Abstract The objective of the present study was to evaluate the effect of different fasting periods on mortality of Litopenaeus vannamei post-larvae and the time it took to molt or die. The study applied an experimental design using 20-days-old post-larvae (PL), with a control group subjected to continuous feeding (CF) and 9 treatments (S2, S4, S6, S8, S10, S12, S14, S16, S18) with varying fasting periods, followed by continuous feeding. The time at which food deprivation resulted in death was analyzed for 50% of the post-larvae, even when they received food after fasting. Statistical analysis of time to molt identified 3 different groups (P < 0.05): group 1 with continuous feeding, group 2 with fasting periods of 2 and 4 days (S2, S4), and group 3 with fasting periods between 6-18 days (S6-S18). In control group with continuous feeding, the time to molt was estimated at about 3.44 ± 0.68 days. Time to death, showed 2 significantly different treatment groups (P < 0.05). In CF treatment, all PLs survived. The first group consisted of fasting tests for 2 and 4 days (S2, S4). The second group corresponded to fasting periods from S6 to S18 days, resulting in the shortest time to death with 71.43 and 100% of individuals dead. The PNR50 was estimated to be around 3.97 ± 0.31 days, demonstrating that fasting periods affected development and potentially caused death in PL of L. vannamei.

Resumen El objetivo del presente estudio fue evaluar el efecto de diferentes períodos de ayuno sobre la mortalidad de las post-larvas de Litopenaeus vannamei y el tiempo que les tomó mudar o morir. El estudio aplicó un diseño experimental utilizando post-larvas de 20 días de edad, con un grupo control sometido a alimentación continua (CF) y 9 tratamientos (S2, S4, S6, S8, S10, S12, S14, S16, S18) con períodos variables de ayuno, seguidos de alimentación continua. Se analizó el momento en el que la privación de alimentos provocó la muerte del 50% de los individuos, incluso cuando recibieron alimento después del ayuno. El análisis estadístico para el tiempo de muda identificó 3 grupos diferentes (P < 0,05). Grupo 1 con alimentación continua; Grupo 2 con periodos de ayuno de 2 y 4 días; y grupo 3 con periodos de ayuno entre 6-18 días. En el grupo control con alimentación continua se estimó un tiempo de muda de alrededor de 3,44 ± 0,68 días. En el tiempo de muerte hubo 2 grupos de tratamientos significativamente diferentes (P < 0,05). En el tratamiento con alimentación continua sobrevivieron todas las PL. El primer grupo consistió en pruebas de ayuno durante 2 y 4 días (S2 y S4). El segundo grupo correspondió desde los periodos de ayuno de S6 a S18 días, resultando el menor tiempo hasta la muerte con 71,43 y 100% de individuos muertos. El PNR50 se estimó alrededor de 3,97 ( 0,31 días, demostrando que los períodos de ayuno afectaron el desarrollo y potencialmente causan mortalidad en las post-larvas de L. vannamei.

The problem of improper disposal of polymeric waste is increasingly in present. Thus, the use of biodegradable polymers is a good alternative, especially for packaging. Compostable and biodegradable polymers such as PHBV can be completely degraded, making them ideal. But the short processability window and fluid instability is an important drawback to the wider application of this polymer in pure form. Production of composite materials has been indicated as a possibility for using this polymer. One source of filler is cellulose, because besides being widely available from agroindustrial waste. In this context, the present work reports the formulation of rigid packaging with PHBV and cellulose waste. An analytical mill was used to promote the dispersion of cellulose fibers. In general, the cellulose fibers increased the Vicat softening point of the polymeric matrix. There were more crystalline structures, according to DSC, and a decrease in impact strength, probably due to increased crystallinity and agglomerate formation. The microscopic analysis indicated greater surface roughness of the composite due to the increase of fibers, resulting in increased contact angle.

ABSTRACT Objective: To assess the repercussions of SARS-CoV-2 infection (suspected or confirmed) and the context of the pandemic on the birth route and humanized assistance during childbirth. Method: Cross-sectional epidemiological study, nested within a cohort and comparative with the research “Birth in Belo Horizonte: Survey on Childbirth and Delivery”.The medical records of three reference maternity hospitals in Belo Horizonte were assessed, with a final sample of 1,682 pregnant women, in the months of May, June and July 2020. A descriptive analysis was carried out, with absolute and relative frequency, and a comparative one, with a Pearson’s chi-square test. Results: It was observed that 2.02% of pregnant women were infected with SARS-CoV-2.Before the pandemic, out of a total of 390 pregnant women, 74.10% gave birth vaginally.During a pandemic, among infected women, 51.61% gave birth via cesarean section and 48,39% via vaginal delivery;among uninfected, 26.99% cesarean sections and 73.01% vaginaldeliveries. Conclusion: There was an increase in the percentage of cesarean sections and a possible influence of the pandemic on the rates of indication of cesarean sections at the time of admission to the maternity ward.

