Avaliação dos óbitos por COVID-19 em médicos no Brasil / Evaluation of deaths by COVID-19 in doctors in Brazil

Introdução: a pandemia da doença do coronavírus 2019 (COVID-19) afetou a população mundial, especialmente os profissionais que atuam na linha de frente, como os médicos. Objetivo: avaliar os óbitos na população médica brasileira pela COVID-19. Metodologia: trata-se de um estudo ecológico e analítico sobre os óbitos por COVID-19 em médicos, no Brasil. Realizou-se análise descritiva e utilizaram-se os testes Qui-quadrado e Qui-quadrado de Pearson com simulações de Monte-Carlo (p˂0,05). A análise espacial foi realizada mediante mapa de densidade de Kernel. Resultados: foram incluídos 938 óbitos, e predominaram vítimas do sexo masculino (86,57%) com idade média de 66,24 anos. A taxa de mortalidade por COVID-19 variou de 82,2 óbitos por 100 mil médicos no sudeste a 739,2 no norte do Brasil. O maior número de óbitos foi apresentado na clínica médica (29,85%), que também obteve a maior taxa de mortalidade de 655,3. Observou-se diferença significativa entre os anos 2020 e 2021 para a faixa etária, com maior frequência nos grupos com mais de 60 anos (p=0,005) e para as áreas de atuação médica, com maior prevalência para a clínica médica (p=0,018). No ano de 2020, os estados brasileiros que apresentaram maiores taxas de mortalidades estão localizados, na sua maioria, nas regiões Norte e Nordeste. Conclusão: devem ser consideradas as diferentes situações que aumentam a vulnerabilidade dos médicos aos riscos de contrair a COVID-19; com isso ações de promoção, proteção e assistência à saúde devem ser aprimoradas, principalmente aos profissionais que estão na linha de frente, visando o preparo para pandemias.

Introduction: the pandemic coronavirus disease 2019 (COVID-19) has affected the world population, especially professionals who are working on the front lines, like the doctors. Objective: evaluate deaths in the Brazilian medical population using COVID-19. Methods: this is a study ecological and analytical on deaths in doctors due to COVID-19, in Brazil. Descriptive analysis was performed, and Pearson's chi-square and chi-square tests were used with Monte-Carlo simulations (p˂0.05). Spatial analysis was performed using density map a Kernel. Results: were included 938 deaths, predominantly male victims (86.57%) with a mean age of 66.24 years. The mortality rate due to COVID-19 ranged from 82.2 deaths per 100,000 doctors in the Southeast to 739.2 in the North of Brazil. The highest number of deaths was presented in the Medical Clinic (29.85%), which also had the highest mortality rate of 655.3. There was a significant difference between the years 2020 and 2021 for the age group, with greater frequency in groups over 60 years old (p=0.005) and for the areas of medical practice, with higher prevalence for Internal Medicine (p=0.018). The Brazilian states had the highest mortality rates in 2020 and were mostly from the North and Northeast regions. Conclusion: the different situations that increase the vulnerability of physicians to the risks of contracting COVID-19 must be considered. Therefore, actions for health promotion, protection and assistance must be improved, with these professionals who are on the front line, aiming to prepare for pandemics.

Preservation of forensic traces by Nursing in emergency services: a scoping review. / Preservação de vestígios forenses pela enfermagem nos serviços de emergência: revisão de escopo.

OBJECTIVE: to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services. METHOD: a scoping review, with searches for studies carried out in six databases, in the gray literature available in Google Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted. RESULTS: 26 studies were included, organized into five categories: 1) Nursing professionals' knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim's body; 3) Procedures performed by Nursing to preserve traces in the victim's belongings/objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing. CONCLUSION: the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim's body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims.

