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National Primary Care Policy (2017) and the roles of community health workers
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Dias, Juliana Roza

; Acioli, Sonia

; Corrêa, Vanessa de Almeida Ferreira

; Souza, Inês Leoneza de

; Rafael, Ricardo de Mattos Russo

; Rodrigues, Paulo Henrique de Almeida

; Bohusch, Glaucia

Revista Brasileira de Enfermagem

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2025, Volume 78 N. 1 elocation e20240230

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: Analisar as novas atribuições dos agentes comunitários de saúde preconizadas pela Política Nacional de Atenção Básica (PNAB) de 2017 sob a ótica dos enfermeiros e dos agentes comunitários de saúde. Métodos: Estudo qualitativo com enfermeiros e agentes comunitários de saúde de equipes de Saúde da Família, por meio de entrevistas semiestruturadas entre agosto de 2021 e abril de 2022. Os dados foram submetidos à análise de conteúdo temática. Resultados: Identificamos profissionais que defenderam que as atribuições dos agentes comunitários visam o aumento da autonomia e valorização profissional desses trabalhadores. Outros apontaram para a perda da originalidade do trabalho, para o exercício ilegal da profissão de enfermeiro ou de técnico de enfermagem. Considerações Finais: A PNAB-2017 atribui a esses trabalhadores uma ênfase na execução de tarefas, contribuindo para a mecanização das ações, reforçando o modelo biomédico e descaracterizando o papel do agente comunitário na promoção da saúde na Atenção Primária.

ABSTRACT Objective: To analyze the new roles of community health workers as outlined in the 2017 National Primary Care Policy (PNAB) from the perspectives of both nurses and community health workers. Methods: This qualitative study involved nurses and community health workers from Family Health teams, conducted through semi-structured interviews via videoconference between August 2021 and April 2022. The data were analyzed using thematic content analysis. Results: We identified professionals who argued that the new roles for community health workers aim to increase their autonomy and professional recognition. Others highlighted concerns about the loss of originality in their work and the potential for the illegal practice of nursing or nursing technician duties. Final Considerations: The 2017 PNAB emphasizes task execution for these workers, contributing to the mechanization of activities, reinforcing the biomedical model, and undermining the role of community health workers in promoting health within Primary Care.

RESUMEN Objetivo: Analizar las nuevas atribuciones de los agentes comunitarios de salud preconizadas por la Política Nacional de Atención Básica (PNAB) de 2017 desde la perspectiva de los enfermeros y los agentes comunitarios de salud. Métodos: Se trata de un estudio cualitativo con enfermeros y agentes comunitarios de salud de equipos de Salud de la Familia, mediante entrevistas semiestructuradas realizadas por videoconferencia entre agosto de 2021 y abril de 2022. Los datos fueron analizados a través del análisis de contenido temático. Resultados: Identificamos profesionales que defendieron que las atribuciones de los agentes comunitarios de salud buscan aumentar la autonomía y el reconocimiento profesional de estos trabajadores. Otros señalaron la pérdida de la originalidad del trabajo y el ejercicio ilegal de la profesión de enfermero o técnico de enfermería. Consideraciones Finales: La PNAB-2017 asigna a estos trabajadores un énfasis en la ejecución de tareas, contribuyendo a la mecanización de las acciones, reforzando el modelo biomédico y desfigurando el papel del agente comunitario en la promoción de la salud en la Atención Primaria.

https://doi.org/10.1590/0034-7167-2024-0230

Subdesenvolvimento e saúde, um olhar a partir da Teoria Marxista da Dependência
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Rodrigues, Paulo Henrique de Almeida

; Gonçalves, Thauanne de Souza

; Monteiro, Nercilene Santos da Silva

; Martins, Amanda de Lucas Xavier

Physis: Revista de Saúde Coletiva

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2025, Volume 35 N. 2 elocation e350213

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Este artigo adota a perspectiva da economia política da saúde apresentando a Teoria Marxista da Dependência (TMD) como referencial teórico potente para o entendimento da dependência econômica, política, social e tecnológica no setor de saúde no Brasil. Apresenta antecedentes sobre a relação entre o desenvolvimento e saúde, contextualizando as três vertentes da teoria da dependência, e destaca razões que podem explicar o silenciamento no último quartel do século XX da TMD no Brasil. No texto, são apresentadas as principais categorias analíticas da TMD, que permitem analisar os mecanismos de transferência de valor do Brasil para os países centrais, a penetração do capital estrangeiro na produção e circulação de bens e serviços no SUS, assim como a superexploração da força de trabalho dos trabalhadores da saúde, resultantes da estrutura dependente. Este artigo pretende contribuir para a construção de um programa de pesquisas sobre a economia política da saúde, que considere o papel do Estado fundamental para o processo de desenvolvimento econômico e social do país e o setor de saúde como um aspecto central deste processo, visando fortalecer o esforço ainda inicial que busca trazer de volta a abordagem teórica marxista no campo da Saúde Pública/Coletiva.

