Melhoria da qualidade da água de rios urbanos: novos paradigmas a explorar - Bacia hidrográfica do rio Pinheiros em São Paulo / Improvement of water quality in urban rivers: new paradigms to explore - Pinheiros river basin, São Paulo, Brazil

RESUMO A questão da qualidade da água nos corpos d'água urbanos é complexa, pois passa pelo controle de cargas poluidoras pontuais e difusas. As cargas pontuais ainda são um problema recorrente no Brasil, porém são mais facilmente identificáveis. As cargas difusas não têm um ponto de lançamento específico, o que torna seu controle mais difícil, pois ocorrem principalmente em função da lavagem das superfícies durante as chuvas. Os corpos d'água em áreas urbanas são severamente afetados por tais descargas, que se refletem na qualidade das águas e em seus usos. Nesse contexto, este trabalho apresenta elementos do monitoramento da qualidade da água do rio Pinheiros nos últimos dez anos; analisa os resultados do monitoramento da Companhia Ambiental do Estado de São Paulo (Cetesb); verifica se há relação com resultados do monitoramento diário do projeto Avaliação da Qualidade das Águas do Sistema Pinheiros-Billings com o Protótipo Flotação; e, por fim, avalia o uso de sistema de biorretenção, que apresenta resultados significativos de reduções da carga poluidora do escoamento superficial chegando, em alguns casos, a mais de 90%. Essa solução é uma alternativa para a redução da poluição difusa na bacia do rio Pinheiros.

Abstract The issue of water quality in urban water bodies is complicated, as it involves controlling on point and diffuse pollution loads. Point loads are still a problem in Brazil, although more easily identifiable. Diffuse loads do not have a specific discharge point, which makes their control more difficult, and they happen mainly due to stormwater surface runoff. Urban water bodies are exposed to the diffuse pollution, which affects their water quality and multiple uses. Thus, this article presents the Pinheiros River's water quality monitoring over the last ten years, analyzes the monitoring results of São Paulo State Environmental Company (Cetesb), and verifies the existence of a relationship with these results with the daily monitoring of the project "Avaliação da Qualidade das Águas do Sistema Pinheiros-Billings com o Protótipo Flotação". Finally, it evaluates the use of a bioretention system with average reductions of runoff pollutants loads, in some cases, more than 90%, being an alternative for diffuse pollution control in the Pinheiros River basin.

Identification and recombinant expression of an antimicrobial peptide (cecropin B-like) from soybean pest Anticarsia gemmatalis

Insects can be found in numerous diverse environments, being exposed to pathogenic organisms like fungi and bacteria. Once these pathogens cross insect physical barriers, the innate immune system operates through cellular and humoral responses. Antimicrobial peptides are small molecules produced by immune signaling cascades that develop an important and generalist role in insect defenses against a variety of microorganisms. In the present work, a cecropin B-like peptide (AgCecropB) sequence was identified in the velvetbean caterpillar Anticarsia gemmatalis and cloned in a bacterial plasmid vector for further heterologous expression and antimicrobial tests. Methods AgCecropB sequence (without the signal peptide) was cloned in the plasmid vector pET-M30-MBP and expressed in the Escherichia coli BL21(DE3) expression host. Expression was induced with IPTG and a recombinant peptide was purified using two affinity chromatography steps with Histrap column. The purified peptide was submitted to high-resolution mass spectrometry (HRMS) and structural analyses. Antimicrobial tests were performed using gram-positive (Bacillus thuringiensis) and gram-negative (Burkholderia kururiensis and E. coli) bacteria. Results AgCecropB was expressed in E. coli BL21 (DE3) at 28°C with IPTG 0.5 mM. The recombinant peptide was purified and enriched after purification steps. HRMS confirmed AgCrecropB molecular mass (4.6 kDa) and circular dichroism assay showed α-helix structure in the presence of SDS. AgCrecropB inhibited almost 50% of gram-positive B. thuringiensis bacteria growth. Conclusions The first cecropin B-like peptide was described in A. gemmatalis and a recombinant peptide was expressed using a bacterial platform. Data confirmed tertiary structure as predicted for the cecropin peptide family. AgCecropB was capable to inhibit B. thuringiensis growth in vitro.(AU)

It is time for top-down venomics

The protein composition of animal venoms is usually determined by peptide-centric proteomics approaches (bottom-up proteomics). However, this technique cannot, in most cases, distinguish among toxin proteoforms, herein called toxiforms, because of the protein inference problem. Top-down proteomics (TDP) analyzes intact proteins without digestion and provides high quality data to identify and characterize toxiforms. Denaturing top-down proteomics is the most disseminated subarea of TDP, which performs qualitative and quantitative analyzes of proteoforms up to ~30 kDa in high-throughput and automated fashion. On the other hand, native top-down proteomics provides access to information on large proteins (> 50 kDA) and protein interactions preserving non-covalent bonds and physiological complex stoichiometry. The use of native and denaturing top-down venomics introduced novel and useful techniques to toxinology, allowing an unprecedented characterization of venom proteins and protein complexes at the toxiform level. The collected data contribute to a deep understanding of venom natural history, open new possibilities to study the toxin evolution, and help in the development of better biotherapeutics.(AU)

