Ataxia-telangiectasia in Latin America: clinical features, immunodeficiency, and mortality in a multicenter study.

Ataxia-telangiectasia (AT) is a rare genetic disorder leading to neurological defects, telangiectasias, and immunodeficiency. We aimed to study the clinical and immunological features of Latin American patients with AT and analyze factors associated with mortality. Referral centers from 9 Latin American countries participated in this retrospective cohort study, and 218 patients were included. Median (IQR) ages at symptom onset and diagnosis were 1.0 (1.0-2.0)  and 5.0 (3.0-8.0) years, respectively. Most patients presented recurrent airway infections, which was significantly associated with IgA deficiency. IgA deficiency was observed in 60.8% of patients and IgG deficiency in 28.6%. T- and B-lymphopenias were also present in most cases. Mean survival was 24.2 years, and Kaplan-Meier 20-year-survival rate was 52.6%, with higher mortality associated with female gender and low IgG levels. These findings suggest that immunologic status should be investigated in all patients with AT.

Long-term impacts of 48-h water and feed deprivation on blood and performance responses of grazing Bos indicus Nellore heifers.

The study investigated the effects of 48-h water and feed deprivation on blood and the performance of grazing Nellore (Bos indicus) heifers. Twenty-four Nellore heifers (initial body weight [BW] = 238 ±â€…10 kg; age = 16 ±â€…2 mo), were ranked by initial BW and age and randomly assigned to one of the two treatments: (1) grazing animals with free access to pasture, water, and mineral-mix (CON; n = 12), or (2) the same grazing conditions but deprived of pasture, water, and mineral-mix for 48 h (DPR; n = 12). The paddocks consisted of Urochloa brizantha cv. Marandu, using a continuous and fixed stocking rate. The experiment lasted 225 d, with the first 14 d considered as the adaptation period (days -14 to -1) and the subsequent 211 d as the evaluation period (days 0 to 211). From days 0 to 2, treatments were applied by keeping the DPR heifers in pens and reintegrating them into the experimental area after a 48-h water and feed deprivation. Individual full BW was recorded on days -14, -13, -1, before (day 0) and after (day 2) treatment application, and on days 6, 11, 12, 41, 42, 210, and 211. Blood samples were collected in the morning on days 0, 2, 6, 12, and 211. A treatment effect was detected (P < 0.001) for shrink BW from days 0 to 2, which was greater (P < 0.001) in DPR vs. CON heifers. Subsequently, DPR animals were lighter (P < 0.001) compared with CON heifers by the end of the deprivation period (day 2). From days 4 to 211, DPR was lighter (P < 0.001) compared with CON heifers after treatment application and for the entire experimental period. In the first 10 d after treatment application (days 2 to 12), DPR heifers showed a partial compensatory average daily gain (ADG; P < 0.001) compared with CON heifers, while no significant differences were observed in ADG between the treatments from days 12 to 42 and 42 to 211 (P > 0.420). Overall ADG (days 2 to 211) was greater (P < 0.001) for DPR vs. CON heifers. All serum variables, except AST, were higher (P < 0.001) in DPR than in CON heifers on day 2 after treatment application. Our study demonstrates that grazing Nellore heifers subjected to 48-h water and feed deprivation experienced significant alterations in their blood metabolites and BW immediately after the stressful event. Although the deprived heifers partially compensated for their BW loss in the early days post-deprivation, they remained 12 kg lighter than the non-deprived animals throughout the production cycle.

Different combinations of monensin and narasin on growth performance, carcass traits, and ruminal fermentation characteristics of finishing beef cattle.

