Hospitalizations by Primary Care Sensitive Conditions: prevalence and costs in the state of Minas Gerais / Internações por Condições Sensíveis à Atenção Primária: prevalência e gastos no estado de Minas Gerais

Resumo Objetivo analisar a prevalência e os gastos com Internações por Condições Sensíveis à Atenção Primária (ICSAP) em Minas Gerais (MG). Método estudo ecológico que analisou internações hospitalares e variáveis de estrutura de serviços em 2009 e 2014. As ICSAP, selecionadas pela Lista Brasileira (2008), foram estudadas nas populações infantil e idosa em relação à prevalência e gastos. A análise estatística entre ICSAP e variáveis de estrutura foi feita pela correlação de Pearson (p ≤ 0,05). Resultados taxas de ICSAP/1.000 habitantes foram reduzidas nas populações infantil e idosa, enquanto gastos totais aumentaram somente para os idosos. Insuficiência cardíaca foi a principal causa para idosos, enquanto pneumonias bacterianas e gastroenterites, para crianças. A cobertura pela Estratégia Saúde da Família (ESF) associou-se estatisticamente com ICSAP em 2009 (p = 0,028) e em 2014 (p = 0,006). Conclusão a expansão da cobertura pela ESF, associada à redução das ICSAP em Minas Gerais, também encontrada em outros estudos, ressalta a importância da Atenção Primária à Saúde (APS) na coordenação do cuidado e ordenação das redes de atenção, contribuindo para o acesso universal e integral do usuário aos serviços. Conhecer a prevalência e os gastos com ICSAP viabiliza a discussão sobre os recursos financeiros disponíveis para a APS.

Abstract Background to analyze the prevalence and costs of hospitalizations by Primary Care Sensitive Conditions (HPCSC) in Minas Gerais (MG). Method ecological study analyzing hospital admissions and service structure variables in 2009 and 2014. Based on the Brazilian List (2008), the HPCSC were selected for the study of the infant and elderly populations concerning prevalence and costs. The Pearson's correlation test (p≤0.05) was used for the statistical analysis between the HPCSC and structure variables. Results lower rates of HPCSC/1000 residents both for the infant and elderly populations and total higher costs only for the elderly. The leading hospitalization causes were heart Failure for the elderly and Bacterial Pneumonias and Gastroenteritis for the children. The coverage by the Family Health Strategy (FHS) was statistically associated with HPCSC in 2009 (p = 0.028) and 2014 (p = 0.006). Conclusion like in previous studies, a larger FHS coverage associated with a lower HPCSC rate in MG highlights the importance of PHC in coordinating care and organizing care networks, contributing to the user's universal and integral access to services. Learning the prevalence and costs of the HPCSC allows for discussing the financial resources available to the PHC.

Effect of short-term pig slurry amendment of soil on humified organic matter and its relationship with the dynamics of heavy metals and metals uptake by plants.

The impact of pig slurry (PS) application on the structural dynamics of humic substances (HS) and on the mobility of Cu, Zn, Ni, and Pb in a dystrophic Red Nitosol planted with winter forage grasses was evaluated. After four PS applications, the humic acids (HA) and fulvic acids (FA) were characterized by spectroscopy techniques allied to chemometrics methods. The metals contents in soil, in HS and in the tissues of plant were quantified. PS application increases the total organic carbon, especially the nonhumic carbon, which contribute to increase FA content. The carbon in FA and HA increases with the highest PS dose applied, especially aliphatic structures in FA and aromatic structures in HA. The amount of Pb and Cu in FA and HA increases respectively, as well as Cu, Zn, Ni, and Pb bioavailable. PS applications increase the biomass production in grasses and the metals content accumulated in the tissues. Our study shows that the PS application modifies the structure of SOM, incorporating fragments, and modifying its dynamics, which regulates the dynamics and the accumulation of metals in soils and plants. The association of metals with soluble structures seems to inactivate their toxicity and does not affect plant growth.

Elevated soluble TNFα levels and upregulated TNFα mRNA expression in purified peripheral blood monocyte subsets associated with high-grade hepatocellular carcinoma.

