Impact of inherent biases built into proteomic techniques: Proximity labeling and affinity capture compared.

The characterization of protein-protein interactions (PPIs) is of high value for understanding protein function. Two strategies are popular for identification of PPIs direct from the cellular environment: affinity capture (pulldown) isolates the protein of interest with an immobilized matrix that specifically captures the target and potential partners, whereas in BioID, genetic fusion of biotin ligase facilitates proximity biotinylation, and labeled proteins are isolated with streptavidin. Whilst both methods provide valuable insights, they can reveal distinct PPIs, but the basis for these differences is less obvious. Here, we compare both methods using four different trypanosome proteins as baits: poly(A)-binding proteins PABP1 and PABP2, mRNA export receptor MEX67, and the nucleoporin NUP158. With BioID, we found that the population of candidate interacting proteins decreases with more confined bait protein localization, but the candidate population is less variable with affinity capture. BioID returned more likely false positives, in particular for proteins with less confined localization, and identified low molecular weight proteins less efficiently. Surprisingly, BioID for MEX67 identified exclusively proteins lining the inner channel of the nuclear pore complex (NPC), consistent with the function of MEX67, whereas the entire NPC was isolated by pulldown. Similarly, for NUP158, BioID returned surprisingly few PPIs within NPC outer rings that were by contrast detected with pulldown but instead returned a larger cohort of nuclear proteins. These rather significant differences highlight a clear issue with reliance on a single method to identify PPIs and suggest that BioID and affinity capture are complementary rather than alternative approaches.

Knocking Down TcNTPDase-1 Gene Reduces in vitro Infectivity of Trypanosoma cruzi.

Ecto-Nucleoside Triphosphate Diphosphohydrolases are enzymes that hydrolyze tri- and/or diphosphate nucleosides. Evidences pointed out to their participation in Trypanosoma cruzi virulence, infectivity, and purine acquisition. In this study, recombinant T. cruzi knocking out or overexpressing the TcNTPDase-1 gene were built, and the role of TcNTPDase-1 in the in vitro interaction with VERO cells was investigated. Results show that epimastigote forms of hemi-knockout parasites showed about 50% lower level of TcNTPDase-1 gene expression when compared to the wild type, while the T. cruzi overexpressing this gene reach 20 times higher gene expression. In trypomastigote forms, the same decreasing in TcNTPDase-1 gene expression was observed to the hemi-knockout parasites. The in vitro infection assays showed a reduction to 51.6 and 59.9% at the adhesion and to 25.2 and 26.4% at the endocytic indexes to the parasites knockout to one or other allele (Hygro and Neo hemi-knockouts), respectively. In contrast, the infection assays with T. cruzi overexpressing TcNTPDase-1 from the WT or Neo hemi-knockout parasites showed an opposite result, with the increasing to 287.7 and 271.1% at the adhesion and to 220.4 and 186.7% at the endocytic indexes, respectively. The parasitic load estimated in infected VERO cells by quantitative real time PCR corroborated these findings. Taken together, the partial silencing and overexpression of the TcNTPDase-1 gene generated viable parasites with low and high infectivity rates, respectively, corroborating that the enzyme encoded for this gene plays an important role to the T. cruzi infectivity.

Knockout of the gamma subunit of the AP-1 adaptor complex in the human parasite Trypanosoma cruzi impairs infectivity and differentiation and prevents the maturation and targeting of the major protease cruzipain.

The AP-1 Adaptor Complex assists clathrin-coated vesicle assembly in the trans-Golgi network (TGN) of eukaryotic cells. However, the role of AP-1 in the protozoan Trypanosoma cruzi-the Chagas disease parasite-has not been addressed. Here, we studied the function and localization of AP-1 in different T. cruzi life cycle forms, by generating a gene knockout of the large AP-1 subunit gamma adaptin (TcAP1-γ), and raising a monoclonal antibody against TcAP1-γ. Co-localization with a Golgi marker and with the clathrin light chain showed that TcAP1-γ is located in the Golgi, and it may interact with clathrin in vivo, at the TGN. Epimastigote (insect form) parasites lacking TcAP1-γ (TcγKO) have reduced proliferation and differentiation into infective metacyclic trypomastigotes (compared with wild-type parasites). TcγKO parasites have also displayed significantly reduced infectivity towards mammalian cells. Importantly, TcAP1-γ knockout impaired maturation and transport to lysosome-related organelles (reservosomes) of a key cargo-the major cysteine protease cruzipain, which is important for parasite nutrition, differentiation and infection. In conclusion, the defective processing and transport of cruzipain upon AP-1 ablation may underlie the phenotype of TcγKO parasites.

Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil.

OBJECTIVE: To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS: This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis - from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS: In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24-14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81-8.43)], smoking (OR = 3.93; 95%CI 1.98-7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15-8.99). CONCLUSIONS: The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo. OBJETIVO: Analisar a prevalência e fatores associados à tuberculose resistente no Espírito Santo. MÉTODOS: Estudo transversal dos casos de tuberculose testados para fármacos de primeira linha (isoniazida, rifampicina, pirazinamida, etambutol e estreptomicina) no Espírito Santo entre 2002 e 2012. Foram utilizados dados laboratoriais e de registro de casos de tuberculose - Sistema Nacional de Agravos de Notificação e Sistema para Tratamentos Especiais de Tuberculose. Os indivíduos foram classificados em resistentes e não resistentes, e comparados para variáveis sociodemográficas, clínicas e epidemiológicas. Algumas variáveis foram inclusas em um modelo de regressão logística para estabelecimento de fatores associados à resistência. RESULTADOS: No período do estudo, 1.669 indivíduos tiveram o teste de sensibilidade aos fármacos antituberculose realizado. Destes, 10,6% apresentaram resistência a qualquer droga antituberculose. A taxa de multirresistência observada, isto é, à rifampicina e isoniazida, foi de 5%. Após a análise múltipla, foram identificados como fatores associados independentes para tuberculose resistente: história de tratamento prévio para tuberculose [Recidiva (OR = 7,72; IC95% 4,24-14,05) e reingresso após abandono (OR = 3,91; IC95% 1,81-8,43)], tabagismo (OR = 3,93; IC95% 1,98-7,79) e cultura positiva para Mycobacterium tuberculosis no momento da notificação do caso (OR = 3,22; IC95% 1,15-8,99). CONCLUSÕES: É necessário o fortalecimento da parceria entre os programas de controle de tuberculose e as equipes de saúde que atuam na rede de Atenção Primária à Saúde. Isso possibilitaria identificar e acompanhar indivíduos com história de tratamento prévio para tuberculose e tabagismo. Além disso, a ampliação da oferta de cultura e Teste de Sensibilidade a fármacos antituberculose proporcionaria maior capacidade diagnóstica para as formas resistentes no Espírito Santo.

Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil / Fatores associados à tuberculose resistente no Espírito Santo, Brasil

ABSTRACT OBJECTIVE To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis – from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24–14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81–8.43)], smoking (OR = 3.93; 95%CI 1.98–7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15–8.99). CONCLUSIONS The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo.

RESUMO OBJETIVO Analisar a prevalência e fatores associados à tuberculose resistente no Espírito Santo. MÉTODOS Estudo transversal dos casos de tuberculose testados para fármacos de primeira linha (isoniazida, rifampicina, pirazinamida, etambutol e estreptomicina) no Espírito Santo entre 2002 e 2012. Foram utilizados dados laboratoriais e de registro de casos de tuberculose – Sistema Nacional de Agravos de Notificação e Sistema para Tratamentos Especiais de Tuberculose. Os indivíduos foram classificados em resistentes e não resistentes, e comparados para variáveis sociodemográficas, clínicas e epidemiológicas. Algumas variáveis foram inclusas em um modelo de regressão logística para estabelecimento de fatores associados à resistência. RESULTADOS No período do estudo, 1.669 indivíduos tiveram o teste de sensibilidade aos fármacos antituberculose realizado. Destes, 10,6% apresentaram resistência a qualquer droga antituberculose. A taxa de multirresistência observada, isto é, à rifampicina e isoniazida, foi de 5%. Após a análise múltipla, foram identificados como fatores associados independentes para tuberculose resistente: história de tratamento prévio para tuberculose [Recidiva (OR = 7,72; IC95% 4,24–14,05) e reingresso após abandono (OR = 3,91; IC95% 1,81–8,43)], tabagismo (OR = 3,93; IC95% 1,98–7,79) e cultura positiva para Mycobacterium tuberculosis no momento da notificação do caso (OR = 3,22; IC95% 1,15–8,99). CONCLUSÕES É necessário o fortalecimento da parceria entre os programas de controle de tuberculose e as equipes de saúde que atuam na rede de Atenção Primária à Saúde. Isso possibilitaria identificar e acompanhar indivíduos com história de tratamento prévio para tuberculose e tabagismo. Além disso, a ampliação da oferta de cultura e Teste de Sensibilidade a fármacos antituberculose proporcionaria maior capacidade diagnóstica para as formas resistentes no Espírito Santo.