Abstract This article adopts the perspective of the political economy of health, presenting the Marxist Dependency Theory (MDT) as a powerful theoretical framework for understanding economic, political, social and technological dependency in the health sector in Brazil. It presents background on the relationship between development and health, contextualizing the three strands of dependency theory and highlights reasons that explain the silencing of MDT in Brazil in the last quarter of the 20th century. The text presents the main analytical categories of the MDT, which allow us to analyze the mechanisms of transfer of value from Brazil to the central countries, the penetration of foreign capital in the production and circulation of goods and services in the SUS, as well as the overexploitation of the health workforce, resulting from the dependent structure. This article aims to contribute to the construction of a research program on the political economy of health, which considers the role of the state to be fundamental to the country's economic and social development process and the health sector as a central aspect of this process, with a view to strengthening the effort to bring back the Marxist theoretical approach in the field of Public/Collective Health.

https://doi.org/10.1590/s0103-73312025350213pt

Da teoria à prática: uma interpretação crítica da noção do Complexo Econômico-Industrial da Saúde (CEIS)
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Rodrigues, Paulo Henrique de Almeida

; Silva, Roberta Dorneles Ferreira da Costa

; Mattos, Arthur Lobo Costa

Trabalho, Educação e Saúde

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2024, Volume 22 elocation e02989261

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

Abstract This article, which plays the role of a problematizing text in the debate promoted by the journal Trabalho Educação e Saúde, in a thematic dossier on the Health Economic-Industrial Complex, criticizes this complex considering its theoretical-political choices, perspectives on the state-civil society relationship, diagnoses of the Brazilian and international reality, and developmental bets on the part of its main advocates. Based on the categories of the Marxist Theory of Dependency, the authors conclude that this project - taken on as public policy by Brazil’s current federal government, in essence, by the forms and contents it defends and assumes - reinforces dependency and economic and technological subordination instead of overcoming it.

Resumo O presente artigo, que cumpre o papel de texto-problematizador do debate promovido pela revista Trabalho Educação e Saúde, em dossiê temático sobre o Complexo Econômico-Industrial da Saúde, submete à crítica o referido Complexo, em face das escolhas teórico-políticas, perspectivas sobre a relação Estado-Sociedade Civil, diagnósticos da realidade brasileira e internacional, e apostas desenvolvimentistas por parte dos seus principais defensores. Com base nas categorias da Teoria Marxista da Dependência, os autores concluem que tal projeto - apropriado como política pública pelo atual governo federal, em essência, pelas formas e pelos conteúdos que defende e assume - reforça a dependência e a subordinação econômica e tecnológica no lugar de superá-la.

Resumen Este artículo, que cumple el papel de texto problematizador en el debate promovido por la revista Trabalho Educação e Saúde, en un dossier temático sobre el Complejo Económico-Industrial de la Salud, critica este complejo a la luz de sus opciones teórico-políticas, perspectivas sobre la relación Estado-sociedad civil, diagnósticos de la realidad brasileña e internacional y apuestas desarrollistas por parte de sus principales defensores. A partir de las categorías de la Teoría Marxista de la Dependencia, los autores concluyen que este proyecto - apropriado como política pública por el actual gobierno federal de Brasil, en esencia, por las formas y contenidos que defiende y asume - refuerza la dependencia y la subordinación económica y tecnológica en lugar de superarla.

https://doi.org/10.1590/1981-7746-ojs2989

O Complexo Econômico-Industrial da Saúde como alternativa para a manutenção do subdesenvolvimento
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Rodrigues, Paulo Henrique de Almeida

; Silva, Roberta Dorneles Ferreira da Costa

; Mattos, Arthur Lobo Costa

Trabalho, Educação e Saúde

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2024, Volume 22 elocation e02995266

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

Abstract This article, which plays the role of a rejoinder in a thematic dossier on the Health Economic-Industrial Complex, reviews the main text’s four comments, partly accepting and partly contesting them, in different proportions. As a synthesis of the problematizations that motivated the debate and the appreciations, favorable or unfavorable, received from different perspectives, the authors of the problematizing text return to their axis of analysis, but now from the ground traced by their critics.

Resumo O presente artigo, que cumpre o papel de tréplica em dossiê temático sobre o Complexo Econômico-Industrial da Saúde, passa em revista os quatro comentários do texto principal, em parte acatando-os, em parte contestando-os, em diferentes proporções. Como síntese das problematizações que motivaram o debate e das apreciações, favoráveis ou desfavoráreis, recebidas por diferentes perspectivas, os autores do texto-problematizador retomam o seu eixo de análise, mas, agora, a partir do terreno traçado por seus críticos.

