ABSTRACT The paper presents a structured approach to address decision-making challenges within the medical clinic service of a mid-sized hospital located in Brazil, using Soft System Methodology (SSM). Its application extends to the medical clinic, a previously unexplored domain within the hospital. Within this context, we introduce a novel conceptual framework for healthcare, wherein we integrate Plan-Do-Check-Act (PDCA) tool into SSM framework. The overarching goal is to rectify the pivotal issue of excessive workload allocation among the medical clinic staff. The developed model effectively addresses this issue by optimizing task allocation. It achieves this by designating primary and auxiliary nursing staff for specific sets of tasks, taking into consideration the necessity for displacement and ensuring a fair distribution of workloads. Furthermore, our model incorporates PDCA into the implementation phase of SSM, thereby establishing a mechanism for ongoing improvement in the initial equilibrium achieved in terms of staff deployment and task distribution.

ABSTRACT The Scientists of Tomorrow/ Cientistas do Amanhã project is an immersive science training program developed by the Program of Post-Graduation in Health Sciences at Hospital Israelita Albert Einstein. This program was conducted in partnership with Volunteering and Escola Municipal de Ensino Fundamental Professor Paulo Freire in Paraisópolis, São Paulo, Brazil. The Scientists of Tomorrow Program comprised a short training period conducted in May 2022 involving 37 students, and a long training period from August to December 2022, which included 15 students. It aimed to popularize science through practical activities; transfer knowledge to young students; sensitize and guide them to pursue academic-scientific careers; reduce stereotypes about scientific work and scientists; and help students understand the social, political, and ethical roles of science within society. All activities were led by postgraduate students and professors from our postgraduate program, physicians, nurses, physiotherapists, biomedicals, and veterinarians from Hospital Israelita Albert Einstein, as well as medical students from Faculdade Israelita de Ciências da Saúde Albert Einstein . Activities in the short training included lectures on cinema and science, strategies to combat fake news, non-violent communication, innovation, design-thinking framework, and developing a scientific project. During the long training period, discussions were focused on nanotechnology, animal research, big data, bioinformatics, meditation, blood and bone marrow donation, telemedicine, sex and sexually-transmitted infections, rehabilitation, career opportunities, and scientific integrity. In addition, practical activities were further expanded using optical and confocal microscopy, cytometry, and basic concepts regarding the structure and function of living cells. The program also included the launching of the open-air outreach Education E-natureza activity, which turned students into ambassadors of nature. In conclusion, the Scientists of Tomorrow Program was innovative and enabled young students to learn that science is a collective activity that can enhance public health.

RESUMO Embora a Língua Brasileira de Sinais - Libras - tenha sido legalmente reconhecida em 2002, o acesso dos surdos à informação interpretada, especialmente nos meios de comunicação, é ainda muito precário. No contexto da pandemia, o acesso à informação e orientação na primeira língua pode ser decisivo para cuidar e manter a vida. Com isto em mente, este artigo aponta as barreiras experimentadas pelos Surdos no Brasil, considerando a ausência de tradutores e intérpretes de Língua de Sinais na grande mídia, bem como nos canais de entidades responsáveis por explicações e orientações sobre cuidados e prevenção, como se viu no caso do contágio e divulgação do novo Coronavírus. Procuramos também refletir sobre os efeitos sócio-emocionais causados pela falta de informações claras, e seus riscos que resultam em preocupação e pânico. Para isso, assumimos uma perspectiva qualitativa de investigação partindo da coleta de depoimentos que nos permitiram evidenciar a urgência de maior acessibilidade no contexto dos meios de comunicação, e os riscos resultantes da ausência de informações precisas para Surdos.

ABSTRACT Although Brazilian Sign Language - Libras - was legally recognized in 2002 as the national language for deaf people, their access to interpreted information (i.e., information in their own language), especially in the media, is still very precarious. In the context of the pandemic, having access to information and guidance in one’s first language can be decisive in caring for and maintaining life. With this in mind, this paper aims at pointing out the barriers experienced by deaf people in Brazil, considering the absence of Brazilian Sign Language translators and interpreters in mainstream journalism and in channels of organizations that are responsible for explanations and guidelines regarding care and prevention. We also seek to reflect about the socio-emotional effects caused by the lack of clear information, and how this may risk causing excessive concern and panic. In order to achieve that, we adopt a qualitative perspective of investigation stemming from the collection of testimonies from deaf people about their experiences in the context of the pandemic. The testimonials, collected by means of a semi-structured questionnaire, allowed us to point out the urgency for greater accessibility in the media context, and the risks resulting from the absence of accurate information both for deaf and hearing people.

