Abstract Objective: Emergency contraception (EC) is an effective and safe method for preventing unplanned pregnancy after unprotected sexual intercourse among adolescents but is infrequently prescribed by pediatricians. Because of the scarcity of data on the discomfort with EC prescription among physicians in Brazil, this study aimed to identify associated factors with discomfort with EC prescription among pediatricians in the state of Amazonas. Methods: A web-based, cross-sectional study including sociodemographic data, knowledge, attitudes, and discomfort with EC prescription was used. Multivariate logistic regression and artificial intelligence methods such as decision tree and random forest analysis were used to identify factors associated with discomfort with EC prescriptions. Results: Among 151 physicians who responded to the survey, 53.0% were uncomfortable with prescribing EC, whereas only 33.1% had already prescribed it. Inexperience was significantly associated with discomfort with EC prescription (odds ratio 4.47, 95% confidence interval 1.71–11.66). Previous EC prescription was protective against discomfort with EC prescription in the three models. Conclusions: EC is still infrequently prescribed by pediatricians because of inexperience and misconceptions. Training these professionals needs to be implemented as part of public health policies to reduce unplanned adolescent pregnancy.

RESUMO Objetivo: A contracepção de emergência (CE) é um método eficaz e seguro para prevenir gravidez não planejada após relação sexual desprotegida entre adolescentes, mas raramente prescrito por pediatras. Diante da escassez de dados sobre o desconforto com a prescrição de CE entre médicos no Brasil, o objetivo deste estudo foi identificar fatores associados a esse desconforto entre pediatras do estado do Amazonas. Métodos: Uma pesquisa do tipo e-survey coletou dados sociodemográficos, conhecimento, atitudes e desconforto com relação à prescrição de CE. Métodos de regressão logística multivariada e inteligência artificial, como árvore de decisão e random forest, foram usados para identificar fatores associados ao desconforto para a prescrição de CE. Resultados: Entre os 151 médicos que responderam à pesquisa, 53,0% sentiam-se desconfortáveis para prescrever CE e apenas 33,1% já a haviam prescrito. A inexperiência foi associada a esse desconforto (odds ratio — OR 4,47, intervalo de confiança — IC95% 1,71–11,66). A prescrição prévia de CE foi fator de proteção com relação ao desconforto nos três modelos. Conclusões: A CE ainda é pouco prescrita por pediatras. Apesar de sua segurança e eficácia, a inexperiência e conceitos equivocados foram associados ao desconforto para sua prescrição. Investigações sobre o assunto são importantes para subsidiar políticas públicas de saúde para a redução da gravidez não intencional na adolescência.

Abstract Objectives: microbiological quality of raw human milk (HM) from donors at the HMB (Human Milk Bank) of Santa Casa de Misericórdia de Ouro Preto was evaluated. Methods: the microbiological quality of milk from each of 10 donors in triplicate (30 samples) was evaluated by enumeration of Staphylococcus aureus and total aerobic mesophiles (surface plating) and total and thermotolerant coliforms (Most Probable Number - MPN). A questionnaire and a checklist were applied after the end of sample collection to verify the compliance of milk extraction and storage procedures by the donors. Results: inadequacies in the procedures for expression and storage of donated HM were observed. The presence of all microorganisms studied were verified in the milk of all donors, and in some cases exceeded the safety limits. The checklist indicated that some necessary hygienic-sanitary procedures were not carefully performed, making it important to properly guide the donors. Conclusions: this study points to an unfavorable scenario for the safety and quality of donated HM, and it is important to encourage further studies to be conducted so that the Brazilian network of HMB adopts stricter criteria for instructions on procedures and support for HM donors.