Conservation and divergence within the clathrin interactome of Trypanosoma cruzi.

Trypanosomatids are parasitic protozoa with a significant burden on human health. African and American trypanosomes are causative agents of Nagana and Chagas disease respectively, and speciated about 300 million years ago. These parasites have highly distinct life cycles, pathologies, transmission strategies and surface proteomes, being dominated by the variant surface glycoprotein (African) or mucins (American) respectively. In African trypanosomes clathrin-mediated trafficking is responsible for endocytosis and post-Golgi transport, with several mechanistic aspects distinct from higher organisms. Using clathrin light chain (TcCLC) and EpsinR (TcEpsinR) as affinity handles, we identified candidate clathrin-associated proteins (CAPs) in Trypanosoma cruzi; the cohort includes orthologs of many proteins known to mediate vesicle trafficking, but significantly not the AP-2 adaptor complex. Several trypanosome-specific proteins common with African trypanosomes, were also identified. Fluorescence microscopy revealed localisations for TcEpsinR, TcCLC and TcCHC at the posterior region of trypomastigote cells, coincident with the flagellar pocket and Golgi apparatus. These data provide the first systematic analysis of clathrin-mediated trafficking in T. cruzi, allowing comparison between protein cohorts and other trypanosomes and also suggest that clathrin trafficking in at least some life stages of T. cruzi may be AP-2-independent.

[Evaluation of the quality of data in the Live Birth Information System and the Information System on Mortality during the neonatal period in the state of Espírito Santo, Brazil, between 2007 and 2009]. / Avaliação da qualidade dos dados do Sistema de Informações sobre Nascidos Vivos e do Sistema de Informações sobre Mortalidade no período neonatal, Espírito Santo, Brasil, de 2007 a 2009.

Health information systems make it possible to be aware of health problems and often represent the sole source of information, thereby making it essential to assess their quality. The scope of this paper was to evaluate the quality of data about live births and deaths in the neonatal period in the Live Births Information System (SINASC) and Mortality Information System (SIM) in the state of Espírito Santo during the period from 2007 to 2009. Descriptive methodology with secondary data obtained from the electronic address of the Informatics Department of the Unified Health System was used to analyze the dimensions of quality of information, namely accessibility, timeliness and completeness. The results indicate that the information is accessible and timely, with a lag of three years compared to the beginning of the study. The completeness of the variables analyzed in SINASC was predominantly classified as excellent. SIM revealed a high percentage of missing data on the number of the Live Birth Declaration, mother's education, age and reproductive history. The conclusion reached is that SINASC is an excellent source of information about births, though SIM reveals a marked need for improvements in the completeness of its information.

Avaliação da qualidade dos dados do Sistema de Informações sobre Nascidos Vivos e do Sistema de Informações sobre Mortalidade no período neonatal, Espírito Santo, Brasil, de 2007 a 2009 / Evaluation of the quality of data in the Live Birth Information System and the Information System on Mortality during the neonatal period in the state of Espírito Santo, Brazil, between 2007 and 2009

Os sistemas de informação em saúde possibilitam conhecer problemas dessa área e muitas vezes representam a única fonte de informação, tornando-se fundamental conhecer sua qualidade. O objetivo foi avaliar a qualidade dos dados sobre nascimentos e óbitos no período neonatal no Sistema de Informações sobre Nascidos Vivos (SINASC) e no Sistema de Informações sobre Mortalidade (SIM) no estado do Espírito Santo, no período de 2007 a 2009. Metodologia descritiva com dados secundários obtidos no endereço eletrônico do Departamento de Informática do Sistema Único de Saúde, no qual foram analisadas as seguintes dimensões da qualidade das informações: acessibilidade, oportunidade e completude. Resultados apontam que as informações são acessíveis e oportunas, com defasagem de três anos em relação ao início do estudo. A completude das variáveis analisados no SINASC foram, na sua maio ria, classificadas como excelente. O SIM exibiu elevado percentual de dados faltantes no número da Declaração de Nascido Vivo, escolaridade e idade da mãe e história reprodutiva. Conclui-se que o SINASC é uma excelente fonte de informação sobre nascimentos, contudo o SIM aponta para a indiscutível necessidade de melhorias na completude de suas informações.