The objective of this study was to evaluate the effects of different combinations of monensin and narasin on finishing cattle. In Exp. 1, 40 rumen-cannulated Nellore steers [initial body weight (BW) = 231 ± 3.64 kg] were blocked by initial BW and assigned to one of the five treatments as follows: Control (CON): no feed additive in the basal diet during the entire feeding period; Sodium monensin (MM) at 25 mg/kg dry matter (DM) during the entire feeding period [adaptation (days 1-21) and finishing (days 22-42) periods]; Narasin (NN) at 13 mg/kg DM during the entire feeding period (adaptation and finishing periods); Sodium monensin at 25 mg/kg DM during the adaptation period and narasin at 13 mg/kg DM during the finishing period (MN); and narasin at 13 mg/kg DM during the adaptation period and sodium monensin at 25 mg/kg DM during the finishing period (NM). Steers fed MM had lower dry matter intake (DMI) during the adaptation period compared to NM (P = 0.02) but not compared to CON, MM, MN, or NN (P ≥ 0.12). No differences in DMI were observed among the treatments during the finishing (P = 0.45) or the total feeding period (P = 0.15). Treatments did not affect the nutrient intake (P ≥ 0.51) or the total apparent digestibility of nutrients (P ≥ 0.22). In Exp. 2, 120 Nellore bulls (initial BW = 425 ± 5.4 kg) were used to evaluate the effects of the same treatments of Exp. 1 on growth performance and carcass characteristics of finishing feedlot cattle. Steers fed NM had greater DMI during the adaptation period compared to CON, MM, and MN (P ≤ 0.03), but no differences were observed between NM and NN (P = 0.66) or between CON, MM, and NN (P ≥ 0.11). No other differences between treatments were observed (P ≥ 12). Feeding narasin at 13 mg/kg DM during the adaptation period increases the DMI compared to monensin at 25 mg/kg DM, but the feed additives evaluated herein did not affect the total tract apparent digestibility of nutrients, growth performance, or carcass characteristics of finishing cattle.

Disposable electropolymerized molecularly imprinted electrochemical sensor for determination of breast cancer biomarker CA 15-3 in human serum samples.

Initially, a printed electrode was fabricated in a paper substrate using carbon nanotube ink, graphite pencil and silver nanoparticle ink. For that the electrode was modified with gold nanoparticles and a molecularly imprintedpolymer (MIP) using CA 15-3 as target molecule. The Atomic Force Microscopy (AFM) images exhibited the change in the morphology after each electrode modification. The roughness increasedafter the electropolymerization, and decreased after the extraction procedure. Next, slightly increased again associated to the interaction of CA 15-3 and the imprinted sites. Finally, the Fourier Transform Infrared Spectroscopy (FTIR) results suggested the extraction/rebinding of CA 15-3 in the MIP sensor and also indicated that the NIP sample do not have specific cavities for the CA 15-3. In short, under optimized conditions, the CNE/AuNP is incubated with CA 15-3 (40 U mL-1) for 2 h at 4 °C. Then the electropolymerization was carried out in the potential range of -0.2 to 1.0 V during 20 cycles at scan rate of 50 mV s-1 using a solution containing 15 mM of oPD. After electropolymerization, the sensor was washed with oxalic acid solution for 2 h, leading to the formation of imprinted cavities. The rebinding process was subsequently constructed for 1 h at 4 °C using CA 15-3 solution. The reproducibility and interference studies showed that the sensor can be reproducible and specific for CA 15-3. Then the sensor was applied in determination of CA 15-3 in samples of serum and saliva. The use in serum presented good recovery, but the application in saliva was not satisfactory. Therefore, the sensor CNE/AuNP/MIP could be used in the determination of CA 15-3 in serum samples.

Estimating the early impact of vaccination against COVID-19 on deaths among elderly people in Brazil: Analyses of routinely-collected data on vaccine coverage and mortality.