RESUMEN Objetivo: Evaluar las repercusiones de la infección por SARS-CoV-2 (sospechosa o confirmada) y el contexto de la pandemia en la vía del parto y la asistencia humanizada durante el parto. Método: Estudio epidemiológico transversal, anidado en una cohorte y comparativo con la investigación “Nacimiento en Belo Horizonte: Encuesta sobre Parto y Parto”.Se enviaron los prontuarios de tres maternidades de referencia en Belo Horizonte, con una muestra final de 1.682 gestantes, en los meses de mayo, junio y julio de 2020. Se realizó un análisis descriptivo, con frecuencia absoluta y relativa, y comparativo. uno, con una prueba de Chi, cuadrado de Pearson. Resultados: Tenga en cuenta que el 2,02% de las mujeres embarazadas estaban infectadas con SARS-CoV-2.Antes de la pandemia, en un total de 390 gestantes, el 74,10% daba a luz por vía vaginal.Durante una pandemia, entre las mujeres infectadas, el 51,61% dio a luz por cesárea y el 48,39% por parto vaginal;en las no infectadas, 26,99% cesáreas y 73,01% vaginales. Conclusión: Hubo un aumento en el porcentaje de cesáreas y una posible influencia de la pandemia en las tasas de indicación de cesáreas al momento del ingreso a la sala de maternidad.

RESUMO Objetivo: Avaliar as repercussões da infecção por SARS-CoV-2 (suspeita ou confirmada) e do contexto da pandemia na via de nascimento e na assistência humanizada ao parto. Método: Estudo epidemiológico transversal, aninhado a uma coorte e comparativo com a pesquisa “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento”. Avaliou-se prontuários de três maternidades-referência em Belo Horizonte, com amostra final de 1.682 parturientes, nos meses de maio, junho e julho de 2020. Realizou-se análise descritiva, com frequência absoluta e relativa, e comparativa, com teste Qui-quadrado de Pearson. Resultados: Observou-se que, 2,02% das gestantes estavam infectadas por SARS-CoV-2. Antes da pandemia, em um total de 390 gestantes, 74,10% pariram via vaginal. Durante a pandemia, nas mulheres infectadas, 51,61% pariram pela via cesariana e 48,39% pela vaginal; nas não infectadas, 26,99% cesarianas e 73,01% vaginais. Conclusão: Observou-se aumento percentual de cesarianas e possível influência da pandemia nas taxas de indicação de cesarianas no momento da admissão na maternidade.

RESUMEN El objetivo es diseñar una estrategia educativa sobre el bienestar económico en los colaboradores del área de servicios y mantenimientos de la Universidad del Pacífico (UP) dentro del marco de Responsabilidad Social Universitaria. Se basó en un estudio de intervención cuasi-experimental en el personal de la UP en el año 2021. La población estuvo compuesta por 28 colaboradores: 16 de la sede de Asunción (ASU) y 12 de Pedro Juan Caballero (PJC). Se realizó una encuesta socioeconómica basal mediante un cuestionario de 13 preguntas. La intervención consistió en cuatro charlas sobre finanzas personales, cuatro consultorías mensuales de 15 minutos por participante por un periodo de tres meses y control de la Guía de Presupuesto. Los resultados basales señalan que 62% de los participantes de ASU y 67% de PJC no realizaban control de sus gastos financieros; con un alto estado de endeudamiento (94% de ASU y 83% de PJC). Con la intervención, 3 (43%) colaboradores en ASU y 2 (29%) en PJC lograron mejoras en la administración de sus recursos financieros. Se concluye que a pesar de la intervención, pocos participantes alcanzaron mejorar la administración de los recursos financieros, probablemente por el corto periodo de seguimiento.