Health information systems make it possible to be aware of health problems and often represent the sole source of information, thereby making it essential to assess their quality. The scope of this paper was to evaluate the quality of data about live births and deaths in the neonatal period in the Live Births Information System (SINASC) and Mortality Information System (SIM) in the state of Espírito Santo during the period from 2007 to 2009. Descriptive methodology with secondary data obtained from the electronic address of the Informatics Department of the Unified Health System was used to analyze the dimensions of quality of information, namely accessibility, timeliness and completeness. The results indicate that the information is accessible and timely, with a lag of three years compared to the beginning of the study. The completeness of the variables analyzed in SINASC was predominantly classified as excellent. SIM revealed a high percentage of missing data on the number of the Live Birth Declaration, mother's education, age and reproductive history. The conclusion reached is that SINASC is an excellent source of information about births, though SIM reveals a marked need for improvements in the completeness of its information.

Diferenças nas características clínicas e epidemiológicas entre os casos notificados por tuberculose na atenção primária e terciária / Differences in clinical and epidemiological features betweentuberculosis cases notified in primary and tertiary health care / Diferencias de las caracteristicas clinicas y epidemiológicas de los casos notificados de tuberculosis en la atención primaria y terciaria

Comparar, quanto aos aspectos clínicos, radiológicos e epidemiológicos, todos os casos de tuberculose (TB) diagnosticados nos serviços terciários de atenção à saúde com aqueles diagnosticados no nível primário de atenção à saúde do município de Vitória-ES. Métodos:Estudo de corte transversal, retrospectivo, com análises do banco de dados do SINAN, para identificar todos os casos residentes no município de Vitória-ES e diagnosticados com tuberculose nos anos de 2006 e 2007. Os pacientes foram divididos em dois grupos: os diagnosticados na Atenção Primária à Saúde (APS) e os diagnosticados na Atenção Terciáriaà Saúde (ATS). Para análise estatística, utilizou-se o programa Stata Corp 9.0.Resultados: Identificou-se um total de 338 pacientes; destes, 207 (61,24%) diagnosticados na APS e 131 (38,76%) na ATS. Observou-se um predomínio da forma clínica pulmonar em ambosos grupos, todavia, a extrapulmonar apresentou maior frequência no grupo da ATS. Quando analisados os resultados da baciloscopia de escarro, a positividade foi encontrada em 114(55,07%) dos pacientes da APS e em 57 (43,51%) da ATS. Com relação à positividade da cultura, 119 (57,48%) pacientes diagnosticados na APS e apenas 38 (29%) na ATS tiveram resultado positivo. Conclusão: Háevidência de elevada proporção de pacientes com TB notificados como “casos novos” na Atenção Terciária no município e foi notado um predomínio da forma clínica pulmonar em ambos os grupos – APS e ATS. Todavia, aextrapulmonar apresentou maior frequência neste...

To compare, on the basis of clinical, radiological and epidemiological aspects, all cases of tuberculosis (TB) diagnosed in the tertiary healthcare services to those diagnosed at the primary healthcare providers in the municipality of Vitória-ES. Methods:Cross- sectional, retrospective study, with analysis of the SINAN’s database, to identify all cases among residents of the municipality of Vitória-ES and diagnosed with TB in 2006 and 2007.Patients were divided into two groups: cases diagnosed in Primary Health Care (PHC) and those diagnosed in Tertiary Health Care (THC). For statistical analysis, it was used the software STATA CORP 9.0. Results:338 patients were identified; 207 (61.24%) of these were diagnosed in PHC and 131 (38.76%) in THC. The pulmonary form was predominantin both groups. However, the extrapulmonary form presented higher frequency in the THC group. When analyzing the results of sputum smear, the positivity was found in 114 (55.07%) patients of the PHC and in 57 (43.51%) of THC. Regarding the positive cultures, 119 (57.48%) patients diagnosed in PHC and only 38 (29%) in THC tested positive. Conclusion: There is evidence of high proportion of patients with TB communicated as “new cases” inTHC in the city and it was observed a predominance of the pulmonary form in both groups - PHC and THC, although the extrapulmonary form was more frequent in the latter...

