Caracterização da saúde e saneamento de uma comunidade quilombola no entorno da capital do Brasil: um scoping review / Characterization of health and sanitation in a quilombola community in the surroundings of the capital of Brazil: a scoping review

RESUMO A comunidade quilombola Mesquita possui uma identidade intimamente relacionada com a terra; todavia, atualmente, as relações entre saúde e saneamento apresentam-se de forma precarizada devido à expansão do agronegócio e do mercado imobiliário. O objetivo deste estudo foi identificar os aspectos de saúde e saneamento da comunidade quilombola Mesquita da Cidade Ocidental do estado de Goiás, Brasil. Esta revisão foi estruturada no método de um scoping review elaborado com a finalidade de síntese de evidências auxiliando no direcionamento de políticas públicas e na tomada de decisões práticas para o território. Os principais resultados encontrados nos aspectos de saúde foram a importância da Unidade Básica de Saúde, da agroecologia e das terapias alternativas. Já nos aspectos de saneamento foram o abastecimento de água e o tratamento/disposição de resíduos sólidos. Constata-se que o fortalecimento e a interdependência da saúde humana e ambiental, da cultura e da ancestralidade da história africana e o reconhecimento dos direitos territoriais potencializarão o cuidado coletivo com o suporte de diferentes atores sociais. É notório que o enfrentamento da escravidão no Brasil ainda existe no Quilombo Mesquita, pela invisibilidade e inassistência refletidas atualmente pelas ações governamentais.

ABSTRACT The Mesquita quilombola community has an identity closely related to land, however, nowadays, the relationship between health and sanitation is precarious due to the expansion of agribusiness and the real estate market. The aim of this study was to identify the health and sanitation aspects of the quilombo community of Mesquita of Cidade Ocidental, in the state of Goiás, Brazil. This review was structured using a scoping review method designed to synthesize evidence to help guide public policies and make practical decisions for the territory. The main results found in health aspects were the importance of the Basic Health Unit, of agroecology, and of alternative therapies. As for sanitation, they were water supply and treatment/disposal of solid waste. It is said that the strengthening and interdependence of human and environmental health, of the culture and ancestry of African history and recognition of territorial rights will enhance collective care with the support of different social actors. It is clear that the fight against slavery in Brazil still exists in the Mesquita quilombo, due to the invisibility and lack of assistance currently reflected by governmental actions.

Survival analysis of recurrent squamous cell carcinoma of the lower oral cavity treated by surgery.

The aim of the present study was to investigate the survival of individuals with squamous cell carcinoma of the lower oral cavity who underwent surgical treatment and experienced recurrence, considering the site of the recurrent disease. A retrospective longitudinal study was conducted, comparing the survival rates of patients with and without recurrence and considering the site of recurrence (local, regional, distant). Statistical analysis was performed with SPSS and a p-value ≤ 0.05 was considered significant. The sample comprised 150 patients, 59 (39.3%) of whom experienced recurrence. Local recurrence occurred in 35 patients (23.4%), regional recurrence in 17 (11.3%), and distant recurrence in seven (4.6%). The average survival of participants with local, regional, and distant recurrence was 12, five, and two months, respectively. Patients with recurrent disease had worse survival than those who did not (P < 0.001). Patients with local recurrence had better survival than those with regional/distant recurrence (P = 0.011). All patients with regional and distant recurrence had deceased by the last follow-up. In conclusion, patients with local recurrence of squamous cell carcinoma of the lower oral cavity treated by surgery have a better survival rate than those with regional and distant recurrence. Local recurrence poses the possibility of curative salvage therapy.

Plasmodium vivax and Plasmodium falciparum infection in Neotropical primates in the western Amazon, Brazil.

The Brazilian Amazon is endemic for malaria and natural infections by Plasmodium spp. have been detected in Neotropical primates. Despite the diversity of primate species in the region, studies on infections by these agents are limited. The aim of the present study was to investigate the frequency of infection by Plasmodium vivax and P. falciparum in free-born primates that were kept in captivity, in the western Amazon, Brazil. Blood samples were collected from 98 Neotropical primates. Detection of P. vivax and P. falciparum DNA was performed using a semi-nested PCR, and the amplified products were sequenced. Plasmodium spp. DNA was detected in 6.12% (6/98) of the primates. P. vivax, and P. falciparum DNA was detected in 2.04% (2/98) and 4.08% (4/98) of these mammals, respectively. Sequencing and phylogenetic analysis confirmed the results obtained from the semi-nested PCR. The presence of infected non-human primates (NHP) can be auxiliary in the maintenance of P. falciparum and P. vivax and may have implications for the malaria surveillance and control in the Brazilian Amazon. It is necessary to structure an efficient surveillance system for the aetiological agents of malaria that infect NHP and humans to reduce the risk of Plasmodium spp. introduction into new areas, to protect all susceptible species.

Ticks (Acari: Ixodidae) of the state of Amazonas, Brazil.