BACKGROUND: Chronic inflammation is involved in the initiation and progression of various cancers, including liver cancer. The current study focuses on the characterization of the peripheral immune response in hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) patients, before and after surgical procedure, in order to assess the effect of tumor resection in the immune system homeostasis and to determine possible prognostic factors associated with high-grade tumors. We developed a whole-blood assay to monitor immune alterations and functional competence of peripheral monocytes in a group of 10 healthy individuals (HG), in 20 HCC patients and 8 CCA patients, by multi-color flow cytometry, qRT-PCR, and ELISA techniques. RESULTS: The qRT-PCR analysis showed an upregulation of TNFα expression by classical and intermediate monocytes purified from HCC patients presenting tumors in grade G3-G4 as compared to G1-G2 HCC patients. Moreover, ELISA assay confirmed elevated serum levels of TNFα in G3-G4 compared to G1-G2 HCC patients. A significant decrease of circulating non-classical monocytes was detected in both CCA and HCC patients before and after surgical procedure. In addition, a functional defect in circulating classical and intermediate monocytes was observed in both groups of cancer patients when compared to the HG, with partial recovery after the surgical intervention. CONCLUSIONS: This integrated analysis permitted the identification of altered functional competence of monocyte subsets in CCA and HCC patients. In addition, our results point to a potential role of TNFα as a prognostic peripheral biomarker in HCC patients, indicating the presence of high-grade tumors that should be further validated.

Functional and Phenotypic Characterization of Tumor-Infiltrating Leukocyte Subsets and Their Contribution to the Pathogenesis of Hepatocellular Carcinoma and Cholangiocarcinoma.

Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) represent the most common primary liver malignancies whose outcome is influenced by the immune response. In the present study, we evaluated the tumor-infiltrating leukocyte (TIL) populations in 21 HCC patients and 8 CCA patients by flow cytometry immediately after the surgical procedure. Moreover, CD4+ T cells, CD8+ T cells, monocytes, and macrophages were purified by cell sorting for further analysis of gene expression by quantitative reverse-transcription polymerase chain reaction. Regarding tumor-infiltrating macrophages, we observed a significantly higher expression of markers associated with M2 phenotype and a higher expression of PD-L1 in patients with HCC in comparison to CCA. In addition, for HCC patients, we found a significant increase in the expression of CD200R in macrophages from tumors that were in grade G3-G4 as compared to tumors in grade G1-G2. Besides, a significantly higher frequency of tumor-infiltrating lymphocytes, CD8+CD56+ T cells, and natural killer cells was detected in HCC biopsies in comparison to CCA. In summary, this study has revealed functional and phenotypic differences in TIL cell subpopulations between CCA and HCC, as well as among different histopathological grades and tumor aggressiveness degrees, and it has provided evidence to better understand the tumor immune microenvironment of CCA and HCC.

Influence of Ischemia Time in Injury of Deep Peribiliary Glands of the Bile Ducts Graft: A Prospective Study.

The deep peribiliary glands (DPBG) are a niche of progenitor cells in the wall of the biliary duct (BD) and are the second line of multiplication when severe lesion of the epithelium occurs. Previous studies have identified DPBG injury as a cause of post-liver transplant (LT) biliary stenosis; this complication is a major cause of post-LT morbidity. The incidence of biliary stenosis in our center is high (38.1%). This study evaluates the lesion of DPBG in response to ischemia. Graft BD was collected in adult LT between August 2016-July 2017, from donation after brain death. Samples of 45 grafts were collected at 2 moments: BD1-during graft preparation and BD2-before biliary anastomosis. Histological analysis of the samples was performed and then classified according to degree of lesion (0, ≤50%, and >50%). A comparison was made between the degree of lesion and graft ischemia, graft histology, donor, and procurement variables. The DPBG lesion was more frequent in BD2 (20.9% vs 7%, P = .079). BD2 lesions with DPBG lesions had higher medians and means at all times of ischemia. The difference was greater in the warm ischemia time (0: 43.3 ± 12.53 minutes vs ≤50%: 52.4 ± 14.38 minutes, P = .068). The group of BD1 with DPBG lesion presented superior median cold ischemia time (CIT). In the analysis of the remaining variables there were also no statistically significant differences. We concluded that during the period of CIT there is already lesion of the DPBG, which increases after reperfusion of the graft, in greater association with longer warm ischemia time.