Background: Vaccination against COVID-19 in Brazil started in January 2021, with health workers and the elderly as the priority groups. We assessed whether there was an impact of vaccinations on the mortality of elderly individuals in a context of wide transmission of the SARS-CoV-2 gamma (P.1) variant. Methods: By May 15, 2021, 238,414 COVID-19 deaths had been reported to the Brazilian Mortality Information System. Denominators for mortality rates were calculated by correcting population estimates for all-cause deaths reported in 2020. Proportionate mortality at ages 70-79 and 80+ years relative to deaths at all ages were calculated for deaths due to COVID-19 and to other causes, as were COVID-19 mortality rate ratios relative to individuals aged 0-69 years. Vaccine coverage data were obtained from the Ministry of Health. All results were tabulated by epidemiological weeks 1-19, 2021. Findings: The proportion of all COVID-19 deaths at ages 80+ years was over 25% in weeks 1-6 and declined rapidly to 12.4% in week 19, whereas proportionate COVID-19 mortality for individuals aged 70-79 years started to decline by week 15. Trends in proportionate mortality due to other causes remained stable. Mortality rates were over 13 times higher in the 80+ years age group compared to that of 0-69 year olds up to week 6, and declined to 5.0 times in week 19. Vaccination coverage (first dose) of 90% was reached by week 9 for individuals aged 80+ years and by week 13 for those aged 70-79 years. Coronavac accounted for 65.4% and AstraZeneca for 29.8% of all doses administered in weeks 1-4, compared to 36.5% and 53.3% in weeks 15-19, respectively. Interpretation: Rapid scaling up of vaccination coverage among elderly Brazilians was associated with important declines in relative mortality compared to younger individuals, in a setting where the gamma variant predominates. Had mortality rates among the elderly remained proportionate to what was observed up to week 6, an estimated additional 43,802 COVID-related deaths would have been expected up to week 19. Funding: CGV and AJDB are funded by the Todos pela Saúde (São Paulo, Brazil) initiative.

Chronological Age, Somatic Maturation and Anthropometric Measures: Association with Physical Performance of Young Male Judo Athletes.

Sport for children and adolescents must consider growth and maturation to ensure suitable training and competition, and anthropometric variables could be used as bio-banding strategies in youth sport. This investigation aimed to analyze the association between chronological age, biologic maturation, and anthropometric characteristics to explain physical performance of young judo athletes. Sixty-seven judokas (11.0-14.7 years) were assessed for anthropometric and physical performance. Predicted adult stature was used as a somatic maturation indicator. A Pearson's bivariate correlation was performed to define which anthropometric variables were associated with each physical test. A multiple linear hierarchical regression was conducted to verify the effects of age, maturity, and anthropometry on physical performance. The regression models were built with age, predicted adult stature, and the three most significantly correlated anthropometric variables for each physical test. Older judokas performed better in most of the physical tests. However, maturation attenuated the age effect in most variables and significantly affected upper body and handgrip strength. Anthropometric variables attenuated age and maturity and those associated with body composition significantly affected the performance in most tests, suggesting a potential as bio-banding strategies. Future studies should investigate the role of anthropometric variables on the maturity effect in young judokas.

MOLECULAR EPIDEMIOLOGY TO UNDERSTAND THE SARS-CoV-2 EMERGENCE IN THE BRAZILIAN AMAZON REGION

The COVID-19 pandemic in Brazil has demonstrated an important public health impact, as has been observed in the world. In Brazil, the Amazon Region contributed with a large number of cases of COVID-19, especially in the beginning of the circulation of SARS-CoV-2 in the country. Thus, we describe the epidemiological profile of COVID-19 and the genetic diversity of SARS-CoV-2 strains circulating in the Amazon Region. We observe an extensive spread of virus in this Brazilian site. The data on sex, age and symptoms presented by the investigated individuals were similar to what has been observed worldwide. The genomic analysis of the viruses revealed important amino acid changes, including the D614G and the I33T in Spike and ORF6 proteins, respectively. The latter found in strains originating in Brazil. The phylogenetic analyzes demonstrated the circulation of the lineages B.1 and B.1.1, whose circulation in Brazil has already been previous reported. Our data reveals molecular epidemiology of SARS-CoV-2 in the Amazon Region. These findings also reinforce the importance of continuous genomic surveillance this virus with the aim of providing accurate and updated data to understand and map the transmission network of this agent in order to subsidize operational decisions in public health.

Milk yield and composition from ewes fed diets containing narasin and their lambs' performance.

