El sistema de distribución de medicamentos en dosis unitarias es un método de dispensación y control de la medicación en servicios de salud,es organizado y coordinado por la farmacia institucional. Objetivo.Analizar los factores asociados para el procedimiento de administración de medicamentos mediante el sistema de dosis unitaria en el hospital de Instituto Ecuatoriano Seguridad Social de la ciudad de Babahoyo. Metodología. Diseño observacional, descriptivo de corte transversal. Institución: Hospital del IESS. Revisión sistemática documental nacional e internacional sobre SDUM y la aplicación de una encuesta a la población objetivo del estudio: 92 médicos, 118 enfermeras, 2 químicos farmacéuticos. Resultados.Confirmaron que el sistema tradicional afecta la racionalización de medicamentos; existiendoescasez de recursos humanos, espacio físico inadecuado, incumplimiento de normas vigentes.Serequiere la capacitación del recurso humano en el 100%. Existiendo la necesidad imperiosa de implementar el sistema de dosis unitaria en el 100% de los servicios de hospitalización del IESS Babahoyo. Conclusión.Los factores que mayor incidencia tienen en la implementación del nuevo sistema son conocimiento del sistema, las normas legales y reglamentación farmacéutica y el número insuficiente de profesionales químicos farmacéuticos especializados, a esto se une el factor presupuesto a nivel central que influye en la adquisición de equipamiento e implementación de las áreas funcionales según el Acuerdo Ministerial 00000569 del 6 de julio de 2011 Norma para la Aplicación del Sistema de Dispensación/Distribución de Medicamentos por Dosis Unitaria -Ministerio de Salud Pública, enero 2013.

Introduction.The system of distribution of medications in unit doses is a method of dispensing and control of medication in health services is organized and coordinated by the institutional pharmacy. Objective.To analyze the factors associated with the benefits of the medication administration procedure through the unit dose system at the Instituto Ecuatoriano Seguridad Social in the city of Babahoyo. Methodology. Observational design, descriptive cross-section. Institution: IESS Hospital. Systematic national and international documentaryreview on SDUM and the application of a survey to the target population of the study: 92 doctors, 118 nurses, 2 pharmaceutical chemists. Results They confirmed that the traditional system affects the rationalization of medicines; There is a shortage of human resources, inadequate physical space, non-compliance with current regulations. 100% human resource training is required. There is a pressing need to implement the unit dose system in 100% of the IESS hospitalization services. Babahoyo.Conclusion: The factors that have the greatest impact on the implementation of the new system are knowledge of the system, legal regulations and pharmaceutical regulation and the insufficient number of specialized pharmaceutical chemists, to this is added the budget factor at the central level that influences the acquisition of equipment and implementation of the functional areas according to the Ministerial Agreement 00000569 of July 6, 2011 Standard for the Application of the Dispensing System / Distribution of Drugs by Unit Dose -Ministry of Public Health, January 2013.

Caracterización epidemiológica del zika en mujeres atendidas en el distrito 09D01 de Guayaquil / Epidemiological characterization of zika in women attended in the district 09D01 of Guayaquil

Introducción. El virus del Zika es un flavivirus que es transmitido por mosquitos principalmente del género Aedes. Aproximadamente el 80 % de las personas infectadas no presenta síntomas. Objetivo. Caracterizar epidemiológicamente la enfermedad del Zika, en mujeres atendidas en el distrito 09D01 durante enero a junio del 2017. Metodología. Fue de diseño no experimental, descriptivo, analítica de corte transversal en mujeres atendidas en la consulta externa. Resultados. Se obtuvo el grupo mayormente afectado de 30 - 39 años con 30,41 %, 20 - 29 años con 29,90 %, entre otros; pero en las embarazadas, fue el grupo etario de 20 ­ 29 años con 47,42 %, seguido del 30 ­ 39 años de edad con 40,21 %, entre otros. En el caso de las no embarazadas se observó en edades de 0 a 9 años, 10 a 19 años y en más de 50 años. En cuanto a las embarazadas, mayormente fueron en el segundo trimestre con 48,44 %. Los resultados de laboratorio dio positivo el 98,97 % de los casos con PCR y nexo epidemiológico 1,03 %; siendo el Hospital Materno Infantil y Centro de Salud N.° 3 de mayor detección. Conclusiones. El comportamiento de la enfermedad del Zika influye en las mujeres atendidas en el distrito 09D01, presentándose a cualquier edad y especialmente en las mujeres embarazadas en el segundo trimestre de gestación; con características sintomáticas variables. Por lo tanto, es significativo anotar que se debe continuar observando el debutar clínico en el futuro próximo, pero sigue siendo importante y de confianza el diagnóstico molecular para su confirmación.