Resumen Este artículo tiene como objetivo analizar los problemas a los que se enfrentan los electricistas de línea viva (ELV) de las redes de distribución de energía eléctrica en cuanto a los aspectos relacionados con el trabajo en la tarea de poda de vegetación. Para ello, se aplicó el Análisis Ergonómico del Trabajo (AET) de forma adaptada. Posteriormente, se realizaron entrevistas semiestructuradas con el equipo de ELV y las respuestas fueron tratadas según el Análisis de Contenido y discutidas desde la perspectiva de la Ergonomía de la Actividad y de la Psicodinámica del Trabajo. Las dificultades a las que se enfrenta el equipo de ELV no sólo están relacionadas con los aspectos fisiológicos derivados de los esfuerzos realizados frente a la alta demanda, sino principalmente con los dispositivos técnicos y organizativos del trabajo. Sin embargo, fue posible identificar aspectos vinculados a la dimensión del placer asociados a las cuestiones del oficio, del trabajo bien hecho y aparentemente invisible para la sociedad.

Resumo Este artigo tem como objetivo analisar as problemáticas enfrentadas por eletricistas de linha viva (ELV) de redes de distribuição de energia elétrica no que diz respeito aos aspectos relacionados ao trabalho na tarefa de poda de vegetação. Para isso realizou-se a aplicação da Análise Ergonômica do Trabalho (AET) de forma adaptada. Posteriormente foram realizadas entrevistas semiestruturadas com a equipe de LV, sendo que as falas foram tratadas conforme a Análise de Conteúdo e discutidas na perspectiva da Ergonomia da Atividade e da Psicodinâmica do trabalho. As dificuldades enfrentadas pelos ELV não dizem respeito somente aos aspectos fisiológicos decorrentes dos esforços empreendidos frente a alta demanda, mas sobretudo referentes aos dispositivos técnicos e organizacionais do trabalho. No entanto, foi possível identificar aspectos ligados à dimensão do prazer associados às questões de ofício, do trabalho bem-feito e aparentemente invisível para a sociedade.

Résumé Cet article a pour but d'analyser les problèmes rencontrés par les électriciens, œuvrant sous tension (ELV) dans des réseaux de distribution d'énergie électrique, concernant la tâche d'élagage de la végétation. L'analyse ergonomique du travail (AET) a été appliquée sous une forme adaptée. Ensuite, des entretiens semi-structurés ont été menés avec l'équipe de ELV, et leur contenu a été soumis à une analyse de contenu et discutés dans la perspective de l'ergonomie de l'activité et de la psychodynamique du travail. Les difficultés rencontrées par les ELV ne sont pas seulement liées aux aspects physiologiques découlant des efforts fournis face à une forte demande, mais surtout aux dispositifs techniques et organisationnels du travail. Cependant, il a été possible d'identifier des aspects liés à la dimension du plaisir associé à des questions du métier, du travail bien fait et apparemment peu visible pour la société.

Abstract This article aims to analyze the problems faced by live-line electricians (ELV) of electrical power distribution networks with regard to aspects related to work in the task of pruning vegetation. To this end, an adapted version of the Ergonomic Analysis of Work (EAW) was applied. Subsequently, semi-structured interviews were conducted with the ELV team, and the speeches were treated according to content analysis and discussed from the perspective of Activity Ergonomics and Psychodynamics of Work. The difficulties faced by the ELV team are not only related to the physiological aspects resulting from the efforts made in the face of high demand but are also mainly related to the technical and organizational devices of the work. However, it was possible to identify aspects linked to the dimension of pleasure associated with issues of craft, of work well done and apparently invisible to society.