The changes promoted by feed additives in ruminal fermentation, especially increasing the availability of propionate, can improve the energy balance of an animal, which is of great importance in the lactation period. This trial aimed to evaluate the inclusion of narasin in the diet of lactating ewes on milk yield, composition, dry matter intake (DMI), and plasma metabolites of the ewes and growth rate of lambs. Thirty-two lactating ewes (59.0 ± 2.42 kg) were assigned to a randomized complete block design. The experimental diets contained 500 g/kg of dry matter (DM) of coast cross (Cynodon dactylon (L.) Pers) hay and 500 g/kg DM of concentrate, and the treatments were: N0-no narasin inclusion; N13-inclusion of 13 mg of narasin/kg DM. Once a week, from week 2 to 10 of lactation, ewes were separated from their lambs, injected with oxytocin, and milked mechanically to empty the udder. After 3 h, the milk production was recorded, using the same procedure, and sampled to evaluate the composition. The blood samples were taken weekly, 4 h after feeding. The average daily gain (ADG) and starter DMI of the lambs were evaluated weekly from week 2 to 12 of age. The inclusion of narasin did not affect (P = 0.93) DMI of ewes; however, it increased milk production (P < 0.01) and feed efficiency (P = 0.02; FE). Ewes fed N13 had a greater milk fat (P < 0.01), protein (P < 0.01), lactose (P = 0.04), and total solids production (P < 0.01). Narasin inclusion in ewe's diet increased plasma glucose concentration (P = 0.05) at weeks 8, 9 and 10; however, there was no effect on plasma urea concentration (P = 0.96). The lambs of N0 ewes had a greater starter DMI (P < 0.01) at weeks 7, 8, 9, and 10; however, the ADG and body weight at weaning and after weaning were similar between treatments (P > 0.05). The results showed that the inclusion of 13 mg of narasin/kg DM improved the milk production and FE of the ewes without altering the composition of the milk. The lower initial consumption of concentrate by N13 lambs before weaning was caused by the higher production of milk. The results obtained in the present study demonstrate the possible productive gain with the inclusion of narasin in diets for lactating ewes.

Bio-Banding in Judo: The Mediation Role of Anthropometric Variables on the Maturation Effect.

Young judo athletes are bio-banding based on age and body mass and compete in weight classes. The purposes of this study were to investigate the influences of maturation on physical performance in young judokas through controlling the chronological age and body mass, and to examine the mediating role of anthropometric variables. Sixty-seven judokas, aged 11.0-14.7, were measured for 11 anthropometric and seven physical performance variables. Pearson partial correlations were conducted to verify the relationship between the maturational indicator and the dependent variables. Mediation analyses were performed to identify the extent to which anthropometric variables mediate the relationship. The maturation effect remained on the aerobic capacity and handgrip strength (p < 0.05). Fat mass (b = 80.335, 95%CI 11.580-204.270) and fat-free mass (b = 108.256, 95%CI 39.508-207.606) totally mediated the effect on aerobic capacity. Fat mass (b = 0.023, 95%CI 0.004-0.057), fat-free mass (b = 0.029, 95%CI 0.011-0.058), stature (b = 0.031, 95%CI 0.008-0.061), arm span (b = 0.021, 95%CI 0.003-0.044), and inferior members length (b = 0.022, 95%CI 0.005-0.049) totally mediated the effect on handgrip strength. The effect of biological maturation is noticeable even after age and body mass control, being mediated by anthropometric variables related to body composition and size.

Os fatores associados à asma em crianças e adolescentes são universais? Estudo sistemático multicêntrico brasileiro / Are the factors associated with asthma in children and adolescents universal? A systematic multicenter Brazilian study

Objetivo: Comparar os fatores de risco associados à asma em escolares brasileiros habitantes de diferentes regiões do país. Método: Participaram estudantes (4-8 anos, n = 4.262; 10-14 anos, n = 10.603) matriculados em escolas privadas ou particulares de onze centros de nove cidades brasileiras, utilizando-se o protocolo do International Study of Asthma and Allergy in Childhood (ISAAC). Após a obtenção das taxas de prevalência de asma, foram selecionados de modo aleatório estudantes com asma ativa (resposta afirmativa para "sibilos nos últimos 12 meses") e sem asma (resposta negativa) mantendo-se como base a proporção 1:2. A seguir os responsáveis responderam questionário complementar ISAAC sobre fatores de risco. A análise de regressão logística identificou os fatores associados à expressão da asma nos escolares, em cada centro de origem. Resultados: Na faixa etária mais jovem, ter antecedente de rinite ou eczema atópico, história familiar de doenças alérgicas e ser exposto ao tabaco foram identificados pela maioria dos centros. Entre os adolescentes ocorreu o mesmo: ter rinite alérgica (8/11 centros), ter antecedentes familiares de doenças alérgicas (6/11), ser exposto passivamente ao tabaco (6/11), assim como a animais domésticos, sobretudo gato (5/11), nascer pré-termo, ter baixo consumo de vegetais e suco de frutas foram os fatores identificados. Conclusões: Os fatores associados ao desenvolvimento de asma em escolares brasileiros não foram uniformes. Fatores genéticos, como ter outra doença alérgica, ou familiares com doença alérgica, foram identificados pela maioria dos centros participantes. A exposição ao tabaco, assim como a animais domésticos, também mostrou ser de importância clínica.