Resumen Este artículo, que cumple la función de dúplica en un dossier temático sobre el Complejo Económico-Industrial de la Salud, pasa revista a los cuatro comentarios del texto principal, en parte aceptándolos, en parte rebatiéndolos, en distintas proporciones. Como síntesis de las problematizaciones que motivaron el debate y de las apreciaciones, favorables o desfavorables, recibidas desde distintas perspectivas, los autores del texto problematizador retoman su eje de análisis, pero ahora desde el terreno trazado por sus críticos.

https://doi.org/10.1590/1981-7746-ojs2995

Mortality, hospitalizations, and persistence of symptoms in the outpatient setting of the first COVID-19 wave in Brazil: results of SARS-Brazil cohort study
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Fonseca, Henrique Andrade Rodrigues

; Pereira, Adriano Jose

; Nawa, Ricardo Kenji

; Sant’Anna, Viviane Aparecida Rodrigues

; Almeida, Tatiana Ferreira de

; Guimarães, Hélio Penna

; Tognon, Alexandre Pereira

; Marques, Lucas Miranda

; Silva, Lucas Santana Coelho da

; Bittencourt, Rafaela de Souza

; Gomes, Camila Pachêco

; Martins, Priscila de Aquino

; Oliveira, Aryadne Lyrio de

; Milan, Eveline Pipolo

; Dall’Orto, Frederico Toledo Campos

; Hoffman Filho, Conrado Roberto

; Almeida, Guacyra

; Hohmann, Fábio Barlem

; Moia, Diogo Duarte Fagundes

; Piano, Luciana Pereira Almeida

; Machado, Felipe Pinheiro

; Soares, Ronaldo Vicente Pereira

; Damiani, Lucas Petri

; Assis, Silvia Regina Lamas

; Amaro Junior, Edson

; Rizzo, Luiz Vicente

; Berwanger, Otávio

einstein (São Paulo)

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2024, Volume 22 elocation eAO0652

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To evaluate deaths, hospitalizations, and persistence of symptoms in patients with COVID-19 after infection in an outpatient setting during the first COVID-19 wave in Brazil. Methods This prospective cohort was between April 2020 and February 2021. Hospitalized or non-hospitalized COVID-19 patients until five days after symptom onset were included. The outcomes measured were incidence of death, hospitalization, and persistence of more than two symptoms 60 days after discharge. Results Out of 1,198 patients enrolled in the study, 66.7% were hospitalized. A total of 289 patients died (1 [0.3%] non-hospitalized and 288 [36%] hospitalized). At 60 days, patients non-hospitalized during admission had more persistent symptoms (16.2%) compared to hospitalized (37.1%). The COVID-19 severity variables associated with the persistence of two or more symptoms were increased age (OR= 1.03; p=0.015), respiratory rate at hospital admission (OR= 1.11; p=0.005), length of hospital stay of more than 60 days (OR= 12.24; p=0.026), and need for intensive care unit admission (OR= 2.04; p=0.038). Conclusion COVID-19 survivors who were older, tachypneic at admission, had a hospital length of stay >60 days, and were admitted to the intensive care unit had more persistent symptoms than patients who did not require hospitalization in the early COVID-19 waves. ClinicalTrials.gov Identifier: NCT04479488.

https://doi.org/10.31744/einstein_journal/2024ao0652

Cis-9, trans-11 and trans-10, cis-12 conjugated linoleic acid gastric administration during the pregestational and gestational periods does not influence the follicular endowment of the progeny
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Freitas, Danielle Storino de

; Lopes, Guilherme Antonio de Gouvêa

; Nascimento, Barbara Rodrigues

; Madureira, Ana Paula

; Campos-Junior, Paulo Henrique Almeida

Animal Reproduction

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2023, Volume 20 N. 3 elocation e20220124

Abstract: En | Text: En | PDF: En

Abstract Fetal programming suggests that maternal stimulation and nutrition during the period of fetal development can program the progeny. Conjugated linoleic acid (CLA), an isomer of linoleic acid, has been characterized in several aspects, but few studies have been performed on its involvement in reproduction and fetal programming. The aim of this study was to evaluate the F1, F2 and F3 progeny of female mice supplemented with CLA during the pregestational and gestational periods with respect to biometric and reproductive parameters, as well as ovarian morphophysiology. The F1 progeny of mothers supplemented with CLA exhibited stable weight gain, while the F2 progeny showed no effects (P=0.0187 and P=0.0245, respectively). A reduction in Lee's Index was observed in both generations at the second post-weaning evaluation week in the animals treated with CLA (P=0.0100 and P=0.0078, respectively). The F2 generation showed an increase in the anogenital index in both sexes of the animals treated with CLA (P= 0.0114 and P<0.0001, female and male respectively). CLA administration to mothers did not affect any of the following in their progeny: ovarian follicle mobilization (P>0.05), follicle number (P>0.05) and the integrated density of the lipid content of oocytes included in antral follicles (P>0.05). This study evaluated the use of CLA in mothers and found that it did not affect the progeny regarding murine reproductive performance, suggesting that this supplement can be used safely.