ABSTRACT The objective is to design an educational strategy on economic well-being in the collaborators of the services and maintenance area of the Universidad del Pacífico (UP) within the framework of University Social Responsibility. It was based on a quasi-experimental intervention study in UP staff in 2021. The population was made up of 28 collaborators: 16 from the Asunción headquarters (ASU) and 12 from Pedro Juan Caballero (PJC). A baseline socioeconomic survey was conducted using a 13-question questionnaire. The intervention consisted of four talks on personal finances, four monthly consultations of 15 minutes per participant for a period of three months and control of the Budget Guide. The baseline results indicate that 62% of the ASU and 67% of the PJC participants did not control their financial expenses; with a high state of indebtedness (94% from ASU and 83% from PJC). With the intervention, 3 (43%) employees at ASU and 2 (29%) at PJC achieved improvements in the management of their financial resources. It is concluded that despite the intervention, few participants managed to improve the administration of financial resources, probably due to the short follow-up period.

RESUMEN Introducción : El Síndrome Metabólico (SM) es una entidad clínica que se manifiesta por obesidad central, dislipidemia, hiperglicemia y/o hipertensión arterial y se relaciona con el desarrollo de Diabetes Mellitus tipo 2 y enfermedades cardiovasculares. Objetivo : Determinar la prevalencia del SM en adolescentes escolarizados del Departamento Central en el 2021 y evaluar los factores de riesgo relacionados. Materiales y Métodos: Estudio descriptivo con componente analítico. Ingresaron 279 adolescentes de 10 a 16 años de 6 escuelas elegidas aleatoriamente. Se realizó una encuesta sobre estilos de vida, prácticas alimentarias, antecedentes familiares y perinatales. Se realizó medición de peso, talla, circunferencia de cintura (CC), glicemia, perfil lipídico y presión arterial. Para el diagnóstico de SM se utilizó los criterios de Cook. Aprobado por el Comité de Ética del IICS y del Hospital de Clínicas. Para el análisis se utilizaron tablas de frecuencias, mediana y Prueba del Chi cuadrado para razón de prevalencias (RP) con nivel de significancia p < 0,05. Resultados : Mediana de edad 13 años en general y 11,5 años en SM, 53 % fueron hombres. La prevalencia de sobrepeso fue del 22,9 % y de obesidad 26,16 %. La hiperglicemia fue del 0,01 %, hipertrigliceridemia 16 %, HDL bajo 37,9 %, Prehipertensión arterial 11% y CC > p90 36%. La prevalencia de SM fue del 10,7 %. La CC >p90 con RP de 31,4 (7,6-128), y la hipertrigliceridemia con RP de 46,8(14,8-147,7), fueron los componentes preponderantes de SM. El peso elevado al nacer y no realizar actividad física, fueron identificados como factores de riesgo significativo. Conclusiones: La prevalencia de SM fue 10,7%, se relacionó con mayor peso al nacimiento, obesidad y sedentarismo.

ABSTRACT Introduction: Metabolic Syndrome (MS) is a clinical entity that is manifested by central obesity, dyslipidemia, hyperglycemia and/or arterial hypertension and is related to the development of Type 2 Diabetes Mellitus and cardiovascular diseases. Objective: To determine the prevalence of MS in adolescents enrolled in school in the Central Department in 2021 and to evaluate their related risk factors. Materials and Methods: This was a descriptive study with an analytical component. 279 adolescents aged 10 to 16 years old from 6 randomly chosen schools were included. A survey on lifestyles, eating practices, family and perinatal history was performed. Weight, height, waist circumference (WC), glycemia, lipid profile, and blood pressure were measured. Cook's criteria were used for the diagnosis of MS. The study was approved by the Ethics Committee of the IICS and the University Hospital. For data analysis, tables of frequencies, median and Chi-square test were used for the prevalence ratio (PR) with a significance level of p < 0.05. Results: Median age was 13 years in general and 11.5 years in MS, 53% were male. The prevalence of overweight adolescents was 22.9% and 26.16% were obese. Hyperglycemia was present in 0.01%, hypertriglyceridemia in 16%, low HDL in 37.9%, arterial prehypertension in 11% and WC > p90 in 36%. The prevalence of MS was 10.7%. WC >p90 with a PR of 31.4 (7.6-128), and hypertriglyceridemia with a PR of 46.8 (14.8-147.7), were the predominant components of MS. High birth weight and physical inactivity were identified as significant risk factors. Conclusions: The prevalence of MS was 10.7%, it was related to higher birth weight, obesity and sedentary lifestyle.

