Rede de atenção às urgências e emergências e a produção viva de mapas de cuidado: Relatório técnico-científico final

Objetivo: analisar o processo de implementação e conformação dos modos de produção do cuidado da política de Rede de Atenção às Urgências e Emergências (RUE), em duas regiões de saúde: Campinas (SP) e Passo Fundo (RS). Procura, ainda, identificar analisadores da produção micropolítica presentes no processo de pactuação e implementação da RUE nessas regiões; analisar as possíveis mudanças no processo de gestão a partir da implementação das RUE; e caracterizar as transformações ocorridas nos modos de produção do cuidado em saúde a partir da implementação das RUE. Metodologia: a pesquisa tem caráter qualitativo, com abordagem micropolítica, e caracteriza-se como estudo de caso e foi desenvolvida através de revisão de literatura, análise de documentos oficiais, coleta de depoimentos de gestores municipais e estaduais, entrevistas narrativas com usuários, e entrevistas em profundidade com gerentes de serviços. No total, foram entrevistados 61 sujeitos. A análise teve como referência a ‘Abordagem do Ciclo de Políticas’. A pesquisa foi desenvolvida por pesquisadores dos programas de Pós-Graduação em Saúde Coletiva da Escola Paulista de Medicina – Universidade Federal de São Paulo (Unifesp-EPM) e da Imed-Faculdade Meridional de Passo Fundo (RS), com apoio de gestores regionais e municipais de saúde e dos Conselhos de Secretários Municipais de Saúde (COSEMS) dos estados de São Paulo e do Rio Grande do Sul. Resultados: Os principais resultados apontam para uma política pública de caráter plural e multifacetado, formulada a partir de diversas influências sociais, econômicas, políticas e teóricas, que expressa como intencionalidade a ampliação do acesso e o cuidado integral em situações de urgência e emergência em saúde. No contexto da prática, apesar da ênfase aos aspectos organizativos e ao financiamento, é observada a política ‘em cena’ onde podem ser identificadas ações de gestão e de produção de cuidado induzidas pela política, mantidas apesar da política e produzidas para além da política da RUE. A relação entre a política oficial e a ação micropolítica dos gestores, tornou-a uma produção singular no campo da governança regional; a necessidade de autonomia dos usuários e a dimensão do cuidado familiar apontam para caminhos na construção da integralidade; há evidências de produções vivas induzidas pela política que qualificam o cuidado, embora iniquidades sejam mantidas ou produzidas; e, a necessidade de articulação entre os componentes em rede, embora evocada, traduz-se em conexões frágeis e não regulares. Considerações Finais: A compreensão dos complexos processos que envolvem as políticas públicas de saúde, os interesses e poderes que as atravessam, tem potencial para fortalecer os atores implicados com a luta pela promoção da equidade em saúde e pela justiça social.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)428431/2018-

Primate ABO Gene is under Weak Positive Selection

ABO locus presents three main alleles: A, B and O. A and B encode glycosyltransferases that catalyze the addiction of an N-GalNac and D-galactose to a precursor substance (H substance), producing A and B antigens, while the O allele does not produce a functional protein. The presence of A and B antigens have been associated to resistance against infectious agents which could use them as attachment factors increasing the virulence of some parasitic agents. As these antigens are not restrict to humans, analyses them in others species, for instance non-human primates, may be crucial to understand the relationship between pathogens and ABO phenotypes. Despite of the relevance of this issue, in the last decade few studies have addressed, mainly in New World Monkeys (NWM), natural reservoir of tropical diseases in Amazon Region. In order to understand the evolution of the ABO system in the primates, it has been obtained the partial sequence of the most important exon of ABO gene (exon 7), in platyrrhini families: Atelidae, Pithecidae and Cebidae. Then, it has been compared the sequences obtained those present in the literature, and measured the selective pressure. The present results shown that residues 266 and 268 are also crucial to distinguish A and B phenotypes in the platyrrhines, such as in catarrhines, and the 266 codon is under positive selection, although the most site codons are under action of purifying selection

Divergent evolution and purifying selection of the H (FUT1) gene in New World monkeys (Primates, Platyrrhini)

Abstract In the present study, the coding region of the H gene was sequenced and analyzed in fourteen genera of New World primates (Alouatta, Aotus, Ateles, Brachyteles, Cacajao, Callicebus, Callithrix, Cebus, Chiropotes, Lagothrix, Leontopithecus, Pithecia, Saguinus, and Saimiri), in order to investigate the evolution of the gene. The analyses revealed that this coding region contains 1,101 nucleotides, with the exception of Brachyteles, the callitrichines (Callithrix, Leontopithecus, and Saguinus) and one species of Callicebus (moloch), in which one codon was deleted. In the primates studied, the high GC content (63%), the nonrandom distribution of codons and the low evolution rate of the gene (0.513 substitutions/site/MA in the order Primates) suggest the action of a purifying type of selective pressure, confirmed by the Z-test. Our analyses did not identify mutations equivalent to those responsible for the H-deficient phenotypes found in humans, nor any other alteration that might explain the lack of expression of the gene in the erythrocytes of Neotropical monkeys. The phylogenetic trees obtained for the H gene and the distance matrix data suggest the occurrence of divergent evolution in the primates

