Abstract Objective: This study aimed to investigate non-alcoholic fatty liver disease (NAFLD) occurrence and factors associated with the disease in phenylketonuria (PKU) patients undergoing exclusive dietary treatment. Method: This cross-sectional study included 101 adolescents 10 to < 20 years of age with PKU, who were undergoing exclusive dietary treatment and monitored since early diagnosis at a single reference service. Anthropometric and biochemical assessments were performed and food intake was documented, and an ultrasound diagnosis of NAFLD was established. Data were evaluated using the Student’s t-test for continuous variables, the chi-square for categorical variables, and logistic regression using the Wald chi-squared test; differences with p < 0.05 were considered to be statistically significant. Results: NAFLD was detected in 26 (25.7%) teenagers. There was no difference in prevalence between the sexes or nutritional status. The final logistic regression model revealed low sensitivity (26.1%) and high specificity (94.7%). The specificity suggested a lower likelihood of NAFLD in older adolescents, in the presence of normal or high levels of alkaline phosphatase, lower carbohydrate intake, and adequate protein and lipid intake. Conclusions: The prevalence of NAFLD in adolescents with PKU was higher than that found in healthy Brazilian adolescents and similar to that found in obese Brazilian children, suggesting a higher risk for NAFLD in patients with PKU treated exclusively by dietary modification.

Abstract The objective of this study was to evaluate the productive performance, egg quality and the morphometry of the organs of Japanese quails (Cotournix cotournix japônica) when kept in comfort and under thermal stress. 192 nine-week-old quail were used, distributed in a completely randomized design at two temperatures (T1 = 24 °C and T2 = 32 °C), with 12 replicates of eight birds each, with an experimental period of 63 days, divided into three 21-day periods. Feed intake (g fowl-1 day-1), water consumption (mL fowl-1 day-1), egg production (%), egg weight (g), egg mass (g fowl- 1 day-1) and feed conversion (kg kg-1 and kg dozen-1). Laying quails after their production cycle are marketed as beef animals. It is observed that the average final live weight was reduced (P = 0.0362) by 27.58 g in birds kept at a temperature of 32 oC, which can compromise its commercial value. The feed intake of the birds was reduced (P = 0.0051) by 14.75% with an increase in ambient temperature. Birds kept at a temperature of 32 oC for 12 h daily showed a reduction in feed intake, final weight, yolk, and gizzard weight, but without affecting egg production, weight and mass.

Application of adsorbents derived from waste in contaminated areas remediation is aligned with sustainable development goals and circular economy principles. As chemical activation can result in increased adsorption capacity, it is an alternative to improve the performance of materials and enable their use. This study evaluated whether activated compost derived from the organic fraction of municipal solid waste would be an efficient and low-cost adsorbent. Chemical activation was performed by impregnating 1 mol L-1 of phosphoric acid for 12 h at 25 °C. Characterization and batch equilibrium tests were carried out to confirm if chemical activation would positively affect the retention of lead (Pb) and cadmium (Cd). Surface functional groups and minerals were verified through Fourier Transform Infrared Spectroscopy (FTIR) and X-Ray Diffractometry (XRD) before and after batch equilibrium test. Removal percentages ranged from 52.49 to 91.22% for Pb (initial concentrations of 20.11 to 889.20 mg L-1) and from 13.33 to 87.13% for Cd (initial concentrations from 1.56 to 667.50 mg L-1). Compared to the original material, activation did not increase Cd adsorption capacity. However, was observed an improvement in adsorption performance for Pb between 76.86 and 443.30 mg L-1. The Langmuir isotherm best fitted the experimental data obtained both for Pb and Cd.