Resumo Objetivos: avaliou-se a qualidade microbiológica do leite humano (LH) cru de doadoras do Banco de Leite Humano (BLH) da Santa Casa de Misericórdia de Ouro Preto. Métodos: a qualidade microbiológica do leite de cada uma das 10 doadoras em triplicata (30 amostras) foi avaliada por meio da enumeração de Staphylococcus aureus e mesóflos aeróbios totais (plaqueamento em superfície) e coliformes totais e termotolerantes (Número Mais Provável -NMP). Para verificar a conformidade dos procedimentos de extração e armazenamento do leite pelas doadoras, aplicou-se um questionário e um checklist após o término da coleta das amostras. Resultados: observou-se inadequações nos procedimentos de expressão e armazenamento do LH doado. A presença de todos os microrganismos estudados foram verificados no leite de todas as doadoras e, em alguns casos, excedeu os limites de segurança. O checklist indicou que alguns procedimentos higiênico-sanitários necessários não foram realizados criteriosamente, tornando importante orientar adequadamente as doadoras. Conclusões: este estudo aponta um cenário desfavorável para a segurança e a qualidade do LH doado, sendo importante incentivar mais estudos a serem realizados para que a rede brasileira de BLH adote critérios mais rigorosos de instruções sobre procedimentos e suporte para doadoras de LH.

Abstract This study aimed to evaluate the application of thermosonication for the viability of Staphylococcus aureus and the antioxidant activity of HM. The US effect on the S. aureus was measured by counting viable cells in discarded HM immediately before and after different treatments varying time (1, 5 and 10 minutes) and temperature (20, 30, 40, 50 and 60 °C) through surface plating on standard agar. The antioxidant activity evaluation was carried out by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging method. With Regarding microbiological quality, it can be concluded that treatment with US at 60 °C for 10 minutes was the most effective in terms of reducing the viability of S. aureus, in addition to presenting a significant increase in the content of antioxidants when compared to raw and pasteurized milk samples.

Abstract Jabuticaba is a fruit sensory appreciated and has significant nutritional and functional value. However, it is quite perishable, and its use is interesting for the preparation of other products such as fermented jabuticaba, from a nutritional, biological and technological point of view. This study evaluated the interference of maceration time over antioxidant capacity, volatile compounds profile and temporal dominant sensation of fermented jabuticaba. Four different treatments of fermented jabuticaba in different fermentation times were prepared (96, 120, 144 and 168 h). After preparation, total monomeric anthocyanin content, total antioxidant activity by 2,2-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid and iron reduction method, volatile compounds profile by gas chromatography and sensory analysis of temporal dominance of sensations were performed of fermented jabuticaba. The highest concentration of total anthocyanins (25.81 mg/100 g) and antioxidant activity (78.34 μmol Trolox/g e 84.69 μM FeSO4/g) of jabuticaba is in its skin. Regarding the antioxidant activity by FRAP method, the fermented beverages presented higher value than the whole fruit. However, after 96 h of maceration, the values decreased, followed by an increase after 144 h. In all maceration times the predominant sensation was acidic taste, initially and then astringency, the most persistent sensation in all treatments. However, there was a downward trend in this sensation with the increase in maceration time, as well as isoamyl alcohol content.

We evaluated sweat, blood and urine specimens obtained from an ongoing cohort study in Brazil. Samples were collected at pre-established intervals after the initial rash presentation and tested for Zika virus (ZIKV) RNA presence by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). From 254 participants with confirmed infection, ZIKV RNA was detected in the sweat of 46 individuals (18.1%). Sweat presented a median cycle threshold (Ct) of 34.74 [interquartile range (IQR) 33.44-36.04], comparable to plasma (Ct 35.96 - IQR 33.29-36.69) and higher than urine (Ct 30.78 - IQR 28.72-33.22). Concomitant detection with other specimens was observed in 33 (72%) of 46 participants who had a positive result in sweat. These findings represent an unusual and not yet investigated virus shedding through eccrine glands.

