Febre reumática e sua invisibilidade em meio a sociedade: uma revisão sistemática

Febre reumática é uma doença considerada autoimune, sendo acarretada pela falta de tratamento ou uma má gestão após episódios de faringoamigdalite, tendo o Streptococcus β-hemolítico do Grupo A como o causador da infecção. A febre reumática apresenta algumas manifestações clínicas muito importantes, tendo a lesão valvular como a mais grave de todas elas. Determinar as incidências da febre reumática e da doença cardíaca reumática no Brasil ainda é uma grande luta. Existem dificuldades na aplicação dos critérios para diagnóstico da doença, no acesso aos cuidados e na continuidade da profilaxia. E todas essas dificuldades provém da falta de exposição sobre a patologia, a inexistência de programas que eduquem a população de como identificar os sintomas iniciais e ensinem os profissionais a receber tais pacientes. A voz dos portadores de febre reumática e da doença cardíaca reumática está se expandindo, exigindo assim, atenção da sociedade e dos especialistas em saúde pública espalhados pelo Brasil e pelo mundo. A implementação de um programa nacional, assertividade no diagnóstico e tratamento da faringoamigdalite, educação para os profissionais e o público sobre a prevenção da febre reumática, desenvolvimento de colaborações bilateral, regional e multilateral são tópicos necessários e que devem ser desenvolvidos para ajudar toda a comunidade

Prevalence of enteroparasitoses in students of a municipal school in Southwestern bahiano / Prevalência de enteroparasitoses em alunos de uma escola municipal no Sudoeste do bahiano

Introduction: Infections caused by intestinal parasites are a silent disease and their high morbidity and mortality rates, especially in children, have been reported in different studies. The high prevalence of parasites in this public is directly associated with the socioeconomic profile of the population, as well as structural development and climatic conditions of the studied regions. Objective: To describe the prevalence of enteroparasitosis in students of a municipal school in southwestern Bahia in 2019. Materials and Methods: This is a cross-sectional, descriptive and quantitative study conducted by applying a questionnaire and collecting parasitological material from 76 Elementary students from a city in southwest Bahia. Results: Among the studied population, 46 (60.5%) were female. Regarding age, they had an average of 8.7 years (± 1.9 years), and 36 (48%) considered themselves brown. The prevalence of enteroparasitosis was 21.1%, with Endolimax Nana (4.1%), Ascaris Lumbricoides (2.0%), Iodamoeba Butshilli (2.0%), Entamoeba Coli (14.3%), Enterobius Vermiculares (4.1%), Giardia Lamblia (6.1%). Conclusion: It was observed that the prevalence of enteroparasitosis in the children analyzed was low, with a predominance in females. This low rate may be related to factors such as the consumption of treated water and the presence of a sewage system, allied to the helminth control, prevention and monitoring work promoted by the Municipal Health Department

Evaluation of the spermicidal action by the action of majority compounds of essential oils / Avaliação da ação espermicida pela ação dos compostos maiores de óleos essenciais