RESUMO O fornecimento de água salgada no semiárido é uma prática recorrente, visto que existe uma grande escassez de água para uso na alimentação animal. Assim, na maioria das vezes a água oferecida às aves pode apresentar sal acima do recomendado. O presente estudo teve como objetivo avaliar o desempenho produtivo e a morfometria dos órgãos de codornas japonesas à medida que eram abastecidas com água potável com diferentes concentrações de cloreto de sódio, sendo mantidas em conforto e sob estresse térmico. As aves receberam água com valores crescentes de condutividade elétrica (1,5, 3,0, 4,5 e 6,0 dS m-1), e foram mantidas em câmara climática em temperatura do ar termoneutra (24 °C) e sob estresse térmico (32 °C), sendo distribuídas em um delineamento inteiramente casualizado e esquema fatorial 2 × 4. As condutividades elétricas da água não afetaram o desempenho das aves, exceto para o peso da moela, que apresentou efeito linear crescente com o aumento da condutividade elétrica. Na temperatura de estresse, houve redução no consumo de ração, peso e massa do ovo e na conversão alimentar por dúzia de ovos, porém sem efeito no peso do coração, fígado e moela. Codornas japonesas na fase de produção podem consumir água com condutividade elétrica de até 6,0 dS m-1, apresentando bom desempenho produtivo e sem comprometer a morfometria dos órgãos.

ABSTRACT The supply of salt water in the semiarid region is a recurrent practice, as there is a severe shortage of water for use in animal consumption. Thus, most of the times the water offered to the birds can contain salts above the recommended amount. The present study aimed to evaluate the production performance and morphometry of the organs of Japanese quails as they were supplied with drinking water with different concentrations of sodium chloride, while being maintained in comfort and under thermal stress. The birds received water with increasing electrical conductivity (1.5, 3.0, 4.5 and 6.0 dS m-1) and were kept in a climate chamber at thermoneutral air temperature (24 °C) and under thermal stress (32 °C), being distributed in a completely randomized design and 2 × 4 factorial scheme. Water electrical conductivities did not affect the performance of the birds, except for the weight of the gizzard, which showed an increasing linear effect as the electrical conductivities increased. At the stress temperature, there was reduction in feed intake, egg weight and mass, and in feed conversion per dozen eggs, but with no effect on the weights of the heart, liver and gizzard. Japanese quails in the production phase can consume water with electrical conductivity of up to 6.0 dS m-1, showing good production performance and without compromising organ morphometry.

Abstract Objective: To estimate the prevalence and factors associated with overweight/obesity development in adolescents with early diagnosed phenylketonuria treated exclusively by diet. Methodology: In this cross-sectional study anthropometric measurements, serum phenylalanine levels, and 10 metabolites associated with lipid and carbohydrate metabolism were analyzed in 101 adolescents aged 10–20 years. Adolescents were categorized into overweight/obesity and eutrophic/low body mass index groups. These patients were compared using Student’s t-test, Pearson’s chi-square test, Wald’s chi-square test for multivariate analysis. Further, to verify whether the prevalence of overweight/obesity found in the study population was similar to that in the general population, the authors compared the nutritional status of 46 patients aged 13–17 years with that of healthy students of the same age from the National School Health Survey using the chi-square test for adherence. The significance threshold was p < 0.5. Results: The prevalence of overweight/obesity in adolescents was 27.7%. There was no difference in prevalence between sexes. Older age was a protective factor and Increased Homeostasis Model Assessment Insulin Resistance index and high phenylalanine and low-density lipoprotein cholesterol levels were predictive factors for overweight/obesity. The equality hypothesis was not rejected in the comparison of nutritional states of 46 patients aged 13–17 years and healthy students of the same age. Conclusion: The prevalence of overweight/obesity in phenylketonuria adolescents was similar to what is found in healthy adolescents.

RESUMEN La turba es un material orgánico que se ha utilizado ampliamente como adsorbente eficiente y de bajo costo. Dado que muchos estudios tienden a centrarse en las turbas templadas, hay una falta de conocimiento sobre el mecanismo de adsorción de las turbas tropicales. Este trabajo investiga el uso de dos turbas brasileñas (Cravinhos - C y Luis Antonio - LA) de la cuenca del río Mogi-Guacu para la adsorción de plomo (Pb), zinc (Zn) y cadmio (Cd), con el fin de contribuir al uso de materiales locales y de fácil acceso para remediar sitios contaminados. Las turbas adsorbieron un alto porcentaje de cationes, especialmente cationes Pb (100,0-46,3%), mostrando la turba comercial C una mayor adsorción que la turba LA. La orden de eliminación fue Pb2+ > Cd2+ ≥ Zn2+ para C y Pb2+ > Zn2+ > Cd2+ para LA. Los datos de equilibrio por lotes para turbas y para todos los metales se ajustaron mejor a la isoterma de Langmuir, con capacidades de adsorción (qm) para Pb, Zn y Cd de 37,3134, 29,0674 y 21,2890 mmol kg-1 en turba C y 21,7391, 14,2550 y 3,6460. mmol kg-1 en LA, respectivamente, valores comparables a los de otras turbas y biosorbentes. Las turbas estudiadas se consideran materiales adsorbentes eficientes, alternativos y de bajo costo para estos metales. La proximidad de las turberas a áreas con alto potencial de contaminación requiere el uso de materiales locales para reducir los costos de remediación.