RESUMO CONTEXTO: O câncer colorretal é a terceira neoplasia mais comum no mundo. A metilação de alguns genes nas ilhas CpG podem causar silenciamento gênico e estar envolvida no desenvolvimento de câncer. O potencial papel de DKK2 como um biomarcador no diagnóstico precoce de CCR permanece incerto. OBJETIVO: O objetivo do estudo foi avaliar o perfil de metilação e expressão de RNAm do gene DKK2 para identificar preditores potenciais de diagnóstico e prognóstico de CCR. MÉTODOS: A expressão de mRNAs que codificam DKK2 em 35 tecidos de câncer colorretal foi quantificada por reação em cadeia da polimerase em tempo real e a metilação do DNA foi verificada por análise de alta resolução. As características gerais dos pacientes foram coletadas. A metilação e expressão de DKK2 foram comparadas aos aspectos clínicos, patológicos e à sobrevida global. RESULTADOS: Entre os 35 pacientes estudados, 18 eram do sexo masculino, 10 tumores eram do cólon ascendente ou transverso e 25 do descendente ou reto. Entre os 20 pacientes com hipermetilação, 12 deles apresentaram baixa expressão de RNAm do gene DKK2. Não houve associação significativa entre a metilação do promotor de DKK2 e a expressão de RNAm de DKK2 e características clínicas ou patológicas. A metilação do promotor de DKK2 e a expressão do RNA de DKK2 não mostraram correlação com sobrevida global dos pacientes com CCR. CONCLUSÃO: A metilação do gene promotor e a expressão do RNAm do gene DKK2 parecem ser biomarcadores de diagnóstico de câncer, mas não se mostraram úteis na avaliação prognóstica.

ABSTRACT BACKGROUND: Colorectal cancer is the third most common neoplasm in the world. Methylation of tumor related genes in CpG islands can cause gene silencing and been involved in the development of cancer. The potential role of DKK2 as a biomarker for early diagnosis of colorectal cancer remains unclear. OBJECTIVE: The aim of the study was to evaluate the profile of methylation and RNAm expression of DKK2 as potential predictors of colorectal cancer diagnosis and prognosis. METHODS: Expression of mRNAs encoding DKK2 in 35 colorectal cancer tissues was quantified using real-time polymerase chain reaction analysis. The DNA methylation was studied by high resolution melting analysis. The general characteristics of the patients were collected. DKK2 methylation and expression were compared to clinical, pathological aspects and overall survival. RESULTS: Among the 35 patients studied, 18 were male, 10 were on right colon and 25 on left colon. Among the 20 patients with high hypermethylation, 15 of them had mRNA low expression of DKK2. There was no significant association between DKK2 promoter methylation and mRNA DKK2 expression and clinical or pathological features. DKK2 promoter methylation (P=0.154) and DKK2 RNA expression (P=0.345) did not show significant correlation with overall survival. CONCLUSION: DKK2 promoter methylation and DKK2 RNA status appear to be biomarkers of cancer diagnosis but not predictors of prognosis.

This work describes the chemical composition of MeOH seeds and flowers extracts of Tapirira guianensis, a known tree that occurs in the Brazilian Atlantic forest. The CH2Cl2 soluble fraction of seeds extract was submitted to chromatographic procedures to obtain a mixture of new alkenyl dihydrobenzofuranoids which were identified as 2-[(10’Z)-dodec-10’-enyl]-dihydro-1-benzofuran-5-ol, 2-[(10’Z)-tridec-10’-enyl]-dihydro-1-benzofuran-5-ol e 2-[(10’Z)-pentadec-10’-enyl]-dihydro-1-benzofuran-5-ol (1 - 3) besides β-sitosterol. From the EtOAc soluble fraction of flowers MeOH extract quercetin, quercitrin and gallic acid were obtained by chromatographic techniques. The fatty acid composition of oils from leaves and seeds were also determinate and the leaves’ oil is composed by 63.94% of saturated and 36.04% of unsaturated fatty acids while in the seeds the oil present 42.13% of saturated and 57.87% of unsaturated. All compounds and derivatives were identified by their spectrometric data analysis. The brine shrimp test of the extracts showed the seed CH2Cl2 and the EtOAc and BuOH soluble fractions of the flowers were actives and, the alkyl phenols are the responsible for this moderate activity. The antioxidant tests of the extracts indicated EtOAc soluble fraction of MeOH extract of flowers showed better results possibly due the presence of flavonoids and gallic acid.