Resumo É relevante conhecer a qualidade higiênico-sanitária do leite humano cru e estabelecer as melhores condições de armazenamento para a preservação de seus componentes nutricionais e funcionais. Portanto, o objetivo deste estudo foi avaliar a qualidade higiênico-sanitária do leite humano extraído no domicílio de mães e analisar o efeito do tempo e da temperatura de congelamento na capacidade antioxidante total desse leite. O leite de cinco mães foi avaliado individualmente para Staphylococcus aureus, contagem total de mesófilos aeróbios, bolores e leveduras, coliformes totais e termotolerantes. As amostras foram armazenadas a -8 °C, -18 °C e -40 °C por 2, 4, 8 e 15 dias, e analisadas quanto à capacidade antioxidante total pelo radical livre 2,2-difenil-1-picrilhidrazil e por métodos de eliminação do ácido 2,2-azino 3-etilbenzotiazolino-6-sulfônico. As análises microbiológicas das amostras de leite humano cru indicaram contagens de todos os microrganismos estudados acima dos limites considerados seguros. Em relação ao efeito do tempo de congelamento e da temperatura na capacidade antioxidante total, concluiu-se que, independentemente da temperatura de congelamento, houve redução significativa ao longo do tempo, e quanto menor a temperatura de armazenamento, maior a atividade antioxidante total do leite.

Abstract Knowledge of the hygienic-sanitary quality of raw human milk helps to establish the best storage conditions for the preservation of its nutritional and functional components. Therefore, this study aimed to evaluate the hygienic-sanitary quality of human milk extracted at the mothers’ homes, and to analyze the effect of freezing time and temperature on the milk’s total antioxidant capacity. Milk of five mothers was evaluated individually for Staphylococcus aureus, total aerobic mesophilic counts, mold and yeasts, total and thermotolerant coliforms. The milk pool was stored at -8 °C, -18 °C and -40 °C for 2, 4, 8 and 15 days and analyzed for the total antioxidant capacity by the 2,2-diphenyl-1-picrylhydrazyl free radical and 2,2-azino 3-ethylbenzothiazoline-6-sulfonic acid scavenging methods. The microbiological analyses of the raw human milk samples indicated counts of all the studied microorganisms above the safe limits. Related to the effect of freezing time and temperature on total antioxidant capacity, it was concluded that, regardless of the freezing temperature, a significant reduction occurred on total antioxidant capacity over time and that the lower the storage temperature, the greater its total antioxidant activity.

Resumo: Buscamos compreender os significados que mulheres que se autodeclaram gordas atribuem às suas experiências corporais cotidianas. Foi realizada uma pesquisa qualitativa de base fenomenológica envolvendo cinco interlocutoras, com idades entre 18 a 46 anos. Utilizou-se a entrevista semiestruturada como técnica de coleta de dados. A análise do material se deu por uma perspectiva fenomenológica e apontou os preconceitos sofridos, mas também as estratégias elaboradas por essas mulheres em sua rotina. Destacamos, ao fim, a necessidade de se ampliar as reflexões sobre a temática dentro das produções teóricas feministas e dos estudos de gênero.

Abstract: We sought to understand the meanings that women self-identified as fat attribute to their daily bodily experiences. A qualitative research based on phenomenological method was carried out involving five interlocutors, aged between 18 and 46 years. A semi-structured interview was used as data collection technique. The material was analyzed from the phenomenological perspective of Moreira (2004), pointing out the prejudices suffered and the strategies developed by these women in their daily routine. It is important to highlight the need of further reflections on the subject in feminist theory and gender studies.

Resumo Este artigo analisa as experiências recentes de ativismo sindical de duas categorias de trabalhadores do setor de serviços urbanos: os teleoperadores e os rodoviários. Mais especificamente, são tratados como objetos a greve dos teleoperadores do estado do Rio de Janeiro, em 2014, e a luta dos rodoviários cariocas entre a criação do Sintraturb-Rio, em 2009, e a greve de 2014. Argumenta-se que o ciclo de protestos iniciado em 2013 revelou e reforçou o entrelaçamento entre a luta pelo direito à cidade e a luta por condições dignas de trabalho nos grandes centros urbanos. As tensões criativas entre gerações distintas de militantes e as inovações táticas observadas nos casos dos teleoperadores e dos rodoviários no Rio de Janeiro apontam nessa direção.