Abstract Italian ryegrass ( Lolium multiflorum L.) has become notorious due to glyphosate resistance evolution. To study the demography of susceptible and glyphosate-resistant Italian ryegrass populations, several experiments were conducted in the grower’s field to evaluate seedling emergence, survival and reproductive traits patterns in three cohorts, and the effect of density on seed production. Results showed that seedling emergence is fast, and under suitable environmental conditions, it can happen within 30-days. Lower plant survival was observed in the first two cohorts (2% and 3%, respectively) compared to the last (13%). A larger number of spikes (spk) per plant (pl) was observed in plants of the first two cohorts (50.34 and 47.02 spk pl-1, respectively) in comparison to the last one (26 spk pl-1); however, the third cohort presented a higher potential for flower (flwrs) production per spikelets (spklt) (13.5 flwrs spklt-1) in detriment to the first two (11.9 and 12.12 flwrs spklt-1). Fecundity was 20,300 and 13,830 seeds pl-1 for susceptible and glyphosate-resistant plants, respectively, and presented density-dependent regulation. A knowledge of Italian ryegrass’s demographic parameters provides valuable information for identifying particularly vulnerable life-history processes and developing population dynamics models that can contribute to designing more rational control strategies.

Abstract Introduction: the visceral adiposity index (VAI) is an indicator of fat distribution and function which is considered a predictor of cardiometabolic risk. Objective: analyze the factors associated with VAI in Brazilian adults. Methods: a cross-sectional population-based study was conducted with 854 adults, in Viçosa, MG, Brazil. A questionnaire was applied and anthropometric measurements, body composition and biochemical data were collected. Ordinal logistic regression was used to evaluate the factors associated with VAI. Results: the increase in percentage of fat, uric acid concentration and ultra-sensitive C reactive protein in the blood was positively associated with VAI in males. The level of physical activity in leisure was negatively associated. Among women, the increase in age, neck circumference, sitting time of more than 300 minutes, increased serum uric acid concentration and ultra-sensitive C reactive protein were associated with VAI. Conclusion: except for age, all other factors associated with VAI are modifiable, suggesting that adopting early intervention measures that promote changes in habits and alter the risk of increased visceral adiposity and consequently the appearance of comorbidities should be encouraged.

Resumen Introducción: el índice de adiposidad visceral (VAI) es un indicador de distribución y función de la grasa que se considera un predictor del riesgo cardiometabólico. Objetivo: analizar los factores asociados con el VAI en adultos brasileños. Métodos: se realizó un estudio transversal de población con 854 adultos, en Viçosa, MG, Brasil. Se aplicó un cuestionario y se analizaron las medidas antropométricas, la composición corporal y los datos bioquímicos. La regresión logística ordinal se utilizó para evaluar los factores asociados con VAI. Resultados: el aumento en el porcentaje de grasa, la concentración de ácido úrico y la proteína C reactiva ultrasensible en la sangre se asoció positivamente con VAI en varones. El nivel de actividad física en el ocio se asoció negativamente. Entre las mujeres, el aumento de la edad, la circunferencia del cuello, el tiempo en sedestación de más de 300 minutos, el aumento de la concentración sérica de ácido úrico y la proteína C reactiva ultrasensible se asociaron con VAI. Conclusión: con excepción de la edad, todos los otros factores asociados con el VAI son modificables, lo que sugiere que debe fomentarse la adopción de medidas de intervención temprana que promuevan cambios en los hábitos y alteren el riesgo de aumento de la adiposidad visceral y, consecuentemente, la aparición de comorbilidades.

RESUMO Estudos sobre o ensino da patologia no Brasil são escassos e mostram um cenário desmotivador para estudantes e professores. Embora essa disciplina seja fundamental à formação médica, o distanciamento entre o seu ensino e o das demais disciplinas clínicas leva ao não reconhecimento, por parte dos estudantes, da importância da patologia para a formação profissional, especialmente na área de doenças infecciosas. O objetivo deste estudo foi investigar o processo de formação e produção do conhecimento em patologia em três faculdades de Medicina com ensino tradicional no Estado do Rio de Janeiro e seu impacto na atuação de patologistas e infectologistas. Trata-se de um estudo qualitativo com utilização da técnica do discurso do sujeito coletivo em entrevistas semiestruturadas. Foram entrevistados sete professores de patologia de duas faculdades públicas e de uma particular e dez médicos - cinco patologistas que atuavam no Rio de Janeiro e cinco infectologistas de um centro de referências em doenças infecciosas no Rio de Janeiro. A disciplina de patologia é oferecida de forma descontextualizada em períodos específicos. Professores reconhecem que aulas descontextualizadas não estimulam o interesse pela especialidade nem preparam estudantes para interação com patologistas e serviços de anatomia patológica. Para infectologistas, falta percepção da importância da patologia na graduação, o que para patologistas gera dificuldades na interação com infectologistas, resultando em preenchimento incompleto de solicitação de exames histopatológicos, dificuldade na interpretação de laudos e envio inadequado de amostras. Infectologistas e patologistas acreditam que mais aulas práticas, maior integração com a clínica e a presença do patologista em outros cenários de aprendizagem aumentem o interesse pela patologia. Todos os professores, infectologistas e patologistas pesquisados reconheceram a existência de lacunas no ensino-aprendizagem na disciplina de patologia na graduação médica e a necessidade de reformulação para torná-la uma especialidade mais interessante e alinhada à realidade profissional.

