Resumo Introdução A fluoretação das águas de abastecimento tem sido apontada em estudos nacionais e internacionais como a mais eficiente e equânime forma de acesso a fluoretos na prevenção da cárie dentária. Objetivo Relatar os resultados do heterocontrole nas águas de abastecimento público do município de Colombo/PR, no período de dezembro de 2013 a novembro de 2014. Método Foram coletadas amostras mensais em 15 Unidades Básicas de Saúde, em dias da semana aleatórios, no período de 12/2013 a 11/2014. As amostras foram analisadas pelo método eletrométrico na Faculdade de Odontologia da Universidade Federal Fluminense. Resultados Foram analisadas 180 amostras, que variaram de <0,001 a 1,480 mg/L (média 0,715±0,232 mg/L). De acordo com o critério estabelecido pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal, 51,11% das amostras apresentavam níveis de fluoretos adequados, 13,34% concentrações de flúor acima do ideal, e 35,56% abaixo do ideal. Conclusão O heterocontrole representa uma das principais estratégias de vigilância em saúde bucal, e, dessa forma, deve ser implementado e efetuado em todas as regiões que utilizam água fluoretada, a fim de garantir a manutenção de níveis ótimos de fluoretos.

Abstract Background The fluoridation of water supply has been pointed out in national and international studies as the most efficient and equal way of accessing fluorides in the prevention of dental caries. Objective To report the results of heterocontrol in public water supply in the municipality of Colombo/PR, from December 2013 to November 2014. Method The samples were monthly collected in 15 Basic Health Units, on random days of the week, from 12/2013 to 11/2014. The samples were analyzed by the electrometric method at the Faculty of Dentistry of Fluminense Federal University. Results 180 samples were analyzed, ranging from <0.001 to 1.480 mg/L (mean 0.715 ± 0.232 mg/L). According to the criteria established by the Collaborating Center of the Ministry of Health in Oral Health Surveillance, 51.11% of the samples had adequate fluoride levels, 13.34% above ideal fluoride levels, and 35.56% below ideal levels. Conclusion Heterocontrol could represent one of the main strategies of oral health surveillance, and, therefore, it should be implemented and carried out in all regions that use fluoridated water, in order to guarantee the maintenance of optimal fluoride levels.

Abstract The World Health Organization recognized the use of herbal medicines as a therapeutic resource and its application in the primary attention to heath. The begin of this expansion was in 2006, with the National Policy on Integrative and Complementary practices of the Unified Health System (SUS). This research aimed to evaluate the questionnaires applied to doctors, who may have prescribed industrialized herbal medicines and to identify the difficulties involved with the implementation of this therapy as an integrative and complementary practice. It is a quantitative, observational and transversal study conducted in the municipality of Pinhais/Brazil. The questionnaire applied had as themes the experience of personal use of industrialized herbal medicines, improvement after their use. Forty-four individuals from four different nationalities: Brazilian (88.64%), Cuban (6.82%), Mexican (2.27%) and Argentinian (2.27%), ages between 25 and 69 years, mainly male sex (54.55%) answered the questionnaire. According to the study, the doctors consider herbal medicines an alternative to the conventional treatment and these medical professionals have already prescribed some industrialized herbal medications. Despite the difficulties faced by medical doctors with the prescription of herbs, it is possible to define strategies to assist these professionals, such as the incentive the actions by the governments.