https://doi.org/10.1590/1984-3143-ar2022-0124

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Abstract: En | Text: En | PDF: En

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal
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Lamas, Carlos José Einicker

; Fachin, Diego Aguilar

; Falaschi, Rafaela Lopes

; Alcantara, Daniel Máximo Correa de

; Ale-Rocha, Rosaly

; Amorim, Dalton de Souza

; Araújo, Maíra Xavier

; Ascendino, Sharlene

; Baldassio, Letícia

; Bellodi, Carolina Ferraz

; Bravo, Freddy

; Calhau, Julia

; Capellari, Renato Soares

; Carmo-Neto, Antonio Marcelino do

; Cegolin, Bianca Melo

; Couri, Márcia Souto

; Carvalho, Claudio José Barros de

; Dios, Rodrigo de Vilhena Perez

; Falcon, Aida Vanessa Gomez

; Fusari, Livia Maria

; Garcia, Carolina de Almeida

; Gil-Azevedo, Leonardo Henrique

; Gomes, Marina Morim

; Graciolli, Gustavo

; Gudin, Filipe Macedo

; Henriques, Augusto Loureiro

; Krolow, Tiago Kütter

; Mendes, Luanna Layla

; Limeira-de-Oliveira, Francisco

; Maia, Valéria Cid

; Marinoni, Luciane

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira

; Patiu, Claudemir

; Proença, Barbara

; Pujol-Luz, Cristiane Vieira de Assis Pujol-Luz, José Roberto Rafael, José Albertino Riccardi, Paula Raile Rodrigues, João Paulo Vinicios Roque, Fabio de Oliveira Sallum, Maria Anice Mureb Santis, Marcelo Domingos de Santos, Charles Morphy Dias dos Santos, Josenilson Rodrigues dos Savaris, Marcoandre Shimabukuro, Paloma Helena Fernandes Silva, Vera Cristina Schelesky-Prado, Daniel de Castro Silva-Neto, Alberto Moreira da Camargo, Alexssandro Sousa, Viviane Rodrigues de Urso-Guimarães, Maria Virginia Wiedenbrug, Sofia Yamaguchi, Carolina Nihei, Silvio Shigueo

Revista Brasileira de Entomologia

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2023, Volume 67 N. 4 elocation e20230051

Abstract: En | Text: En | PDF: En

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.

https://doi.org/10.1590/1806-9665-rbent-2023-0051

Estado e acumulação de capital na saúde brasileira sob a ótica da Teoria Marxista da Dependência
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Rodrigues, Paulo Henrique de Almeida

; Mattos, Arthur Lobo Costa

; Monteiro, Nercilene Santos da Silva

; Silva, Roberta Dorneles Ferreira da Costa

; Baldo, Valentina Sofía Suárez

Cadernos de Saúde Pública

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2023, Volume 39 N. 12 elocation e00082923

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

Resumo: O setor de saúde constitui um dos maiores campos de desenvolvimento econômico, social, científico e tecnológico do Brasil e tem sido arena de disputa entre os interesses capitalistas, que entendem a saúde como bem de mercado, e os defensores do acesso universal, que a entendem como bem essencial. No Brasil, a Constituição Federal de 1988 determinou que a saúde é direito de todos e dever do Estado, e, desde então, o país avança com a política pública, mas sofre recuos e bloqueios pela condição de país de economia periférica, historicamente subordinado aos interesses dos países centrais, que o veem como um amplo mercado consumidor. Esses interesses externos, associados à burguesia interna, têm obtido vantagens do Estado brasileiro desde a década de 1960, quando a formação de grupos empresariais se expandiu, dominando diversos segmentos da saúde, sobretudo a partir de políticas neoliberais dos anos de 1990. Esses aspectos são muito explorados nas publicações do campo da Saúde Coletiva, mas este texto busca uma nova abordagem, utilizando a Teoria Marxista da Dependência como referência para analisar, ainda que de forma preliminar, a situação de dependência política, econômica e tecnológica que tem distanciado a política de saúde dos ideais de um sistema público e universal, defendido na Reforma Sanitária brasileira.