Abstract This article analyzes recent experiences of union activism displayed by two categories of workers in the urban services sector: telemarketers and bus drivers. More specifically, the objects analyzed here are the telemarketers’ strike in the State of Rio de Janeiro in 2014 and the struggle of Rio de Janeiro’s bus drivers between the creation of Sintraturb-Rio, in 2009, and the 2014 strike. We argue that the cycle of protests initiated in 2013 has revealed and reinforced the interweaving between the struggle for the right to the city and the struggle for decent working conditions in large urban centers. The creative tensions between different generations of militants and the tactical innovations observed in the cases of telemarketers and bus drivers in Rio de Janeiro point towards this conclusion.

Trichomonas vaginalis and Leishmania spp. are protozoal species responsible for millions of cases of parasitic diseases worldwide. Considering the potential of natural products and the need for more effective and less toxic alternatives to treat trichomoniasis and leishmaniasis, this study aimed to evaluate the effect of two series of triterpenes derivatives with different modifications at C-3 and C-28 positions of the ursolic acid (UA) and betulinic acid (BA) against trophozoites of Trichomonas vaginalis and promastigotes forms of Leishmania (L.) amazonensis. The compounds modified just at C-3 were the most active. The 3β-acetyl betulinic acid (1b) reduced the trophozoites viability of T. vaginalis at 74%, followed by the 3-oxo ursolic acid and 3-oxo betulinic acid (3a and 3b) compounds (55% of reduction). The compound 3β-isobutyl ursolic acid (7a) inhibited the viability of L. amazonensis promastigotes by 55%. Therefore, analyzing the structure-activity relationship and the data of literature, it is possible to suppose that the inclusion of polar groups in the skeletons could improve the antiprotozoal activity. Overall, further studies are necessary to develop triterpenic derivatives with more powerful trichomonicidal and leishmanicidal properties.

Abstract The consumption of white sesame has become a healthy option for those who are concerned about health and wish to reduce oxidative stress. The germination has been used an effective method to increase the nutrients availability and thus provide a better nutritional quality of these seeds. Due to the lack of researches about sesame germination the objective of this study was to evaluate the different times of germination on the chemical composition (moisture, fat, protein and ashes), the antioxidant capacity and the phenolic compounds of white sesame. The germination occurred inside a greenhouse with controlled temperature at 30 °C and the variables were analyzed in the times 0, 24, 36 and 48 hours of germination. The process increased the levels of moisture and reduced the levels of fat, protein and ashes. On the other hand, it also increased the antioxidant capacity by two methods and raised the quantity of total phenolic compounds. Based in the present study and in others similar works, it is possible to affirm that the germination process increase the white sesames’ antioxidant capacity, however further studies are needed to evaluate a better environmental condition of germination and others factors that may affect the composition.

Resumo: O rastreamento de Chlamydia trachomatis não é feito de rotina em mulheres jovens assintomáticas no Brasil. O estudo avaliou o desempenho, utilidade e adequação operacional do teste de DNA Digene Hybrid Capture II (HCII) CT-ID como ferramenta de rastreamento oportunista para detectar C. trachomatis no sistema público de saúde em Manaus, Amazonas. Mulheres entre 14 e 25 anos de idade que frequentavam serviços de atenção básica foram entrevistadas, com a coleta de uma amostra cervicouterina durante o rastreamento citológico. O teste HCII CT foi avaliado em relação à capacidade de detectar a presença de C. trachomatis, e comparado à PCR em tempo real (q-PCR) em um sub-conjunto de amostras. O desempenho operacional foi avaliado através de entrevistas com profissionais e pacientes. Foram examinadas 1.187 mulheres, das quais 1.169 tiveram um resultado de teste HCII CT-ID (destas, 292 foram testadas também com q-PCR). Um total de 153 mulheres (13,1%) testaram positivas para C. trachomatis. A sensibilidade, especificidade e valores preditivos positivo e negativo do HCII CT foram 72,3% (IC95%: 65,4-78,6), 91,3% (IC95%: 84,1-95,9), 93,8% (IC95%: 88,5-97,1) e 64,4% (IC95%: 56,0-72,1), respectivamente. A coleta de amostras provocou desconforto em 19,7% das mulheres. As principais barreiras relatadas pelos profissionais de saúde (n = 52) eram casos positivos que não retornavam para os resultados (56,4%), falta de disponibilidade de realizar o rastreamento sem consulta agendada (45,1%) e aumento da carga de trabalho (38,8%). O HCII CT-ID identificou alta prevalência de C. trachomatis em mulheres jovens de Manaus. Entretanto, a sensibilidade moderada limita o uso como ferramenta de rastreamento oportunista em serviços de atenção básica naquela cidade. O rastreamento era bem-recebido, mas as barreiras identificadas, principalmente entre profissionais de saúde, limitam a detecção através do rastreamento e as iniciativas de tratamento.