1 INTRODUCTIONThe use of contraceptives is a recurrent method among sexually active teenagers belonging to this populational group, reiterating the psychosocial questions and the negative approach of gestation in this age range. The epidemiological numbers obtained in the last decade in Brazil registered by the Sistema de Informações Sobre Nascidos Vivos (SINASC) and the Sistema Único de Saúde (SUS), currently, 66% of pregnancies in adolescents are unwanted, stimulate the use, and primarily, the production of new methods to prevent pregnancy (BRASIL, 2017; OLIVEIRA, 2012).Nowadays, several contraceptive methods are described by the medical literature as an alternative to avoid unplanned pregnancy. Among the best-known are the mechanical methods with the male condom as its foremost representative, besides the vaginal diaphragms (GÓMEZ et al., 2007). There are also chemical barrier methods, such as vaginal spermicides; among these are creams, gels, foaming aerosols, along with others, which are, for the most part, made based on Nonoxynol-9. This compound is capable of causing cervical and vaginal irritative effects that can indulge the appearance of infectious microorganisms and/or the increase of proliferation of microorganisms specific to this microbiota, such as lactobacilli (SCHREIBER et al., 2006).Several pieces of research are being developed in countries like the United States, England, India, and China in search of new spermicidal contraceptives that do not result in significant side effects (SILVA et al., 2003). Thus, there is a need to replace these spermicidal agents with safer and more effective alternatives, such as natural contraceptives. The objective of this work was to investigate the action of alternative spermicidal agents, evaluating in vitro spermicidal activity of plant extracts from endemic plants in Northeastern Brazil. 2 METHODOLOGY            The project was developed in partnership with Dr. Luís Cláudio Nascimento da Silva from the Universidade Federal de Pernambuco (UFPE/Recife), who already has a license from the ethics committee for collection and analysis of human semen (Plataforma Brasil, Parecer N° 02604312.6.0000.5203). Semen samples were collected by voluntary donors after a period of sexual abstinence and sent to the Laboratory of Cellular and Molecular Biology and Microscopy of the UPE Campus Garanhuns, for in vitro tests. The method was followed according to Gallego et al. (2012), where the semen was thinned in a saline solution and incubated with four types of oily plant extracts from the plants Myracrodruon urundeuva (casca de aroeira), Leonotis nepetaefolia (flor de cordão-de-frade), Hymenaea courbaril (casca de jatobá) e Stryphnodendron barbatiman (casca de barbatimão), from a quilombola community in Garanhuns town.In the Cellular and Molecular Biology laboratory, each type of extract was added to fresh human semen in a 1:1 ratio, where 10 µL of the mixture was collected to assess mobility/viability using an optical microscope (40X) in a range from 0 to 30 minutes. 3 RESULTS AND DISCUSSIONBoth samples of human semen used were in the standards indicated by the World Health Organization (2010), which guides relevant aspects such as volume (? 1.5 mL), total motility (? 40%), and sperm vitality (? 58 %). It was determined that M. urundeuva; L. nepetaefolia; H. courbaril; and S. barbatiman extracts designated, in the course of 30 min, an effect on the decrease of the progressive sperm motility, which is fundamental for the success of fertilization. It was also observed that the rate of the spermicidal effect was assorted according to the types of extract. The extracts of H. courbaril and S. barbatiman resulted in a 50% decrease in the viability of the sperm cells, while the other extracts displayed a reduction of 20 to 35% (Figure 1).The results suggest that at least two extracts manifested favorable results in the decay of sperm mobility, compared to the control group, which had a higher index of viable cells. The research by Paul et al. (2006), demonstrated similar results found in the current study, sperm viability decreased significantly around 50%, within the same 30 min. Also taken into consideration, when exposed to the extract of Achyranthes aspera and Stephania hernandifolia. Gallego et al. (2012), also appraised and obtained satisfactory results regarding the spermicidal activity of vegetables (Muehlenbeckia platyclada, Zanthoxylum lenticulare and Piper subpedale) in more than 40% in immobilization on human sperm, similar results to two of the tested extracts.Another study carried out in 2013, by Medina et al., indicated that the extract of the plant Sapindus saponaria L. produced an immobilizing but non-lethal effect on human sperm, due to extracts have much more marked effect on mobility (decrease progressive mobility or increased immobility), this characteristic of a larger effect on mobility also coincided with extracts from plants in the Northeast. It is observed that some extracts have an action that reflects more on the mobility parameter, instead of viability. Notwithstanding, both results are important factors for sperm infeasibility, thus, hence presenting spermicidal activity. Therefore, it is proven that endemic plants of the Northeast region can be used and further investigated as to their action as chemical barrier agents, which make sperm viability impossible for a potential pregnancy.The plants utilized in the referring research in vitro and reported in the literature by other researchers can perform as subsidies that minimize the irritative-inflammatory damages in the vaginal flora, provoked by the current spermicides manufactured with the base of Nonoxynol-9. Since, the different chemical components of spermicides that exist today can cause damage to the vaginal epithelium due to lack of cell specificity, which implies that it affects not only the viability of the sperm but also the superficial cells of the epithelium (AITKEN et al., 2011). Fig. 1. Effect of plant extracts of Myracrodruon urundeuva, Leonotis nepetaefolia, Hymenaea courbaril e Stryphnodendron barbatiman on the in vitro sperm motility of human semen.  4 FINAL CONSIDERATIONS OR CONCLUSIONSIt may be concluded that all plant extracts, especially the extracts obtained from H. courbaril and S. barbatiman have some factor with spermicidal properties, reducing the motility of human sperm in vitro. However, this reduction can still be considered low, since compromises contraceptive efficiency. Therefore, other extracts will be tested in vitro, to obtain a product with greater efficiency in the spermicidal action.

Erros pré-analiticos em laboratórios de análises clínicas: uma revisão / Pre-analytical errors in clinical analysis laboratories: a review

O laboratório de análises clínicas tem uma função indispensável na promoção da saúde além de ter como propósito prestar apoio ao diagnóstico. Dentre os processos que envolvem a análise de um espécime, a fase pré-analítica é uma etapa de grande importância para obtenção de um resultado confiável, e é onde se concentra a maior parte dos erros laboratoriais devido à dificuldade de controlar as variáveis e por depender de trabalhos manuais. Esse trabalho tem como objetivo revisar publicações sobre erros pré-analíticos em laboratórios de análises clínicas nos últimos dez anos. Após a pesquisa nas bases de dados Web of Science, ScienceDirect e Medline foram encontrados 80 artigos e destes dez foram selecionados conforme critérios de inclusão: artigos científicos no idioma português, inglês e espanhol que reportaram erros pré-analíticos em laboratórios de análises clínicas. Os estudos mostraram que hemólise, quantidade inusficiente e amostra coagulada são os erros pré-analíticos que mais ocorrem nos laboratórios