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ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5

RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5

https://doi.org/10.62675/2965-2774.20240210-en

Importance of genetic cancer risk assessment as a strategy to stratify risk and provide precision prevention in high-risk patients and families highrisk high
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Ashton-Prolla, Patricia

; Achatz, Maria Isabel Waddington

; Moreira, Miguel Angelo Martins

; Palmero, Edenir Inez

; Soares, Diogo Cordeiro de Queiroz

; Ferraz, Victor Evangelista de Faria

; Caires, Inacelli Queiroz de Souza

; Guindalini, Rodrigo Santa Cruz

; Gifoni, Ana Carolina Leite Vieira Costa

Revista da Associação Médica Brasileira

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2024, Volume 70 Suppl. 1 elocation e2024S117

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.2024s117

II Brazilian Society of Rheumatology consensus for lupus nephritis diagnosis and treatment
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Reis-Neto, Edgard Torres dos

; Seguro, Luciana Parente Costa

; Sato, Emília Inoue

; Borba, Eduardo Ferreira

; Klumb, Evandro Mendes

; Costallat, Lilian Tereza Lavras

; Medeiros, Marta Maria das Chagas

; Bonfá, Eloisa

; Araújo, Nafice Costa

; Appenzeller, Simone

; Montandon, Ana Carolina de Oliveira e Silva

; Yuki, Emily Figueiredo Neves

; Teixeira, Roberto Cordeiro de Andrade

; Telles, Rosa Weiss

; Egypto, Danielle Christinne Soares do

; Ribeiro, Francinne Machado

; Gasparin, Andrese Aline

; Araujo Junior, Antonio Silaide de

; Neiva, Cláudia Lopes Santoro

; Calderaro, Debora Cerqueira

; Monticielo, Odirlei Andre

Advances in Rheumatology

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2024, Volume 64 elocation 48

Abstract: En | Text: En | PDF: En

Abstract Objective To develop the second evidence-based Brazilian Society of Rheumatology consensus for diagnosis and treatment of lupus nephritis (LN). Methods Two methodologists and 20 rheumatologists from Lupus Comittee of Brazilian Society of Rheumatology participate in the development of this guideline. Fourteen PICO questions were defined and a systematic review was performed. Eligible randomized controlled trials were analyzed regarding complete renal remission, partial renal remission, serum creatinine, proteinuria, serum creatinine doubling, progression to end-stage renal disease, renal relapse, and severe adverse events (infections and mortality). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to develop these recommendations. Recommendations required ≥82% of agreement among the voting members and were classified as strongly in favor, weakly in favor, conditional, weakly against or strongly against a particular intervention. Other aspects of LN management (diagnosis, general principles of treatment, treatment of comorbidities and refractory cases) were evaluated through literature review and expert opinion. Results All SLE patients should undergo creatinine and urinalysis tests to assess renal involvement. Kidney biopsy is considered the gold standard for diagnosing LN but, if it is not available or there is a contraindication to the procedure, therapeutic decisions should be based on clinical and laboratory parameters. Fourteen recommendations were developed. Target Renal response (TRR) was defined as improvement or maintenance of renal function (±10% at baseline of treatment) combined with a decrease in 24-h proteinuria or 24-h UPCR of 25% at 3 months, a decrease of 50% at 6 months, and proteinuria < 0.8 g/24 h at 12 months. Hydroxychloroquine should be prescribed to all SLE patients, except in cases of contraindication. Glucocorticoids should be used at the lowest dose and for the minimal necessary period. In class III or IV (±V), mycophenolate (MMF), cyclophosphamide, MMF plus tacrolimus (TAC), MMF plus belimumab or TAC can be used as induction therapy. For maintenance therapy, MMF or azathioprine (AZA) are the first choice and TAC or cyclosporin or leflunomide can be used in patients who cannot use MMF or AZA. Rituximab can be prescribed in cases of refractory disease. In cases of failure in achieving TRR, it is important to assess adherence, immunosuppressant dosage, adjuvant therapy, comorbidities, and consider biopsy/rebiopsy. Conclusion This consensus provides evidence-based data to guide LN diagnosis and treatment, supporting the development of public and supplementary health policies in Brazil. evidencebased evidence LN. . (LN) 2 guideline performed remission doubling endstage end stage disease relapse infections mortality. mortality mortality) Assessment GRADE (GRADE 82 ≥82 favor conditional intervention diagnosis, (diagnosis opinion involvement but procedure parameters developed TRR (TRR ±10% 10 (±10 24h 24 25 months 50 08 0 8 0. g24 g g/2 1 period ±V, V ±V , (±V) MMF, (MMF) cyclophosphamide TAC, (TAC) therapy AZA (AZA adherence dosage biopsyrebiopsy rebiopsy biopsy/rebiopsy Brazil (LN ≥8 ±10 (±1 5 g2 g/ (±V (MMF (TAC ≥ ±1 (± ± (