Introduction. The Zika virus is a flavivirus that is transmitted by mosquitoes mainly of the genus Aedes. Approximately 80 % of infected people have no symptoms. Objective. Epidemiological characterization of Zika's disease in women treated in the district 09D01 during January to June of 2017. Methodology. It was of non-experimental, descriptive, cross-sectional analytic design in women attended at the outpatient clinic. Results. It was obtained the group most affected of 30 - 39 years with 30,41 %, 20 - 29 years with 29,90 %, among others; but in the pregnant women, it was the 20- to 29-year-old age group with 47,42 % followed by 30-39 years of age with 40,21 %, among others. In the case of non-pregnant women, it was observed in the ages of 0 to 9 years, 10 to 19 years and in more than 50 years. As for the pregnant women, they were mostly in the second quarter with 48,44 %. Laboratory results were positive in 98,97 % of the cases with PCR and epidemiological link 1,03 %; being the hospital Maternal Infantile and Health Center N.° 3 of greater detection. Conclusions. The behavior of Zika'sdisease influences the women treated in the district 09D01, presenting at any age and especially in pregnant women in the second trimester of gestation; with variable symptomatic characteristics. Therefore, it is significant to note that clinical debut should continue to be observed in the near future, but the molecular diagnosis for confirmation remains important and reliable.

Expression of annexin A1 in Leishmania-infected skin and its correlation with histopathological features

ABSTRACTINTRODUCTION:The aim of this study was quantify annexin A1 expression in macrophages and cluster of differentiation 4 (CD4) + and cluster of differentiation 8 (CD8)+ T cells from the skin of patients with cutaneous leishmaniasis (n=55) and correlate with histopathological aspects.METHODS:Infecting species were identified by polymerase chain reaction-restriction fragment length polymorphism, and expression of annexin A1 was analyzed by immunofluorescence.RESULTS:All patients (n = 55) were infected with Leishmania braziliensis . Annexin A1 was expressed more abundantly in CD163 + macrophages in infected skin (p < 0.0001) than in uninfected skin. In addition, macrophages in necrotic exudative reaction lesions expressed annexin A1 at higher levels than those observed in granulomatous (p < 0.01) and cellular lesions p < 0.05). This difference might be due to the need to clear both parasites and necrotic tissue from necrotic lesions. CD4 + cells in cellular lesions expressed annexin A1 more abundantly than did those in necrotic (p < 0.05) and granulomatous lesions (p < 0.01). Expression in CD8 + T cells followed the same trend. These differences might be due to the pervasiveness of lymphohistiocytic and plasmacytic infiltrate in cellular lesions.CONCLUSIONS:Annexin A1 is differentially expressed in CD163 + macrophages and T cells depending on the histopathological features of Leishmania -infected skin, which might affect cell activation.

Occurrence of potentially pathogenic Vibrio in oysters (Crassostrea gigas) and waters from bivalve mollusk cultivations in the South Bay of Santa Catarina

Introduction This research aimed to identify and quantify potentially pathogenic Vibrio from different cultivations of bivalve shellfish in the State of Santa Catarina, Brazil, and water regions in the South Bay, as well as correlate the incidence of these microorganisms with the physicochemical parameters of marine waters. Methods Between October 2008 and March 2009, 60 oyster and seawater samples were collected from six regions of bivalve mollusk cultivation, and these samples were submitted for Vibrio counts. Results Twenty-nine (48.3%) oyster samples were revealed to be contaminated with one or more Vibrio species. The Vibrio parahaemolyticus and Vibrio vulnificus counts in the samples ranged from < 0.5 log10 Most Probable Number (MPN) g–1 to 2.3 log10 MPN g–1 oyster and from < 0.5 log10 MPN g–1 to 2.1 log10 MPN g–1 oyster, respectively. Of the 60 seawater samples analyzed, 44 (73.3%) showed signs of contamination with one or more vibrio species. The counts of V. parahaemolyticus and V. vulnificus in the samples ranged from < 0.3 log10 MPN·100mL–1 to 1.7 log10MPN·100mL–1 seawater and from < 0.3 log10 MPN·100mL–1 to 2.0 log10 MPN·100mL–1 seawater, respectively. A positive correlation between V. vulnificus counts and the seawater temperature as well as a negative correlation between the V. parahaemolyticus counts and salinity were observed. Conclusions The results suggest the need to implement strategies to prevent vibrio diseases from being transmitted by the consumption of contaminated bivalve shellfish. .