Preservação de vestígios forenses pela enfermagem nos serviços de emergência: revisão de escopo / Preservation of forensic traces by Nursing in emergency services: a scoping review / Preservación de los rastros forenses que realizan los enfermeros en los servicios de emergencias: revisión de alcance

Resumo Objetivo: mapear a produção científica sobre a preservação de vestígios forenses pelos profissionais de enfermagem que atuam nos serviços de emergência. Método: revisão de escopo, com buscas dos estudos realizadas em seis bases de dados, na literatura cinzenta disponível no Google Scholar e nas referências dos estudos selecionados. Para análise, adotou-se o método de redução de dados. Resultados: foram incluídos 26 estudos que foram organizados em cinco categorias: 1) Conhecimento dos profissionais de enfermagem sobre a preservação de vestígios forenses; 2) Procedimentos realizados pela enfermagem para preservação de vestígios no corpo da vítima; 3) Procedimentos realizados pela enfermagem para preservação de vestígios em pertences/objetos da vítima; 4) Procedimentos realizados pela enfermagem para documentação dos vestígios; e 5) Ações de manutenção da cadeia de custódia realizada pela enfermagem. Conclusão: os estudos mostraram situações em que o enfermeiro de emergência pode atuar na preservação de vestígios forenses presentes no corpo da vítima e em objetos, bem como no registro dos vestígios, verificando-se a atuação da enfermagem para garantir a integridade da cadeia de custódia, principalmente em situações de agressão, de ferimento com arma de fogo, violência sexual, abuso infantil e na assistência a vítimas de trauma.

Abstract Objective: to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services. Method: a scoping review, with searches for studies carried out in six databases, in the gray literature available in Google Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted. Results: 26 studies were included, organized into five categories: 1) Nursing professionals' knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim's body; 3) Procedures performed by Nursing to preserve traces in the victim's belongings/objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing. Conclusion: the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim's body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims.

Resumen Objetivo: mapear la producción científica sobre la preservación de rastros forenses por profesionales de enfermería que trabajan en los servicios de emergencias. Método: revisión de alcance, con búsqueda de los estudios realizados en seis bases de datos, en la literatura gris disponible en Google Scholar y en las referencias de los estudios seleccionados. Para el análisis, se adoptó el método de reducción de datos. Resultados: se incluyeron 26 estudios organizados en cinco categorías: 1) Conocimiento de los profesionales de enfermería sobre la preservación de rastros forenses; 2) Procedimientos que realizan los enfermeros para preservar rastros en el cuerpo de la víctima; 3) Procedimientos que realizan los enfermeros para preservar rastros en las pertenencias/objetos de la víctima; 4) Procedimientos que realiza el personal de enfermería para documentar los rastros; y 5) Acciones que llevan a cabo los enfermeros para mantener la cadena de custodia. Conclusión: los estudios demostraron que hay situaciones en las cuales el enfermero de emergencias puede actuar para preservar los rastros forenses presentes en el cuerpo de la víctima y en los objetos, así como también registrar los rastros, lo que comprueba la actuación del enfermero para garantizar la integridad de la cadena de custodia, particularmente en situaciones de agresión, heridas con arma de fuego, violencia sexual, abuso infantil y asistencia a víctimas de trauma.

Vivência de peritos criminais sobre vestígios forenses não preservados por profissionais da saúde e segurança / Criminal experts' experience on forensic traces not preserved by health and safety professionals

RESUMO Objetivo desvelar a vivência de peritos sobre vestígios não preservados por profissionais da saúde e segurança. Métodos pesquisa qualitativa desenvolvida com 27 peritos criminais por meio de entrevista telefônica. Os dados foram processados no Software IraMuTeQ e analisados pela Classificação Hierárquica Descendente. Resultados foram obtidas quatro classes temáticas que evidenciaram a existência de lacuna de comunicação com o serviço pré-hospitalar vivenciada pelos peritos, os quais acreditam ser necessário treinamento desses profissionais e dos policiais. Nos casos de diferenciação entre suicídio e homicídio, os peritos vivenciam a mobilização do cadáver, além da retirada de arma do local original. Os profissionais da saúde descaracterizam o corpo da vítima e deixam no local objetos do cuidado em saúde, como luvas e seringas, enquanto os policiais descaracterizam a cena, movimentam objetos e não isolam a cena adequadamente. Conclusão os peritos vivenciam vestígios forenses não preservados pelos profissionais de saúde e segurança na posição dos objetos e do corpo da vítima, sentem lacuna de comunicação e apontam a necessidade de treinamento e sensibilização dos profissionais. Contribuição para a prática: os achados podem redirecionar o treinamento de policiais e profissionais de saúde que atuam com situações de crime.