Molecular Evolution of the Glycosyltransferase 6 Gene Family in Primates

Glycosyltransferase 6 gene family includes ABO, Ggta1, iGb3S, and GBGT1 genes and by three putative genes restricted to mammals, GT6m6, GTm6, and GT6m7, only the latter is found in primates. GT6 genes may encode functional and nonfunctional proteins. Ggta1 and GBGT1 genes, for instance, are pseudogenes in catarrhine primates, while iGb3S gene is only inactive in human, bonobo, and chimpanzee. Even inactivated, these genes tend to be conversed in primates. As some of the GT6 genes are related to the susceptibility or resistance to parasites, we investigated (i) the selective pressure on the GT6 paralogs genes in primates; (ii) the basis of the conservation of iGb3S in human, chimpanzee, and bonobo; and (iii) the functional potential of the GBGT1 and GT6m7 in catarrhines. We observed that the purifying selection is prevalent and these genes have a low diversity, though ABO and Ggta1 genes have some sites under positive selection. GT6m7, a putative gene associated with aggressive periodontitis, may have regulatory function, but experimental studies are needed to assess its function. The evolutionary conservation of iGb3S in humans, chimpanzee, and bonobo seems to be the result of proximity to genes with important biological functions

Sanitary quality of the public groundwater supply for the municipality of Belém in northern Brazil

The present study verified the quality of the water of Água Preta Lake, which is part of the public supply for the Northern Brazilian municipality of Belém (Pará State). Six samples were collected from each of six sampling points. The concentration (NMP) of coliforms was determined by Multiple-tube fermentation Technique. The isolates of Escherichia coli obtained from the samples were tested for susceptibility to the antibiotics (cefoxitin, ampicillin, imipenem, gentamicin, and amikacin). Furthermore, was analyzed the presence of diagnostic genes for the diarrheagenic strains of E. coli. None of the genes was identified, however, the recorded concentrations of thermo-tolerant coliforms were within the recommended limits for standing water sources used for public supplies. Nevertheless, the highest concentrations of total and thermo-tolerant coliforms were recorded at two points, one adjacent to the most densely-populated area of the lake margin, and the other near the catchment area for water from the Guamá River. The susceptibility testing indicated the presence of six resistance phenotype profiles, including multi-resistant strains. The results of the study reinforce the need for the systematic monitoring of this water source, in order to provide guidelines for the development of effective management policies for public water supplies, as well as the prevention of water-borne diseases

Description and phylogeny of Tetrakeronopsis silvanetoi gen. nov., sp. nov. (Hypotricha, Pseudokeronopsidae), a new benthic marine ciliate from Brazil.

Pseudokeronopsidae Borror & Wicklow, 1983 are biotechnologically important ciliate protists which produce toxic defense substances; however, their diversity is still little known in Brazil. In the present study, Tetrakeronopsis silvanetoi, a new genus and species of marine pseudokeronopsid hypotrichs is described from samples of water with bottom sediment collected from the coast of São Paulo state. Its phylogenetic affinities to the "core urostyloids" are hypothesized based on analyses of the 18S-rDNA marker, and a new subfamily, the Nothoholostichinae subfam. nov., is erected to name the monophylum composed of pseudokeronopsids in which the anterior corona is usually formed by four frontal cirri. In addition, the new combination Monocoronella longissima comb. nov. is proposed for Nothoholosticha longissima (Dragesco & Dragesco-Kernéis, 1986) Li et al., 2009

Description and molecular phylogeny of Paramecium grohmannae sp. nov. (Ciliophora, Peniculida) from a wastewater treatment plant in Brazil

A new morphological species of Paramecium Müller, 1773, was discovered in samples of water with activated sludge of a wastewater treatment plant in Rio de Janeiro, Brazil. It is described based on light microscopy and its phylogenetic position hypothesized from 18S-rDNA analyses. Paramecium grohmannae sp. nov. is characterized by a unique combination of features. It is a counterclockwise rotating freshwater Paramecium with body outline intermediate between “aurelia” and “bursaria” forms, two contractile vacuoles, each with one excretion pore and usually nine collecting canals; oral opening slight below body equator; macronucleus ellipsoid to obovoid, measuring ~64 x 24 μm and located in anterior half of body; one (less frequently two) globular endosomal micronuclei ~5 μm in diameter with endosome ~2.5 μm. Phylogenetic analyses unambiguously place the new species within the P. multimicronucleatum complex

Distance matrix of 18S-rDNA sequences of representatives of the Pseudokeronopsidae.

<p>Distance matrix of 18S-rDNA sequences of representatives of the Pseudokeronopsidae.</p

Part of the analyzed nucleotide matrix containing the Pseudokeronopsidae and showing the positions that are identity markers for the Nothoholostichinae subfam.

<p>nov. (rectangle) within the context of studied data. NCBI/GenBank accession codes are displayed left of species names.</p