Diastolic Dysfunction in Liver Cirrhosis: Prognostic Predictor in Liver Transplantation?

BACKGROUND: Patients with liver cirrhosis may develop cirrhotic cardiomyopathy (CC), characterized by blunted contractile responsiveness to stress, diastolic dysfunction (DD), and electrophysiological abnormalities. It may adversely affect the long-term prognosis of these patients. METHODS: We conducted a retrospective analysis of patients undergoing liver transplantation (LT) for cirrhosis from January 2012 to June 2015. We analyzed demographic characteristics, the etiology of cirrhosis, Child-Pugh and Model for End-Stage Liver Disease (MELD) scores, the corrected QT (QTc) interval in the preoperative period, diastolic and systolic dysfunction, mortality and survival, and duration of mechanical ventilation and vasopressor support in the post-LT period. These variables were compared with diastolic dysfunction and prolongation of QTc, with the use of chi-square, Fisher, and Mann-Whitney U tests. RESULTS: The study included 106 patients, 80.2% male and overall average age 54.83 years. The median MELD score was 16, and Child-Pugh class C in 55.4%. Prolonged QTc interval before LT was present in 19% and DD in 35.8% of patients. QTc before LT or DD did not vary significantly with MELD or Child-Pugh score. CONCLUSIONS: The patients in the pre-LT period presented with a significant incidence of DD, which can predispose them to adverse cardiac events. The presence of DD correlates with mortality after LT in patients with hepatic cirrhosis.

Geographic Differentiation and Population Genetic Structure of Moniliophthora roreri in the Principal Cocoa Production Areas in Colombia.

Frosty pod rot (FPR) disease on cocoa, caused by Moniliophthora roreri, is one of the most devastating cocoa disease in the Western Hemisphere. In Colombia, the disease is particularly severe in the Magdalena Valley, which is considered the possible center of origin for the pathogen species. We analyzed the genetic diversity of isolates from the departments of Santander, Antioquia, Tolima, and Huila in Colombia using 23 simple-sequence repeats (SSR) markers. In total, 117 different multilocus genotypes were found among 120 isolates, each one representing a unique haplotype. High mutation rates in the SSR and gene flow can explain the high levels of diversity. Also, the observed and standardized indexes of association (IA and rd) indicate that the populations of M. roreri are clonal. Furthermore, given the high haplotype diversity and the significant linkage disequilibrium observed, we hypothesize that M. roreri could be a primarily asexual species undergoing sporadic recombination or partial recombination through parasexuality. A Bayesian clustering analysis implemented by STRUCTURE showed that the most probable number of genetic groups in the data was three, confirming the geographical differentiation among isolates. Similar results were obtained by a discriminant analysis of principal components, a principal coordinate analysis, and a neighbor-joining tree from microsatellite loci base on Nei distance. Cacao genotypes and environmental variables did contribute to the genetic differentiation of the groups. We discuss how this information could be used to improve the management of FPR at the regional level.

Fungal Planet description sheets: 320-370.

