Avaliação dos Indicadores de Mortalidade do município de São Mateus-ES, nos anos de 1980 e 2016

This article aims to report and evaluate the health situation in the municipality of São Mateus, through the study of mortality indicators' evolution from 1980 to 2016. Thus, understanding the influences of these indicators on the population's quality of life, considering the changes the municipality has undergone in recent decades in economic, cultural, social, and structural areas. This article is a comparative descriptive study of São Mateus, in the state of Espírito Santo, regarding the health situation in the years 1980 and 2016. Data collected from SINASC, DATASUS, SIM, and IBGE were used. An improvement in the population's epidemiological profile was found, with a decrease in the overall mortality rate from 4.45 to 4.06. The infant mortality rate also improved over time, with a reduction of 4.53%. There is a clear improvement in the quality of healthcare services when observing the transition from Nelson de Moraes' U-shaped curve in 1980 to a J-shaped curve in 2016. There was an increase in mortality from chronic diseases and a decrease in infectious and parasitic causes as well as unknown causes, indicating an epidemiological transition from preventable deaths to deaths due to the progression of chronic and degenerative diseases.Este artigo tem por objetivo relatar e avaliar a situação de saúde do município de São Mateus, através do estudo da evolução de indicadores de mortalidade de 1980 e de 2016. Assim, compreendendo as influências desses indicadores na qualidade de vida da população, considerando as modificações pelas quais o município passou nas últimas décadas nas áreas econômicas, culturais, sociais e estruturais. Este artigo é um estudo descritivo comparativo sobre o município de São Mateus, no estado do Espírito Santo, entre a situação de saúde dos anos de 1980 e 2016. Foram utilizados dados coletados no SINASC, DATASUS, SIM e IBGE. Foi encontrado uma melhora no perfil epidemiológico da população, com redução do coeficiente de mortalidade geral de 4,45 para 4,06, O coeficiente de mortalidade infantil também teve melhora com o passar do tempo, com redução de 4,53%. É nítido a melhora da qualidade do serviço de saúde ao se observar a transição da curva de Nelson de Moraes de U em 1980 para J em 2016. Houve um aumento das causas de mortalidade por doenças crônicas e uma diminuição de causas infecto parasitárias e causas desconhecidas, traduzindo uma transição epidemiológica da saúde que antes eram mortes preveníveis e agora por evolução de doenças crônico-degenerativas

Planejamento de Promoção de Saúde na Unidade Básica do Forte São João em Vitória - ES

The article analyzes the fundamental role of Basic Health Units in promoting the health of the Forte São João community in Vitória, Espírito Santo. Throughout its history, dating back to 1592, this area has faced challenges such as limited access to services and poor housing conditions. Based on data from the Municipal Health Secretary and information collected at the local Basic Health Unit, the study identified coronavirus infection as one of the main health problems across all age groups, along with other infectious and chronic diseases. Age-specific analysis revealed that different groups faced specific health challenges. The main demands of the Basic Health Unit included cases of coronavirus infection, hypertension, diabetes, routine consultations, and general exams. The study concluded that Forte São João faces significant challenges due to poor housing conditions, low education levels, limited access to medical care, and high crime rates. However, it highlighted the vital role of Basic Health Units in improving the quality of life and comprehensive well-being of the community. These units play a crucial role in prevention, health education, and promoting healthy lifestyles. There is a need for health policies aimed at meeting the specific needs of this community and improving their quality of life.O artigo analisa o papel fundamental das Unidades Básicas de Saúde na promoção da saúde da comunidade da região do Forte São João em Vitória, Espírito Santo. Ao longo de sua história, que remonta a 1592, essa área enfrentou desafios, como acesso limitado a serviços e condições precárias de moradia. O estudo, baseado em dados da Secretaria Municipal de Saúde e coleta de informações na Unidade Básica de Saúde local, identificou a infecção por coronavírus como um dos principais problemas de saúde em todas as faixas etárias, juntamente com outras doenças infecciosas e crônicas. A análise por idade revelou que diferentes grupos enfrentavam desafios específicos de saúde. As principais demandas da Unidade Básica de Saúde incluíam casos de infecção por coronavírus, hipertensão, diabetes, consultas de rotina e exames gerais. O estudo concluiu que o Forte São João enfrenta desafios significativos devido a condições precárias de moradia, baixa escolaridade, acesso limitado à assistência médica e alta criminalidade. No entanto, ressaltou o papel vital das Unidades Básicas de Saúde na melhoria da qualidade de vida e no bem-estar abrangente da comunidade. Essas unidades desempenham um papel crucial na prevenção, educação em saúde e promoção de estilos de vida saudáveis. Portanto, o artigo enfatiza a necessidade de políticas de saúde direcionadas para atender às necessidades específicas dessa comunidade e melhorar sua qualidade de vida