ABSTRACT Synthetic preservatives are widely present in processed foods, but most of them have carcinogenic potential, requiring the development of new natural alternatives such as fruit extracts, for microbial control. The objective of the study was to evaluate the chemical characterization, antioxidant, and antimicrobial activity of the sugar apple pulp (Annona squamosa L.). Physicochemical characteristics were evaluated, an extract was prepared, and its antioxidant activity by DPPH method and antimicrobial by disk diffusion. Minimal inhibitory concentration and minimum bactericidal concentration against strains of Salmonella typhimurium, Escherichia coli, Listeria monocytogenes, and Staphylococcus aureus were evaluated. The physicochemical analysis revealed that sugar apple pulp had 75.0% moisture, 3.0% ash, 4.0% protein, 0.2% lipids, 3.3% fibers, and 14.5% carbohydrates. The antioxidant activity of the extract by the DPPH method was 20.6%. The pulp extract from the sugar apple had inhibition zone for Staphylococcus aureus, satisfactory inhibitory effect against Staphylococcus aureus, Escherichia coli, Listeria monocytogenes, and Salmonella Typhimurium, but did not present a bactericidal effect. Sugar apple pulp presents adequate levels of nutrients and potential for food application due to its microbiological activity and antioxidant properties.

RESUMEN Los conservantes sintéticos están ampliamente presentes en los alimentos procesados, pero la mayoría tienen potencial carcinogénico, lo que requiere el desarrollo de nuevas alternativas naturales para el control microbiano, como los extractos de frutas. El objetivo del estudio fue evaluar la caracterización química, la actividad antioxidante y antimicrobiana de la pulpa de manzana de azúcar (Annona squamosa L.). Se evaluaron las características fisicoquímicas, y se evaluó su actividad antioxidante mediante el método DPPH y antimicrobiano por difusión en disco, concentración inhibitoria mínima y concentración bactericida mínima contra cepas de Salmonella Typhimurium, Escherichia coli, Listeria monocytogenes y Staphylococcus aureus. El análisis fisicoquímico reveló que la pulpa de manzana de azúcar tiene 75.0% de humedad, 3.0% de cenizas, 4.0% de proteínas, 0.2% de lípidos, 3.3% de fibras y 14.5% de carbohidratos. La actividad antioxidante del extracto por el método DPPH fue del 20.6%. El extracto de pulpa de la manzana de azúcar tenía zona de inhibición para Staphylococcus aureus, efecto inhibidor satisfactorio contra Staphylococcus aureus, Escherichia coli, Listeria monocytogenes y Salmonella Typhimurium, pero no presenta efecto bactericida. La pulpa de manzana de azúcar presenta niveles adecuados de nutrientes y potencial para la aplicación de alimentos debido a su actividad microbiológica y propiedades antioxidantes.

RESUMO Este trabalho objetivou investigar a diversidade algal no que se refere a gênero em sistemas de lagoas de estabilização tratando esgoto doméstico, bem como analisar a viabilidade de um sistema de eletroflotação por corrente alternada para obter simultaneamente separação e ruptura celular. A avaliação de diversidade algal mostrou que os gêneros Euglena e Chlorella estiveram presentes com relativamente elevada frequência em cinco dos seis efluentes analisados. A aplicação de eletroflotação por corrente alternada em um efluente que apresentou elevada predominância de Chlorella alcançou eficiências de remoção de turbidez e clorofila-a maiores que 70 e 90%, respectivamente, depois de 70 minutos de operação. O rendimento de lipídios totais para a biomassa rica em Chlorella foi de 21,4±2,02%. Esse elevado teor lipídico demonstra potencial para obtenção de biodiesel de lipídios de efluentes. O presente artigo descreve uma primeira tentativa, com resultados promissores, da utilização de eletroflotação por corrente alternada para separação e ruptura celular simultânea com baixo custo.