ABSTRACT Objective to unveil experts' experiences on traces not preserved by health and safety professionals. Methods qualitative research developed with 27 criminal experts through telephone interview. Data were processed in IraMuTeQ and analyzed by the Descending Hierarchical Classification. Results four thematic classes were obtained that evidenced the existence of a communication gap with the pre-hospital service experienced by experts, who believe that training of these professionals and police officers is necessary. In cases of differentiation between suicide and homicide, experts experience corpse mobilization, in addition to weapon removal from the original location. Health professionals mischaracterize the victim's corpse and leave health care objects, such as gloves and syringes, in place, while police mischaracterize the scene, move objects and do not adequately isolate the scene. Conclusion experts experience forensic traces not preserved by health and safety professionals in the position of objects and the victim's corpse, feel a communication gap and point out the need for training and awareness of professionals. Contribution to practice: the findings can redirect the training of police officers and health professionals who work with crime situations.

Produção científica sobre parada cardiorrespiratória nos periódicos brasileiros de enfermagem: estudo bibliométrico / Producción científica sobre paro cardiorrespiratorio en revistas brasileñas de enfermería: estudio bibliométrico / Scientific production on cardiorespiratory arrest in brazilian nursing journals: bibliometric study

Objetivo: analisar a produção científica sobre parada cardiorrespiratória nos periódicos brasileiros de enfermagem. Método: estudo bibliométrico realizado mediante acesso eletrônico aos websites das 14 revistas brasileiras de enfermagem, classificadas na Plataforma Sucupira, para análise dos artigos publicados entre 2010 e 2019. Resultados: foram analisados 18.266 artigos, dos quais 50 foram selecionados para integrar a amostra. Foi possível observar que 50% dos artigos foram publicados em periódicos de extrato Qualis A e 80% das produções foram derivadas da Região Sudeste. Em relação ao tipo de estudo, 54% foram descritivos e 64% quantitativos. Quanto à temática mais investigada, 28% retrataram o conhecimento dos enfermeiros e 22% contemplaram o treinamento da enfermagem sobre parada cardiorrespiratória. Conclusão: a produção científica dos periódicos brasileiros demonstrou predominância de artigos publicados em periódico Qualis A, oriundos da Região Sudeste, do tipo descritivo, quantitativos, que investigaram predominantemente o conhecimento e o treinamento dos profissionais.

Objetivo: analizar la producción científica sobre paro cardiorrespiratorio en revistas brasileñas de enfermería. Método: estudio bibliométrico realizado a través del acceso electrónico a los sitios de las 14 revistas brasileñas de enfermería, clasificadas en la Plataforma Sucupira, para el análisis de artículos publicados entre 2010 y 2019. Resultados: se analizaron 18.266 artículos, de los cuales 50 fueron seleccionados para integrar la muestra. Fue posible observar que el 50% de los artículos fueron publicados en revistas de extracto Qualis A y el 80% de las producciones se derivaron de la Región Sureste. En cuanto al tipo de estudio, el 54% fueron descriptivos y 64% cuantitativos. En cuanto al tema más investigado, el 28% retrataron el conocimiento de las enfermeras y el 22% contemplaban la formación de enfermería en el paro cardiorrespiratorio. Conclusión: la producción científica de revistas brasileñas mostró un predominio de artículos publicados en la revista Qualis A, de la Región Sureste, descriptivos, cuantitativos, que investigaron predominantemente el conocimiento y la formación de los profesionales.