ABSTRACT Studies on the teaching of pathology are scarce in Brazil and show a demotivating scenario for students and professors. Although it is fundamental for medical training, the distance between pathology and other clinical disciplines leads to students not recognizing the importance of pathology for their professional education, especially in the field of infectious diseases. The aim of this study was to investigate the teaching-learning process of pathology in three medical schools in the state of Rio de Janeiro which offer traditional teaching, and its impact on the work of pathologists and infectious disease specialists. It is a qualitative study using the collective subject discourse technique in semi-structured interviews. We interviewed seven pathology professors from the three medical schools along with 10 physicians, five pathologists working in pathology laboratories and five infectious disease specialists from a referral center on infectious diseases in Rio de Janeiro. The discipline of pathology is taught in a non-contextualized manner limited to a few semesters. Professors recognize that non-contextualized classes neither stimulate interest in the specialty nor prepare students for interaction with pathologists and pathology laboratories. For infectious disease specialists, medical undergraduates’ lack of perception regarding the importance of pathology leads to difficult interaction between pathologists and infectious disease specialists. This difficult interaction translates into incomplete histopathological requests, difficulty in interpreting pathology reports and inadequate sending of samples. Infectious disease specialists and pathologists believe that a focus on more practical activities, greater integration with clinical disciplines and the presence of pathologists in other learning scenarios would increase interest in pathology. All the professors and physicians surveyed acknowledged the existence of gaps in the teaching of pathology in medical schools and the need for a reformulation to make it a more interesting discipline and aligned with future practice.

ABSTRACT Background: The patient safety culture (PSC) in health institutions depends on various organizational and human factors. Our aim was to evaluate, as a teaching strategy, the knowledge in patient safety and perceptions about the PSC. Methods: A convenience sample, with 122 health professionals from Regional Minister of Health’s patient safety courses attendees in 2015. Before each course, were delivered a knowledge questionnaire about patient safety (own elaboration) and a validated PSC questionnaire (estimating 3 dimensions: managerial support, perception of safety and expectations / actions). Valuations on CSP were recategorized in positive, negative and neutral, identifying strengths (≥75% of positive evaluations) and opportunities for improvement (≥50% of negative evaluations). At the end of each course an anonymous satisfaction questionnaire was delivered. Results: 60% responded correctly to questions about knowledge in patient safety, identifying areas for improvement in safe practices (hand hygiene and microorganisms resistant to antibiotics, with 66% and 61% of incorrect answers, respectively), and in management of health risks (investigation and identification of adverse events, with 62% and 56% of incorrect answers, respectively). 80% considered the institutional PSC positive, and the perception of safety as an opportunity for improvement (63.9% of negative evaluations). Thus, 88% admitted worrying about patient safety only after adverse incidents, and 65% felt afraid to talk about them. The satisfaction with the teaching methodology was 9.3 points out of 10. Conclusions: The overall assessment of PSC was mostly positive, identifying specific areas for improvement that allowed orienting the training in patient safety, motivating the participants and suggesting intervention strategies to improve patient safety in our organizations.