ABSTRACT This work aimed to investigate algal diversity at the genus level in stabilization pond systems treating domestic wastewater and to evaluate the feasibility of an electroflotation by alternate current (EFAC) system for simultaneous microalgae separation and cell disruption. Evaluation of algal diversity showed that the genera Euglena and Chlorella were present in relatively high frequencies in five of the six effluents analyzed. The use of EFAC on an effluent that presented bloom of Chlorella achieved turbidity and chlorophyll-a removal efficiencies higher than 70 and 90%, respectively, after 70 minutes of operation. Total lipid yield for the Chlorella-rich biomass was 21.4±2.02%. Such high biomass lipid content demonstrates the potential for obtaining lipid-based biofuels from wastes. The current paper describes the first attempt, with promising results, at using electroflotation by alternate current for low cost, simultaneous microalgae harvesting and disruption.

RESUMO Objetivo Verificar o impacto da metodologia Lean Seis Sigma na redução de lançamentos incorretos de receitas e despesas não apropriadas. Métodos Processo de revisão e aplicação de metodologia Lean Seis Sigma, no período de dezembro de 2015 e setembro de 2016, em um hospital geral de alta complexidade da cidade de São Paulo (SP). Resultados Foram auditados 3.756.814 (100%) lançamentos durante os meses de dezembro de 2015 e setembro de 2016. O nível Sigma foi demonstrado na evolução do processo e aumentou de 3,44 Sigma, em dezembro de 2015, para 5,92 Sigma, em setembro de 2016. Os lançamentos classificados como receitas e despesas não apropriadas chegaram a 0% ao término do estudo. Conclusão O uso da metodologia Lean Seis Sigma foi eficiente na redução de lançamentos incorretos, na apuração correta de custos, na garantia de compliance na prestação de contas e na acurácia no projeto de custos e desfechos.

ABSTRACT Objective To verify the impact of the Lean Six Sigma methodology in reducing incorrect entries of non-appropriated revenues and expenses. Methods Process for the review and application of the Lean Six Sigma methodology between December 2015 and September 2016, in a high-complexity general hospital in the city of São Paulo (SP). Results A total of 3,756,814 (100%) entries were audited between December 2015 and September 2016. The Sigma level evolved over the course of the process and increased from 3.44 Sigma in December 2015 to 5.92 Sigma in September 2016. Entries classified as non-appropriated revenues and expenses were brought down to 0% at the end of the study. Conclusion The use of the Lean Six Sigma methodology was efficient in reducing incorrect entries, calculating costs, ensuring compliance in rendering of accounts and accurately determining cost-outcome ratios.

Abstract: Data from 241 interviews collected in 2013 was analyzed to characterize populations of pigs (Mexican Hairless Pig (MH), Cuino Pig (CU) and Crossbred Pig (UD)). Variables were body weight (BW), head length (HL), body length (BL), thoracic perimeter (CG), height at withers (HW), croup width (RW), number of nipples (TC), dense or sparse hair (HD), presence or absence of tusks (TU), short or long snout (ST), upright or floppy ears (ER), calm or restless temperament (TM), proportionality index (PI), body index (BI) and relative weight index (RWI). Analyses were carried out with GLM and GENMOD of SAS. Models included state and population. Population was significant (P<0.05) for BW, BL, CG, HW, RW, TU, TM, PI, BI and RWI. Coefficients of variation (VC) showed the minor and major values for BW (18.8 %) and CG (27.8 %). VC were 13.0, 14.6 and 45.8 % for PI, BI and RWI. Least squares means for MH, CU and UD were: 48.06±6.17a, 35.93±3.04b and 61.11±7.42a kg (BW); 77.81±3.65ab, 69.56±2.02a and 88.52±4.93b cm (BL); 80.55±3.98ab, 71.72±2.20a and 93.23±5.37b cm (CG); 56.88±2.45ab, 51.26±1.36a and 60.32±3.31b cm (HW); 57±4a, 71±19b and 62±34a % (HD); 68±31ab, 70±14a and 61±27b% (TU); 65±30 a, 56±12b and 62±3a% (TM). The MH and UD populations were similar in morphometry and different from the CU population. The CU population showed lower weight, smaller size and calmer temperament. The characterization of these populations is important for designing strategies for their conservation and efficient use.