Objective: to analyze the scientific production on cardiorespiratory arrest in Brazilian nursing journals. Method: bibliometric study carried out through electronic access to the websites of the 14 Brazilian nursing journals, classified in the Sucupira Platform, for analysis of articles published between 2010 and 2019. Results: 18,266 articles were analyzed, of which 50 were selected to integrate the sample. It was possible to observe that 50% of the articles were published in Qualis A extract journals and 80% of the productions were derived from the Southeast Region. Regarding the type of study, 54% were descriptive and 64% quantitative. Regarding the most investigated theme, 28% portrayed the knowledge of nurses and 22% contemplated nursing training on cardiorespiratory arrest. Conclusion: the scientific production of Brazilian journals showed a predominance of articles published in Qualis A journals, from the Southeast Region, descriptive, quantitative, which predominantly investigated the knowledge and training of professionals.

The Roles of Empathy, Attachment Style, and Burnout in Pharmacy Students' Academic Satisfaction.

Objective. To investigate empathy, burnout, and attachment style, and explore the relationships between these variables and academic satisfaction in a group of pharmacy students. Methods. Students enrolled in the first two years (n=200) and last two years (n=210) of a five-year master's degree program in pharmaceutical sciences were invited to participate. The data collected included sociodemographic characteristics; responses on the Portuguese version of the Interpersonal Reactivity Index (IRI) to assess empathy levels; responses on the Maslach Burnout Inventory (MBI) to measure emotional exhaustion, depersonalization, and personal accomplishment; responses on the Adult Attachment Scale (AAS) to evaluate students' attachment style; and responses on an original academic satisfaction scale. Results. Although students in both groups had similar levels of empathy, female students had significantly higher scores in the IRI subscales and in emotional exhaustion. Students in the last two years of the program had significantly higher depersonalization scores. The majority of students reported that they were satisfied with the quality of their academic experience, however, the satisfaction scores of students enrolled in their first two years were significantly higher. Attachment styles explained 14% of all students' depersonalization and academic satisfaction scores (11%). Burnout explained 39% of all students' academic dissatisfaction. Conclusion. Although a majority of pharmacy students were satisfied with their academic life, burnout negatively influenced the academic satisfaction of some students completing the final years of their education. The type of interpersonal relationship students have influences their ability to understand patients and the quality of their learning experience. A large percentage of students indicated they had a significant level of burnout, which underscores the need to provide preventive and restorative interventions for these students.

Evaluation of the relationships among happiness, stress, anxiety, and depression in pharmacy students.

INTRODUCTION: To present the results of a survey on stress, anxiety, depression, subjective happiness, and academic satisfaction among pharmacy students. METHODS: A total of 410 pharmacy students, were included. Sociodemographic characteristics, stress, anxiety and depressive symptoms, and happiness were evaluated using the Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale (HADS), and Subjective Happiness Scale (SHS), in May 2015. RESULTS: First and second year student's (n = 200) presented higher levels of academic satisfaction (p = 0.003) and lower levels of stress (p < 0.001), anxiety (p = 0.011) and depression (p = 0.010) than third and fourth year students (n = 210). Academic satisfaction, HADS, and the PSS explained 36.7% of the students' happiness. CONCLUSIONS: The student's psychological distress, academic satisfaction, and happiness varies through the school years. Monitoring a probable cumulative effect during pharmacy school may contribute to identify students at risk.

Mechanistic View of hnRNPA2 Low-Complexity Domain Structure, Interactions, and Phase Separation Altered by Mutation and Arginine Methylation.

hnRNPA2, a component of RNA-processing membraneless organelles, forms inclusions when mutated in a syndrome characterized by the degeneration of neurons (bearing features of amyotrophic lateral sclerosis [ALS] and frontotemporal dementia), muscle, and bone. Here we provide a unified structural view of hnRNPA2 self-assembly, aggregation, and interaction and the distinct effects of small chemical changes-disease mutations and arginine methylation-on these assemblies. The hnRNPA2 low-complexity (LC) domain is compact and intrinsically disordered as a monomer, retaining predominant disorder in a liquid-liquid phase-separated form. Disease mutations D290V and P298L induce aggregation by enhancing and extending, respectively, the aggregation-prone region. Co-aggregating in disease inclusions, hnRNPA2 LC directly interacts with and induces phase separation of TDP-43. Conversely, arginine methylation reduces hnRNPA2 phase separation, disrupting arginine-mediated contacts. These results highlight the mechanistic role of specific LC domain interactions and modifications conserved across many hnRNP family members but altered by aggregation-causing pathological mutations.