Comparar todos los casos de tuberculosis (TB) diagnosticados en los servicios terciarios de salud con aquellosdiagnosticados en nivel primario de salud del municipio de Vitoria-ES acerca de los aspectos clínicos, radiológicos yepidemiológicos Métodos: Estudio trasversal, retrospectivo, con análisis del banco de datos del SINAN para identificar todos los casos residentes en el municipio de Vitoria-ES y diagnosticados con tuberculosis en los años 206 y 2007. Los pacientes fuerondivididos en dos grupos: los diagnosticados en la Atención Primaria en Salud (APS) y los diagnosticados en la Atención Terciaria en Salud (ATS). Para el análisis estadístico se utilizó el programa Stata Corp 9.0. Resultados:Se identificó un total de 338 pacientes; de esos, 207 (61,24%) fueron diagnosticados en la APS y 131 (38,76%) en la ATS. Se observó un predominio de la forma clínica pulmonar en ambos grupos, sin embargo, laextra pulmonar presentó mayor frecuencia en el grupo de la ATS.Cuando analizados los resultados de la baciloscopia de esputo, la positividad fue encontrada en 114 (55,07%) de los pacientes de la APS y en 57 (43,51%) de la ATS. Respecto la positividadde la cultura, 119 (57,48%) pacientes diagnosticados en la APS y apenas 38 (29%) en la ATS tuvieron resultado positivo. Conclusión: Hay evidencia de elevada proporción de pacientescon TB notificados como “casos nuevos” en la Atención Terciaria del municipio y fue observado un predominio de la forma clínica pulmonar en ambos grupos – APS y ATS. Sin embargo, la extrapulmonar presentó mayor frecuencia en este...

Identification and subcellular localization of TcHIP, a putative Golgi zDHHC palmitoyl transferase of Trypanosoma cruzi.

Protein palmitoylation is a post-translational modification that contributes to determining protein localization and function. Palmitoylation has been described in trypanosomatid protozoa, but no zDHHC palmitoyl transferase has been identified in Trypanosoma cruzi, the etiological agent of Chagas disease in Latin America. In this study we identify and show the subcellular localization of TcHIP (Tc00.1047053508199.50), a putative T. cruzi zDHHC palmitoyl transferase. Analysis of the deduced protein sequence indicates that it contains ankyrin repeats (Ank and Ank2) and the zDHHC conserved domain, typical of zDHHC palmitoyl transferases. A TcHIP polyclonal antiserum obtained from mice immunized with the purified recombinant protein was used to study the presence and subcellular localization of the native enzyme. In western blots this antiserum recognized a protein of about 95 kDa, consistent with the predicted molecular mass of TcHIP (95.4 kDa), in whole extracts of T. cruzi epimastigotes, metacyclic trypomastigotes and intracellular amastigotes. Immunolocalization by confocal microscopy showed TcHIP labeling at the Golgi complex, co-localizing with the T. cruzi Golgi marker TcRab7-GFP. Transfectant T. cruzi epimastigotes containing a construct encoding TcHIP fused to proteins A and C (TcHIP/AC) were obtained. In western blotting experiments, the TcHIP polyclonal antiserum recognized both native and TcHIP/AC proteins in extracts of the transfectants. Confocal microscopy showed co-localization of native TcHIP with TcHIP/AC. These findings demonstrate the presence of a putative zDHHC palmitoyl transferase (TcHIP) containing ankyrin and zDHHC domains in different developmental forms of T. cruzi, and its association with the Golgi complex.

Para além da ilusão: o real na crítica freudiana à religião

Pretende-se demonstrar como a matriz primeira de interpretação freudiana da religião - baseada na crítica aos elementos imaginários que compõem o quadro da adesão religiosa - é suplantada por Freud com a escrita de Moisés e o monoteísmo em 1939. É a leitura deste ensaio que nos permite perceber a presença do real na genealogia da religião. O sentimento de desamparo vinculado à experiência de satisfação foi alvo de nossa investigação, fornecendo subsídios que confirmaram a presença de outros elementos além dos imaginários no fenômeno religioso

Beyond Illusion: the Real in Freud's criticism to religion. This paper aims to demonstrate how the first religious interpretative Freud's matrix - based on the criticism of imaginary elements that constitute the framework of the religious adhesion - is overcome by Freud's Moses and the Monotheism in 1939. This reading allows us to realize the presence of the Real in the genealogy of religion. The analysis of the feeling of helplessness combined with the experience of satisfaction was also investigated here, providing subsidies that confirm the presence of other elements beyond the imaginary in the religious phenomenon

Para além da ilusão: o real na crítica freudiana à religião / Beyond the illusion: the actual Freudian critique of religion

Pretende-se demonstrar como a matriz primeira de interpretação freudiana da religião - baseada na crítica aos elementos imaginários que compõem o quadro da adesão religiosa - é suplantada por Freud com a escrita de Moisés e o monoteísmo em 1939. É a leitura deste ensaio que nos permite perceber a presença do real na genealogia da religião. O sentimento de desamparo vinculado à experiência de satisfação foi alvo de nossa investigação, fornecendo subsídios que confirmaram a presença de outros elementos além dos imaginários no fenômeno religioso.