ABSTRACT Peat is an organic material that has been widely used as an efficient and low-cost adsorbent. As many studies tend to focus on temperate peats, there is a lack of knowledge about the adsorption mechanism of tropical peats. This paper investigates the use of two Brazilian peats (Cravinhos - C and Luis Antônio - LA) from the Mogi-Guaçu river basin for the adsorption of lead (Pb), zinc (Zn), and cadmium (Cd), in order to contribute to the use of local and easy access materials to remediate contaminated sites. The peats adsorbed a high percentage of cations, especially Pb cations (100.0-46.3%), with commercial peat C showing higher adsorption than peat LA. The removal order was Pb2+ > Cd2+ ≥ Zn2+ for C and Pb2+ > Zn2+ > Cd2+ for LA. The batch data for both peats and for all metals were better fit by the Langmuir isotherm, with adsorption capacities (q m ) for Pb, Zn, and Cd of 37.3134, 29.0674 and 21.2890 mmol kg-1 in peat C and 21.7391, 14.2550 and 3.6460 mmol kg-1 in LA, respectively, values comparable to those of other peats and biosorbents. The studied peats are considered efficient, alternative and low-cost adsorptive materials for these metals. The proximity of peatlands to areas with high potential for contamination necessitates the use of local materials to reduce remediation costs.

Resumo Fundamento As doenças cardiovasculares constituem um grupo importante de causas de morte no Brasil. As doenças isquêmicas do coração são as principais causas de parada cardiorrespiratória, levando a um impacto na mortalidade devido às doenças cardiovasculares no sistema de saúde. Objetivo Avaliar o número de óbitos domiciliares por parada cardiorrespiratória notificados pelo Serviço de Atendimento Móvel de Urgência (SAMU) em março de 2018, 2019 e 2020. Métodos Trata-se de um estudo observacional realizado a partir da análise de dados de mortalidade por parada cardiorrespiratória de cidadãos atendidos pelo SAMU em Belo Horizonte, Minas Gerais, Brasil. Foram analisadas as características sociais e clínicas e as informações de ocorrência. Foi avaliada a taxa de mortalidade por parada cardiorrespiratória em relação ao número total de atendimentos. Foi considerado um nível de significância de 95%. Resultados Houve um aumento nos óbitos domiciliares por parada cardiorrespiratória em março de 2020, em comparação com março de 2018 (p < 0,001) e março de 2019 (p = 0,050). Dos óbitos relatados em 2020, 63,8% dos pacientes tinham 60 anos ou mais; 63,7% das ocorrências foram à tarde e aproximadamente 87% dos casos de parada cardiorrespiratória notificados apresentavam comorbidades clínicas, com hipertensão arterial sistêmicas e parada cardíaca correspondendo a 22,87% e 13,03% dos casos relatados, respectivamente. A maioria da amostra avaliada deste estudo não teve acompanhamento médico (88,7%). Conclusão Considerando o aumento do número de óbitos, sugerimos reflexões e reajustes quanto ao monitoramento das doenças crônicas não transmissíveis durante a pandemia, bem como melhorias na vigilância dos óbitos. (Arq Bras Cardiol. 2021; 116(2):266-271)