Objective: To compare factors associated with the development of asthma in Brazilian schoolchildren residing in different geographical regions. Method: Children and adolescents (4-8 years, n = 4,262; 10-14 years, n = 10,603) enrolled in public or private schools at 11 centers from 9 Brazilian cities were screened using the protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). After obtaining asthma prevalence rates, schoolchildren with active asthma (positive response for wheezing in the past 12 months) and without asthma (negative response) were randomly selected at a ratio of 1:2. Then, their parents or guardians were asked to answer the supplementary ISAAC questionnaire on risk factors. Multivariate logistic regression analysis identified factors associated with the expression of asthma among schoolchildren at each center. Results: Among children, having a history of rhinitis or atopic eczema, having a family history of allergic diseases, and being exposed to tobacco were identified as risk factors at most centers. Among adolescents, similar results were found: having allergic rhinitis (8/11 centers), having a family history of allergic diseases (6/11), being passively exposed to tobacco (6/11), being exposed to domestic animals, especially cat (5/11), having been born preterm, and having a low intake of vegetables and fruit juice were the main factors identified. Conclusion: Risk factors for the development of asthma in Brazilian schoolchildren were not unanimous. Genetic factors, such as having another allergic disease, or having family members with allergic disease, were identified by most of the participating centers. Exposure to tobacco, as well as to domestic animals, also showed to be clinically important.

Interference of heart and transcutaneous oxygen monitoring in the measurement of bioelectrical impedance analysis in preterm newborns / Interferência da monitoração cardíaca e transcutânea de oxigênio na aferição da bioimpedância elétrica em recém-nascidos pré-termo

Abstract Objective: To verify if the connection of electrodes for heart and transcutaneous oxygen monitoring interfere with the measurement of electrical bioimpedance in preterm newborns. Methods: This was a prospective, blinded, controlled, cross-sectional, crossover study that assessed and compared paired measures of resistance (R) and reactance (Xc) by BIA, obtained with and without monitoring wires attached to the preterm newborn. The measurements were performed in immediate sequence, after randomization to the presence or absence of electrodes. The sample size calculated was 114 measurements or tests with monitoring wires and 114 without monitoring wires, considering for a difference between the averages of 0.1 ohms, with an alpha error of 10% and beta error of 20%, with significance <0.05. Results: No differences were observed between the R (677.37 ± 196.07 vs. 677.46 ± 194.86) and Xc (31.15 ± 9.36 vs. 31.01 ± 9.56) values obtained with and without monitoring wires, respectively, with good correlation between them (R: 0.997 and Xc: 0.968). Conclusion: The presence of heart and/or transcutaneous oxygen monitoring wires connected to the preterm newborn did not affect the values of R or Xc measured by BIA, allowing them to be carried out in this population without risks.

Resumo Objetivo Verificar se a conexão de eletrodos e os fios de monitoração cardíaca e transcutânea de oxigênio interferem na aferição da bioimpedância elétrica em recém-nascidos pré-termo (RNPT). Metodologia Estudo prospectivo, cego, randomizado, transversal, crossover, em que foram mensuradas e comparadas medidas pareadas de resistência (R) e reatância (Xc) por meio da BIA, obtidas com e sem os fios de monitoração acoplados aos RNPT. As medidas foram feitas em sequência imediata, após aleatorização para a presença ou ausência dos eletrodos. O tamanho amostral calculado foi de 114 aferições ou exames com fios de monitoração e 114 sem fios de monitoração, foi calculado para uma diferença entre as médias de 0,1 ohms, com erro alfa de 10% e erro beta de 20%, com significância < 0,05. Resultados Não foram observadas diferenças entre os valores de resistência (677,37 ± 196,07 vs. 677,46 ± 194,86) e reatância (31,15 ± 9,36 vs. 31,01 ± 9,56) obtidos com e sem fios de monitoração respectivamente, com boa correlação entre ambos (resistência: 0,997 e reatância: 0,968). Conclusão A presença de fios de monitoração cardíaca e/ou transcutânea de oxigênio não interferiu nos valores da resistência ou da reatância aferidos pela BIA em RNPT. Recomenda-se, então, a feitura desse exame, sem riscos, para essa população.