Beyond Illusion: the Real in Freud's criticism to religion. This paper aims to demonstrate how the first religious interpretative Freud's matrix - based on the criticism of imaginary elements that constitute the framework of the religious adhesion - is overcome by Freud's Moses and the Monotheism in 1939. This reading allows us to realize the presence of the Real in the genealogy of religion. The analysis of the feeling of helplessness combined with the experience of satisfaction was also investigated here, providing subsidies that confirm the presence of other elements beyond the imaginary in the religious phenomenon.

Sintomáticos respiratórios nas unidades de atenção primária no Município de Vitória, Espírito Santo, Brasil / Respiratory symptomatics among patients at primary health clinics in Vitória, Espírito Santo State, Brazil

The aim of this study was to estimate the rate of positive respiratory symptomatics among patients seeking treatment at primary health clinics in Vitória, Espírito Santo State, Brazil. This cross-sectional study included 603 individuals that answered a questionnaire with socio-demographic data and a question on cough in the previous three weeks. The prevalence ratio was calculated with 5 percent significance. The proportion of patients with positive respiratory symptoms in the municipality was 4 percent, varying from 1.6 to 11.7 percent between regions. The majority (71 percent) did not report cough as the reason for coming to the health clinic. Variables significantly associated with respiratory symptoms were: shortness of breath (PR = 6.29; 95 percentCI: 2.22-21.81) and lack of appetite (PR = 2.75; 95 percentCI: 1.08-6.82). Among patients with respiratory symptoms, cough was the principal reason for seeking treatment. This condition was only associated with two variables, thus demonstrating the need to adopt different strategies to identify these individuals among the daily patient flow in primary health clinics.

O objetivo do estudo foi estimar a proporção de sintomáticos respiratórios na população que busca atendimento nas unidades de atenção primária do Município de Vitória, Espírito Santo. Foi realizado um estudo transversal do qual participaram 603 indivíduos que responderam a um questionário referente a dados sócio-demográficos e questão sobre tosse há mais de três semanas. Foi calculada a razão de prevalência com nível de significância de 5 por cento. A proporção de sintomáticos respiratórios encontrada no município foi de 4 por cento, variando de 1,6 a 11,7 por cento entre as regiões. A maioria (71 por cento) não referiu a tosse como motivo de procura do serviço. As variáveis significativamente associadas à condição de sintomático respiratório foram: falta de ar (RP = 6,29; IC95 por cento: 2,22-21,81) e falta de apetite (RP = 2,75; IC95 por cento: 1,08-6,82). Entre os sintomáticos respiratórios, a tosse foi o principal motivo de consulta. Observou-se associação dessa condição com somente duas variáveis, demonstrando a necessidade de adoção de diferentes estratégias para busca e identificação desses indivíduos na demanda diária das unidades de atenção primária.

[Respiratory symptomatics among patients at primary health clinics in Vitória, Espírito Santo State, Brazil]. / Sintomáticos respiratórios nas unidades de atenção primária no Município de Vitória, Espírito Santo, Brasil.

The aim of this study was to estimate the rate of positive respiratory symptomatics among patients seeking treatment at primary health clinics in Vitória, Espírito Santo State, Brazil. This cross-sectional study included 603 individuals that answered a questionnaire with socio-demographic data and a question on cough in the previous three weeks. The prevalence ratio was calculated with 5% significance. The proportion of patients with positive respiratory symptoms in the municipality was 4%, varying from 1.6 to 11.7% between regions. The majority (71%) did not report cough as the reason for coming to the health clinic. Variables significantly associated with respiratory symptoms were: shortness of breath (PR = 6.29; 95%CI: 2.22-21.81) and lack of appetite (PR = 2.75; 95%CI: 1.08-6.82). Among patients with respiratory symptoms, cough was the principal reason for seeking treatment. This condition was only associated with two variables, thus demonstrating the need to adopt different strategies to identify these individuals among the daily patient flow in primary health clinics.

Perfil epidemiológico de casos notificados de tuberculose em residentes de abrigos em vitória e vila velha, espírito santo, no período de 2000 a 2006 / Epidemiologic profile of reported cases of tuberculosis among residents ofshelters in Vitoria and Vila Velha, Brazil, in the period of 2000 - 2006.