RESUMEN Fundamentos: La cultura de seguridad del paciente (CSP) en las instituciones sanitarias depende de diversos factores organizativos y humanos. Nuestro objetivo fue evaluar, como estrategia docente, los conocimientos y percepciones sobre la CSP. Métodos: Muestra de conveniencia, con 122 profesionales sanitarios y no sanitarios, que asistieron en 2015 a cursos sobre seguridad del paciente organizados por la Consejería de Sanidad de Madrid. Antes de cada curso, autocompletaron un cuestionario de conocimientos sobre seguridad del paciente (elaboración propia) y otro cuestionario validado sobre CSP (estimando 3 dimensiones: apoyo directivo, percepción de seguridad y expectativas/acciones). Las valoraciones sobre la CSP se recategorizaron en positivas, negativas y neutras, identificando fortalezas (≥75% de valoraciones positivas) y oportunidades de mejora (≥50% de valoraciones negativas). Al finalizar cada curso, cumplimentaron un cuestionario anónimo de satisfacción. Resultados: El 60% respondió correctamente a las preguntas sobre conocimientos en seguridad del paciente, identificando áreas de mejora en prácticas seguras (higiene de manos y microorganismos resistentes a antibióticos, con 66% y 61% de respuestas incorrectas, respectivamente), y en gestión de riesgos sanitarios (investigación e identificación de eventos adversos, con el 62% y 56% de respuestas incorrectas, respectivamente). El 80% consideró positiva la CSP institucional, y la percepción de seguridad como oportunidad de mejora (63,9% de valoraciones negativas). Así, el 88% reconocía preocuparse por la seguridad del paciente sólo tras incidentes adversos, y el 65% sentía miedo a hablar sobre estos. La satisfacción con la metodología docente fue de 9,3 puntos sobre 10. Conclusiones: La valoración global de la CSP fue mayoritariamente positiva, identificándose áreas de mejora específicas utilizadas como estrategia docente para ilustrar conceptos, motivar a los participantes y sugerir estrategias de intervención para mejorar la cultura de seguridad del paciente en nuestras organizaciones.

ABSTRACT Background: The patient safety culture (PSC) in health institutions depends on various organizational and human factors. Our aim was to evaluate, as a teaching strategy, the knowledge in patient safety and perceptions about the PSC. Methods: A convenience sample, with 122 health professionals from Regional Minister of Health’s patient safety courses attendees in 2015. Before each course, were delivered a knowledge questionnaire about patient safety (own elaboration) and a validated PSC questionnaire (estimating 3 dimensions: managerial support, perception of safety and expectations / actions). Valuations on CSP were recategorized in positive, negative and neutral, identifying strengths (≥75% of positive evaluations) and opportunities for improvement (≥50% of negative evaluations). At the end of each course an anonymous satisfaction questionnaire was delivered. Results: 60% responded correctly to questions about knowledge in patient safety, identifying areas for improvement in safe practices (hand hygiene and microorganisms resistant to antibiotics, with 66% and 61% of incorrect answers, respectively), and in management of health risks (investigation and identification of adverse events, with 62% and 56% of incorrect answers, respectively). 80% considered the institutional PSC positive, and the perception of safety as an opportunity for improvement (63.9% of negative evaluations). Thus, 88% admitted worrying about patient safety only after adverse incidents, and 65% felt afraid to talk about them. The satisfaction with the teaching methodology was 9.3 points out of 10. Conclusions: The overall assessment of PSC was mostly positive, identifying specific areas for improvement that allowed orienting the training in patient safety, motivating the participants and suggesting intervention strategies to improve patient safety in our organizations.

RESUMEN Fundamentos: La cultura de seguridad del paciente (CSP) en las instituciones sanitarias depende de diversos factores organizativos y humanos. Nuestro objetivo fue evaluar, como estrategia docente, los conocimientos y percepciones sobre la CSP. Métodos: Muestra de conveniencia, con 122 profesionales sanitarios y no sanitarios, que asistieron en 2015 a cursos sobre seguridad del paciente organizados por la Consejería de Sanidad de Madrid. Antes de cada curso, autocompletaron un cuestionario de conocimientos sobre seguridad del paciente (elaboración propia) y otro cuestionario validado sobre CSP (estimando 3 dimensiones: apoyo directivo, percepción de seguridad y expectativas/acciones). Las valoraciones sobre la CSP se recategorizaron en positivas, negativas y neutras, identificando fortalezas (≥75% de valoraciones positivas) y oportunidades de mejora (≥50% de valoraciones negativas). Al finalizar cada curso, cumplimentaron un cuestionario anónimo de satisfacción. Resultados: El 60% respondió correctamente a las preguntas sobre conocimientos en seguridad del paciente, identificando áreas de mejora en prácticas seguras (higiene de manos y microorganismos resistentes a antibióticos, con 66% y 61% de respuestas incorrectas, respectivamente), y en gestión de riesgos sanitarios (investigación e identificación de eventos adversos, con el 62% y 56% de respuestas incorrectas, respectivamente). El 80% consideró positiva la CSP institucional, y la percepción de seguridad como oportunidad de mejora (63,9% de valoraciones negativas). Así, el 88% reconocía preocuparse por la seguridad del paciente sólo tras incidentes adversos, y el 65% sentía miedo a hablar sobre estos. La satisfacción con la metodología docente fue de 9,3 puntos sobre 10. Conclusiones: La valoración global de la CSP fue mayoritariamente positiva, identificándose áreas de mejora específicas utilizadas como estrategia docente para ilustrar conceptos, motivar a los participantes y sugerir estrategias de intervención para mejorar la cultura de seguridad del paciente en nuestras organizaciones.