Abstract Background Cardiovascular diseases constitute an important group of causes of death in the country. Ischemic heart diseases that are the main causes of cardiopulmonary arrest, leading to an impact on the mortality of the cardiovascular diseases in the health system. Objective Assess the number of home deaths by cardiopulmonary arrest notified by the Mobile Emergency Medical Service (SAMU) in March 2018, 2019 and 2020. Methods Observational study carried out from the analysis of cardiopulmonary arrest mortality data of citizens assisted by SAMU in Belo Horizonte, Minas Gerais, Brazil. Social and clinical characteristics and occurrence information of the patients were analyzed. The mortality rate due to cardiopulmonary arrest in relation to the total number of attendances was assessed. A significance level of 95% was considered. Results There was increase of home deaths due to cardiopulmonary arrest in March 2020 compared to March 2018 (p<0.001) and March 2019 (p=0.050). Of the deaths reported in 2020, 63.8% of the patients were aged 60 years or older, 63.7% of the occurrences were performed in the afternoon and approximately 87% of the cardiopulmonary arrest notified had associated clinical comorbidities, with systemic arterial hypertension and heart failure represented by 22.87% and 13.03% of the reported cases, respectively. The majority of the evaluated sample of this study did not have any medical care follow-up (88.7%). Conclusion Considering the increase in the number of the deaths, we suggest reflections and readjustments regarding the monitoring of chronic non-transmissible diseases during a pandemic, as well as improvements in death surveillance. (Arq Bras Cardiol. 2021; 116(2):266-271)

RESUMEN Los suelos lateríticos se han utilizado ampliamente en la construcción de revestimientos de basureros para residuos sólidos. Por otro lado, hay poca práctica en el uso de cambisols (menos arcillosos) para esta finalidad. El uso de suelo local para la construcción de revestimientos para impermeabilizar y retener contaminantes representa una alternativa para controlar este tipo de contaminación. Por lo tanto, el objetivo de este estudio fue determinar las propiedades físicas y químicas de un suelo tropical fuertemente degradado recolectado en la ciudad de Eldorado (Valle de Ribeira), y evaluar la capacidad de este suelo para adsorber plomo (Pb). La contaminación del suelo y el agua por Pb es un problema mundial, y, en el Valle de Ribeira, la contaminación por Pb es común en áreas específicas, debido principalmente a la eliminación inadecuada de los desechos mineros. La eficiencia de la adsorción de Pb por el cambisol fue indirectamente proporcional a las concentraciones de Pb en la solución. Cuando la concentración inicial de 20 mg/L, el porcentaje de adsorción de Pb fue del 92,5% y cuando la concentración inicial fue de 100 mg/L, la tasa de adsorción fue del 81,7%. Además de la retención de Pb, este suelo presentó las siguientes características que son favorables para el uso de suelos en la construcción de revestimientos: es un suelo franco limoso (arcilla de alta plasticidad, CH), con límite de líquido (LL) del 57%, índice de plasticidad (PI) del 33%, medio oxidante y El predominio de las cargas negativas en la superficie de las partículas coloidales. Por lo tanto, se concluye que el suelo residual tropical (cambisol) presenta características que le permiten ser utilizado como revestimiento en la eliminación de residuos que contienen Pb.

ABSTRACT Lateritic soils have been widely used in the construction of landfill base liners for solid waste disposal. On the other hand, there is little practice in the use of cambisols (less clayey) for this finality. The use of local soil for the construction of liners in order to waterproof and retain contaminants represents an alternative to control this type of contamination. Thus, the objective of this study was to determine the physical and chemical properties of a cambisol collected in the city of Eldorado (Ribeira Valley) and to evaluate the ability of this soil to adsorb lead (Pb). The contamination of soil and water by Pb is a worldwide problem, and in the Ribeira Valley the contamination by Pb is common in specific areas mainly due to inadequate mining waste disposal. The efficiency of Pb adsorption by the cambisol was indirectly proportional to the concentrations of Pb in solution. When the initial concentration of 20 mg/L was used, the adsorption percentage of Pb was 92.5% and when the initial concentration was 100 mg/L, the adsorption rate was 81.7%. In addition to the retention of Pb, this soil presented the following characteristics which are favorable for using soils in the construction of liners: a silt loam (a high plasticity clay, CH), with liquid limit (LL) of 57%, plasticity index (PI) of 33%, oxidizing medium and the predominance of negative charges on the surface of the colloidal particles. Thus, it is concluded that this tropical soil (cambisol) exhibits characteristics that allow it to be used as a liner in the disposal of residues containing Pb.