Novel species of fungi described in the present study include the following from Malaysia: Castanediella eucalypti from Eucalyptus pellita, Codinaea acacia from Acacia mangium, Emarcea eucalyptigena from Eucalyptus brassiana, Myrtapenidiella eucalyptorum from Eucalyptus pellita, Pilidiella eucalyptigena from Eucalyptus brassiana and Strelitziana malaysiana from Acacia mangium. Furthermore, Stachybotrys sansevieriicola is described from Sansevieria ehrenbergii (Tanzania), Phacidium grevilleae from Grevillea robusta (Uganda), Graphium jumulu from Adansonia gregorii and Ophiostoma eucalyptigena from Eucalyptus marginata (Australia), Pleurophoma ossicola from bone and Plectosphaerella populi from Populus nigra (Germany), Colletotrichum neosansevieriae from Sansevieria trifasciata, Elsinoë othonnae from Othonna quinquedentata and Zeloasperisporium cliviae (Zeloasperisporiaceae fam. nov.) from Clivia sp. (South Africa), Neodevriesia pakbiae, Phaeophleospora hymenocallidis and Phaeophleospora hymenocallidicola on leaves of a fern (Thailand), Melanconium elaeidicola from Elaeis guineensis (Indonesia), Hormonema viticola from Vitis vinifera (Canary Islands), Chlorophyllum pseudoglobossum from a grassland (India), Triadelphia disseminata from an immunocompromised patient (Saudi Arabia), Colletotrichum abscissum from Citrus (Brazil), Polyschema sclerotigenum and Phialemonium limoniforme from human patients (USA), Cadophora vitícola from Vitis vinifera (Spain), Entoloma flavovelutinum and Bolbitius aurantiorugosus from soil (Vietnam), Rhizopogon granuloflavus from soil (Cape Verde Islands), Tulasnella eremophila from Euphorbia officinarum subsp. echinus (Morocco), Verrucostoma martinicensis from Danaea elliptica (French West Indies), Metschnikowia colchici from Colchicum autumnale (Bulgaria), Thelebolus microcarpus from soil (Argentina) and Ceratocystis adelpha from Theobroma cacao (Ecuador). Myrmecridium iridis (Myrmecridiales ord. nov., Myrmecridiaceae fam. nov.) is also described from Iris sp. (The Netherlands). Novel genera include (Ascomycetes): Budhanggurabania from Cynodon dactylon (Australia), Soloacrosporiella, Xenocamarosporium, Neostrelitziana and Castanediella from Acacia mangium and Sabahriopsis from Eucalyptus brassiana (Malaysia), Readerielliopsis from basidiomata of Fuscoporia wahlbergii (French Guyana), Neoplatysporoides from Aloe ferox (Tanzania), Wojnowiciella, Chrysofolia and Neoeriomycopsis from Eucalyptus (Colombia), Neophaeomoniella from Eucalyptus globulus (USA), Pseudophaeomoniella from Olea europaea (Italy), Paraphaeomoniella from Encephalartos altensteinii, Aequabiliella, Celerioriella and Minutiella from Prunus (South Africa). Tephrocybella (Basidiomycetes) represents a novel genus from wood (Italy). Morphological and culture characteristics along with ITS DNA barcodes are provided for all taxa.

Liver retransplantation in patients with acquired familial amyloid polyneuropathy: a Portuguese center experience.

In 1995 Furtado et al performed the first domino transplantation using a donor liver with familial amyloid polyneuropathy (FAP), thereby increasing the pool of donors. Our experience showed that the onset of FAP symptoms occurs earlier in some patients. Patients with FAP acquired by transplantation are candidates for liver retransplantation to minimize the progression of symptoms. Liver retransplantation is considered to be a high-risk procedure and has lower survival compared with the first transplantation. We evaluated the risk of liver retransplantation in patients with acquired FAP. We did a retrospective analysis of these patients based on the records of perioperative data. From 1995 to 2004 we carried out 81 domino transplantations, of which 10 were submitted to liver retransplantation because of acquired FAP. The better outcomes in this group lead us to think that the liver retransplantation in patients with acquired FAP is not associated with the same risks of liver retransplantation in candidates with graft failure.

Evaluation of operative risk in de novo familial amyloid polyneuropathy retransplantation.

Familial amyloid polyneuropathy (FAP) is the most common hereditary amyloidosis, characterized by progressive peripheral sensory and motor neuropathy. The livers of patients with FAP are used in domino liver transplantation in selected cases to increase the number of grafts available. In our department 10 patients underwent liver retransplantation (ReLTx) in the absence of liver dysfunction by de novo FAP after domino liver transplantation. Our aim was to compare the differences in the consumption of blood products and intraoperative hemodynamic support among patients with FAP undergoing liver transplantation (LTx) and patients with de novo FAP undergoing ReLTx in the same time frame. The anesthetic records of all patients who underwent LTx for FAP and ReLTx for de novo FAP were analyzed, from January 2009 to May 2014. Patients were divided into 2 groups: group 1 patients with FAP, and group 2 patients with de novo FAP. Statistical differences in the value of preoperative creatinine were found. Hemoglobin levels, preoperative international normalized ratio (INR), use of blood products, aminergic support, and surgical time showed no statistical difference. Major bleeding rates would be expected in patients undergoing ReLTx. Changes in renal function, chronic immunosuppressive therapy, and age may contribute to the increase in intraoperative complications. We did not find statistically significant differences, leading us to the conclusion that de novo FAP does not seem to be a predictor of perioperative risk.