Evaluation of the PetrifilmTM EB and TEMPO® EB systems with ISO 21528-2:2004 method for the count of Enterobacteriaceae in milk

The development of alternative microbiological techniques is driven by the necessity to meet the current needs to deliver rapid results in the manufacturing process of foods, but it is important that these methods be evaluated for each application. The objective of the present study was to assess the PetrifilmTM EB and the TEMPO® EB systems with ISO 21528-2:2004 for the count of Enterobacteriaceae in pasteurized and UHT milk samples. We analyzed the microflora of 141 pasteurized milk samples, 15 samples of artificially contaminated pasteurized milk and 15 samples of artificially contaminated UHT milk. Investigation of the method PetrifilmTM EB and ISO 21528:2 regression analysis showed a high correlation in the samples, r = 0.90 for the microflora of pasteurized milk, r = 0.98 for artificially contaminated pasteurized milk and r = 0.99 for the artificially contaminated UHT milk. In evaluating the system TEMPO EB ® method and ISO 21528:2 correlation was also significant in the analyzed samples, with r = 0.86 for the microflora of pasteurized milk, r = 0.96 for artificially contaminated pasteurized milk and r = 0.99 for artificially contaminated UHT milk. No statistically significant differences were observed between the three methods conducted to analyze artificially contaminated pasteurized and UHT milk at three inoculum levels. In conclusion, the PetrifilmTM EB system and the TEMPO® EB system may be an alternative to the ISO 21528-2:2004 for the Enterobacteriaceae assay for milk as because of the ease-of-operation and the time reduction achieved for conducting the microbiological assay using these systems.

Resultados do acompanhamento dos usuários do Centro de Atenção Psicossocial - Álcool e Drogas (Caps-AD) / Resultados del acompañamiento de los usuarios del Centro de Atención Psicosocial - Alcohol y Drogas (CAPS - AD) / Results of monitoring of users treated in the Psychosocial Care Center - Alcohol and Drugs (CAPS-AD)

Neste trabalho, delinearam-se os problemas de saúde, as hipóteses diagnósticas, as substâncias psicoativas utilizadas e se há ou não aderência aos tratamentos entre os pacientes atendidos pelo Caps. O estudo, do tipo exploratório descritivo, com abordagem quantitativa, foi realizado por meio de uma entrevista com todos os pacientes (n=31) em regime de hospitalidade-dia no Caps, antes das suas consultas ambulatoriais. Dos pacientes, 35,5% tinham idade superior a 41 anos, 83,9% a cor da pele autorreferida branca e 71% eram solteiros, 74,2% tinham apenas o ensino fundamental e 48,3% tinham renda mensal de até um salário-mínimo. O principal problema de saúde identificado foi o etilismo e a hipótese diagnóstica mais comum foi o tabagismo associado ao etilismo. A maioria dos usuários administra seus medicamentos no horário certo e não pratica automedicação.

This study has drawn a line on health problems, diagnostic hypotheses, psychoactive substances used and if there is or not adherence to treatment among patients treated by the CAPS. The exploratory and descriptive research with a quantitative approach was conducted through an interview with all patients (n=31) under hospitality day at CAPS before their outpatient consultations. From all of them, 35.5% were older than 41 years, 83.9% had skin color self-reported as white and 71% were single, 74.2% had completed only primary education and 48.3% had a monthly income of up to a basic wage. The main health problem identified was alcoholism and the most common diagnostic hypothesis was smoking associated with alcoholism. Most users take their medication at the right time and do not practice self-medication.

El trabajo delineó los problemas de salud, las hipótesis diagnósticas, las substancias psicoactivas utilizadas y se hay o no adherencia a los tratamientos entre los pacientes atendidos por el CAPS. El estudio del tipo exploratorio descriptivo en abordaje cuantitativo fue realizado, por medio de una entrevista con todos los pacientes (n=31) en régimen de hospitalidad día en el CAPS antes de sus consultas de ambulatorio. 35,5% de los pacientes tenían edad superior a 41 años, 83,9% el color de la piel auto-referida blanca y 71% eran solteros. 74,2% tenían apenas la enseñanza fundamental y 48,3% tenían renta mensual de hasta un salario. El principal problema de salud identificado fue el etilismo y la hipótesis diagnóstica más común fue el tabaquismo asociado al etilismo. La mayoría de los usuarios administra sus medicamentos en la hora cierta y no practica automedicación.