A tuberculose acomete 8 milhões de pessoas anualmente em todo o mundo. A população de asilos convive com situações de fragilidade social, favorecendo a transmissão da doença. O objetivo deste trabalho foi traçar o perfil epidemiológico de casos notificados de tuberculose entre de moradores de abrigos em Vitória e Vila Velha no período de2000 a 2006. No período foram notificados 32 casos, 23 residentes de Vitória, 9 em Vila Velha, com idade média de 41 anos, sendo 30 do sexo masculino. A forma pulmonar foi predominante (88%), 91% dos casos apresentaram raios-X suspeito e 97% não realizaram o teste tuberculínico. O tratamento supervisionado ocorreu em50% dos pacientes. 50% dos pacientes obtiveram cura, 18,8% abandonaram o tratamento, 15,6% morreram e 15,6% foram transferidos. Apesar das dificuldades de controlar a tuberculose no interior de abrigos, realizar um rastreamento dessa população seria indicado para evitar a disseminação da doença.

Tuberculosis-related mortality in the state of Espírito Santo, Brazil, 1985-2004.

OBJECTIVE: The purpose of this study was to describe tuberculosis-related mortality in Espírito Santo, Brazil, evaluating its tendencies in relation to clinical presentation, gender and age bracket. METHODS: We conducted a retrospective, descriptive study based on secondary data. For the 1985-2004 period, we investigated all deaths of residents of Espírito Santo in which tuberculosis was given as the underlying cause, as reported in the Brazilian National Mortality Database. RESULTS: The adjusted mortality rates for all forms of tuberculosis paralleled the overall mortality rates in the state, decreasing from 5.6/100,000 inhabitants in 1985 to 2.0/100,000 inhabitants in 2004. Pulmonary tuberculosis was the predominant form of the disease (89.7% of tuberculosis-related deaths) throughout the period studied, and the male/female mortality rate ratio ranged from 1.1 in 1998 to 3.19 in 2004. CONCLUSIONS: We observed a decrease in the mortality rates in all age brackets. Predominance of the pulmonary form, male gender and advanced age was similar to that of overall tuberculosis-related mortality in Brazil.

Mortalidade específica por tuberculose no estado do Espírito Santo, no período de 1985 a 2004 / Tuberculosis-related mortality in the state of Espírito Santo, Brazil, 1985-2004

OBJETIVO: O objetivo deste trabalho é descrever a mortalidade específica por tuberculose no estado do Espírito Santo, e sua tendência em relação às variáveis: forma clínica, sexo e faixas etárias. MÉTODOS: Realizou-se um estudo descritivo retrospectivo baseado em dados secundários. Foram incluídos os óbitos registrados no Sistema de Informações sobre Mortalidade que possuíam como causa básica a tuberculose de residentes no estado do Espírito Santo, no período de 1985 a 2004. RESULTADOS: A taxa de mortalidade específica ajustada por tuberculose de todas as formas acompanhou a taxa de mortalidade geral do estado apresentando redução de 5,6/100.000 habitantes, em 1985, para 2,0/100.000 habitantes, em 2004. A forma pulmonar foi a mais freqüente em todo o período (89,7 por cento dos óbitos por tuberculose). A razão da taxa de mortalidade no sexo masculino/feminino variou de 1,1 em 1998 a 3,19 no ano de 2004. CONCLUSÕES: Ocorreu redução da taxa de mortalidade em todas as faixas etárias. A predominância da forma pulmonar, sexo masculino e faixas etárias mais avançadas foram semelhantes à da mortalidade específica por tuberculose no país como um todo.

OBJECTIVE: The purpose of this study was to describe tuberculosis-related mortality in Espírito Santo, Brazil, evaluating its tendencies in relation to clinical presentation, gender and age bracket. METHODS: We conducted a retrospective, descriptive study based on secondary data. For the 1985-2004 period, we investigated all deaths of residents of Espírito Santo in which tuberculosis was given as the underlying cause, as reported in the Brazilian National Mortality Database. RESULTS: The adjusted mortality rates for all forms of tuberculosis paralleled the overall mortality rates in the state, decreasing from 5.6/100,000 inhabitants in 1985 to 2.0/100,000 inhabitants in 2004. Pulmonary tuberculosis was the predominant form of the disease (89.7 percent of tuberculosis-related deaths) throughout the period studied, and the male/female mortality rate ratio ranged from 1.1 in 1998 to 3.19 in 2004. CONCLUSIONS: We observed a decrease in the mortality rates in all age brackets. Predominance of the pulmonary form, male gender and advanced age was similar to that of overall tuberculosis-related mortality in Brazil.