https://doi.org/10.1186/s42358-024-00386-8

Repercussions of SARS-CoV-2 infection and the pandemic on birth routes: a cross-sectional study SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- routes crosssectional cross sectional SARS-CoV
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Oliveira, Isabela Carolina de Paula

; Geraldo, Letícia Marcella Cordeiro Soares

; Faria, Ana Paula Vieira

; Silva, Thales Philipe Rodrigues da

; Amorim, Torcata

; Pereira, Patricia Feliciano

; Souza, Kleyde Ventura de

; Matozinhos, Fernanda Penido

Revista Gaúcha de Enfermagem

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2023, Volume 44 elocation e20220320

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

RESUMEN Objetivo: Evaluar las repercusiones de la infección por SARS-CoV-2 (sospechosa o confirmada) y el contexto de la pandemia en la vía del parto y la asistencia humanizada durante el parto. Método: Estudio epidemiológico transversal, anidado en una cohorte y comparativo con la investigación “Nacimiento en Belo Horizonte: Encuesta sobre Parto y Parto”.Se enviaron los prontuarios de tres maternidades de referencia en Belo Horizonte, con una muestra final de 1.682 gestantes, en los meses de mayo, junio y julio de 2020. Se realizó un análisis descriptivo, con frecuencia absoluta y relativa, y comparativo. uno, con una prueba de Chi, cuadrado de Pearson. Resultados: Tenga en cuenta que el 2,02% de las mujeres embarazadas estaban infectadas con SARS-CoV-2.Antes de la pandemia, en un total de 390 gestantes, el 74,10% daba a luz por vía vaginal.Durante una pandemia, entre las mujeres infectadas, el 51,61% dio a luz por cesárea y el 48,39% por parto vaginal;en las no infectadas, 26,99% cesáreas y 73,01% vaginales. Conclusión: Hubo un aumento en el porcentaje de cesáreas y una posible influencia de la pandemia en las tasas de indicación de cesáreas al momento del ingreso a la sala de maternidad. Objetivo SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- sospechosa confirmada Método transversal Nacimiento Horizonte Parto.Se PartoSe .Se 1682 1 682 1.68 gestantes mayo 2020 descriptivo relativa uno Chi Pearson Resultados 202 02 2,02 SARSCoV2.Antes SARSCoV2Antes SARSCoVAntes 2.Antes Antes 39 7410 74 10 74,10 vaginalDurante vaginal Durante 5161 51 61 51,61 4839 48 48,39 vaginalen 2699 26 99 26,99 7301 73 01 73,01 vaginales Conclusión maternidad SARS-CoV 168 68 1.6 20 0 2,0 2Antes 3 741 7 74,1 516 5 6 51,6 483 4 48,3 269 9 26,9 730 73,0 16 1. 2, 74, 51, 48, 26, 73,

ABSTRACT Objective: To assess the repercussions of SARS-CoV-2 infection (suspected or confirmed) and the context of the pandemic on the birth route and humanized assistance during childbirth. Method: Cross-sectional epidemiological study, nested within a cohort and comparative with the research “Birth in Belo Horizonte: Survey on Childbirth and Delivery”.The medical records of three reference maternity hospitals in Belo Horizonte were assessed, with a final sample of 1,682 pregnant women, in the months of May, June and July 2020. A descriptive analysis was carried out, with absolute and relative frequency, and a comparative one, with a Pearson’s chi-square test. Results: It was observed that 2.02% of pregnant women were infected with SARS-CoV-2.Before the pandemic, out of a total of 390 pregnant women, 74.10% gave birth vaginally.During a pandemic, among infected women, 51.61% gave birth via cesarean section and 48,39% via vaginal delivery;among uninfected, 26.99% cesarean sections and 73.01% vaginaldeliveries. Conclusion: There was an increase in the percentage of cesarean sections and a possible influence of the pandemic on the rates of indication of cesarean sections at the time of admission to the maternity ward. Objective SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- suspected confirmed childbirth Method Crosssectional Cross sectional study Birth Delivery.The DeliveryThe Delivery .The The assessed 1682 1 682 1,68 May 2020 frequency one Pearsons Pearson s chisquare chi square test Results 202 02 2.02 SARSCoV2.Before SARSCoV2Before SARSCoVBefore 2.Before Before 39 7410 74 10 74.10 vaginallyDuring vaginally During 5161 51 61 51.61 4839 48 48,39 deliveryamong delivery uninfected 2699 26 99 26.99 7301 73 01 73.01 vaginaldeliveries Conclusion ward SARS-CoV 168 68 1,6 20 0 2.0 2Before 3 741 7 74.1 516 5 6 51.6 483 4 48,3 269 9 26.9 730 73.0 16 1, 2. 74. 51. 48, 26. 73.