Resumen: El sector de la salud es uno de los mayores campos de desarrollo económico, social, científico y tecnológico de Brasil y ha sido un escenario de disputa entre los intereses capitalistas, que entienden la salud como un bien de mercado, y los defensores del acceso universal, que entienden la salud como un bien esencial. En Brasil, la Constitución Federal de 1988 estableció que la salud es un derecho de todos y un deber del Estado, y desde entonces el país ha avanzado con políticas públicas, no exentas de retrocesos y bloqueos debido a la condición de país de periferia económica, históricamente subordinado a los intereses de los países centrales, que ven a Brasil como un amplio mercado consumidor. Estos intereses externos, asociados a la burguesía interna, han obtenido ventajas del Estado brasileño desde la década de 1960, cuando se expandió la formación de grupos empresariales, dominando varios segmentos de la salud, sobre todo a partir de políticas neoliberales de la década de 1990. Estos aspectos son ampliamente explorados en publicaciones del campo de la Salud Colectiva, pero este texto busca un nuevo enfoque, utilizando la Teoría Marxista de la Dependencia como referencia para analizar, aunque de forma preliminar, la situación de dependencia política, económica y tecnológica que ha alejado la política de salud de los ideales de un sistema público y universal, defendido en la Reforma Sanitaria brasileña.

Abstract: The health sector is one of the major fields of economic, social, scientific, and technological development in Brazil, and has been the arena of dispute between capitalist interests that regard health as a commodity and advocates of universal access who regard health as an essential good. The Brazilian Federal Constitution of 1988 determined that health is a fundamental right and the State’s responsibility, and since then the country has made progress with public policy, but has suffered setbacks and blockages due to its status as a peripheric country, historically subordinated to the interests of core countries, which see Brazil as a broad consumer market. These external interests associated with the internal bourgeoisie have been taking advantage of the Brazilian State since the 1960s, when the foundation of business groups expanded, dominating various health segments, especially since the neoliberal policies of the 1990s. These aspects are much explored in publications in Public Health, but this text seeks a new approach, using the Marxist Theory of Dependency as a reference to analyze, albeit in a preliminary way, the situation of political, economic, and technological dependence that has distanced health policy from the ideals of a public and universal system, defended in the Brazilian Health Reform.

https://doi.org/10.1590/0102-311xpt082923

10.

Estado e acumulação de capital na saúde brasileira sob a ótica da Teoria Marxista da Dependência
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Rodrigues, Paulo Henrique de Almeida

; Mattos, Arthur Lobo Costa

; Monteiro, Nercilene Santos da Silva

; Silva, Roberta Dorneles Ferreira da Costa

; Baldo, Valentina Sofía Suárez

Cadernos de Saúde Pública

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2023, Volume 39 N. 12 elocation e00082923

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

https://doi.org/10.1590/0102-311xpt082923

11.

Mudanças recentes e continuidade da dependência tecnológica e econômica na indústria farmacêutica no Brasil
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Rodrigues, Paulo Henrique de Almeida

; Silva, Roberta Dorneles Ferreira da Costa

; Kiss, Catalina

Cadernos de Saúde Pública

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2022, Volume 38 Suppl. 2 elocation e00104020

Abstract: Es Pt En | Text: Es Pt En | PDF: Es | PDF: Pt | PDF: En

Este artículo presenta los resultados de investigación sobre la industria farmacéutica en Brasil, durante el período reciente, realizada en el ámbito del proyecto multicéntrico Complejo Económico-Industrial de la Salud, Innovación y Dinámica Capitalista: Desafíos Estructurales para la Construcción del Sistema Universal de Salud en Brasil. Los cuatro componentes estudiados sobre la evolución de la industria farmacéutica en Brasil fueron: las políticas industriales del Estado; los cambios en la composición financiera y patrimonial de las empresas de capital nacional, la evolución de la producción; y el comportamiento de la balanza comercial. Los análisis tuvieron en consideración el marco teórico propuesto por Luiz Filgueiras y Reinaldo Gonçalves, respecto a la implantación de un “modelo liberal y periférico” en la economía brasileña, a partir del año 1990. Se recabaron y analizaron datos sobre: la situación de las Colaboraciones de Desarrollo Productivo (PDP por su sigla en portugués) para medicamentos entre 2009 y 2020; de la Encuesta Industrial Anual (PIA), del Instituto Brasileño de Geografía y Estadística (IBGE), entre 1996 y 2018; y los datos de la evolución de la balanza comercial del sector entre 1996 y 2019. Los resultados evidencian que la agenda del Estado para el sector favoreció el crecimiento de la producción de medicamentos genéricos, de los medicamentos exentos de prescripción (MIP) y comenzó algunos proyectos de transferencia de tecnología vía PDPs para la producción de medicamentos biológicos y sintéticos. A pesar de esa evolución, Brasil sigue siendo dependiente de la importación de insumos químicos y farmacéuticos y de medicamentos acabados. Esto nos mantiene en una situación de vulnerabilidad tecnológica y económica, en relación con los proveedores mundiales, además de una profundización del déficit de la balanza comercial del sector.