ABSTRACT The Parque das Nações in Lisbon is a residential, commercial and recreational waterfront area. It is the result of an urban intervention of public initiative associated to the Expo’98. The intervention was characterized by the total demolition of the buildings and the substitution of populations of lower income, for populations with greater resources. The objectives of this article are: 1) To portray the area before the demolition as a space of living and to describe the displacement of the populations living there; 2) To interpret this process of urban transformation in the light of the concept of gentrification; and 3) To present the theoretical debate surrounding the concept, questioning its usefulness to understand the recent trends of the elitization of urban centers and of the transformation of urban waterfronts.

RESUMO O Parque das Nações em Lisboa, área ribeirinha residencial, comercial, de serviços e de usufruto lúdico, resulta de uma intervenção urbana de iniciativa pública associada à realização Expo’98. A intervenção caracterizou-se pela total demolição do edificado e pela substituição de populações com poucos recursos socioeconómicos por populações com maiores recursos. São objetivos deste artigo: (i) retratar a zona na época anterior à demolição como espaço de vivência e descrever o processo de expulsão das populações ali residentes; (ii) fazer uma leitura desse processo de transformação urbana à luz do conceito de gentrificação; (iii) e ainda apresentar alguns momentos do debate teórico em torno do conceito, questionando a sua utilidade para compreender as recentes tendências de elitização dos centros urbanos e de transformação de frentes de água urbanas.

Aims: the present study aims to evaluate the prevalence of cardiometabolic changes according to the hypertriglyceridemic waist (HW) phenotype in Brazilian adults. Methods: it is a population based transversal study with 976 adults (n = 533 women) 20-59 years old. Phenotype was defined by triglycerides concentration (TGL) ≥150 mg/dl and waist circumference (WC) ≥80 cm in females and ≥90 cm in males. All the analyses were adjusted according to the study design and pondered by gender, age and schooling. A descriptive analysis was performed through averages and ratios; their respective confidence intervals were herein presented (CI 95%). The prevalence of cardiometabolic changes due to the presence of HW and to gender was calculated and compared by means of Pearson�fs chi-square test. Statistic significance level was 0.05. The probability of coronary event risk was estimated in 10 years and calculated from Framinghan score, using Kernel density graph. Results: no difference in phenotype prevalence between genders was observed. Higher averages in all the cardiometabolic risk factors analyzed and higher probability of evolving to a cardiovascular event in 10 years were observed in individuals with the HW phenotype. Lower HDL values were only verified in this group. Conclusion: the HW phenotype is an important cardiovascular risk sign and allows the premature identification of individuals with higher risk, so that its use in clinical practice must be encouraged, mainly because it is a simple low cost asset.

Objetivos: evaluar la prevalencia de alteraciones cardiometabólicas según el fenotipo cintura hipertrigliceridémica (CH) en adultos brasileños. Métodos: estudio transversal, de base poblacional, con 976 (n = 533 mujeres) individuos de 20 a 59 años. El CH fue definido por un aumento en las concentraciones de triglicéridos y en la circunferencia de la cintura (CC). Todos los análisis fueron ajustados por el efecto del diseño del estudio y ponderados por género, edad y escolaridad. Fue realizado un anaìlisis descriptivo de promedio y presentados sus respectivos intervalos de confianza (IC 95%). La prevalencia de las alteraciones cardiometabólicas según la presencia o no del fenotipo CH y según el sexo fue calculada y comparada a través del test chi-cuadrado de Pearson. El nivel de significancia estadística adoptado fue de 0,05. Se estimó la probabilidad de riesgo de evento coronario en 10 años, a partir del score de Framinghan a través del gráfico de densidad de Kernel. Resultados: la prevalencia del fenotipo CH en la muestra fue de 17,32% (IC 95% 13,54-21,89), no se observó diferencia entre sexos. Se observaron mayores promedios para todos los factores de riesgo cardiometabólico analizados en aquellos con CH. Sólo Se verificaron menores valores medianos para el HDL en este grupo. Los individuos con CH presentaban mayor probabilidad de evolucionar hacia un evento cardiovascular en 10 años que aquellos sin el fenotipo. Conclusión: el fenotipo CH constituye un importante marcador precoz del riesgo cardiovascular. Su utilización en la práctica clínica debe ser incentivada, ya que se trata de una herramienta sencilla y de bajo coste.