Incidentally discovered hepatocellular carcinoma in explanted liver: clinical, histopathologic features and outcome.

BACKGROUND: Incidental hepatocellular carcinomas (iHCCs) are tumors discovered on the explanted liver that were not present on imaging before transplantation. The natural history, histopathologic characteristics, and prognosis are not clearly defined. METHODS: We compared the characteristics of iHCC and previously known hepatocellular carcinoma (pkHCC) in patients who underwent liver transplantation from 1998 to 2012 in a retrospective study. RESULTS: During this period a total of 675 patients were transplanted; 56 patients (9%) had pkHCC and 12 (2%) had iHCC. The sex and age distributions were similar. The median Model for End-Stage Liver Disease score in iHCC patients was 17.0 versus 13.0 in patients with pkHCC (P = .001). Thirty-three percent of iHCC patients had multiple tumors, and 25% had bilobar involvement. The median cumulative tumor size in iHCC was 1.8 cm, and 5.5 cm in pkHCC (P = .005). Incidence of microvascular invasion was not different (16.7% vs 38.9%; P = .191). American Joint Committee on Cancer T1 stage was found in 58.3% of patients with iHCC and in 22.2% of pkHCC patients. Patients with iHCC had 1-, 3-, and 5-year survivals, respectively, of 100%, 83% and 64%, compared with 80%, 66%, and 38% for patients with pkHCC (P = .138). None of the patients with iHCC had recurrence of HCC, whereas incidence of recurrence in pkHCC patients was 12.5%. CONCLUSIONS: iHCC occurred in patients with more advanced liver disease. The cumulative tumor size of iHCC was smaller but one-third were multifocal. Survival was similar to patients with pkHCC, and recurrence was not noted in patients with iHCC.

Long-term outcome of the first 150 liver transplant recipients: a single-center experience.

INTRODUCTION: Liver transplantation modifies the natural history of end-stage liver diseases and stabilizes the course of familial amyloidotic polyneuropathy. An evaluation of its long-term results allows insight and awareness of factors that impact survival. PATIENTS AND METHODS: We included 150 consecutive patients who underwent liver transplantation between October 1992 and January 1998. The impact of disease, cold ischemic time, ABO compatibility, acute and chronic rejection episodes, and vascular, biliary and infectious complications on survival were compared. RESULTS: We included 65 patients (43.3%) with familial amyloidotic polyneuropathy, 41 (27.3%) with cirrhosis, 12 (8%) with hepatocellular carcinoma, and 11 (7.3%) with acute hepatic failure. The mean age was 39 years. The mean cold ischemic time was 493 ± 161 minutes. There were 115 (77.2%) ABO-identical transplants; 25 (16.8%) were ABO compatible, and 9 (6%) were ABO incompatible. Acute cellular rejection occurred in 88 recipients (58.7%); chronic rejection was diagnosed in 9 (6%). Complications included vascular (16.7% patients; n = 25) and biliary (38.7%; n = 58). Infections were bacterial in 92 (61.3%), fungal in 35 (23.3%), and cytomegalovirus in 9 (6%). The survival rates were 78% at 1 year, 68.7% at 5 years, and 58% at 10 years. Of the 150 patients, 82 survived until November 2011. Follow-up ranged from 13 to 19 years. In this study, only bacterial infections had a negative influence on patients' survival (P = .014). CONCLUSION: The high frequency of biliary and vascular complications was associated with increased morbidity but not mortality. Bacterial infections were related to an ominous outcome, being responsible for short- and long-term mortality.

Idiopathic Parkinson's disease: vocal and quality of life analysis.