Resumo Introdução: O teste de caminhada de seis minutos (TC6min) é amplamente utilizado para avaliar a capacidade funcional em crianças. A medida do trabalho durante o TC6 poderia adicionar informações importantes à avaliação do TC6 nessa população, no que se refere à eficiência da marcha. Objetivo: Verificar os determinantes do trabalho durante o Teste de Caminhada (TC6min) em crianças em idade escolar. Método: Trata-se de um estudo transversal e exploratório que incluiu crianças saudáveis recrutadas nas escolas públicas e privadas das cidades de Belo Horizonte e Uberlândia, Brasil. Os critérios de inclusão foram: crianças de 7 a 12 anos sem diagnóstico de doença cardiorrespiratória crônica, distúrbio cognitivo, comportamental ou comprometimento da função física (informações obtidas por auto-relato dos responsáveis pelas crianças). Os critérios de exclusão foram: crianças que se recusaram a realizar o TC6; que não entenderam o TC6 ou que não responderam aos comandos de teste. Trezentos e dezenove crianças em idade escolar foram incluídas no estudo. Análises de correlação e análise de regressão linear múltipla foram utilizadas para identificar as variáveis associadas ao trabalho com TC6. Resultados: Idade, altura, estado nutricional, atividade física e frequência cardíaca apresentaram correlação significativa com o trabalho durante o TC6min (p <0,001) e explicaram 87% de sua variação (p = 0,0001). Conclusão: Idade, altura, estado nutricional e variação da frequência cardíaca são determinantes do trabalho no TC6, e portanto, devem ser considerados na avaliação da capacidade funcional de crianças em idade escolar.

Abstract Introduction: The Six-Minute Walk Test (6MWT) is widely used to assess functional capacity in children. The measure of work during 6MWT can add important information to the 6MWT assessment in this population as it relates to walking efficiency. Objective: To verify the determinants of work during the Six-Minute Walk Test (6MWTwork) in school-aged children. Method: This is a cross-sectional and exploratory study that included healthy children recruited from the public and private schools of the cities of Belo Horizonte and Uberlândia, Brazil. The inclusion criteria were: children aged 7 to 12 years without diagnosis of chronic cardiorespiratory disease, cognitive, behavioral disorder or physical function impairment (information obtained through self-report of those responsible for children). Exclusion criteria were children who refused to perform the 6MWT; who did not understand the 6MWT or who did not answer the test commands. Three hundred and nineteen school-aged children were included in the study. Correlation analyses and multiple linear regression analysis were used to identify the variables associated with the 6MWTwork. Results: Age, height, nutritional status, physical activity and heart rate showed significant correlation with 6MWTwork (p <0.001) and explained 87% of its variation (p = 0.0001). Conclusion: Age, height, nutritional status and heart rate variation are determinants of 6MWTwork that is able to evaluate functional capacity of school-aged children.

RESUMO Objetivo Analisar as demandas judiciais do brometo de tiotrópio para tratar a doença pulmonar obstrutiva crônica. Métodos Foram considerados dados secundários dos sistemas gerenciais de assistência farmacêutica, disponibilizados pelo Centro de Medicamentos do Paraná. Resultados Ações civis públicas e ações ordinárias, de procedimento comum, entre outras, foram as mais praticadas pelos pacientes para obter o medicamento. Duas Regionais de Saúde do Paraná (Londrina e Umuarama) concentraram mais de 50% das ações. Quanto à especialidade dos médicos prescritores, 33,8% eram pneumologistas. Verificou-se discreto impacto financeiro do brometo de tiotrópio nos gastos gerais com medicamentos pelo Centro de Medicamentos do Paraná. Entretanto, também houve relevante impacto financeiro individual, pois uma unidade do medicamento consome 38% do salário mínimo. Conclusão O estudo aponta para a necessidade de incorporação deste medicamento da classe broncodilatadores anticolinérgicos de longa duração, no Sistema Único de Saúde.

ABSTRACT Objective To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. Methods We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. Results Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. Conclusion Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.

Abstract INTRODUCTION: Rabies is an acute zoonotic disease, caused by a rhabdovirus that can affect all mammals, and is commonly transmitted by the bite of a rabid animal. The definitive diagnosis is laboratorial, by the Fluorescent Antibody Test (FAT) as a quick test and Mouse Inoculation Test (MIT) as a confirmatory test (gold standard). Studies conducted over the past three decades indicate that MIT and Virus Isolation in Cell Culture (VICC) can provide the same effectiveness, the latter being considered superior in bioethics and animal welfare. The aim of this study was to compare VICC with MIT, in terms of accuracy, biosafety and occupational health, supply and equipment costs, bioethics and animal welfare, in a Brazilian public health lab. METHODS: We utilized 400 samples of animal neurological tissue to compare the performance of VICC against MIT. The variables analyzed were accuracy, biosafety and occupational health, time spent in performing the tests, supply and equipment costs, bioethics and animal welfare evaluation. RESULTS: Both VICC and MIT had almost the same accuracy (99.8%), although VICC presented fewer risks regarding biosafety and mental health of the technicians, and reduced time between inoculation and obtaining the results (approximately 22 days less). In addition, VICC presented lower supply costs (86.5% less), equipment costs (32.6% less), and the advantage of not using animals. CONCLUSIONS: These results confirm that VICC can replace MIT, offering the same accuracy and better features regarding cost, results, biosafety and occupational health, and bioethics and animal welfare.