It is time for top-down venomics

Abstract The protein composition of animal venoms is usually determined by peptide-centric proteomics approaches (bottom-up proteomics). However, this technique cannot, in most cases, distinguish among toxin proteoforms, herein called toxiforms, because of the protein inference problem. Top-down proteomics (TDP) analyzes intact proteins without digestion and provides high quality data to identify and characterize toxiforms. Denaturing top-down proteomics is the most disseminated subarea of TDP, which performs qualitative and quantitative analyzes of proteoforms up to ~30 kDa in high-throughput and automated fashion. On the other hand, native top-down proteomics provides access to information on large proteins (> 50 kDA) and protein interactions preserving non-covalent bonds and physiological complex stoichiometry. The use of native and denaturing top-down venomics introduced novel and useful techniques to toxinology, allowing an unprecedented characterization of venom proteins and protein complexes at the toxiform level. The collected data contribute to a deep understanding of venom natural history, open new possibilities to study the toxin evolution, and help in the development of better biotherapeutics.

Systematic training model for teaching, development and training of instructors in inguinal hernia treatment using the Lichtenstein technique. Hernia campaign 2014 & 2015. / Modelo de treinamento sistematizado para o ensino, desenvolvimento e formação de instrutores no tratamento da hérnia inguinal pela técnica de Lichtenstein. Mutirão da hérnia 2014 e 2015.

ABSTRACT Objective: to evaluate the method of training and continuing education of 18 surgeons in 2014, and 28 surgeons in 2015, in the Holy Homes of Ribeirao Preto, Araraquara, Franca and San Carlos of São Paulo, in the performance of Lichtenstein inguinal herniorrhaphy, tutored by the Faculty of Medical Sciences of the São Paulo Holy Home and the organization HERNIA HELP - "Hernia Repair for the Underserved". Methods: the training was tutored and systematized through an active methodology of teaching and learning, aiming to offer competence, skills and attitudes, measured by a previously validated Qualification Form, qualifying leaders in trainees' improvement. Results: in 2014 the outcomes were: the difficulty of the case, direction, incision, dissection, mesh preparation, mesh cutting, mesh setting, closing, instruments, respect to tissues, flow, time and motion, and performance, all presented change in the general rating (p=0.000002); there was greater confidence in the execution of the procedure in 80% of trainees, considered "very valuable" in 93.3% of the interventions. In 2015, 28 surgeons were trained by ten surgeons previously qualified in 2014. The nerve identification rate, a relevant time the Lichtenstein technique, was 95.5% for the Iliohypogastric, 98.5% for the ilioinguinal and 89.4% for the genital branch of the genitofemoral nerve. Conclusion: the applied teaching method is possible, reproducible, reliable and valid. The joint efforts offer enormous opportunity of directed education, reaching underserved populations, revealing the great teacher-student social responsibility.

RESUMO Objetivo: avaliar resultados do método de treinamento e educação continuada de 18 cirurgiões, em 2014, e 28 cirurgiões, em 2015, nas Santas Casas de Ribeirão Preto, Araraquara, Franca e São Carlos do Estado de São Paulo, na realização da Herniorrafia Inguinal à Lichtenstein, tutorados pela Faculdade de Ciências Médicas da Santa Casa de São Paulo e pela organização HERNIA HELP - "Hernia Repair for the Underserved". Métodos: treinamento tutorado e sistematizado, através de metodologia ativa de ensino e aprendizagem, visando a oferecer competência, habilidade e atitudes, auferidas por um Formulário de Qualificação previamente validado, qualificando líderes no aperfeiçoamento de treinandos. Resultados: em 2014, os desfechos foram: dificuldade do caso, direção, incisão, dissecção, preparo da tela, corte da tela, fixação da tela, fechamento, instrumentos, respeito aos tecidos, fluxo, tempo e movimento e desempenho, apresentaram mudança na Classificação Geral (p=0,000002); houve maior confiança na execução do procedimento em 80% dos treinandos, sendo considerado "Muito Valioso" em 93,3% das participações. Em 2015, os 28 cirurgiões foram treinados por dez cirurgiões previamente qualificados em 2014. A taxa de identificação dos nervos, tempo relevante da técnica de Lichtenstein, foi 95,5 % para o ílio-hipogástrico, 98,5% para o ilioinguinal e 89,4% para o ramo genital do nervo genitofemoral. Conclusão: o método de ensino aplicado é possível, reprodutível, confiável e válido. Os mutirões oferecem a enorme oportunidade do ensino, dirigido, atingindo populações carentes, revelando a grande responsabilidade social docente-discente.