OBJECTIVE: To compare voice and life quality of male patients with idiopathic Parkinson's disease, with individuals without disease (Control Group). METHODS: A cross-sectional study that evaluated the voice of individuals with Parkinson's disease, the group was composed of 27 subjects, aged from 39 to 79 years-old (average 59.96). The Control Group was matched on sex and age. Participants underwent voice recording. Perceptual evaluation was made using GRBASI scale, which considers G as the overall degree of dysphonia, R as roughness, B as breathiness, A as asthenia, S as strain and I as instability. The acoustic parameters analyzed were: fundamental frequency, jitter, shimmer, and harmonic to noise ratio (NHR). For vocal self-perception analysis, we used the Voice Related Quality of Life protocol. RESULTS: Fundamental frequency and jitter presented higher values in the Parkinson's group. NHR values were higher in the Control Group. Perceptual analysis showed a deviation ranging. The vocal disorder self-perception demonstrated a worse impact on quality of life. CONCLUSIONS: Individuals with Parkinson's disease have an altered voice quality and a negative impact on quality of life.

Idiopathic Parkinson's disease: vocal and quality of life analysis / Doença de Parkinson idiopática: análise vocal e da qualidade de vida

OBJECTIVE: To compare voice and life quality of male patients with idiopathic Parkinson's disease, with individuals without disease (Control Group). METHODS: A cross-sectional study that evaluated the voice of individuals with Parkinson's disease, the group was composed of 27 subjects, aged from 39 to 79 years-old (average 59.96). The Control Group was matched on sex and age. Participants underwent voice recording. Perceptual evaluation was made using GRBASI scale, which considers G as the overall degree of dysphonia, R as roughness, B as breathiness, A as asthenia, S as strain and I as instability. The acoustic parameters analyzed were: fundamental frequency, jitter, shimmer, and harmonic to noise ratio (NHR). For vocal self-perception analysis, we used the Voice Related Quality of Life protocol. RESULTS: Fundamental frequency and jitter presented higher values in the Parkinson's group. NHR values were higher in the Control Group. Perceptual analysis showed a deviation ranging. The vocal disorder self-perception demonstrated a worse impact on quality of life. CONCLUSIONS: Individuals with Parkinson's disease have an altered voice quality and a negative impact on quality of life.

OBJETIVO: Comparar a qualidade vocal e a qualidade de vida entre pacientes do sexo masculino com doença de Parkinson idiopática e indivíduos sem a doença (Grupo Controle). MÉTODOS: Estudo transversal que avaliou a voz de 27 indivíduos com doença de Parkinson, com idades entre 39 a 79 anos (média de 59,96). O Grupo Controle foi pareado em sexo e idade. Avaliação perceptiva foi feita usando escala GRBASI, que considera G como o grau global da disfonia, R como a rugosidade, B como soprosidade, A como astenia, S como tensão e I como instabilidade. Os parâmetros acústicos analisados foram: frequência fundamental, jitter, shimmer e harmonic to noise ratio (NHR). Para análise da autopercepção vocal, utilizou-se o protocolo Qualidade de Vida e Voz. RESULTADOS: As medidas frequência fundamental e jitter apresentaram valores mais altos no grupo com doença de Parkinson. Valores de NHR foram maiores no Grupo Controle. Análise perceptivo-auditiva mostrou desvio da qualidade vocal. O distúrbio de autopercepção vocal demonstrou impacto negativo na qualidade de vida. CONCLUSÕES: Indivíduos com doença de Parkinson idiopática apresentam qualidade vocal alterada e impacto negativo na qualidade de vida.

Peritoneal and hepatic hydatid disease causing major bile duct destruction.

Echinococcosis is endemic in Mediterranean regions and is found primarily in the liver. Biliary fistula is a common complication, but major biliary duct involvement is very rare, and occurs in 0.47% of patients with hepatic hydatid disease. Cyst rupture causing secondary peritoneal hydatidosis is a rare but serious complication. We report the case of a 27-year-old man with multiple peritoneal and hepatic hydatid cysts. The patient came to our attention with cholestatic jaundice. Imaging exams showed numerous peritoneal cysts and massive hydatid disease of the liver, which involved the hepatic confluence, with destruction of the right hepatic duct and fistula formation to the left hepatic duct. The patient was treated with pre-operative albendazole therapy and radical surgery, which consisted of resection of all peritoneal cysts and extended right hepatectomy with biliary reconstruction. No recurrence was seen on CT investigations on the 12th month following surgery. Radical surgical approach remains the treatment of choice.