Este artigo apresenta os resultados de pesquisa sobre a indústria farmacêutica no Brasil, no período recente, realizada no âmbito do projeto multicêntrico Complexo Econômico-Industrial da Saúde, Inovação e Dinâmica Capitalista: Desafios Estruturais para a Construção do Sistema Universal de Saúde no Brasil. Os quatro componentes estudados sobre a evolução da indústria farmacêutica no Brasil foram: as políticas industriais do Estado; as mudanças na composição financeira e patrimonial das empresas de capital nacional, a evolução da produção; e o comportamento da balança comercial. As análises levaram em consideração o marco teórico proposto por Luiz Filgueiras e Reinaldo Gonçalves a respeito da implantação de um “modelo liberal e periférico” na economia brasileira a partir dos anos 1990. Foram levantados e analisados dados sobre: a situação das Parcerias de Desenvolvimento Produtivo (PDP) para medicamentos entre 2009 e 2020; da Pesquisa Industrial Anual (PIA), do Instituto Brasileiro de Geografia e Estatística (IBGE), entre 1996 e 2018; e os dados da evolução da balança comercial do setor entre 1996 e 2019. Os resultados evidenciam que a agenda do Estado para o setor favoreceu o crescimento da produção de medicamentos genéricos, dos medicamentos isentos de prescrição (MIP) e deu início a alguns projetos de transferência de tecnologia via PDPs para a produção de medicamentos biológicos e sintéticos. Apesar dessa evolução, o Brasil se mantém dependente da importação de insumos químicos e farmacêuticos e de medicamentos acabados. Isto nos mantém em situação de vulnerabilidade tecnológica e econômica em relação aos fornecedores mundiais, além de um aprofundamento do déficit da balança comercial do setor.

This article presents the results of a study on the pharmaceutical industry in Brazil in the recent period, as part of the multicenter project Health Economic-Industrial Complex, Innovation and Capitalist Dynamics: Structural Challenges for Construction of the Universal Health System in Brazil. The four components studied in the evolution of the Brazilian pharmaceutical industry were: State industrial policies; changes in the financial and shareholding composition of companies with domestic capital; trends in production; and trade balance behavior. The analyses considered the theoretical framework proposed by Luiz Filgueiras and Reinaldo Gonçalves concerning the implementation of a “liberal and peripheral model” in the Brazilian economy since the 1990s. Data were collected and analyzed on the situation with the Product Development Partnerships (PDP) for medicines from 2009 to 2020 from the Annual Industrial Survey (PIA) of the Brazilian Institute of Geography and Statistics (IBGE) from 1996 to 2018 and data on the evolution of the sector’s trade balance from 1996 to 2019. The results show that the State’s agenda for the sector favored the growth in production of generic drugs and over-the-counter drugs and started some technology transfer projects via PDPs for production of biological and synthetic drugs. Despite this evolution, Brazil is still dependent on the importation of chemical and pharmaceutical inputs and finished drugs. This keeps Brazil in a situation of technological and economic vulnerability in relation to global suppliers, besides a growing trade deficit in the sector.

https://doi.org/10.1590/0102-311x00104020

12.

Checklist of the dipterofauna (Insecta) from Roraima, Brazil, with special reference to the Brazilian Ecological Station of Maracá
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Riccardi, Paula Raile

; Fachin, Diego Aguilar

; Ale-Rocha, Rosaly

; Amaral, Edna Maria

; Amorim, Dalton de Souza

; Gil-Azevedo, Leonardo Henrique

; Capellari, Renato Soares

; Carmo, Daniel Dias Dornelas do

; Carvalho, Claudio José Barros de

; Ferro, Gustavo Borges

; Flores, Heloísa Fernandes

; Gomes, Lucas Roberto Pereira

; Gottschalk, Marco Silva

; Lamas, Carlos José Einicker

; Lampert, Silvana

; Marinho, Marco Antonio Tonus

; Marques, Dayse Willkenia Almeida

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Menezes, Marco Antônio

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira de

; Pereira, Thalles Platiny Lavinscky

; Pereira-Colavite, Alessandre

; Pirani, Gabriela

; Rafael, José Albertino

; Santos, Josenilson Rodrigues dos

; Savaris, Marcoandre

; Schelesky-Prado, Daniel de Castro

; Silva, Vera Cristina

; Sousa, Viviane Rodrigues de

; Urso-Guimarães, Maria Virginia

; Vargas, Laura Viana

; Yamaguchi, Carolina

; Falaschi, Rafaela Lopes

Papéis Avulsos de Zoologia

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2022, Volume 62 elocation e202262014