Aspectos éticos da inovação em saúde em Portugal / Ethical aspects of innovation in health in Portugal / Aspectos éticos de la innovación en salud en Portugal

A gestão eficaz de recursos é preocupação atual das instituições de saúde em Portugal, havendo necessidade de racionalizar e estabelecer prioridades de acordo com princípios éticos que garantam a equidade. O acesso à inovação tem-se revelado fundamental na promoção dos cuidados de saúde e na consequente melhoria da qualidade de vida dos cidadãos, ainda que com custos associados. Tendo em conta o rápido desenvolvimento da ciência e a crescente disponibilização de inovação, na forma de tecnologia ou terapêuticas, tem-se mostrado imperativa uma discussão clara, consciente e fundamentada sobre a adoção e o estabelecimento de prioridades no que respeita à inovação em saúde. Centrado na definição de inovação em saúde, no levantamento das prioridades, na percepção dessas prioridades e nas suas dimensões políticas, o presente artigo propõe uma reflexão crítica à luz de aspectos éticos que evidenciem as principais indagações relacionadas com a introdução da inovação em saúde em Portugal.

Effective management of resources is a current concern of health institutions in Portugal, requiring rationalization and prioritization according to ethical principles to ensure fairness. Access to innovation has proved fundamental in promoting health care and consequently improving quality of life, albeit with associated costs. Given the rapid development of science and the growing prevalence of innovation in the form of technology and treatments, a clear, conscious and reasoned discussion about the adoption and establishment of priorities with regard to innovation in health is imperative. Centered on a definition of innovation in health, the study of priorities, the perception of the same and their political aspects, the present article proposes a critical reflection in the light of ethical aspects that evidence the main questions related to the introduction of innovation in health in Portugal.

La gestión eficaz de recursos es una preocupación actual de las instituciones de salud en Portugal, existiendo una necesidad de racionalización y establecimiento de prioridades de acuerdo con los principios éticos para garantizar la equidad. El acceso a la innovación ha demostrado ser fundamental en la promoción de la atención de salud y la consecuente mejora en la calidad de vida, aunque traiga ciertos costos asociados. Dado el rápido desarrollo de la ciencia y la creciente disponibilidad de innovación, en forma de tecnologías y tratamientos, ha resultado imprescindible una discusión clara, conciente y fundamentada acerca de la adopción y el establecimiento de prioridades en materia de innovación en salud. Haciendo foco en la definición de innovación en salud, en la definición de prioridades, en la percepción de las mismas y en sus aspectos políticos, este artículo propone una reflexión crítica a la luz de los aspectos éticos que evidencian los principales interrogantes relacionados con la introducción de la innovación en salud en Portugal.

Relationship between nutritional and psychological status of pregnant adolescents and non-adolescents in Brazil.

This study compared the nutritional and psychological status of 855 pregnant adolescents and non-adolescents and assessed their relationships at three interviews (gestational age < or = 16 weeks, 20-26 weeks, and 30-36 weeks). The instruments used were: anthropometry, state-trait anxiety inventories (STAI), general health questionnaire (GHQ), and perceived stress scale (PSS). More adolescents were thinner, had higher scores of the trait anxiety inventory (TAI), wished to abort their children, and were worried about changes in their bodies than non-adolescents. Multiple linear regression analyses (controlling for toxic exposure, socioeconomic, demographic and obstetric factors) detected negative associations between weight gain in the first interview and distress (GHQ) for both the groups of women and weight gain in the second interview and the variable "worry about body's change" for the non-adolescent group. The negative associations between body mass index and chronic anxiety (TAI) were present in the three interviews for non-adolescents. This study detected a relationship between the nutritional and the psychological status of pregnant women, although there were more associations for non-adolescents.

Esclerotomia modificada na síndrome de efusão uveal / Mofified sclerotomy in uveal effusion syndrome

Objetivo: Relatar resultado visual e anatômico após cirurgia escleral modificada em um paciente com síndrome de efusão uveal com deslocamento da retina e coróide. Local: Dep. Uveíte do Hospital São Geraldo - UFMG. Métodos: Em um paciente com deslocamento da retina e coróide e síndrome de efusão uveal idiopática, realizamos esclerotomia sem sutura com espessura total no nível da pars plana sem esclerotomia. Resultados: O deslocamento da retina e coróide diminuiu o espessamento da coróide. Entretanto, o paciente não apresentou melhora visual. Conclusão: A síndrome de efusão uveal que for refratária ao tratamento meicamentoso (altas doses de corticóides) pode ser manejável por esclerotomia com espessura total, sem sutura, e sem esclerotomia.