IMPACTO DAS TECNOLOGIAS DE SAÚDE NA ATENÇÃO PRIMÁRIA A SAÚDE PARA ATENDIMENTO E GESTÃO

Introdução: as ações de saúde precisam ser organizadas perante os princípios da humanização do cuidado, buscando sempre conhecimentos e métodos para as atividades de saúde, oferecendo a população a um cuidado continuado e preventivo. As tecnologias das relações usadas nesse contexto buscam mais acesso, acolhimento e vínculo dos pacientes para com as unidades. Desta maneira, o estudo da implementação de tecnologia na atenção devem ser estimulados e suscitam questionamentos acerca de sua viabilidade, acessibilidade e real impacto na captação a atividades preventivas de saúde. Métodos: Trata-se de uma revisão bibliográfica com abordagem qualitativa dos ultimos 15 anos, visando descrever os impactos do uso de aparatos tecnológicos para o atendimento de pacientes na atenção básica. Resultados e discussão: o uso de tecnologias das relações deve ser pautado priorizando-se o respeito e o acolhimento no atendimento de atenção básica. Aplicação de questionários mostrou-se necessária para entender a realidade de cada unidade e a forma de planejamento da equipe, pois ainda há grande dificuldade em implantar e aplicar a infraestrutura da telemedicina e o gestão em saúde nos territórios avaliados. Conclusão: Grande parte dos territórios ainda não possuem aplicação satisfatória das tecnologias para melhor atendimento em saúde na atenção básica, havendo grande discrepância entre as regiões do Brasil, porém, as equipes que os possuem mostram benefícios importantes

NEUROCIÊNCIA E TDAH: EXPLORANDO CONEXÕES CEREBRAIS E AVANÇOS EM INTERVENÇÕES TERAPÊUTICAS

The topic involving neuroscience and attention deficit hyperactivity disorder is complex and multifaceted, in addition to involving the understanding of the neural bases and how each region is affected and interfered, it is also possible to develop better and efficient therapeutic processes from this. that help to significantly improve the quality of life of each individual. Objective: To understand the relationship between neuroscience and ADHD, in addition to addressing the best therapeutic paths. Methodology: The bibliographic search to carry out the integrative review was conducted in specialized databases, PubMed and Scopus, using a combination of controlled and uncontrolled terms related to neuroscience, ADHD and therapeutic interventions, the Mesh used: “Attention Deficit Disorder with Hyperactivity ”; “Cognitive Neuroscience”; “Mental Health”. Results: The multiple neural systems and neurotransmitters affected in this process cause impacts on the nervous system and with this arises the importance of developing therapeutic approaches. Thus, the main points of impact are the prefrontal cortex, dopaminergic system, striatum nucleus and attentional network. Each affected region causes a series of changes confirming the theory that ADHD is a neurobiological condition.A temática envolvendo a neurociência e o Transtorno do déficit de atenção e hiperatividade é complexa e multifacetada, além de envolver o entendimento das bases neurais e como cada região é afetada e interferida, também é possível a partir disso desenvolver melhores e eficientes processos terapêuticos que ajudem na melhora significativa na qualidade de vida de cada indivíduo. Objetivo: Entender a relação entre a neurociência e o TDAH, além de abordar os melhores caminhos terapêuticos. Metodologia: A busca bibliográfica para realização da revisão integrativa foi conduzida em bases de dados especializadas, PubMed e Scopus, utilizando uma combinação de termos controlados e não controlados relacionados à neurociência, TDAH e intervenções terapêuticas, os Mesh usados: “Attention Deficit Disorder with Hyperactivity”; “Neurociencia Cognitiva”; “Mental Health”. Resultados: Os múltiplos sistemas neurais e  neurotransmissores afetados nesse processo causam impactos no sistema nervoso e com isso surge a importância de desenvolvimento de abordagens terapêuticas. Desse modo, os principais pontos de impacto são córtex pré-frontal, sistema dopaminérgico, núcleo estriado e rede atencional. Cada região afetada causa uma série de mudanças confirmando a teoria que o TDAH é uma condição neurobiológica.&nbsp

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Ecotoxicological evaluation of antibiotic amoxicillin considering its presence in aquatic environment