Abstract: Screening for Chlamydia trachomatis is not routinely offered to young asymptomatic women in Brazil. This study evaluated the performance, usefulness, and operational suitability of the Digene Hybrid Capture II (HCII) CT-ID DNA-test as an opportunistic screening tool to detect C. trachomatis in the public health system in Manaus, Amazonas State. Women aged 14-25 years who attended primary health care services were interviewed and one cervical specimen was collected during cytological screening. The HCII CT test was evaluated for its ability to detect the presence of C. trachomatis and against real-time PCR (q-PCR) in a subset of samples. Operational performance was assessed through interviews with providers and patients. Overall, 1,187 women were screened, and 1,169 had a HCII CT-ID test result (292 of these were also tested by q-PCR). Of those, 13.1% (n = 153) were positive. The sensitivity, specificity, positive and negative predictive values of HCII CT were 72.3% (95%CI: 65.4-78.6), 91.3% (95%CI: 84.1-95.9), 93.8% (95%CI: 88.5-97.1), and 64.4% (95%CI: 56.0-72.1), respectively. Sample collection caused discomfort in 19.7% of women. Among health professionals (n = 52), the main barriers reported included positive cases who did not return for results (56.4%), unwillingness to screen without an appointment (45.1%), and increase in their workload (38.8%). HCII CT-ID identified a high proportion of C. trachomatis cases among young women in Manaus. However, its moderate sensitivity limits its use as an opportunistic screening tool in primary health care settings in Manaus. Screening was well accepted although the barriers we identified, especially among health professionals, challenge screening detection and treatment efforts.

Resumen: Los exámenes de control de Chlamydia trachomatis no se ofrecen habitualmente a las mujeres jóvenes asintomáticas en Brasil. Este estudio evaluó los resultados, utilidad e idoneidad operativa del test Digene Hybrid Capture II (HCII) CT-ID DNA como una herramienta de examen apropiada para detectar la C. trachomatis en el sistema de salud público de Manaus, Amazonas. Las mujeres con una edad comprendida entre los 14-25 años que asistieron a un centro de atención primaria fueron entrevistadas, y se recogió una muestra cervical durante el examen citológico. Se evaluó el test HCII CT, debido a su habilidad para detectar la presencia de C. trachomatis, frente al realtime PCR (q-PCR) en un subconjunto de muestras. El resultado operativo fue evaluado mediante entrevistas con proveedores y pacientes. Globalmente, se examinaron a 1.187 mujeres, y 1.169 de ellas contaban con los resultados de la prueba HCII CT-ID (a 292 de las cuales también se les aplicó el test q-PCR). Entre ellas, un 13,1% (n = 153) eran positivo. La sensibilidad, especificidad, los valores predictivos positivos y negativos del HCII CT fueron 72,3% (IC95%: 65,4-78,6), 91,3% (IC95%: 84,1-95,9), 93,8% (IC95%: 88,5-97,1), y 64,4% (IC95%: 56,0-72,1), respectivamente. La toma de muestras resultó incómoda en un 19,7% de las mujeres. Entre los profesionales de la salud (n = 52), las barreras principales informadas incluyeron casos positivos que no volvieron a recoger los resultados (56,4%), reticencia a realizarse el examen sin cita previa (45,1%), e incremento en su carga laboral (38,8%). El HCII CT-ID identificó un alto porcentaje de casos de C. trachomatis entre mujeres jóvenes en Manaus. No obstante, su moderada sensibilidad limita su uso como una herramienta idónea en los centros de atención primaria en Manaus. El examen fue bien aceptado, pese a que identificamos obstáculos, especialmente entre los profesionales de salud, lo que supone un desafío para la detección de la enfermedad que requiere esfuerzos para su tratamiento.