Resumo Objetivos Apresentar a prevalência geral e caracterizar as deficiências de tetrahidrobiopterina - BH4 - com hiperfenilalaninemia, identificadas pelo Programa de Triagem Neonatal do Estadode Minas Gerais. Métodos Estudo descritivo de pacientes com deficiência de BH4 do Programa de Triagem Neonatal do Estado de Minas Gerais. Resultados A prevalência encontrada foi de 2,1 para 1.000.000 recém-nascidos vivos e a frequência de 1,71%, dentre as hiperfenilalaninemias. Quatro casos (40%) com deficiência de 6-piruvoil-tetrahidropterina sintase, três com deficiência de GTP ciclohidrolase I e três com deficiência de dihidropteridina redutase (30% cada um). Seis pacientes foram diagnosticadospor suspeita clínica e quatro pela pesquisa sistemática na triagem neonatal. Após o início do tratamento, os pacientes identificados pela triagem neonatal tiveram melhora rápida e melhor desenvolvimento neuropsicomotor em comparação com aqueles diagnosticados pela história clínica. Conclusões A prevalência das deficiências de BH4 em Minas Gerais foi um pouco maior que a encontrada na literatura, mas a frequência, entre as hiperfenilalaninemias, foi semelhante. Embora raras, são graves e, se não tratadas, levam a atraso de desenvolvimento, movimentos anormais, convulsões e morte precoce. O tratamento precoce (início antes dos 5 meses) mostrou bons resultados na prevenção de deficiência intelectual, justificando a pesquisa dessas deficiências nos recém-nascidos com hiperfenilalaninemia pelos programas de triagem neonatalpara fenilcetonúria.

Abstract Objectives To show the general prevalence and to characterize tetrahydrobiopterin (BH4) deficiencies with hyperphenylalaninemia, identified by the Neonatal Screening Program of the State of Minas Gerais. Methods Descriptive study of patients with BH4 deficiency identified by the Neonatal Screening Program of the State of Minas Gerais. Results The prevalence found was 2.1 for 1,000,000 live births, with a frequency of 1.71% among hyperphenylalaninemias. There were four cases (40%) with 6-pyruvoyl-tetrahydropterin synthase deficiency, three with GTP cyclohydrolase I - autosomal recessive form deficiency, and three with dihydropteridine reductase deficiency (30% each). Six patients were diagnosed due to clinical suspicion and four cases due to systematic screening in neonatal screening. After the start of the treatment, patients identified by neonatal screening had rapid improvement and improved neuropsychomotor development compared to those diagnosed by the medical history. Conclusions The prevalence of BH4 deficiencies in Minas Gerais was slightly higher than that found in the literature, but the frequency among hyperphenylalaninemias was similar. Although rare, they are severe diseases and, if left untreated, lead to developmental delays, abnormal movements, seizures, and premature death. Early treatment onset (starting before 5 months of age) showed good results in preventing intellectual disability, justifying the screening of these deficiencies in newborns with hyperphenylalaninemia identified at the neonatal screening programs for phenylketonuria.

Resumen Escurrimiento superficial en terrenos susceptibles sin asociación con el drenaje adecuado causa erosión del suelo. Las cárcavas y el drenaje son importantes para proyectos de recuperación, ya que la erosión puede ser reactivada después de la aplicación de técnicas de recuperación. Describimos un proyecto de bajo costo para macrodrenaje en Nazareno (MG, Brasil), proporcionando suporte a la gestión y recuperación de cárcavas. Utilizamos una metodología con la aplicación de Sistemas de Información Geográfica (SIG) y modelos hidrológicos y hidráulicos concentrados (softwares libres). La cuenca ha presentado pendientes elevadas (8 a 20%); el flujo de agua es direccionado preferentemente al noroeste, contribuyendo al agravamiento de la erosión. Estudiamos el efecto de condiciones medioambientales en diferentes simulaciones para un proyecto de sistema de drenaje usando las herramientas de softwares. Así pues, los resultados de este artículo pueden auxiliar la gestión y recuperación de cárcavas para esta y otras áreas con problemas similares.