La representación social de cuidadores de niños y adolescentes con parálisis cerebral hemipléjica / Social representations of caregivers of children and adolescents suffering from hemiplegic cerebral palsy

El objetivo de este estudio ha sido evaluar la representación social de los padres/cuidadores de niños y/o adolescentes con parálisis cerebral hemipléjica, a partir de la “Escala de Evaluación de la Implicancia Familiar” en los pacientes en rehabilitación y un protocolo con preguntas abiertas y cerradas. El análisis cuantitativo se realizó con estadística descriptiva y el análisis cualitativo a través de análisis de contenido. Se evaluaron 24 niños y/o adolescentes y sus cuidadores. Los cuidadores son mujeres de bajos ingresos, baja escolaridad y formación profesional. La representación social de estas cuidadoras, en cuanto al rendimiento motor, la participación escolar y social de sus hijos, tiene la expectativa de un patrón normal y sentimientos ambiguos sobre el proceso de rehabilitación.

Controle da ferrugem das folhas do capim-limão [Cymbopogon citratus (DC. ) Stapf] com produtos naturais / Rust control in leaves of lemongrass [Cymbopogon citratus (DC. ) Stapf] by using natural products

Cymbopogon citratus (DC.) Stapf é uma planta medicinal pertencente a família Poaceae, perene, importante para a indústria farmacêutica e alimentícia devido ao óleo essencial que produz. Um problema limitante para a produção comercial é a ferrugem, doença cujo agente etiológico é o fungo Puccinia nakanishikii Dietel. O presente trabalho objetivou avaliar a ação de produtos naturais no controle da doença in vitro e in vivo. Para os testes in vitro, empregaram-se os seguintes produtos sobre a germinação de esporos do patógeno: óleos essenciais de eucalipto, palma-rosa, cravo-da-índia, menta, limão, citronela e mil-folhas; extrato pirolenhoso de eucalipto e mentol cristalizado, em diferentes concentrações. Para os testes de campo foram selecionados quatro produtos, o óleo de citronela e de eucalipto, o extrato pirolenhoso, e o mentol. In vitro, todos os agentes mostraram-se promissores no controle do patógeno. Quando em condições in vivo, sob alta severidade da doença no ato da avaliação, os produtos testados foram capazes de reduzir a severidade da doença em comparação com a testemunha. O controle da doença com os agentes naturais variou de 38% (extrato pirolenhoso) a 61%(óleo essencial de eucalipto).

Cymbopogon citratus (DC.) Stapf is a medicinal plant that belongs to the Poaceae family; it is perennial and important for the pharmaceutical and food industry due to the essential oil it produces. A limiting problem for commercial production is rust, a disease that has as etiological agent the fungus Puccinia nakanishikii Dietel. The present study aimed to evaluate the action of natural products on the disease control, in vitro and in vivo. For the in vitro tests, the following products were employed on the germination of the pathogen spores: essential oils from eucalyptus, palmarosa, clove, peppermint, lemon, citronella and yarrow, pyroligneous extract from eucalyptus, and crystallized menthol, at different concentrations. Four products were selected for the tests in the field: citronella and eucalyptus oil, pyroligneous extract and menthol. In vitro, all agents showed promising in controlling the pathogen. Under in vivo conditions and great severity of the disease at evaluation, the tested products were capable of reducing the disease severity when compared to the control. The disease control by the natural products varied from 38% (pyroligneous extract) to 61% (eucalyptus essential oil).