Resumo: O rastreamento de Chlamydia trachomatis não é feito de rotina em mulheres jovens assintomáticas no Brasil. O estudo avaliou o desempenho, utilidade e adequação operacional do teste de DNA Digene Hybrid Capture II (HCII) CT-ID como ferramenta de rastreamento oportunista para detectar C. trachomatis no sistema público de saúde em Manaus, Amazonas. Mulheres entre 14 e 25 anos de idade que frequentavam serviços de atenção básica foram entrevistadas, com a coleta de uma amostra cervicouterina durante o rastreamento citológico. O teste HCII CT foi avaliado em relação à capacidade de detectar a presença de C. trachomatis, e comparado à PCR em tempo real (q-PCR) em um sub-conjunto de amostras. O desempenho operacional foi avaliado através de entrevistas com profissionais e pacientes. Foram examinadas 1.187 mulheres, das quais 1.169 tiveram um resultado de teste HCII CT-ID (destas, 292 foram testadas também com q-PCR). Um total de 153 mulheres (13,1%) testaram positivas para C. trachomatis. A sensibilidade, especificidade e valores preditivos positivo e negativo do HCII CT foram 72,3% (IC95%: 65,4-78,6), 91,3% (IC95%: 84,1-95,9), 93,8% (IC95%: 88,5-97,1) e 64,4% (IC95%: 56,0-72,1), respectivamente. A coleta de amostras provocou desconforto em 19,7% das mulheres. As principais barreiras relatadas pelos profissionais de saúde (n = 52) eram casos positivos que não retornavam para os resultados (56,4%), falta de disponibilidade de realizar o rastreamento sem consulta agendada (45,1%) e aumento da carga de trabalho (38,8%). O HCII CT-ID identificou alta prevalência de C. trachomatis em mulheres jovens de Manaus. Entretanto, a sensibilidade moderada limita o uso como ferramenta de rastreamento oportunista em serviços de atenção básica naquela cidade. O rastreamento era bem-recebido, mas as barreiras identificadas, principalmente entre profissionais de saúde, limitam a detecção através do rastreamento e as iniciativas de tratamento.

Abstract: Screening for Chlamydia trachomatis is not routinely offered to young asymptomatic women in Brazil. This study evaluated the performance, usefulness, and operational suitability of the Digene Hybrid Capture II (HCII) CT-ID DNA-test as an opportunistic screening tool to detect C. trachomatis in the public health system in Manaus, Amazonas State. Women aged 14-25 years who attended primary health care services were interviewed and one cervical specimen was collected during cytological screening. The HCII CT test was evaluated for its ability to detect the presence of C. trachomatis and against real-time PCR (q-PCR) in a subset of samples. Operational performance was assessed through interviews with providers and patients. Overall, 1,187 women were screened, and 1,169 had a HCII CT-ID test result (292 of these were also tested by q-PCR). Of those, 13.1% (n = 153) were positive. The sensitivity, specificity, positive and negative predictive values of HCII CT were 72.3% (95%CI: 65.4-78.6), 91.3% (95%CI: 84.1-95.9), 93.8% (95%CI: 88.5-97.1), and 64.4% (95%CI: 56.0-72.1), respectively. Sample collection caused discomfort in 19.7% of women. Among health professionals (n = 52), the main barriers reported included positive cases who did not return for results (56.4%), unwillingness to screen without an appointment (45.1%), and increase in their workload (38.8%). HCII CT-ID identified a high proportion of C. trachomatis cases among young women in Manaus. However, its moderate sensitivity limits its use as an opportunistic screening tool in primary health care settings in Manaus. Screening was well accepted although the barriers we identified, especially among health professionals, challenge screening detection and treatment efforts.