Abstract Runoff on susceptible terrains that is not associated with adequate drainage causes soil erosion, as gullies. Gullies and drainage continue to be major issues in reclamation projects since soil erosion can be reactivated after the application of recovery measures. This paper describes a low-cost project framework for macrodrainage for a gully in Nazareno (MG, Brazil) to provide support to gully management and recovery. We used a simple methodology with the application of Geographic Information Systems (GIS) and concentrated hydrologic and hydraulic models (freely available softwares). The basin has steep slopes (8 to 20%) and the water flows mainly to the northwest, which contribute to exacerbate erosion problems. We studied the effect of environmental conditions on different simulations to elaborate a drainage system project using the free software tools. Therefore, the findings of this paper can aid gully management and recovery for this and other areas with similar issues.

Erosión es un problema crítico en todo el mundo. Este documento evalúa las interacciones de los usos del suelo con la dinámica macroscópica y propiedades microscópicas del suelo frente a la susceptibilidad su erosión. Examinamos la reativación de una cárcava recuperada en la ciudad de Nazareno (Brasil), comparando la evaluación de campo con experimentos de laboratorio utilizando dos tipos de suelo (suelo bien desenvuelto y granito-gneiss saprolito). Ambos demostraron que el comportamiento macroscópico de los suelos esta relacionado con las características microscópicas. Suelo bien desenvuelto es más resistente a la erosión que granito-gneiss saprolito, pero los usos de la tierra de los alrededores no respeta estas diferencias. Estos análisis han permitido explicar por qué este y otras cárcavas del municipio aparentemente se estabilizaron, pero las pierdas de suelo siguen ocurriendo. Se ha demostrado que la expansión urbana y rural desempeñó un papel importante en el desencadenamiento de estas erosiones y pierdas de suelo.

Gully erosion is a critical issue worldwide. To correctly understand the association that the environmental data (such as climate, vegetation cover, etc.) has with soil erosion susceptibility and land uses remains a challenge in land management. This paper evaluates land use interactions with macroscopic dynamics and microscopic soil properties in terms of soil's susceptibility to erosion. We examine the reactivation of a stabilized gully in Nazareno (Brazil) by comparing field assessments with laboratory experiments, using two types of soil (well-developed soil and granite-gneiss saprolite). Both of these showed that the macroscopic behavior of soils is connected with microscopic characteristics. Well-developed soil is more erosion resistant than granite-gneiss saprolite, but the surrounding land uses do not respect these differences. These analyses enable us to explain why this and other gullies in the municipality are apparently stabilized, but soil loss continues to occur. This paper demonstrates that urban and rural expansion played a major role in triggering gully and soil losses.

ABSTRACT The objective of this study was to evaluate the putative effects of the use of coffee husk as floor covering on boar semen quality. Sixteen boars were divided into two groups. The first group was held in a conventional system with a compact floor. The second group was kept on a compact floor covered with coffee pods. The experimental period was 60 days. Levels of caffeine and chlorogenic acid in the insemination doses (ID) before and after 96 h of storage at 15 °C and the reproductive performance (litter size and rate of return to estrus) of these doses after their utilization in a standard artificial insemination protocol were evaluated. The ID from the animals kept in pens containing the coffee pods contained 25.4±8.7 µg/mL of caffeine, whereas no significant amounts of chlorogenic acid were detected. Semen from boars housed with coffee husk showed a significant increase in malondialdehyde levels, which indicates a significant increase in cell membrane peroxidation, after 96 h of storage. There were no significant differences in the other evaluated semen quality parameters when analyzed among groups. Likewise, there was no significant influence of coffee hulls on either the rate of return to estrus or the litter size of inseminated females. The use of coffee husks as floor covering worsens the quality of fresh semen and that of insemination doses stored for 96 h but not the quality of semen immediately diluted; therefore, coffee husks may be used only on farms that use semen immediately processed after collection without affecting the reproductive parameters of breeding stock.

Trata-se de um relato de experiência sobre o processo de implementação do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção, nas fases de Avaliação Externa e Censo, das Unidades da atenção básica no estado do Acre. Foram avaliadas 35 equipes de Atenção Básica e realizado em censo em 224 UBS. Este artigo está organizado a partir de uma breve caracterização do estado e das regiões de saúde, análise do planejamento e operacionalização da Avaliação Externa, suas peculiaridadese desafios. Como aprendizado para a equipe de avaliação, dois aspectos se destacaram, como o uso do planejamento como ferramenta norteadora e flexível e da articulação institucional como mediador e redutor de conflitos institucionais. Para as equipes de saúde, foi importante reconhecer a necessidade de realizar avaliação e planejamento periódicos.