ABSTRACT This study aimed to assess the physical performance of Pantaneiro horses with and without equine infectious anemia (EIA) under functional conditions of cattle management. The horses were subjected to a performance test and split into two groups according to a completely randomized design: animals were chosen from populations testing positive and negative for EIA. Performance was measured as a function of a data envelopment analysis (DEA) model considering four outputs and one unitary input. The output measures were the distance achieved in the performance test, hematocrit as a weighted average over the test duration, respiratory rate as weighted average over the test duration, and the level of lactic acid at the test termination. Weights for the hematocrit and the respiratory rate output variables were determined by means of factor analysis. The performance score was a weighted average of the output variables with the weights defined by the averages of the optimum individual multipliers in the DEA analysis. Contextual variables of interest were age, horse weight, room temperature, and corporal temperature. Only groups and room temperature were statistically significant effects, as indicated by a bootstrap analysis. The performance of group positive for EIA is significantly lower than that of the group negative for EIA and room temperature has a negative effect.

Resumo Este trabalho teve como objetivo determinar duas drogas psicotrópicas mais dispensadas pelos Centros de Atenção Psicossocial (CAPS) nas águas de um rio urbano (sub-bacia do rio Belém, Curitiba - PR, Brasil). Foi desenvolvido e validado um método analítico SPE seguido de HPLC-DAD. Os cartuchos Strata-X® foram utilizados para extrair carbamezepina (CZ) e diazepam (DZ) das águas e as condições de SPE foram otimizadas por um planejamento fatorial 23. O método validado foi específico para compostos alvo. Os coeficientes de correlação foram superiores a 0,9998, a recuperação entre 85,8 e 98,4% e a precisão abaixo de 6,60% (RSD, n = 3). Este método foi aplicado com sucesso para analisar amostras de rios e pontos críticos de poluição foram reconhecidos. A CZ e DZ foram encontradas em concentrações variando de 0,670 a 0,856 μg L-1 e de LOQ a 0,763 μg L-1, respectivamente, confirmam que o consumo de drogas está diretamente relacionado à poluição do rio na região estudada.

Abstract This work sought to determine the two psychotropic drugs most commonly released by Psychosocial Care Centers (CAPS) into urban river waters (Belém sub-basin, Curitiba, PR, Brazil). A simple analytical method using SPE followed by a HPLC-DAD was developed and validated. Strata-X® cartridges were used to extract (carbamazepine) CZ and diazepam (DZ) from water and SPE conditions were optimized by 23 factorial design. The validated method was specific for target compounds; correlation coefficients were above 0.9998, recovery between 85.8 and 98.4% and precision below 6.60% (RSD, n=3). This method was successfully applied to analyze river samples and pollution hotspots were identified. The CZ and DZ concentrations found ranged from 0.670 to 0.856 µg L-1 and from LOQ to 0.763 µg L-1, respectively, and confirmed that drug consumption is directly related to river pollution in the studied region.