La representación social de cuidadores de niños y adolescentes con parálisis cerebral hemipléjica / Social representations of caregivers of children and adolescents suffering from hemiplegic cerebral palsy

El objetivo de este estudio ha sido evaluar la representación social de los padres/cuidadores de niños y/o adolescentes con parálisis cerebral hemipléjica, a partir de la ôEscala de Evaluación de la Implicancia Familiarö en los pacientes en rehabilitación y un protocolo con preguntas abiertas y cerradas. El análisis cuantitativo se realizó con estadística descriptiva y el análisis cualitativo a través de análisis de contenido. Se evaluaron 24 niños y/o adolescentes y sus cuidadores. Los cuidadores son mujeres de bajos ingresos, baja escolaridad y formación profesional. La representación social de estas cuidadoras, en cuanto al rendimiento motor, la participación escolar y social de sus hijos, tiene la expectativa de un patrón normal y sentimientos ambiguos sobre el proceso de rehabilitación. (AU)

La representación social de cuidadores de niños y adolescentes con parálisis cerebral hemipléjica / Social representations of caregivers of children and adolescents suffering from hemiplegic cerebral palsy

El objetivo de este estudio ha sido evaluar la representación social de los padres/cuidadores de niños y/o adolescentes con parálisis cerebral hemipléjica, a partir de la ôEscala de Evaluación de la Implicancia Familiarö en los pacientes en rehabilitación y un protocolo con preguntas abiertas y cerradas. El análisis cuantitativo se realizó con estadística descriptiva y el análisis cualitativo a través de análisis de contenido. Se evaluaron 24 niños y/o adolescentes y sus cuidadores. Los cuidadores son mujeres de bajos ingresos, baja escolaridad y formación profesional. La representación social de estas cuidadoras, en cuanto al rendimiento motor, la participación escolar y social de sus hijos, tiene la expectativa de un patrón normal y sentimientos ambiguos sobre el proceso de rehabilitación. (AU)

Comportamento do maracujazeiro amarelo, variedade Afruvec, ante uma população de Fusarium solani, agente causal da podridão do colo / Behaviour of yellow passion fruit, Afruvec variety, in relation to a population of Fusarium solani, causal agent of collar rot

O objetivo do presente trabalho foi verificar o comportamento do maracujazeiro amarelo, variedade Afruvec, ante uma população de Fusarium solani, obtida desse mesmo hospedeiro. O delineamento adotado foi o de blocos ao acaso, contendo dez tratamentos (nove isolados e tratamento testemunha), com quatro repetições, sendo cada parcela representada por um vaso contendo uma planta. Um disco do meio de cultura, colonizado com cada isolado do fungo, foi inoculado no colo ferido das plantas da variedade Afruvec, dois meses após a semeadura. Avaliou-se a patogenicidade, a incidência (número de plantas mortas) e a severidade da doença (comprimento da lesão no colo), até os sessenta dias após a inoculação. A variedade Afruvec foi suscetível ao fungo e apresentou variabilidade quanto à incidência e severidade da doença diante dos diferentes isolados. A população do fungo apresentou variabilidade em relação à agressividade. Com a evidência de diversidade genética na população do fungo, recomenda-se, também, nos testes de seleção de materiais ao patógeno, a avaliação desses materiais em diferentes localidades com histórico da doença ou inoculação com uma mistura de isolados do fungo, a fim de se conhecer a resistência ampla do genótipo ao patógeno.

The objective of the present work was to verify the behavior of yellow passion fruit, Afruvec variety, in relation to a population of Fusarium solani, obtained from this crop. The experimental delineation was random blocks, containing 10 treatments [9 isolates and 1 control treatment], with 4 repetitions, each plot being represented by a vase containing a plant. A disk of culture medium colonized by each isolate of the fungus was inoculated in the wounded collar region of the plants of the Afruvec variety two months after sowing. The appraised parameters were: the pathogenicity, the incidence (number of dead plants) and the severity of the disease (length of the lesion in the collar region), until 60 days after inoculation. The Afruvec variety was susceptible to the fungus and also presented variability as to the severity of the disease and incidence in relation to the different isolates. The population of the fungus showed variability in regard to aggressiveness. In light of the evidence of genetic diversity in the F. solani population, it is also suggested, in the tests of selection of materials to the pathogen, that these materials should be evaluated in different places with a history of the disease or inoculation with a pool of isolates of the fungus, in order to know the wide resistance of the genotype to the pathogen.