Submitted by Cássia Santos ([email protected]) on 2017-01-27T09:34:21Z No. of bitstreams: 2 Dissertação - Lara Barroso Brito - 2016.pdf: 19284674 bytes, checksum: 73aa3e2fc34b886b960712220045839d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2017-01-30T10:01:07Z (GMT) No. of bitstreams: 2 Dissertação - Lara Barroso Brito - 2016.pdf: 19284674 bytes, checksum: 73aa3e2fc34b886b960712220045839d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2017-01-30T10:01:07Z (GMT). No. of bitstreams: 2 Dissertação - Lara Barroso Brito - 2016.pdf: 19284674 bytes, checksum: 73aa3e2fc34b886b960712220045839d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-03-23Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqPharmaceuticals can be introduced directly into the environmental by household disposal or pharmaceutical industry waste and indirectly through the excretion of humans and animals. Antibiotics are considered emerging contaminants because they are typically present at very low levels in the environmental and their human or ecological health effects are unclear. β-lactams represent more than 70% of antibiotics consumed in Brazil. Thus, in this context, this work evaluated the environmental impact of antibiotic amoxicillin (AMX) in different organisms, considering its presence in water. For that, we used the phytotoxicity test with seeds of tomato (Lycopersicon esculentum), cucumber (Cucumis sativus) and lettuce (Lactuca sativa), brine shrimp toxicity assay (Artemia salina), and embryo-larval toxicity test zebrafish (D. rerio), considering the lethal and sublethal effects and biomarkers determinations. AMX showed no toxicity to seeds of tomato, cucumber and lettuce in relation to seed germination and root elongation endpoints. For microcrustacean A. salina, AMX did not induce significant mortality after 24 h and 48 h exposure (LC50 > 100 mg/L) and it was classified as non-toxic (not categorized) according to the Globally Harmonized System (GHS). AMX also did not cause significant mortality in embryos and larvae zebrafish during 168 h of exposure. It had no significant effect on embryos hatching and larvae equilibrium. However, AMX significantly increased the larvae size at 6.25, 12.5 and 25 mg/L. Catalase (CAT), glutathione S-transferase (GST) and lactate dehydrogenase (LDH) activities in embryos and larvae of zebrafish were inhibited at 12.5 mg/L of AMX, 6.25, 12.5, 25, 50 and 100 mg/L of AMX and 1.5, 3.0, 6.25 and 12.5 mg/L of AMX, respectively. Therefore, AMX showed no significant acute toxicity to tested organisms, but it induced sublethal effects on larvae zebrafish in concentrations greater than those found in the aquatic environment, indicating that long-term chronic exposures must be investigated.Os fármacos e insumos farmacêuticos podem ser introduzidos no ambiente de forma direta, ou seja, através do descarte doméstico ou por efluentes da indústria farmacêutica, e ainda indiretamente, por meio da excreção humana e animal. Os antibióticos são considerados contaminantes emergentes, uma vez que são detectados em concentrações muito baixas no ambiente e seus efeitos sobre o ambiente e saúde humana permanecem incertos. Os β- lactâmicos representam mais de 70% dos antibióticos consumidos no Brasil. Assim, dentro deste contexto, este trabalho propôs avaliar o impacto ambiental do antibiótico amoxicilina (AMX) em diferentes organismos, considerando a sua presença nos recursos hídricos. Para tanto foram utilizados os ensaios de fitotoxicidade com sementes de tomate (Lycopersicon esculentum), pepino (Cucumis sativus) e alface (Lactuca sativa) e de toxicidade aguda com Artemia salina, assim como o teste com o estágio embriolarval de zebrafish (Danio rerio), considerando os efeitos letais, subletais e atividade de biomarcadores enzimáticos. A AMX não foi tóxica para as sementes de tomate, pepino e alface, não apresentando diferenças estatísticas significativas para os parâmetros de germinação das sementes e do desenvolvimento das raízes. Para o microcrustáceo A. salina, a AMX não induziu mortalidade significativa com valores de CL50 maior que 100 mg/L para 24 h e 48 h de exposição, sendo classificada como não tóxica (não categorizada) de acordo com o Globally Harmonized System (GHS). A AMX não provocou mortalidade significante nos embriões e larvas de zebrafish durante as 168 h de exposição, assim como não alterou significativamente a eclosão dos embriões e o equilíbrio de larvas de zebrafish. Entretanto, o antibiótico aumentou significativamente o tamanho das larvas desse peixe nas concentrações de 6,25; 12,5 e 25 mg/L. As atividades da catalase (CAT), da glutationa Stransferase (GST) e da lactato desidrogenase (LDH) de embriões e larvas de peixezebra foram inibidas significativamente nas exposições à 12,5 mg/L de AMX, 6,25; 12,5; 25; 50 e 100 mg/L de AMX e 1,5; 3,0; 6,25 e 12,5 mg/L de AMX, respectivamente. Portanto, o antibiótico AMX não apresenta toxicidade aguda relevante para os organismos testados, mas causa alguns efeitos subletais em larvas de zebrafish em concentrações superiores às encontradas no ambiente aquático, o que indica a necessidade de se investigar exposições a esse composto a longo prazo