Resumo Introdução O heterocontrole, que é o monitoramento da concentração de fluoreto na água de abastecimento, deve ser feito por instituições do Estado e tem sido motivado para garantir a eficácia e a segurança da fluoretação. Este estudo teve como objetivo analisar o heterocontrole de municípios com população acima de 50 mil habitantes da Região Metropolitana de Curitiba nos anos de 2014 e 2015. Metodologia Dados sobre o heterocontrole foram fornecidos pelos serviços de Vigilância em Saúde dos municípios do estudo e analisados de acordo com o critério técnico do CECOL para a concentração de fluoreto. Resultados Em alguns municípios e meses, houve falha na realização das coletas de amostras de água em relação ao número adequado para o parâmetro fluoreto. Do total de amostras analisadas, somente 51,5% estavam na faixa de melhor benefício-risco para a concentração de fluoreto, com 8% de benefício e risco insignificantes e 0,1% das amostras com concentração de fluoreto de alto risco, sem nenhum benefício. Conclusão Os municípios analisados realizaram o heterocontrole, com períodos em que o número de coletas não foi adequado. As concentrações de fluoreto na água de abastecimento dos municípios do estudo apresentaram resultado pouco satisfatório. O heterocontrole é fundamental para manter os teores de fluoreto em níveis adequados.

Abstract Introduction External control is the monitoring of fluoride concentration in the water supply that must be done by state institutions, and has been motivated to ensure the efficacy and safety of fluoridation. This study aimed to analyze the external control of municipalities with more than 50.000 inhabitants in the metropolitan region of Curitiba in the years 2014 and 2015. Methodology Health surveillance services of the studied municipalities provided external control data, which were analyzed according to the technical criterion of the CECOL for fluoride content. Results Collection of water samples failed in some municipalities and months for an adequate number for the fluoride parameter. From the total samples analyzed, only 51.5% were in the best benefit-risk range for the fluoride concentration. Eight percent of the samples presented insignificant benefit and risk and 0.1% showed a high-risk fluoride concentration, without any benefit. Conclusion the analyzed municipalities performed the external control, with periods of inadequate sample collections. Fluoride concentrations in the supply water of the study municipalities presented an unsatisfactory result. The main goal of external control is to maintain fluoride levels at adequate levels.

Resumo O presente trabalho propôs relacionar o sobrepeso infantil com a percepção familiar da silhueta da criança e a preocupação com o excesso de peso na infância. Foi realizado um estudo transversal com crianças de 20 a 48 meses de idade usuárias de Unidades de Saúde ou centros de ensino infantil de Curitiba, no período de junho a dezembro de 2014. Fez-se uso de questionário para coletar dados referentes a renda familiar, peso, altura, percepção da silhueta da criança e verificar a preocupação com o excesso de peso. O sobrepeso e a obesidade não foram percebidos corretamente pelos responsáveis (kappa =0,11) e grande parte destes não sabiam o peso e altura da crianças e nem estavam preocupados com excesso de peso. Na população estudada, as crianças de famílias de menor renda apresentaram mais chance de desenvolver sobrepeso na infância (p = 0,02). Se faz necessário investir na sensibilização das famílias, pois é de extrema importância a atenção à obesidade desde a infância prevenindo assim novos casos e evitando agravos na vida adulta.

Abstract The scope of this study was to relate child obesity with the family’s perception of the child’s silhouette’s and concern with excess weight in childhood A cross-sectional study was conducted among children aged between 20 and 48 months who frequent Health Units or are preschoolers in the city of Curitiba from June to December 2014. A questionnaire was used to collect data relating to family income, weight, height, perception of child silhouette’s and assess concern about obesity by parents. Overweight and obesity was not correctly perceived by relations (kappa = 0,11) and the vast majority of parents did not know the child’s height and weight and were not even concerned with childhood obesity. In the population studied, children from lower income family were more likely to suffer from overweight in childhood (p = 0,02). It is necessary to invest in the sensitization of families, since it is extremely important to pay attention to obesity from childhood onwards, thus preventing new cases and avoiding problems in adult life.