Interference of heart and transcutaneous oxygen monitoring in the measurement of bioelectrical impedance analysis in preterm newborns.

OBJECTIVE: To verify if the connection of electrodes for heart and transcutaneous oxygen monitoring interfere with the measurement of electrical bioimpedance in preterm newborns. METHODS: This was a prospective, blinded, controlled, cross-sectional, crossover study that assessed and compared paired measures of resistance (R) and reactance (Xc) by BIA, obtained with and without monitoring wires attached to the preterm newborn. The measurements were performed in immediate sequence, after randomization to the presence or absence of electrodes. The sample size calculated was 114 measurements or tests with monitoring wires and 114 without monitoring wires, considering for a difference between the averages of 0.1 ohms, with an alpha error of 10% and beta error of 20%, with significance <0.05. RESULTS: No differences were observed between the R (677.37±196.07 vs. 677.46±194.86) and Xc (31.15±9.36 vs. 31.01±9.56) values obtained with and without monitoring wires, respectively, with good correlation between them (R: 0.997 and Xc: 0.968). CONCLUSION: The presence of heart and/or transcutaneous oxygen monitoring wires connected to the preterm newborn did not affect the values of R or Xc measured by BIA, allowing them to be carried out in this population without risks.

Environmental implications of anaerobic digestion for manure management in dairy farms in Mexico: a life cycle perspective.

The environmental profile of milk production in Mexico was analysed for three manure management scenarios: fertilization (F), anaerobic digestion (AD) and enhanced anaerobic digestion (EAD). The study used the life cycle assessment (LCA) technique, considering a 'cradle-to-gate' approach. The assessment model was constructed using SimaPro LCA software, and the life cycle impact assessment was performed according to the ReCiPe method. Dairy farms with AD and EAD scenarios were found to exhibit, respectively, 12% and 27% less greenhouse gas emissions, 58% and 31% less terrestrial acidification, and 3% and 18% less freshwater eutrophication than the F scenario. A different trend was observed in the damage to resource availability indicator, as the F scenario presented 6% and 22% less damage than the EAD and AD scenarios, respectively. The magnitude of environmental damage from milk production in the three dairy manure management scenarios, using a general single score indicator, was 0.118, 0.107 and 0.081 Pt/L of milk for the F, AD and EAD scenarios, respectively. These results indicate that manure management systems with anaerobic digestion can improve the environmental profile of each litre of milk produced.

Pregnancy, maternal exposure to analgesic medicines, and leukemia in Brazilian children below 2 years of age.

Childhood leukemia etiology, and mainly the interactions of genetic and environmental risk factors, remains largely unexplored. This national hospital-based case-control study was carried out in Brazil among children aged 0-23 months who were recruited at cancer and general hospitals in 13 states. Maternal medicine intake during pregnancy, including analgesic intake, was assessed by face-to-face interviews with the mothers of 231 leukemia patients and 411 controls. Unconditional logistic regression was used to ascertain crude and adjusted odds ratios (ORs), and their 95% confidence intervals (CIs) for the association between maternal analgesic use during pregnancy and early age leukemia. Acetaminophen use during the first trimester of pregnancy showed an OR=0.39 (95% CI 0.17-0.93) for acute lymphocytic leukemia and an OR=0.37 (95% CI 0.16-0.88) for use in the second trimester. For acute myeloid leukemia, an OR=0.11 (95% CI 0.02-0.97) was found following acetaminophen use in the second trimester. For acute lymphocytic leukemia, the exclusive use of dipyrone during preconception showed an OR=1.63 (95% CI 1.06-2.53) and dipyrone intake during lactation showed an OR=2.00 (95% CI 1.18-3.39). These results suggest that acetaminophen use during pregnancy may protect against development of early age leukemia in the offspring, whereas dipyrone use may act as a risk factor for such an outcome.