Novel Epstein-Barr virus-like particles incorporating gH/gL-EBNA1 or gB-LMP2 induce high neutralizing antibody titers and EBV-specific T-cell responses in immunized mice.

Previous Epstein-Barr virus (EBV) prophylactic vaccines based on the major surface glycoprotein gp350/220 as an immunogen have failed to block viral infection in humans, suggesting a need to target other viral envelope glycoproteins. In this study, we reasoned that incorporating gH/gL or gB, critical glycoproteins for viral fusion and entry, on the surface of a virus-like particle (VLP) would be more immunogenic than gp350/220 for generating effective neutralizing antibodies to prevent viral infection of both epithelial and B cell lines. To boost the humoral response and trigger cell-mediated immunity, EBV nuclear antigen 1 (EBNA1) and latent membrane protein 2 (LMP2), intracellular latency proteins expressed in all EBV-infected cells, were also included as critical components of the polyvalent EBV VLP. gH/gL-EBNA1 and gB-LMP2 VLPs were efficiently produced in Chinese hamster ovary cells, an FDA-approved vehicle for mass-production of biologics. Immunization with gH/gL-EBNA1 and gB-LMP2 VLPs without adjuvant generated both high neutralizing antibody titers in vitro and EBV-specific T-cell responses in BALB/c mice. These data demonstrate that will be invaluable not only in preventing EBV infection, but importantly, in preventing and treating the 200,000 cases of EBV-associated cancers that occur globally every year.

Bactérias aeróbias mesófilas contaminantes do leite de vaca uht (ultra hight temperature) comercializado em Maceió - Al / UHT (ultra hight temperature) cow's milk contaminating aerobic bacteria marketed in Maceió - Al

O leite de vaca UHT nem sempre é um alimento isento de contaminações, podendo sofrer deterioração. A má qualidade microbiológica do leite, além de ser um problema de saúde pública, também altera as características sensoriais e a vida útil dos seus derivados. Inúmeras pesquisas mostram que os principais fatores responsáveis por surtos de doenças de origem alimentar estão no manuseio incorreto dos alimentos desde a sua obtenção até a sua estocagem, incluindo a falta de higiene na sua obtenção ou no processamento e no tratamento térmico insuficiente ou incorreto, deste modo podendo ser incorporados ou sobreviver no leite diversos micro-organismos. O objetivo deste estudo foi quantificar bactérias aeróbias mesófilas contaminantes do leite de vaca UHT comercializado em Maceió - AL. Para a contagem padrão de bactérias aeróbias mesófilas, 1,0mL de cada diluição foisemeado em duplicata diretamente em placas de Petri esterilizadas, pelo método pour plate, com Ágar para contagem padrão (PCA). Das doze marcas comerciais analisadas, cinco (41,6%) apresentaram contaminação por bactérias aeróbias mesófilas, porém nenhuma delas com contagens acima do permitido pelo Regulamento Técnico. Os Leites UHT analisados não apresentaram contaminantes microbianos ou valores destes acima do permitido pela legislação, o que demonstra eficiência do processo de esterilização UHT, evidenciando-se também a aplicação das Boas Práticas de maneira eficiente.

The UHT cow milk is not always a food free from contamination and may suffer decay. Poor microbiological quality of milk, in addition to being a problem of public health also changes the sensory characteristics and lifetime of its derivatives. Numerous polls show that the main factors responsible for outbreaks of food-borne diseases are on the mishandling of food since its acquisition until its storage, including the lack of hygiene in your obtaining or processing and heat treatment insufficient or incorrect in this way may be embedded or survive in milk various microorganisms. The objective of this study was to quantify aerobic mesophilic bacteria contaminants of UHT cow milk marketed in Maceió/AL. For the default count of aerobic mesophilic bacteria, 1.0 mL of each dilution was sown in duplicate directly into sterile Petri dishes, pour plate method, with Agar for count standard (PCA). Of the twelve trademarks analyzed five (41.6) showed contamination by mesophilic aerobic bacteria, but none with scores above the allowed by the Technical Regulation. The UHT Milks analyzed showed no microbial contaminants or values of these above permitted by legislation, which demonstrates efficiency of UHT sterilization process, showing also the application of good practices efficiently.