RESUMO Objetivo: Avaliar as repercussões da infecção por SARS-CoV-2 (suspeita ou confirmada) e do contexto da pandemia na via de nascimento e na assistência humanizada ao parto. Método: Estudo epidemiológico transversal, aninhado a uma coorte e comparativo com a pesquisa “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento”. Avaliou-se prontuários de três maternidades-referência em Belo Horizonte, com amostra final de 1.682 parturientes, nos meses de maio, junho e julho de 2020. Realizou-se análise descritiva, com frequência absoluta e relativa, e comparativa, com teste Qui-quadrado de Pearson. Resultados: Observou-se que, 2,02% das gestantes estavam infectadas por SARS-CoV-2. Antes da pandemia, em um total de 390 gestantes, 74,10% pariram via vaginal. Durante a pandemia, nas mulheres infectadas, 51,61% pariram pela via cesariana e 48,39% pela vaginal; nas não infectadas, 26,99% cesarianas e 73,01% vaginais. Conclusão: Observou-se aumento percentual de cesarianas e possível influência da pandemia nas taxas de indicação de cesarianas no momento da admissão na maternidade. Objetivo SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- suspeita confirmada parto Método transversal Nascer Horizonte Nascimento. Nascimento . Nascimento” Avaliouse Avaliou se maternidadesreferência maternidades referência 1682 1 682 1.68 parturientes maio 2020 Realizouse Realizou descritiva relativa comparativa Quiquadrado Qui quadrado Pearson Resultados Observouse Observou que 202 02 2,02 SARSCoV2. 2. 39 7410 74 10 74,10 vaginal 5161 51 61 51,61 4839 48 48,39 2699 26 99 26,99 7301 73 01 73,01 vaginais Conclusão maternidade SARS-CoV 168 68 1.6 20 0 2,0 3 741 7 74,1 516 5 6 51,6 483 4 48,3 269 9 26,9 730 73,0 16 1. 2, 74, 51, 48, 26, 73,

https://doi.org/10.1590/1983-1447.2023.20220320.en

Nontuberculous mycobacteria in milk from positive cows in the intradermal comparative cervical tuberculin test: implications for human tuberculosis infections
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Bolaños, Carmen Alicia Daza

; Franco, Marília Masello Junqueira

; Souza Filho, Antonio Francisco

; Ikuta, Cássia Yumi

; Burbano-Rosero, Edith Mariela

; Ferreira Neto, José Soares

; Heinemann, Marcos Bryan

; Motta, Rodrigo Garcia

; Paula, Carolina Lechinski de

; Morais, Amanda Bonalume Cordeiro de

; Guerra, Simony Trevizan

; Alves, Ana Carolina

; Listoni, Fernando José Paganini

; Ribeiro, Márcio Garcia

Revista do Instituto de Medicina Tropical de São Paulo

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2018, Volume 60 elocation e6