Resumen: Los exámenes de control de Chlamydia trachomatis no se ofrecen habitualmente a las mujeres jóvenes asintomáticas en Brasil. Este estudio evaluó los resultados, utilidad e idoneidad operativa del test Digene Hybrid Capture II (HCII) CT-ID DNA como una herramienta de examen apropiada para detectar la C. trachomatis en el sistema de salud público de Manaus, Amazonas. Las mujeres con una edad comprendida entre los 14-25 años que asistieron a un centro de atención primaria fueron entrevistadas, y se recogió una muestra cervical durante el examen citológico. Se evaluó el test HCII CT, debido a su habilidad para detectar la presencia de C. trachomatis, frente al realtime PCR (q-PCR) en un subconjunto de muestras. El resultado operativo fue evaluado mediante entrevistas con proveedores y pacientes. Globalmente, se examinaron a 1.187 mujeres, y 1.169 de ellas contaban con los resultados de la prueba HCII CT-ID (a 292 de las cuales también se les aplicó el test q-PCR). Entre ellas, un 13,1% (n = 153) eran positivo. La sensibilidad, especificidad, los valores predictivos positivos y negativos del HCII CT fueron 72,3% (IC95%: 65,4-78,6), 91,3% (IC95%: 84,1-95,9), 93,8% (IC95%: 88,5-97,1), y 64,4% (IC95%: 56,0-72,1), respectivamente. La toma de muestras resultó incómoda en un 19,7% de las mujeres. Entre los profesionales de la salud (n = 52), las barreras principales informadas incluyeron casos positivos que no volvieron a recoger los resultados (56,4%), reticencia a realizarse el examen sin cita previa (45,1%), e incremento en su carga laboral (38,8%). El HCII CT-ID identificó un alto porcentaje de casos de C. trachomatis entre mujeres jóvenes en Manaus. No obstante, su moderada sensibilidad limita su uso como una herramienta idónea en los centros de atención primaria en Manaus. El examen fue bien aceptado, pese a que identificamos obstáculos, especialmente entre los profesionales de salud, lo que supone un desafío para la detección de la enfermedad que requiere esfuerzos para su tratamiento.

ABSTRACT PURPOSE: To quantify the amount of lymph nodes harvested in modified radical neck dissection. METHODS: Cross-sectional anatomical study conducted in 28 non-preserved cadavers. RESULTS: The mean number of lymph nodes found in each nodal level of the 56 modified radical neck dissections performed were: level IA - 1.5 (95% CI: 1.1 - 1.8), level IB - 2.5 (95% CI: 2.1 - 2.9), level IIA - 7.2 (95% CI: 6.0 - 8.5), IIB level - 6.5 (95% CI: 5.5 - 7.4), level III - 6.6 (95% CI: 5.7 - 7.4), level IV - 8.6 (95% CI: 7.1 - 10.1), level V - 11 (95% CI: 9.2 - 12.7), totalizing 43.8 lymph nodes (95% CI: 40.3 - 47.4). CONCLUSION: The results defined a parameter in relation to the minimum recommended nodal yield in a modified radical neck dissection, as well as the number of lymph nodes in each level of this dissection, performed in clinical practice.

Trichomonas vaginalis is the etiologic agent of trichomoniasis, the most common non-viral sexually transmitted disease (STD) in the world. The diagnosis is based on wet mount preparation and direct microscopy on fixed and stained clinical specimens. The aim of this study was to compare the performance of different fixing and staining techniques used in the detection of T. vaginalis in urine. The smears were fixed and submitted to different methods of permanent staining and then, the morphological aspects of the parasites were analyzed and compared. The Papanicolaou staining with ethanol as the fixative solution showed to be the best method of permanent staining. Our data suggest that staining techniques in association with wet mount examination of fresh specimens contribute to increase the sensitivity in the diagnosis of trichomoniasis.