Abstract: En | Text: En | PDF: En

Abstract Roraima is a Brazilian state located in the northern portion of the Amazon basin, with few studies regarding its biodiversity. The Ecological Station of Maracá (Brazil, state of Roraima) harbors the third largest Brazilian pluvial island and is composed of a transitional landscape of savanna and Amazon rainforest components. Despite its ecological importance and strategic localization, few studies covered the dipterofauna of this locality. An updated checklist addressing 41 families of true flies (Diptera) occurring in Roraima is presented based on the literature and the specimens collected during a field expedition that occurred in 2015. This checklist brings several improvements such as new records of 165 taxa to the state of Roraima, 29 taxa to Brazil, and 259 morphotypes, mostly likely representing undescribed species.

https://doi.org/10.11606/1807-0205/2022.62.014

13.

Technical performance of a lateral flow immunoassay for detection of anti-SARS-CoV-2 IgG in the outpatient follow-up of non-severe cases and at different times after vaccination: comparison with enzyme and chemiluminescent immunoassays
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Barreira, Gabriel Acca

; Santos, Emilly Henrique dos

; Pereira, Maria Fernanda Bádue

; Rodrigues, Karen Alessandra

; Rocha, Mussya Cisotto

; Kanunfre, Kelly Aparecida

; Marques, Heloisa Helena de Sousa

; Okay, Thelma Suely

; Eisencraft, Adriana Pasmanik Rossi Junior, Alfio Fante, Alice Lima Cora, Aline Pivetta Costa Reis, Amelia Gorete A. de Ferrer, Ana Paula Scoleze Andrade, Anarella Penha Meirelles de Watanabe, Andreia Gonçalves, Angelina Maria Freire Waetge, Aurora Rosaria Pagliara Silva, Camila Altenfelder Ceneviva, Carina Lazari, Carolina dos Santos Abellan, Deipara Monteiro Sabino, Ester Cerdeira Bianchini, Fabíola Roberta Marim Alcantara, Flávio Ferraz de Paes Ramos, Gabriel Frizzo Leal, Gabriela Nunes Rodriguez, Isadora Souza Pinho, João Renato Rebello Carneiro, Jorge David Avaizoglou Paz, Jose Albino Ferreira, Juliana Carvalho Ferranti, Juliana Ferreira Ferreira, Juliana de Oliveira Achili Framil, Juliana Valéria de Souza Silva, Katia Regina da Bastos, Karina Lucio de Medeiros Galleti, Karine Vusberg Cristofani, Lilian Maria Suzuki, Lisa Campos, Lucia Maria Arruda Perondi, Maria Beatriz de Moliterno Diniz, Maria de Fatima Rodrigues Fonseca, Maria Fernanda Mota Cordon, Mariana Nutti de Almeida Pissolato, Mariana Peres, Marina Silva Garanito, Marlene Pereira Imamura, Marta Dorna, Mayra de Barros Luglio, Michele Aikawa, Nadia Emi Degaspare, Natalia Viu Sakita, Neusa Keico Udsen, Nicole Lee Scudeller, Paula Gobi Gaiolla, Paula Vieira de Vincenzi Severini, Rafael da Silva Giannasi Rodrigues, Regina Maria Toma, Ricardo Katsuya Paula, Ricardo Iunis Citrangulo de Palmeira, Patricia Forsait, Silvana Farhat, Sylvia Costa Lima Sakano, Tânia Miyuki Shimoda Koch, Vera Hermina Kalika Cobello Junior, Vilson

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e49

Abstract: En | Text: En | PDF: En

ABSTRACT This study assessed the technical performance of a rapid lateral flow immunochromatographic assay (LFIA) for the detection of anti-SARS-CoV-2 IgG and compared LFIA results with chemiluminescent immunoassay (CLIA) results and an in-house enzyme immunoassay (EIA). To this end, a total of 216 whole blood or serum samples from three groups were analyzed: the first group was composed of 68 true negative cases corresponding to blood bank donors, healthy young volunteers, and eight pediatric patients diagnosed with other coronavirus infections. The serum samples from these participants were obtained and stored in a pre-COVID-19 period, thus they were not expected to have COVID-19. In the second group of true positive cases, we chose to replace natural cases of COVID-19 by 96 participants who were expected to have produced anti-SARS-CoV-2 IgG antibodies 30-60 days after the vaccine booster dose. The serum samples were collected on the same day that LFIA were tested either by EIA or CLIA. The third study group was composed of 52 participants (12 adults and 40 children) who did or did not have anti-SARS-CoV-2 IgG antibodies due to specific clinical scenarios. The 12 adults had been vaccinated more than seven months before LFIA testing, and the 40 children had non-severe COVID-19 diagnosed using RT-PCR during the acute phase of infection. They were referred for outpatient follow-up and during this period the serum samples were collected and tested by CLIA and LFIA. All tests were performed by the same healthcare operator and there was no variation of LFIA results when tests were performed on finger prick whole blood or serum samples, so that results were grouped for analysis. LFIA’s sensitivity in detecting anti-SARS-CoV-2 IgG antibodies was 90%, specificity 97.6%, efficiency 93%, PPV 98.3%, NPV 86.6%, and likelihood ratio for a positive or a negative result were 37.5 and 0.01 respectively. There was a good agreement (Kappa index of 0.677) between LFIA results and serological (EIA or CLIA) results. In conclusion, LFIA analyzed in this study showed a good technical performance and agreement with reference serological assays (EIA or CLIA), therefore it can be recommended for use in the outpatient follow-up of non-severe cases of COVID-19 and to assess anti-SARS-CoV-2 IgG antibody production induced by vaccination and the antibodies decrease over time. However, LFIAs should be confirmed by using reference serological assays whenever possible.