Manejo quirúrgico de carcinoma escamocelular de paladar óseo / Surgical management of squamous carcinoma of the hard palate

Los tumores malignos en el paladar óseo son una patología poco frecuente. Se reportan del 1 al 5% de las neoplasias malignas de la cavidad oral, donde dos tercios de las lesiones son carcinomas escamocelulares. Por lo general se presentan como una masa o ulceración no dolorosa en el techo de la boca o el borde alveolar. La invasión ósea ocurre tardíamente y las lesiones se pueden tornar exofíticas cuando no se tratan. Uno de los factores predisponentes para esta patología es el tabaquismo invertido. Las metástasis clínicas se manifiestan entre un 10 a 25%. En estadios tempranos puede ser tratado de manera efectiva con cirugía o radioterapia. Presentamos el caso de un paciente con una lesión ulcerada en paladar óseo a nivel del torus palatino, de tres meses de evolución, con antecedente de alcoholismo y tabaquismo. Se documentó carcinoma escamocelular y se le practicó palatectomía parcial, con colocación de prótesis dental en paladar óseo …

Malignant tumors of the palate are an infrequent pathology. It accounts about 1 to 5% of malignancies of the oral cavity, where two thirds of lesions are squamous cell carcinomas. Usually palate tumors appear with a painless mass or an ulceration on the roof of the mouth or alveolar ridge. Bone invasion occurs late. The lesions can become exophytic when left untreated. One of the predisposing factors for this pathology is the Reverse Smoking. Clinical metastases are found between 10 to 25%. In early stages, these tumors can be succesfully treated with surgery or radiation therapy. We report a patient with and ulcerated lesion in hard palate at palatine torus level with 3 months course. He has alcoholism and smoking history. It was documented a squamous cells carcinoma. It was performed a partial palatectomy with placement of dental prostheses …

Plano diretor de atenção primária como estratégia de educação permanente: perspectiva dos facilitadores / The facilitators’ point of view regarding the primary health care planning as a continuing education program

Trata-se de um estudo qualitativo cujo objetivo foi analisar o Plano Diretor de Atenção Primária à Saúde no processo da educação permanente, bem como a formação dos profissionais para atuação como multiplicadores nesse processo. Os dados empíricos foram obtidos de entrevista com 11 enfermeiros que atuaram como facilitadores do Plano Diretor em um município da região metropolitana de Belo Horizonte. Os resultados indicam que a vivência como facilitador permitiu reflexões sobre o processo de trabalho, contribuindo para a incorporação de novas ferramentas na atenção primária. Os participantes relataram as dificuldades enfrentadas na condução do trabalho, bem como lacunas na formação desses profissionais para atuarem na Atenção Primária à Saúde e implementarem processos de educação permanente no cotidiano dos serviços. O Plano Diretor representa importante estratégia de educação permanente com potencial para transformar processos e práticas na atenção primária à saúde.

Microbiological quality of pre-cooked seafood marketed in Santa Catarina Island, Brazil / Qualidade microbiológica de frutos do mar pré-cozidos comercializados na Ilha de Santa Catarina, Brasil

The present study assessed the microbiological quality of pre-cooked and refrigera ted sea food marketed in Santa Catarina Island, Brazil. Forty-eight samples of crabs, mussels, shrimp and clams were purchase dat fish markets in Santa Catarina Island from June to September 2008. Microbiological analysis were conducted for total counts of psychrotrophic, coliforms at 45 °C, Enterococcus spp., Escherichia coli, coagulase-positive staphylococci and Salmonella spp. detecting. All of analyzed samples showed absenceof Salmonella spp. in 25g. Two (4.2 per cent) samples exceeded the counting limits of coliforms at 45 °C (one ofmussel and one of crab meat), and nine (18.75 per cent) samples (five of clams and four of crab meat) exceeded the limits for coagulase-positive staphylococci. The psychrotrophic counts were high in all products analyzed. Positive correlations were found between coliforms counting at 45 °C and Escherichia coli, but no correlation was found between Enterococcus spp. and coliforms at 45 °C or Escherichia coli. This study evidenced that about 20 per cent of the samples were not comply with the sanitary standards established by the Brazilian legislation.