Resumen: Para caracterizar a las poblaciones del cerdo Pelón Mexicano (PPM), cerdo Cuino (PCU) y cerdos cruzados (PCI) se analizó información de 241 entrevistas realizadas durante 2013. Las variables analizadas fueron: peso corporal (Peco), longitud de cabeza (Loca), longitud del cuerpo (Locu), circunferencia del pecho (Circu), altura a la cruz (Acruz), ancho de pelvis (Anpe), número de pezones (Nupe), pelo denso o escaso (Cape), presencia o ausencia de colmillos (Colm), hocico corto o largo (Hoc), orejas erguidas o no erguidas (Posio), temperamento tranquilo o inquieto (Tem), índice de proporcionalidad (IP), índice corporal (IC) e índice de peso relativo (IPR). Los datos se analizaron con GLM y GENMOD del SAS. Los modelos estadísticos incluyeron Estado y Población. Población influyó (P<0.05) Peco, Locu, Circu, Acruz, Cape, Colm, Tem IP, IC e IPR. Los coeficientes de variación (CV) mostraron a Peco y Anpe como las características con menor y mayor variación (18.8 y 27.8 %). Para IP, IC e IPR los CV fueron 13.0, 14.6 y 45.8 %. Las medias de cuadrados mínimos para PPM, PCU y PCI fueron 48.06±6.17a, 35.93±3.04b y 61.11±7.42a kg (Peco); 77.81±3.65ab, 69.56±2.02a y 88.52±4.93 b cm (Locu); 80.55±3.98ab, 71.72±2.20a y 93.23±5.37b cm (Circu); 56.88±2.45ab, 51.26±1.36a y 60.32±3.31b cm (Acruz); 57±4a, 71±19 b y 62±34a% (Cape); 68±31 ab, 70±14a y 61±27b% (Colm); 65±30a, 56±12b y 62±3a% (Tem). PPM y PCI fueron similares en morfometría pero diferentes de PCU. La población PCU mostró menor peso, menor talla y temperamento más inquieto. Caracterizar a estas poblaciones es importante para diseñar estrategias para su conservación y uso eficiente.

Abstract The objective was to evaluate some morphological characteristics of backyard turkeys (n=248) coming from 126 rural production units located in 75 municipalities of 24 States of the Mexican Republic. The statistical model included sex, state, and municipality within state. The three explanatory variables affected all the response variables (P<0.01), except municipality, which did not affect breast circumference (P>0.05). Male turkeys had greater (P<0.001) body length (10.7 cm more), wingspan (11.4 cm more), breast circumference (13.8 cm more), shank length (2.5 cm more), body weight (2.5 kg more), stockiness (9.0 percentage units more) and massiveness (2.8 percentage units more) than female turkeys. Body weight showed to be highly correlated phenotypically (P<0.01) with breast circumference in both males (r=0.74) and females (r=0.71). Body length was lowly correlated with shank length (r=0.25; P<0.01) in males, but it was not correlated with shank length in females (r=0.05; P>0.05). Body weight increased 143 g in males (P<0.01) and 113 g in females (P<0.01) for each centimeter increment in breast circumference. The predominant colors in the plumage, skin and tarsus were black, white and brown, respectively. The Mexican backyard turkey presented significant sexual dimorphism and strong phenotypic correlation between breast circumference and body weight.

Resumen El objetivo fue evaluar algunas características morfológicas de pavos de traspatio (n=248) provenientes de 126 unidades rurales de producción localizadas en 75 municipios de 24 estados de la República Mexicana. El modelo estadístico incluyó sexo, estado y municipio anidado en estado. Las tres variables explicativas afectaron a todas las variables de respuesta (P<0.01), excepto municipio, que no afectó circunferencia de la pechuga (P>0.05). Los machos tuvieron mayor (P<0.001) longitud corporal (10.4 cm más), envergadura (11.4 cm más), circunferencia de la pechuga (13.8 cm más), longitud de tarso (2.5 cm más), peso corporal (2.5 kg más), robustez (9.0 puntos porcentuales más) y solidez (2.8 puntos porcentuales más) que las hembras. Peso corporal mostró estar altamente correlacionado fenotípicamente (P<0.01) con circunferencia de la pechuga tanto en machos (r=0.74) como en hembras (r=0.71). En machos, longitud corporal mostró una correlación baja con longitud del tarso (r=0.25; P<0.01), pero en hembras no estuvo correlacionada (r=0.05; P>0.05). El peso corporal aumentó 143 g (P<0.01) en machos y 113 g en hembras (P<0.01) por cada centímetro que aumentó la circunferencia de la pechuga. Los colores predominantes en el plumaje, la piel y el tarso fueron negro, blanco y café, respectivamente. El pavo de traspatio mexicano presentó dimorfismo sexual significativo y alta correlación fenotípica entre circunferencia de la pechuga y peso corporal.