The tick fauna of Brazil is currently composed by 72 species. The state of Amazonas is the largest of Brazil, with an area of ≈ 19% of the Brazilian land. Besides its vast geographic area, only 19 tick species have been reported for Amazonas. Herein, lots containing ticks from the state of Amazonas were examined in three major tick collections from Brazil. A total of 5933 tick specimens were examined and recorded, comprising 2693 males, 1247 females, 1509 nymphs, and 484 larvae. These ticks were identified into the following 22 species: Amblyomma cajennense sensu lato, Amblyomma calcaratum, Amblyomma coelebs, Amblyomma dissimile, Amblyomma dubitatum, Amblyomma geayi, Amblyomma goeldii, Amblyomma humerale, Amblyomma latepunctatun, Amblyomma longirostre, Amblyomma naponense, Amblyomma oblongoguttatum, Amblyomma ovale, Amblyomma rotundatum, Amblyomma scalpturatum, Amblyomma varium, Dermacentor nitens, Haemaphysalis juxtakochi, Ixodes cf. Ixodes fuscipes, Ixodes luciae, Rhipicephalus microplus, Rhipicephalus sanguineus sensu lato. Ticks were collected from 17 (27.4%) out of the 62 municipalities that currently compose the state of Amazonas. The following four species are reported for the first time in the state of Amazonas: A. coelebs, A. dubitatum, H. juxtakochi, and Ixodes cf. I. fuscipes. The only tick species previously reported for Amazonas and not found in the present study is Amblyomma parvum. This study provides a great expansion of geographical and host records of ticks for the state of Amazonas, which is now considered to have a tick fauna composed by 23 species. It is noteworthy that we report 1391 Amblyomma nymphs that were identified to 13 different species.

Ticks (Acari: Ixodidae) of the state of Amazonas, Brazil

The tick fauna of Brazil is currently composed by 72 species. The state of Amazonas is the largest of Brazil, with an area of ae 19% of the Brazilian land. Besides its vast geographic area, only 19 tick species have been reported for Amazonas. Herein, lots containing ticks from the state of Amazonas were examined in three major tick collections from Brazil. A total of 5933 tick specimens were examined and recorded, comprising 2693 males, 1247 females, 1509 nymphs, and 484 larvae. These ticks were identified into the following 22 species: Amblyomma cajennense sensu lato, Amblyomma calcaratum, Amblyomma coelebs, Amblyomma dissimile, Amblyomma dubitatum, Amblyomma geayi, Amblyomma goeldii, Amblyomma humerale, Amblyomma latepunctatun, Amblyomma longirostre, Amblyomma naponense, Amblyomma oblongoguttatum, Amblyomma ovale, Amblyomma rotundatum, Amblyomma scalpturatum, Amblyomma varium, Dermacentor nitens, Haemaphysalis juxtakochi, Ixodes cf. Ixodes fuscipes, Ixodes luciae, Rhipicephalus microplus, Rhipicephalus sanguineus sensu lato. Ticks were collected from 17 (27.4%) out of the 62 municipalities that currently compose the state of Amazonas. The following four species are reported for the first time in the state of Amazonas: A. coelebs, A. dubitatum, H. juxtakochi, and Ixodes cf. I. fuscipes. The only tick species previously reported for Amazonas and not found in the present study is Amblyomma parvum. This study provides a great expansion of geographical and host records of ticks for the state of Amazonas, which is now considered to have a tick fauna composed by 23 species. It is noteworthy that we report 1391 Amblyomma nymphs that were identified to 13 different species.

Trypanosoma cruzi infection in captive Neotropical primates in the Brazilian Amazon.

The aim of this study was to detect the infection by Trypanosoma cruzi in captive Neotropical primates in the Brazilian Amazon. From February 2013 to July 2014, 112 blood samples were collected from Neotropical primates from the Amazonas, Amapá, and Pará States, north of Brazil. The subjects belonged to the families Cebidae (N = 59), Atelidae (N = 41), Callitrichidae (N = 5), Pitheciidae (N = 4), and Aotidae (N = 3). Blood smears also were examined for the presence of trypomastigotes by optical microscopy. For the detection of T. cruzi DNA, a Nested-PCR with primers TCZ1/TCZ2 and TCZ3/TCZ4 was performed. T. cruzi DNA was detected in 12.5% (14/112) of Neotropical primates examined. Positive samples were detected in 16%, 12.5%, and 11.11% of the different species of primates sampled from the Amapá, Pará, and Amazonas states, respectively. The analysis of the blood smears did not reveal trypomastigote forms of T. cruzi. In conclusion, Neotropical primates kept in captivity were infected by T. cruzi in the studied areas. We recommend that a health management protocol be put into place to prevent the transmission of infectious agents among captive populations, captive and wild populations, and between NHPs and the technicians who handle these animals.

Periorbital subcutaneous emphysema in rhinoplasty.