Atividade antimicrobiana de Lactobacillus reuteri contra bactérias de interesse alimentar / Antimicrobial activity of Lactobacillus reuteri against bacteria of nourishment concern

Lactobacillus reuteri é uma espécie heterofermentativa que reside nos tratos gastrointestinal (GI), vaginale oral do homem e de outros animais de sangue quente. A ação probiótica de L. reuteri é atribuída a sua capacidade de exercer um efeito inibitório sobre micro-organismos patogênicos pela combinação de diversos mecanismos, incluindo-se a produção de ácido lático, peróxido de hidrogênio e produção de bacteriocinas. A reuterina é um composto neutro, de baixo peso molecular, solúvel em água, ativa em uma larga faixa de pH e resistente a ação de enzimas proteolíticas e lipolíticas. Neste estudo foi avaliado o efeito inibitório de L. reuteri sobre bactérias patogênicas ou deteriorantes de alimentos. L. reuteri apresentou capacidadede inibir o crescimento de Aeromonas hydrophila, Bacillus cereus, Enterobacter aerogenes, Proteus vulgaris, Pseudomonas aeruginosa, Salmonella tiphymurium, Staphylococcus aureus e Vibrio cholerae. Sugere-se que o antimicrobiano produzido pelo L. reuteri seja a reuterina.

Lactobacillus reuteri is a heterofermentative species that lives in the gastrointestinal (GI), vaginal and oraltracts of humans and other warm-blooded animals. The action of probiotic L. reuteri is derived from itsability to exert an inhibitory effect on pathogens, combining several mechanisms, including the productionof lactic acid, hydrogen peroxide and bacteriocin production. The reuterin is a neutral compound of lowmolecular weight, water soluble, active in a wide pH range, and resistant to proteolytic and lipolytic enzymes.This study evaluated the inhibitory effect of L. reuteri on pathogenic bacteria or food deterioration. L. reuterishowed ability to inhibit the growth of Aeromonas hydrophila, Bacillus cereus, Enterobacter aerogenes, Proteusvulgaris, Pseudomonas aeruginosa, Salmonella tiphymurium, Staphylococcus aureus and Vibrio cholerae. Itis suggested that the antibiotic produced by L. reuteri is the reuterin.Key words. reuterin, L. reuteri, antimicrobial activity.

Atividade antimicrobiana de Lactobacillus reuteri contra bactérias de interesse alimentar / Antimicrobial activity of Lactobacillus reuteri against bacteria of nourishment concern

Lactobacillus reuteri é uma espécie heterofermentativa que reside nos tratos gastrointestinal (GI), vaginale oral do homem e de outros animais de sangue quente. A ação probiótica de L. reuteri é atribuída a sua capacidade de exercer um efeito inibitório sobre micro-organismos patogênicos pela combinação de diversos mecanismos, incluindo-se a produção de ácido lático, peróxido de hidrogênio e produção de bacteriocinas. A reuterina é um composto neutro, de baixo peso molecular, solúvel em água, ativa em uma larga faixa de pH e resistente a ação de enzimas proteolíticas e lipolíticas. Neste estudo foi avaliado o efeito inibitório de L. reuteri sobre bactérias patogênicas ou deteriorantes de alimentos. L. reuteri apresentou capacidadede inibir o crescimento de Aeromonas hydrophila, Bacillus cereus, Enterobacter aerogenes, Proteus vulgaris, Pseudomonas aeruginosa, Salmonella tiphymurium, Staphylococcus aureus e Vibrio cholerae. Sugere-se que o antimicrobiano produzido pelo L. reuteri seja a reuterina.

Lactobacillus reuteri is a heterofermentative species that lives in the gastrointestinal (GI), vaginal and oraltracts of humans and other warm-blooded animals. The action of probiotic L. reuteri is derived from itsability to exert an inhibitory effect on pathogens, combining several mechanisms, including the productionof lactic acid, hydrogen peroxide and bacteriocin production. The reuterin is a neutral compound of lowmolecular weight, water soluble, active in a wide pH range, and resistant to proteolytic and lipolytic enzymes.This study evaluated the inhibitory effect of L. reuteri on pathogenic bacteria or food deterioration. L. reuterishowed ability to inhibit the growth of Aeromonas hydrophila, Bacillus cereus, Enterobacter aerogenes, Proteusvulgaris, Pseudomonas aeruginosa, Salmonella tiphymurium, Staphylococcus aureus and Vibrio cholerae. Itis suggested that the antibiotic produced by L. reuteri is the reuterin.Key words. reuterin, L. reuteri, antimicrobial activity.