RESUMO: Esta pesquisa teve como objetivo detectar diretamente em amostras de leite contaminado artificialmente Staphylococcus coagulase positiva (ECP) por multiplex PCR (mPCR). Cepas padrão e isolados de S. aureus, S. epidermidis, S. hyicus, S. intermedius, Listeria monocytogenes e Escherichia coli foram utilizados no estudo. Foram utilizados primers específicos para o gene nuc (NUC1-NUC2 para o S. aureus, NUC3-NUC4 para o S. hyicus e NUC5-NUC6 para o S. intermedius ). Foi possível detectar as três espécies-alvo por mPCR, formar diretamente nas amostras de leite integral bovino, com especificidade adequada e limite de detecção aceitável para identificação de espécies de Staphylococcus coagulase positiva (ECP) em alimentos. A especificidade foi determinada por meio da amplificação de fragmentos específicos das espécies e o limite de detecção foi avaliado pelos limiares de detecção obtidos para as três espécies (103 UFC mL-1 para as espécies presentes nas amostras de leite contaminadas artificialmente).

ABSTRACT: This research aimed to detect coagulase-positive Staphylococcus (CPS) directly in samples of artificially contaminated milk, using multiplex PCR (mPCR). Standard and isolated bacterial strains of S. aureus, S. epidermidis, S. hyicus, S. intermedius, Listeria monocytogenes and Escherichia coli species were used, evaluating the specificity and detection limit of mPCR, for artificially contaminated UHT milk. Primers specific for the nuc gene (NUC1-NUC2 were used for S. aureus, NUC3-NUC4 for S. hyicus and NUC5-NUC6 for S. intermedius). It was possible to detect the three target species by mPCR, directly from bovine whole milk, with adequate specificity and acceptable detention limit for identification of coagulase-positive Staphylococcus (CPS) in foods. The specificity was determined by the amplification of species-specific fragments, and the detection limit was assessed by the detection thresholds obtained for the three species (103 CFU mL-1). From these results, the mPCR described, with the proposed set of primers, has the potential for use in precise identification and differentiation between CPSs in milk samples.

Abstract Objective The aim of the present study was to obtain information about deaths due to sepsis in São Paulo from 2004 to 2009 and their relationship with geographical distribution. Methods Causes of death, both main and secondary, were defined according to the codes of the International Classification of Disease version 10 (ICD-10) contained in the database. Sepsis, septic shock, multiple organ failure, pneumonia, urinary tract infection, peritonitis and other intraabdominal infections, skin and soft tissue infections (including surgical wound infection) and meningitis were considered as immediate cause of death or as the condition leading to the immediate cause of death related or associated to sepsis. Results In the analyzed period, there was a 15.3% increase in the absolute number of deaths from sepsis in São Paulo. The mean number of deaths during this period was 28,472 ± 1566. Most deaths due to sepsis and sepsis-related diseases over the studied period occurred in a hospital or health care facility, showing that most of the patients received medical care during the event that led to death. We observed a significant concentration of deaths in the most populous regions, tending more toward the center of the city. Conclusions Georeferencing data from death certificates or other sources can be a powerful tool to uncover regional epidemiological differences between populations. Our study revealed an even distribution of sepsis all over the inhabited areas of São Paulo.