Resumo O presente trabalho propôs relacionar o sobrepeso infantil com a percepção familiar da silhueta da criança e a preocupação com o excesso de peso na infância. Foi realizado um estudo transversal com crianças de 20 a 48 meses de idade usuárias de Unidades de Saúde ou centros de ensino infantil de Curitiba, no período de junho a dezembro de 2014. Fez-se uso de questionário para coletar dados referentes a renda familiar, peso, altura, percepção da silhueta da criança e verificar a preocupação com o excesso de peso. O sobrepeso e a obesidade não foram percebidos corretamente pelos responsáveis (kappa =0,11) e grande parte destes não sabiam o peso e altura da crianças e nem estavam preocupados com excesso de peso. Na população estudada, as crianças de famílias de menor renda apresentaram mais chance de desenvolver sobrepeso na infância (p = 0,02). Se faz necessário investir na sensibilização das famílias, pois é de extrema importância a atenção à obesidade desde a infância prevenindo assim novos casos e evitando agravos na vida adulta.

Abstract The scope of this study was to relate child obesity with the family’s perception of the child’s silhouette’s and concern with excess weight in childhood A cross-sectional study was conducted among children aged between 20 and 48 months who frequent Health Units or are preschoolers in the city of Curitiba from June to December 2014. A questionnaire was used to collect data relating to family income, weight, height, perception of child silhouette’s and assess concern about obesity by parents. Overweight and obesity was not correctly perceived by relations (kappa = 0,11) and the vast majority of parents did not know the child’s height and weight and were not even concerned with childhood obesity. In the population studied, children from lower income family were more likely to suffer from overweight in childhood (p = 0,02). It is necessary to invest in the sensitization of families, since it is extremely important to pay attention to obesity from childhood onwards, thus preventing new cases and avoiding problems in adult life.

Nonhuman primates are considered as the natural hosts of Hepatitis A virus (HAV), as well as other pathogens, and can serve as natural sentinels to investigate epizootics and endemic diseases that are of public health importance. During this study, blood samples were collected from 112 Neotropical primates (NTPs) (Sapajus nigritus and S. cay, n = 75; Alouatta caraya, n = 37) trap-captured at the Paraná River basin, Brazil, located between the States of Paraná and Mato Grosso do Sul. Anti-HAV IgG antibodies were detected in 4.5% (5/112) of NTPs, specifically in 6.7% (5/75) of Sapajus spp. and 0% (0/37) of A. caraya. In addition, all samples were negative for the presence of IgM anti-HAV antibodies. These results suggest that free-ranging NTPs were exposed to HAV within the geographical regions evaluated.

INTRODUCTION: The aim of the present study was to evaluate the presence of arboviruses from the Flavivirus genus in asymptomatic free-living non-human primates (NHPs) living in close contact with humans and vectors in the States of Paraná and Mato Grosso do Sul, Brazil. METHODS: NHP sera samples (total n = 80, Alouatta spp. n = 07, Callithrix spp. n = 29 and Sapajus spp. n = 44) were screened for the presence of viral genomes using reverse transcription polymerase chain reaction and 10% polyacrylamide gel electrophoresis techniques. RESULTS: All of the samples were negative for the Flavivirus genome following the 10% polyacrylamide gel electrophoresis analysis. CONCLUSIONS: These negative results indicate that the analyzed animals were not infected with arboviruses from the Flavivirus genus and did not represent a risk for viral transmission through vectors during the period in which the samples were collected.

São apresentados os resultados de pesquisa exploratória-descritiva realizada no setor supermercadista visando avaliar a qualidade e adequabilidade do acondicionamento (embalagem) e local de armazenagem de chás frente à legislação vigente. Além de proporcionar um panorama geral da situação de armazenagem de chás, também se buscou gerar um instrumento-base para incrementar a inspeção sanitária neste setor de comercialização. A coleta de dados foi efetuada a partir de visitas a 6 supermercados selecionados, no período de 2 a 30 de abril de 2001, observando-se a seção de mercearia seca no interior da loja e depósito anexo, quando permitido. Adicionalmente, efetuaram-se entrevistas com técnicos responsáveis pelos citados setores, para esclarecimentos e conferência de práticas de armazenagem. De modo geral, a maioria das lojas analisadas foi categorizada como portadora de boa (quatro lojas) à excelente (duas lojas) qualidade de armazenagem de chás. Os depósitos visitados apresentavam-se com qualidade boa (3) à regular (1). A avaliação detalhada do formulário básico de coleta de dados permitiu evidenciar que o problema mais freqüentemente registrado, tanto nas lojas quanto nos depósitos, refere-se à falta de controle de temperatura e umidade adequada (ausentes na totalidade dos estabelecimentos visitados). Um outro problema, que igualmente foi registrado com relativa freqüência, refere-se ao espaçamento mínimo requerido. Com menor freqüência, foram evidenciadas inadequações quanto à limpeza do local de armazenagem e luminárias, proximidade de produtos tóxicos além de forma e qualidade do empilhamento.