Abstract: En | Text: En | PDF: En

ABSTRACT Although the tuberculin test represents the main in vivo diagnostic method used in the control and eradication of bovine tuberculosis, few studies have focused on the identification of mycobacteria in the milk from cows positive to the tuberculin test. The aim of this study was to identify Mycobacterium species in milk samples from cows positive to the comparative intradermal test. Milk samples from 142 cows positive to the comparative intradermal test carried out in 4,766 animals were aseptically collected, cultivated on Lowenstein-Jensen and Stonebrink media and incubated for up to 90 days. Colonies compatible with mycobacteria were stained by Ziehl-Neelsen to detect acid-fast bacilli, while to confirm the Mycobacterium genus, conventional PCR was performed. Fourteen mycobacterial strains were isolated from 12 cows (8.4%). The hsp65 gene sequencing identified M. engbaekii (n=5), M. arupense (n=4), M. nonchromogenicum (n=3), and M. heraklionense (n=2) species belong to the Mycobacterium terrae complex. Despite the absence of M. tuberculosis complex species in the milk samples, identification of these mycobacteria highlights the risk of pathogen transmission from bovines to humans throughout milk or dairy products, since many of mycobacterial species described here have been reported in pulmonary and extrapulmonary diseases both in immunocompetent and immunocompromised people.

https://doi.org/10.1590/s1678-9946201860006 1691 downloads

Saberes sociais e a construção da preferência pela água de consumo humano
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Soares, Ana Carolina Cordeiro

; Carmo, Rose Ferraz

; Bevilacqua, Paula Dias

Ciência & Saúde Coletiva

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oct 2017, Volume 22 N. 10 Pages 3215 - 3223

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

Resumo A territorialização em Vigilância em Saúde e o cotidiano como categorias analíticas nortearam o delineamento do presente estudo, que procurou, a partir do referencial metodológico da pesquisa qualitativa, compreender fatores imbricados na utilização de soluções de abastecimento individual como fonte de água para consumo humano. Realizamos entrevistas semiestruturadas com moradores de 22 domicílios, de um município da Zona da Mata Mineira. Os depoimentos foram integralmente transcritos, tratados pela análise de conteúdo e interpretados com base na teoria psicossocial das representações sociais. Foi possível apreender os componentes social e afetivo das representações sociais. O componente social, revelado pela representação da água proveniente de soluções de abastecimento individual (SAI)como limpa e de boa qualidade, pareceu conduzir ou justificar a “resistência” dos indivíduos em usar a água do abastecimento público. O componente afetivo esteve relacionado ao uso da água proveniente de SAI como retorno e defesa das origens, como forma de reforçar a identidade dos sujeitos. Os resultados sinalizaram que percepções e demandas da população podem nortear ações que visem estimular a confiança na água proveniente do sistema público e a opção por essa fonte de abastecimento contribuindo com a proteção da saúde.

Abstract The analytical categories of Health Surveillance territorialization and daily life guided the design of this study, which aimed to understand from the methodological framework of qualitative research the factors involved in the use of individual supply solutions (ISS) as drinking water sources. We conducted semi-structured interviews with residents of 22 households set at a municipality in the Zona da Mata Mineira. Statements were fully transcribed, processed through content analysis and interpreted based on the psychosocial theory of social representations. It was possible to apprehend the social and affective components of social representations. The social component characterized by the representation of water from IWSS ISS water as clean and of good quality seemed to drive or justify the “resistance” of individuals to use water from public supply. The affective component referred to the use of IWSS water from ISS as a return to and protection of individuals’ origins, a way to strengthen respondents’ identity. The results pointed out that people’s perceptions and demands might guide actions aimed to stimulate trust in the use of public system water and the choice of this source of supply, contributing to health protection.

https://doi.org/10.1590/1413-812320172210.17702017 144 downloads

Saberes sociais e a construção da preferência pela água de consumo humano
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Soares, Ana Carolina Cordeiro

; Carmo, Rose Ferraz

; Bevilacqua, Paula Dias

Ciência & Saúde Coletiva

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oct 2017, Volume 22 N. 10 Pages 3215 - 3223

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

https://doi.org/10.1590/1413-812320172210.17702017 1857 downloads

Diretriz de Telecardiologia no Cuidado de Pacientes com Síndrome Coronariana Aguda e Outras Doenças Cardíacas
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Oliveira Junior, Mucio Tavares de

; Canesin, Manoel Fernandes

; Marcolino, Milena Soriano

; Ribeiro, Antonio Luiz Pinho

; Carvalho, Antonio Carlos de Camargo

; Reddy, Shankar

; Santos, Adson Roberto França dos

; Fernandes, Alfredo Manoel da Silva

; Amaral, Amaury Zatorre

; Rezende, Ana Carolina de

; Nechar Junior, Antonio

; Nascimento, Bruno Ramos do

; Pastore, Carlos Alberto

; Wen, Chao Lung

; Gualandro, Danielle Menosi

; Napoli, Domingos Guilherme

; França, Francisco Faustino A. C.