Spray drying as a strategy for biosurfactant recovery, concentration and storage.

The objective of this study was to analyze the use of Spray Drying for concentration and preservation of biosurfactants produced by Bacillus subtilis LBBMA RI4914 isolated from a heavy oil reservoir. Kaolinite and maltodextrin 10DE or 20DE were tested as drying adjuvants. Surface activity of the biosurfactant was analyzed by preparing dilution x surface activity curves of crude biosurfactant, crude biosurfactant plus adjuvants and of the dried products, after their reconstitution in water. The shelf life of the dried products was also evaluated. Spray drying was effective in the recovery and concentration of biosurfactant, while keeping its surface activity. Drying adjuvants were required to obtain a solid product with the desired characteristics. These compounds did not interfere with tensoactive properties of the biosurfactant molecules. The dehydrated product maintained its surfactant properties during storage at room temperature during the evaluation period (120 days), with no detectable loss of activity.

Análise da viabilidade financeira e dos aspectos legais para implementação de clínica odontológica na cidade de Goiânia / Analysis of financial feasibility and legal aspects for dental clinic implementation in the city of Goiânia

Embora o empreendedorismo seja um desafio no Brasil, sua taxa aumentou muito nos últimos anos, sendo considerado por muitos uma opção desejável de carreira. Na área da saúde, as dificuldades enfrentadas pelo Sistema Único de Saúde (SUS) favorecem o surgimento e a permanência de entidades de natureza empresarial. No entanto, o índice de mortalidade das micro e pequenas empresas ainda é motivo de grande preocupação, cuja principal razão envolve as demandas jurídico-legais e a ausência do planejamento financeiro, necessário para análise da viabilidade financeira do negócio. Diante disso, há necessidade de orientar os potenciais empreendedores no desenvolvimento do planejamento para implementação dessas empresas. Objetivo: orientar as diretrizes gerais envolvidas na implementação e permanência no mercado de empresa na modalidade clínica odontológica. Material e método: revisão bibliográfica em artigos, livros especializados, normas publicadas em Diário Oficial, além de coleta de dados em empresas e instituições públicas para demonstração do planejamento financeiro e dos demais aspectos relacionados. Resultados: desenvolvimento de estudo da viabilidade financeira adaptável às diversas realidades do mercado e demonstração da sequência dos aspectos jurídico-legais. Conclusão: Os conhecimentos sobre a viabilidade financeira e demais aspectos relacionados contribuem com a redução do risco de insucesso para os potenciais empreendedores na medida em que viabilizam as informações necessárias para tal fim.

Although entrepreneurship is a challenge in Brazil, its rate has increased a lot in recent years, and it is considered by many as a desirable career option. In health, the difficulties faced by the Unified Health System (SUS) support the emergence and persistence of business entities. However, the mortality rate of the micro and small enterprises is still a big concern, which the main reason involves juridical and legal demands and the lack of financial planning, necessary to analyze the financial viability of the business. Therefore, there is the need to advise potential entrepreneurs in the development of planning for implementation of these enterprises. Objective: To guide the general guidelines involved in implementing and persisting in business in dental clinic modality. Materials and Methods: articles literature review, specialized books, standards published inthe Official Gazette, and data collection at companies and public institutions for demonstration of financial planning and other related aspects. Results: development of financial feasibility study adaptable to various market realities and demonstration of following juridical and legal aspects. Conclusion: Knowledge about financial viability and other related aspects contribute to reducing the risk of failure for potential entrepreneurs, as they enable the necessary information for such purpose.