This paper presents the results of a survey conducted in the supermarket sector to evaluate the quality and adequacy of tea packaging and storage areas, considering the current legislation. In addition to providing a general view of tea storage practices, this survey aimed to generate a basic instrument to develop sanitary inspection in this market sector. The data were collected in April 2001 during visits to six supermarkets, when their dry goods department and attached warehouse were inspected. In addition, interviews were held with staff responsible for the aforementioned sectors to clarify and check the storage practices. The overall quality of tea storage was classified as good at four stores and excellent at the other two stores. The warehouses presented good (3) to regular (1) quality. A detailed analysis of the questionnaire indicated that the most frequent problem at the supermarkets and warehouses involved the lack of proper temperature and humidity control (none of the supermarkets had controlled environments). Another frequently mentioned problem had to do with the minimum spacing required. Less frequently reported problems were inadequate cleaning and lighting of storage areas, proximity to toxic products, and type and quality of stacking.

A aplicação de prospectiva para cadeias produtivas engloba várias etapas como a segmentação de cada elo, a análise do ambiente institucional e organizacional que envolve a cadeia, a identificação das necessidades e aspirações de cada segmento da cadeia e dos fatores críticos para a melhoria do desempenho. Desta forma, considerando a importância econômica da produção, industrialização e comercialização do capim-limão, Cymbopogon citratus (D.C.) Stapf, e visando uma ação integrada do setor agrícola envolvido, este trabalho propõe o estudo prospectivo da cadeia produtiva desta espécie no estado do Paraná, identificando também fatores e condicionantes de qualidade em cada segmento desta cadeia. Para isto, o presente estudo apresenta o panorama da produção agroindustrial e da comunidade produtora agrícola paranaense de capim-limão; identifica e caracteriza os outros segmentos que integram a respectiva cadeia produtiva no Paraná e, por fim, identifica e analisa os principais gargalos, elos faltantes e pontos de estrangulamento. Evidenciaram-se como principais componentes da cadeia produtiva: a unidade produtiva, a agroindústria, a indústria (alimentícia, farmacêutica e química) e o mercado consumidor interno (atacadista e varejista) e externo. Com esse estudo prospectivo, espera-se contribuir para a implementação de medidas político-organizacionais, entre os agentes econômicos dos setores público e privado, que fazem parte da cadeia produtiva do capim-limão, possibilitando-lhes desenvolver estratégias que aumentem a competitividade e conduzam à expansão do mercado.

The application of a prospective study to productive chains incorporates several stages like the segmentation of each link, the analysis of institutional and organizational environments to include the chain, the identification of necessities and aspirations of each chain segment and the critical factors for the improvement of performance. Thus, regarding the economic importance of production, industrialization and trading of lemon grass, Cymbopogon citratus (D.C.) Stapf and aiming at an integrated action of the agricultural sector involved, this paper proposes the prospective study of production chain of this species in Paraná State, identifying factors and conditioning of quality in each link of production chain. Thus the paper presents a view of: the lemon grass agricultural production in Paraná and its agricultural production community in Paraná; identifying and characterizing other segments of production chain of this species in Paraná and finally identifying and analyzing main bottlenecks, absent links and narrows points in the chain segments in the State. The following were identified as major components of the production chain: production unit, the agro-industry, the industry (nutrition, pharmaceutical and chemical) and the inside consumer market (wholesale and retail); thus, cooperating with implementation of political-organizational attitudes among economic agents of public and private sectors involved in the lemon grass production chain, enabling them to develop strategies that increase the competitiveness and expand the market.