Completeness of tuberculosis control program records in the case registry database of the state of Espírito Santo, Brazil: analysis of the 2001-2005 period.

OBJECTIVE: To investigate the completeness of tuberculosis control program records for the 2001-2005 period in the case registry database of the state of Espírito Santo, Brazil. METHODS: A descriptive study using secondary data analysis. The following variables were studied: race/color; educational level, supervised treatment, sputum culture at treatment outcome, HIV status, smear sputum microscopy at the sixth month of treatment and treatment outcome. RESULTS: Using technical parameters of the case registry database of the Brazilian National Ministry of Health regarding the percentage of completeness of data on the reporting forms, the tuberculosis database of the state of Espírito Santo can be classified as fair to excellent. The state of Espírito Santo has 78 cities, 8 of which are considered priorities for tuberculosis control. For the variables studied, the cities not considered priorities presented better completeness of records than did those considered priorities, the exception being the variable treatment outcome, for which the percentage of completeness was comparable among all of the cities. CONCLUSIONS: Since the cities that are considered priorities accounted for 70.2% of the total number of reports, the responsible officials in those cities should improve the quality of those reports in terms of the completeness of forms and the updating of data, which are fundamental to the reliability of epidemiological analyses. That will make it possible to plan activities aimed at the prevention and control of tuberculosis in the state.

Completude dos dados do Programa de Controle da Tuberculose no Sistema de Informação de Agravos de Notificação no Estado do Espírito Santo, Brasil: uma análise do período de 2001 a 2005 / Completeness of tuberculosis control program records in the case registry database of the state of Espírito Santo, Brazil: analysis of the 2001-2005 period

OBJETIVO: analisar a completude dos dados do Programa de Controle da Tuberculose no Sistema de Informação de Agravos de Notificação do Estado do Espírito Santo no período de 2001 a 2005. MÉTODOS: estudo descritivo de análise de dados secundários. As variáveis estudadas foram: raça/cor, escolaridade, tratamento supervisionado, encerramento de cultura de escarro, situação de HIV, baciloscopia de 6º mês e situação de encerramento. RESULTADOS: Utilizando-se os parâmetros técnicos do Sistema de Informação de Agravos de Notificação do Ministério da Saúde que dizem respeito ao percentual de preenchimento dos campos das fichas de notificação, o banco de dados sobre tuberculose no estado do Espírito Santo pode ser considerado de regular a excelente. Há no estado do Espírito Santo 78 municípios, dos quais 8 são prioritários no controle da tuberculose. Os municípios não prioritários apresentaram maior completude do que os prioritários em relação às variáveis estudadas, exceto na situação de encerramento, com percentual idêntico de preenchimento. CONCLUSÕES: Os municípios prioritários são responsáveis por 70,2 por cento do total de notificações, devendo, portanto, melhorar a qualidade dos registros em relação ao preenchimento dos campos e à atualização dos dados, primordiais para a confiabilidade da análise epidemiológica. Isto possibilitará o planejamento de ações de prevenção e controle da tuberculose no estado.

OBJECTIVE: To investigate the completeness of tuberculosis control program records for the 2001-2005 period in the case registry database of the state of Espírito Santo, Brazil. METHODS: A descriptive study using secondary data analysis. The following variables were studied: race/color; educational level, supervised treatment, sputum culture at treatment outcome, HIV status, smear sputum microscopy at the sixth month of treatment and treatment outcome. RESULTS: Using technical parameters of the case registry database of the Brazilian National Ministry of Health regarding the percentage of completeness of data on the reporting forms, the tuberculosis database of the state of Espírito Santo can be classified as fair to excellent. The state of Espírito Santo has 78 cities, 8 of which are considered priorities for tuberculosis control. For the variables studied, the cities not considered priorities presented better completeness of records than did those considered priorities, the exception being the variable treatment outcome, for which the percentage of completeness was comparable among all of the cities. CONCLUSIONS: Since the cities that are considered priorities accounted for 70.2 percent of the total number of reports, the responsible officials in those cities should improve the quality of those reports in terms of the completeness of forms and the updating of data, which are fundamental to the reliability of epidemiological analyses. That will make it possible to plan activities aimed at the prevention and control of tuberculosis in the state.