Aplicação de protocolo proposto pela Agência Nacional de Vigilância Sanitária para uso de antibióticos em recém-nascidos de muito baixo peso / Implementation of a protocol proposed by the brazilian National Health Surveillance Agency for antibiotic use in very low birth weight infants

OBJETIVO: Analisar a aplicação de um protocolo proposto pela Agência Nacional de Vigilância Sanitária (ANVISA) para aprimorar o diagnóstico de sepse em recém-nascidos de muito baixo peso. MÉTODOS: Estudo prospectivo que avaliou a aplicação de protocolo envolvendo critérios clínicos e laboratoriais (escore hematológico de Rodwell e dosagem seriada da proteína C-reativa), recomendado pela ANVISA, para aprimorar o diagnóstico de sepse neonatal em recém-nascidos de muito baixo peso. Participaram do estudo todos os pacientes que nasceram e permaneceram na Unidade Neonatal até a alta ou óbito, e foram excluídos aqueles com doenças congênitas. Os principais desfechos analisados entre os recém-nascidos antes da aplicação do protocolo (2006-2007) e após a aplicação do mesmo (2008) foram as taxas de sepses precoce e tardia, o uso de antimicrobianos e a mortalidade. As médias foram comparadas por meio de teste t e as variáveis categóricas pelo teste Qui-quadrado (χ2); o nível de significância para todos eles foi fixado em 95%. RESULTADOS: Foram incluídos no estudo 136 recém-nascidos de muito baixo peso. Não houve diferença entre os grupos em relação às características clínicas gerais nos períodos estudados. Houve, no entanto, redução na quantidade de diagnóstico de sepse precoce provável (p < 0,001), de uso de esquemas antimicrobianos (p < 0,001) e da mortalidade geral e associada à sepse (p = 0,009 e p = 0,049, respectivamente). CONCLUSÃO: A utilização do protocolo permitiu aprimorar o diagnóstico de sepse, reduzindo o diagnóstico de sepse precoce provável, promovendo, desta forma, o uso racional de antimicrobianos na população estudada.

OBJECTIVE: To analyze the implementation of a protocol proposed by the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) to improve sepsis diagnosis in very low birth weight newborns. METHODS: This was a prospective study that evaluated the implementation of a protocol involving clinical and laboratory criteria (hematologic scoring system of Rodwell and C-reactive protein serial measurements), recommended by ANVISA, to improve the diagnosis of neonatal sepsis in very low birth weight newborns. The study included all patients who were born and remained in the neonatal intensive care unit until discharge or death, and excluded those with congenital diseases. The main outcomes measured in newborns before (2006-2007) and after implementation of the protocol (2008) were the rates of early and late sepsis, use of antibiotics, and mortality. Means were compared by Student's t-test and categorical variables were compared by the chi-squared test; the significance level for all tests was set at 95%. RESULTS: The study included 136 newborns with very low birth weight. There was no difference between groups regarding general clinical characteristics in the studied periods. There was, however, a decrease in the number of diagnoses of probable early-onset sepsis (p < 0.001), use of antimicrobial regimens (p < 0.001), and overall mortality and infection-related mortality (p = 0.009 and p = 0.049, respectively). CONCLUSION: The implementation of the protocol allowed improvement of sepsis diagnosis by reducing the diagnosis of probable early-onset sepsis, thus promoting efficient antimicrobial use in this population.

Implementation of a protocol proposed by the Brazilian National Health Surveillance Agency for antibiotic use in very low birth weight infants.

OBJECTIVE: To analyze the implementation of a protocol proposed by the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) to improve sepsis diagnosis in very low birth weight newborns. METHODS: This was a prospective study that evaluated the implementation of a protocol involving clinical and laboratory criteria (hematologic scoring system of Rodwell and C-reactive protein serial measurements), recommended by ANVISA, to improve the diagnosis of neonatal sepsis in very low birth weight newborns. The study included all patients who were born and remained in the neonatal intensive care unit until discharge or death, and excluded those with congenital diseases. The main outcomes measured in newborns before (2006-2007) and after implementation of the protocol (2008) were the rates of early and late-onset sepsis, use of antibiotics, and mortality. Means were compared by Student's t-test and categorical variables were compared by the chi-squared test; the significance level for all tests was set at 95%. RESULTS: The study included 136 newborns with very low birth weight. There was no difference between groups regarding general clinical characteristics in the studied periods. There was, however, a decrease in the number of diagnoses of probable early-onset sepsis (p<0.001), use of antimicrobial regimens (p<0.001), and overall mortality and infection-related mortality (p=0.009 and p=0.049, respectively). CONCLUSION: The implementation of the protocol allowed improvement of sepsis diagnosis by reducing the diagnosis of probable early-onset sepsis, thus promoting efficient antimicrobial use in this population.