Eventos de infecção puerperal em uma maternidade de referência no município de Caxias, Maranhão / Puerperal infection events in a reference maternity in the city of Caxias, Maranhão

Objetivo: identificar a incidência de infecção puerperal em uma Maternidade de Referência no município de Caxias-MA,determinando a incidência e o intervalo de suas manifestações. Metodologia: trata-se de um estudo descritivo exploratório e de abordagem quantitativa. A pesquisa ocorreu na Maternidade Carmosina Coutinho em Caxias-MA,analisou-se 12.047 prontuários de gestantes submetidas a partos normais e cesáreos ocorridos na maternidade, no período de janeiro de 2013 a dezembro de 2015. Os aspectos éticos e legais do estudo foram preservados e atendeu a Resolução 466/2012 que trata da pesquisa envolvendo seres humanos. Iniciou-se o estudo após aprovação do Comitê de Ética e Pesquisa da Universidade Estadual do Maranhão – CESC/UEMA, através da Plataforma Brasil. Resultados: observou-se que 1.225 entraram para tratamento, destes 103 (8%), tinham o diagnóstico de infecção puerperal e 1.122 (92%) estavam relacionadas a outros tipos de tratamentos clínicos. Levantaram-se as variáveis relacionadas ao tipo de parto e a presença de infecção, além disso, verificou-se a associação entre a infecção puerperal e os principais fatores de risco, como faixa etária, baixa escolaridade, tempo de internação e tipo de parto. Conclusão: apesar dos avanços tecnológicos, a infecção puerperal ainda é considerada uma das mais incidentes complicações do puerpério por falha do serviço de saúde que deve informar a paciente todos os cuidados durante este período. Os altos índices de infecção puerperal podem está relacionados à discrepante quantidade de partos cesáreos, bem como a utilização de técnicas não assépticas durante a realização dos procedimentos.

Objective: to identify the incidence of puerperal infection in a reference maternity in the city of Caxias-MA, to determine the incidence and range of its manifestations. Methodology: this is a descriptive exploratory study quantitative approach.The research took place at the Maternity Carmosina Coutinho in Caxias-MA, analyzed 12,047 records of pregnant women submitted to normal and Cesarean births in the maternity hospital from January 2013 to December 2015. The ethical andlegal aspects of the study have been preserved and attended Resolution 466/2012 that deals with research involving human subjects. It began the study after approval by the Research Ethics Committee of the State University of Maranhão -CESC / UEMA by Platform Brazil. Results: it was observed that 1,225 entered treatment, 103 (8%) had a diagnosis of puerperal infection and 1,122 (92%) were related to other clinical treatments. Raised the variables related to the type ofdelivery and the presence of infection, in addition, there was an association between puerperal infection and the mainrisk factors such as age, low education, length of stay and type of delivery. Conclusion: despite technological advances,puerperal infection is still considered one of the incidents complications after delivery by failure of the health service that should inform the patient all care during this period. The high rates of puerperal infection can be related to discrepantamount of cesarean deliveries, and the use of non-aseptic techniques during the procedures.

Determinaçäo de albumina humana em soros normais: comparaçäo de três métodos / Determinantion of human albumin in normal sera: comparison of 3 methods

A concentraçäo de albumina em soros de indivíduos normais foi determinada através dos métodos verde de bromocresol (VBC), púrpura de bromocresol (PBC) e imunoturbidimetria (I). A precisäo (Cv) destes métodos, investigada em "pool" de soros normais, foi de 3,6% para o imunoensaio e de 2,8% e 2,5% para o VBC e PBC, respectivamente. Estudos comparativos mostraram que os valores de albumina obtidos pelos métodos colorimétricos foram sistemática e significativamente mais elevados que os determinados por imunoturbidimetria. A PBC proporcionou valores de albumina mais próximos daqueles conferidos pela imunoturbidimetria, corroborando as evidências já apontadas na literatura a cerca da maior especificidade da reaçäo PBC-albumina