This article is an experience report on the implementation process of evaluation of basic care in the state of Acre. 35 UBS were evaluated and 224 censuses conducted. It is organized from a brief characterization of the State and the health regions, planning and implementing evaluation. As a result two important aspects of this process stood out like the using of planning as a guiding and flexible toll, and institutional coordination as a mediator and reducing institutional conflicts. For the health teams, learning it was important to recognize the need for periodic reviews and planning.

Trata-se de um relato de experiência sobre o processo de implementação do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção, nas fases de Avaliação Externa e Censo, das Unidades da atenção básica no estado do Acre. Foram avaliadas 35 equipes de Atenção Básica e realizado em censo em 224 UBS. Este artigo está organizado a partir de uma breve caracterização do estado e das regiões de saúde, análise do planejamento e operacionalização da Avaliação Externa, suas peculiaridadese desafios. Como aprendizado para a equipe de avaliação, dois aspectos se destacaram, como o uso do planejamento como ferramenta norteadora e flexível e da articulação institucional como mediador e redutor de conflitos institucionais. Para as equipes de saúde, foi importante reconhecer a necessidade de realizar avaliação e planejamento periódicos.

This article is an experience report on the implementation process of evaluation of basic care in the state of Acre. 35 UBS were evaluated and 224 censuses conducted. It is organized from a brief characterization of the State and the health regions, planning and implementing evaluation. As a result two important aspects of this process stood out like the using of planning as a guiding and flexible toll, and institutional coordination as a mediator and reducing institutional conflicts. For the health teams, learning it was important to recognize the need for periodic reviews and planning.

Visando-se determinar se o plasma sangüíneo tem efeitos sobre o crescimento, o desenvolvimento bacteriano e a estrutura intestinal de leitões desmamados aos 28 dias de idade consumindo quantidades iguais de dietas, 24 leitões desmamados aos 28 dias de idade foram utilizados em um experimento com delineamento em blocos ao acaso com quatro tratamentos (dietas com 0,0; 2,5; 5,0 e 7,5% de plasma sangüíneo), seis repetições e um animal por unidade experimental. Foram constatadas diferenças significativas entre os tratamentos em relação aos ganhos de peso, às conversões alimentares e às quantidades de colônias de E. coli. Os animais que consumiram as dietas com plasma sangüíneo apresentaram maiores ganhos de peso, melhores conversões alimentares e menores quantidades de E. coli no intestino delgado do que os animais que receberam dietas sem plasma. Não se observou efeitos significativos das quantidades de plasma sangüíneo consumido sobre a estrutura intestinal dos leitões doze dias após o desmame. Concluiu-se que a inclusão de plasma sangüíneo na proporção mínima de 2,5% aumenta ganho de peso, melhora conversão alimentar e reduz a incidência de colônias de E. coli no intestino de leitões desmamados aos 28 dias de idade criados em condições de desafio, mas não afeta a estrutura intestinal.

In order to evaluate the effects of spray-dried plasma on performance (weight gain, feed intake, and feed conversion), growth, intestinal health (microflora colonization and intestinal wall morphology) of piglets fed equal amounts per day of feed, 24 piglets weaned at 28 days old were used in an experiment performed as a randomised block design with four treatments (diets with 0.0, 2.5, 5.0 and 7.5% inclusion of spray-dried plasma), six replicates and one animal per experimental unit. Significant differences were observed among treatments weight gain, feed conversion and numbers of E. coli colony forming-units (CFU). Pigletsfed diets with different levels of spray-dried plasma had higher weight gain, better feed conversion and lower amounts of E. coli CFU in the small intestine than animals fed diets without spray-dried plasma in the diets. No significant effect of the treatments on the intestinal wall morphology at day twelve after weaning was observed. In conclusion, the inclusion of 2.5% spray-dried plasma in the diets in creases weight gain, improves feed conversion and reduces the incidence of E. coli CFU in the small intestine of piglets weaned at 28 days of age reared under challenging conditions, however, no beneficial effect on the intestinal wall morphology was observed with the inclusion of spray dried plasma in the diets.