; Feitosa-Filho, Gilson Soares

; Saad, Jamil Abdalla

; Pilli, Jeanne

; Paula, Leonardo Jorge Cordeiro de

; Lodi-Junqueira, Lucas

; Cesar, Luis Antonio Machado

; Bodanese, Luiz Carlos

; Gutierrez, Marco Antonio

; Alkmim, Maria Beatriz Moreira

; Nunes, Mauricio Batista

; Medeiros, Orlando Otávio de

; Moreno, Ramon Alfredo

; Gundim, Rosângela Simões

; Montenegro, Sergio Tavares

; Nazima, Willyan Issamu

Arquivos Brasileiros de Cardiologia

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jun 2015, Volume 104 N. 5 Pages 1 - 26

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.5935/abc.20150057 8085 downloads

Vigilância da qualidade da água para consumo humano no âmbito municipal: contornos, desafios e possibilidades
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Bevilacqua, Paula Dias

; Carmo, Rose Ferraz

; Melo, Cristiane Magalhães de

; Bastos, Rafael Kopschitz Xavier

; Oliveira, Daniel Cobucci de

; Soares, Ana Carolina Cordeiro

; Oliveira, Juliana Ferreira de

Saúde e Sociedade

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jun 2014, Volume 23 N. 2 Pages 467 - 483

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

A amplitude das atribuições da vigilância da qualidade da água para consumo humano (VQACH) associada à heterogeneidade dos municípios brasileiros (perfil demográfico e epidemiológico, recursos humanos e financeiros) impõe ao nível local de gestão o desafio de implementar com efetividade e sustentabilidade as ações previstas no modelo de atuação da VQACH. Tendo como cenário de estudo um município mineiro de pequeno porte, o trabalho apresenta desafios e possibilidades vivenciados durante a implementação do modelo. O atendimento às ações estratégicas e básicas e aos princípios doutrinários, organizacionais e executivos previstos no modelo de atuação foi verificado e as estratégias para o enfrentamento dos desafios impostos ao exercício da VQACH foram apresentadas. A conformação de uma equipe de profissionais em quantidade e qualidade compatíveis com as ações de VQACH foi aspecto fundamental, além da melhor explicitação de procedimentos como análise integrada dos sistemas de informação e análise e classificação do grau de risco à saúde das diferentes formas de abastecimento de água. O estudo permite adiantar aos gestores dos diferentes níveis de governo desafios e estratégias para contorná-los, bem como instrumentaliza a coordenação da VQACH no nível federal sobre questões que necessitam tratamento mais detalhado e específico.

The magnitude of drinking-water quality surveillance (DWQS) attributions in meeting its primary function of health protection, associated with the heterogeneity of Brazilian municipalities (demographic and epidemiological profile, human and financial resources), is an important challenge in implementing actions which are effective and sustainable at the local level. The study presents the experience in rolling out the national operation model for DWQS in a small municipality in Minas Gerais state. The paper whether the strategic and basic actions and the doctrinal, organizational and executive principles provided in the operation model were achieved and how they were accomplished. Also, certain strategies for confronting the challenges imposed by DWQS assignment were presented. The existence of a well prepared and measured professional team is a fundamental aspect in achieving the DWQS objectives. In addition, some procedures should have clear guidelines, such as the integrated analysis of information systems and analysis and health risk classification of water supplies. In conclusion, different challenges must be overcome to implement drinking-water quality surveillance at the local level and managers could experience some difficulties. Federal level managers should be aware of issues that require more detailed and specific treatment.

https://doi.org/10.1590/S0104-12902014000200009 315 downloads

10.

Vigilância da qualidade da água para consumo humano no âmbito municipal: contornos, desafios e possibilidades
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Bevilacqua, Paula Dias

; Carmo, Rose Ferraz

; Melo, Cristiane Magalhães de

; Bastos, Rafael Kopschitz Xavier

; Oliveira, Daniel Cobucci de

; Soares, Ana Carolina Cordeiro

; Oliveira, Juliana Ferreira de

Saúde e Sociedade

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jun 2014, Volume 23 N. 2 Pages 467 - 483

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

https://doi.org/10.1590/S0104-12902014000200009 5596 downloads

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Glossary and search help

You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.

For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

See below the complete list of search indexes that can be used:

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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