Abstract BACKGROUND: Melanoma inhibitory activity is a protein secreted by melanoma cells and has been used as a tumor marker. Increased Melanoma inhibitory activity serum levels are related to metastatic disease or tumor recurrence. Currently there are no studies on Melanoma inhibitory activity and cutaneous melanoma involving Brazilian patients. OBJECTIVE: To evaluate the performance and feasibility of measuring Melanoma inhibitory activity levels in Brazilian patients with cutaneous melanoma. METHODS: Blood was obtained from ten patients with proved metastatic cutaneous melanoma (Group 1), 15 patients resected for cutaneous melanoma without metastasis (Group 2) and 5 healthy donors (Group 3). Melanoma inhibitory activity was measured using a commercially available ELISA kit. RESULTS: There was a statistically significant difference of Melanoma inhibitory activity levels between patients with and without metastasis (p=0.002), and between patients with metastasis and healthy donors (p=0.002). There was no difference between patients without metastasis and healthy donors (p=0.443). CONCLUSION: Melanoma inhibitory activity is a tumor marker for cutaneous melanoma and the Melanoma inhibitory activity-ELISA test can be easily performed. Patients with metastasis have increased Melanoma inhibitory activity serum levels when compared to patients without metastasis and healthy donors.

Introduction: A aldosterone is a component of the renin-angiotensin-aldosterone system, classically known for its role in sodium and water retention. Besides its effects, has been shown that the aldosterone is associated with the pathogenesis and progression of metabolic syndrome components. A better understanding of this system and interfering factors could help develop pharmacotherapeutic alternatives for several disorders. Objectives: Investigate the relationship between diet and aldosterone, and its influence on cardiometabolic risk factors. Results and Discussion: Diet can affect plasma aldosterone levels; high fructose and fat intake can lead to increased aldosterone levels, whereas the effect of sodium intake remains controversial. Adipose tissue, particularly visceral tissue, appears to produce a lipid-soluble factor that increases aldosterone production. Patients with metabolic syndrome have higher aldosterone levels; moreover, an increased cardiometabolic risk associated with insulin resistance could be partially mediated by the action of aldosterone via mineralocorticoid receptors. Even a subtle activation of this hormonal system may have deleterious effects on the glucose and lipid metabolism related to metabolic syndrome. Nevertheless, additional studies are required to better understand the interactions among adipose tissue, aldosterone, and cardiovascular risk as well as the possible role of diet.

Introducción: La aldosterona es un componente del sistema renina-angiotensina-aldosterona, clasicamente conocida por su papel en la retención de sodio y agua. Además de estos efectos, ha sido demostrado que la aldosterona está asociada a la patogénesis y progresión de componentes del síndrome metabólico. Una mejor comprensión de este sistema y de los factores interferentes podría ayudar a desarrollar alternativas farmacoterapéuticas para varias enfermedades. Objetivos: Investigar la relación entre dieta y aldosterona, y su influencia sobre factores de riesgo cardiometabólico. Resultados y Discusión: La dieta es capaz de modular las concentraciones plasmáticas de aldosterona; alto contenido de fructosa y la ingestión de grasa pueden llevar al aumento de los niveles de aldosterona, mientras que el efecto de la ingestión de sodio permanece polémico. El tejido adiposo, particularmente el visceral, parece producir un factor liposoluble que aumenta la producción de aldosterona. Pacientes con síndrome metabólico tienen concentraciones más elevadas de aldosterona; Además de eso, un aumento del riesgo cardiometabólico asociado con la resistencia a la insulina puede ser parcialmente mediada por la acción de la aldosterona a través de los receptores mineralocorticoides. Aunque la activación sutil de este sistema hormonal parece ejercer efectos deleterios en el metabolismo glicémico y lipídico, asociado con el síndrome metabólico. Sin embargo, otros estudios son necesarios para el entendimento de las interaciones entre tejido adiposo, aldosterona y riesgo cardiovascular, así como el posible papel de la dieta.