RESUMO A doença de Chagas, causada pelo Trypanosoma cruzi, possui uma ampla distribuição na América do Sul, e tem como principal método de controle a eliminação de triatomíneos. Apresenta-se aqui a distribuição geográfica e a taxa de infecção natural por T. cruzi de triatomíneos coletados e avaliados de 2008 a 2013, no sudoeste da Bahia. Os triatomíneos foram capturados nas áreas intradomiciliares e peridomiciliares de cinco cidades localizadas no sudoeste da Bahia, identificados e analisados quanto à presença de tripanossomatídeos em suas fezes. Durante o período de estudo o número de pacientes com suspeita de doença de Chagas aguda foi recuperado a partir do Sistema de Informação de Agravos de Notificação (SINAN). 8966 triatomíneos foram capturados e identificados como pertencentes a oito espécies. Vinte e seis apresentaram-se infectados, sendo Triatoma sordida o que mostrou maior percentagem de infecção pelo T. cruzi. Tremedal foi a cidade com o maior número de casos de doença de Chagas aguda relatado pelo SINAN. Todas as cidades apresentaram triatomíneos infectados com o T. cruzi, por isso, existe um risco considerável de transmissão vetorial da doença de Chagas no sudoeste da Bahia, evidenciando a necessidade de programas de controle de vetores de transmissão e medidas de vigilância preventiva.

ABSTRACT Chagas disease, caused by the Trypanosoma cruzi, has a wide distribution in South America, and its main method of control is the elimination of triatomines. It is presented here the geographic distribution and the rate of natural infection by T. cruzi of triatomines collected and evaluated from 2008 to 2013 in southwest of Bahia. Triatomines were captured in the intradomiciliary and peridomiciliary areas of five cities located in the southwest of Bahia state, identified, and analyzed for the presence of trypanosomatids in their feces. During the study period the number of patients suspected for acute Chagas disease was recovered from the Notifiable Diseases Information System (SINAN). 8966 triatomines were captured and identified as belonging to eight species. Twenty-six presented themselves infected, being Triatoma sordida the most abundant and with the highest percentage of infection by T. cruzi. Tremedal was the city with the highest number of cases of acute Chagas' disease reported to SINAN. All cities showed triatomines infected with T. cruzi, so there is considerable risk of vectorial transmission of Chagas disease in the southwestern Bahia state, evidencing the need for vector transmission control programs and preventive surveillance measures.

A doença de Chagas, apesar das campanhas de saúde pública e das ações de vigilância epidemiológica, ainda constitui-se um sério problema de saúde na América Latina. De acordo com dados divulgados pela Organização Mundial de Saúde, existem cerca de 7 a 8 milhões de pessoas infectadas com Trypanosoma cruzi em todo o mundo, principalmente na América Latina. Este estudo tem por objetivo analisar o perfil sorológico de doadores de sangue dos bancos de sangue do Hemominas de Ituiutaba, Minas Gerais. Os doadores também foram separados de acordo com o sexo e a idade. A amostra do estudo foi composta por 53.941 doadores de sangue durante o período de janeiro de 2001 a dezembro de 2011. Duzentos e setenta e sete doações (0,5%) foram considerados sorologicamente inaptas para a doença de Chagas. Quanto à idade, a maior proporção de doadores impróprios foi de 40 a 49 anos (30%). Os dados não revelaram diferença significativa entre os sexos (p < 0,05). Houve correlação positiva entre o aumento da idade e o percentual de pacientes soropositivos para doença de Chagas. É imprescindível a adoção de estratégias que permitam a identificação segura de um doador com sorologia positiva para doença de Chagas, tentando assim minimizar ou eliminar resultados sorológicos indeterminados.

Despite public health campaigns and epidemiological surveillance activities, Chagas disease remains a major health problem in Latin America. According to data from the World Health Organization, there are approximately 7-8 million people infected with Trypanosoma cruzi worldwide, a large percentage of which in Latin America. This study aims to examine the serological profile of blood donors in blood banks of Hemominas hematology center, in the town of Ituiutaba, Minas Gerais State, Brazil. The study sample consisted of 53,941 blood donors, which were grouped according to gender and age. Sample collections were performed from January 1991 to December 2011, and 277 donors (0.5%) were considered serologically ineligible due to Chagas disease. Analysis of data showed no significant difference between genders. As for age, the highest proportion of ineligible donors was from 40 to 49 years (30%), and there was a positive correlation between increasing age and the percentage of patients seropositive for Chagas disease. Therefore, adopting strategies that allow the safe identification of donors with positive serology for Chagas disease is essential to reduce or eliminate indeterminate serological results.