In this article, the authors present a case of postrhinoplasty periorbital subcutaneous emphysema in a 35-year-old woman. This is an uncommon and benign rhinoplasty complication that can sometimes result from other pathologies such as barotrauma, hematoma, and allergic reaction. This patient's symptoms appeared to be a result of postanesthesia agitation. The patient's symptoms resolved after 1 week.

Mortalidade materna em cidade-polo de assistência na região Sudeste: tendência temporal e determinantes sociais / Maternal death in town providing leading health assistance inSoutheastern Brazil: temporal tendency and social determinants

Introdução: a mortalidade materna consiste em evento prioritário de saúde pública, afetando particularmente mulheres no ciclo gravídico puerperal de classes sociais mais desfavorecidas. Objetivo: analisar, a partir dos dados do Comitê Municipal de Prevenção à Mortalidade Materna de Juiz de Fora, os determinantes sociais envolvidos nesse evento, o perfil reprodutivo dessas mulheres, a acessibilidade e a qualidade dos serviços de saúde. Método: estudo retrospectivo, com análise dos 81 óbitos maternos de Juiz de Fora, entre 1996 e 2008. Foram consideradas como variáveis para análise: número de consultas e qualidade do pré-natal, período gestacional, tipo de parto, momento do óbito, causa básica da morte, local de ocorrência, além dos problemas e sugestões propostos pelo Comitê. Resultados: a RMM média entre 1996 e 2001 foi de 98,5 por 100.000 nascidos vivos, passando nos seis anos seguintes (2002 a 2007) para 77,8 por 100.000 nascidos vivos. Foi encontrada associação entre número de consultas pré-natais e cor (p=0,02) e também correlação (r=0,90, p-valor=0,01) entre áreas de exclusão social e número de óbitos maternos. Do total de óbitos, 74% foram declarados. A maioria dos óbitos ocorreu no puerpério (69,1%), foi do tipo obstétrico direto (63%) e 64% eram evitáveis. Conclusão: a elevada taxa de mortalidade materna associada a precárias condições socioeconômicas e ao potencial de evitabilidade de grande parte dos óbitos maternos revelam a necessidade de políticas públicas mais eficientes.

Introduction: Maternal death represents a priority public health issue that particularly affects socially unprivileged women in their pregnancy and puerperal period. Objective: To analyze the social determinants involved in this issue, the reproductive characteristics of these women and the access to and the quality of health services building on data provided by the Municipal Committee for Prevention of Maternal Death in the Municipality of Juiz de Fora. Method: This is a retrospective study that analyses 81 maternal deaths in Juiz de Fora from 1996 through 2008. The analysis included the following variables: number and quality of prenatal appointments, pregnancy duration, type of delivery, moment of death, basic cause of death, and place of death, as well as the issues and related suggestions pointed by the Municipal Committee. Results: The average maternal mortality rate from 1996 through 2001 was 98.5 per 100,000 live newborns, but decreased to 77.8/100,000 from 2002 to 2007. Significant correlations were found between prenatal appointments and skin color (p=0.02) as well as between zones of social exclusion and number of maternal deaths (r=0.90, p=0.01). Medical death certificate was provided in 70% of the cases. Most deaths took place during puerperium (69.1), were registered as direct obstetric death (63%) and were considered evitable (64%). Conclusion: The high maternal mortality rate associated with poor socioeconomic conditions and the meaningful occurrence of potentially evitable cases of death points to the need of more efficient public policies

Fitobezoar associado à endometriose intestinal: uma rara causa de obstrução intestinal / Intestinal endemetriosis associated to phytobezoar: a rare of bowel obstruction

A endometriose intestinal é uma patologia benigna que afeta preferencialmente a porção retossigmóidea, sendo pouco frequente a localização em íleo terminal. Trata-se de um caso de uma paciente de 29 anos que foi admitida com dor abdominal difusa, náuseas e vômitos. Na propedêutica da obstrução intestinal a tomografia computadorizada revelou massa heterogênea em topografia ileocecal. Submetida a laparotomia exploradora onde foi feita a remoção de fibras vegetais mal digeridas aglomeradas em íleo terminal e ressecção de segmento íleoceco cólico devido a presença de estenose na válvula ileocecal. O exame anátomo patológico revelou endometriose intestinal e fitobezoar. A paciente evoluiu bem com alta no terceiro dia de pós operatório.

Intestinal endometriosis is a benign pathology, it occurs most often on the rectosigmoid portion, and the finding isn`t very common on the terminal ileum. On this article the autors present a report from a 29 years old pacient, who had a difuse abdominal pain, nausea and vomiting. Computadorized tomography (CT) showed a heterogeneous mass on the ileocaecal area . An exploratory laparotomy was performed , badly metabolized vegetable fibers were removed from the terminal ileum, and a surgical removal of the ileocaecal - colic portion was done, since there was a stenosis on that area. The anatomical-pathologic study showed intestinal endometriosis and phytobezoar The patient had a good follow up and got out the hospital on the third day after surgery.