https://doi.org/10.1590/s1678-9946202264049

14.

Hesio Cordeiro no I Simpósio sobre Política Nacional de Saúde da Câmara de Deputados, 1979
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Rodrigues, Paulo Henrique de Almeida

Physis: Revista de Saúde Coletiva

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2021, Volume 31 N. 3 elocation e310303

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/s0103-73312021310303

15.

Vulnerabilidade e resposta social à pandemia de Covid-19 em territórios metropolitanos de São Paulo e da Baixada Santista, SP, Brasil
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Nasser, Mariana Arantes

; Calazans, Marília Oliveira

; Fegadolli, Claudia

; Oliveira, Sandro Barbosa de

; Rodrigues, Joana de Fátima

; Costa, Rosangela Calado da

; Santos, Eduardo Henrique Moraes

; Zanchetta, Giovanna Moreira

; Furtado, Lumena Almeida Castro

Interface - Comunicação, Saúde, Educação

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2021, Volume 25 Suppl. 1 elocation e210125

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

Este artigo analisa a vulnerabilidade e o enfrentamento à pandemia de Covid-19 em 16 territórios metropolitanos de São Paulo e da Baixada Santista (São Paulo, Brasil), objetos de pesquisa participante desenvolvida por estudo de casos múltiplos, sob o referencial teórico da vulnerabilidade e dos direitos humanos, em 2020. As condições socioeconômicas são distintas entre os territórios. A vulnerabilidade à infecção e à doença pelo coronavírus é relacionada a fatores individuais, sociais e programáticos: informações, percepções e possibilidades de proteção; convivência familiar/interpessoal, moradia, trabalho e violência; e acesso a cuidados de saúde e programas sociais. As redes de solidariedade, formadas principalmente por associações comunitárias e movimentos sociais, enfocam superar a fome, gerar renda e acessar direitos. Para a resposta social, é fundamental reconhecer as necessidades específicas, as experiências potentes e a centralidade do caminhar conjunto de sujeitos e coletivos em cada território.

Este artículo analiza la vulnerabilidad y el enfrentamiento a la pandemia de Covid-19 en 16 territorios metropolitanos de São Paulo y de la Región de la Baixada Santista (São Paulo, Brasil), objetos de investigación participante, desarrollada por estudio de casos múltiples, bajo el referencial teórico de la vulnerabilidad y de los derechos humanos, en 2020. Las condiciones socioeconómicas son distintas entre los territorios. La vulnerabilidad a la infección y enfermedad por el coronavirus se relaciona a factores individuales, sociales y programáticos: informaciones, percepciones y posibilidades de protección; convivencia familiar/interpersonal, vivienda, trabajo y violencia; y acceso a cuidados de salud y programas sociales. Las redes de solidaridad, formadas principalmente por asociaciones comunitarias y movimientos sociales, se enfocan en superar el hambre, generar renta y tener acceso a derechos. Para la respuesta social, es fundamental reconocer las necesidades específicas, las experiencias potentes y la centralidad del caminar conjunto de sujetos y colectivos en cada territorio.

This paper analyzes vulnerability and the tackling of the Covid-19 pandemic in 16 metropolitan territories of São Paulo and Baixada Santista (State of São Paulo, Brazil), objects of a participatory research developed in 2020 through a multiple-case study, in light of the theoretical framework of vulnerability and human rights. Socioeconomic conditions are different between territories. Vulnerability to coronavirus infection and disease is related to individual, social and programmatic factors: information, perceptions and possibilities of protection; family/interpersonal coexistence, housing, work and violence; and access to healthcare and social programs. Solidarity networks, formed mainly by community associations and social movements, focus on overcoming hunger, generating income and accessing rights. For the social response, it is essential to recognize specific needs, powerful experiences and the centrality of the joint walk of individuals and collectives in each territory.

https://doi.org/10.1590/interface.210125

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