MORTALIDADE POR CAUSAS GARBAGE NOS MUNICÍPIOS BRASILEIROS: DIFERENÇAS ENTRE AS ESTIMATIVAS DIRETAS E INDIRETAS EM 2015 A 2017

Objectives: the present study aims to generate estimates of mortality rates due to garbage codes (GC) for municipalities in Brazil by comparing direct and indirect methods, based on deaths registered in the Mortality Information System (SIM) between 2015 and 2017. Methods: Data from the SIM were used. The analysis was performed in groups of GC, levels 1 and 2, levels 3 and 4 and total GC. Mortality rates were estimated directly and indirectly, Empirical Bayesian Estimators. Results: about 38% of CG were estimated and regional differences in mortality rates were observed, higher in the Northeast and Southeast and lower in the South and Midwest. The Southeast presented similar rates for the two groups of CG analyzed. The smallest differences between direct and indirect estimates were observed in large cities, above 500 thousand. The municipalities in the north of Minas Gerais and the states of Rio de Janeiro, São Paulo and Bahia presented municipalities with high rates at levels 1 and 2. Conclusion: there are differences in the quality of the definition of the underlying causes of death, even with the use of indirect methodology which assists in smoothing rates. The quality of the definition of causes of death is important since they are associated with the access and quality of health services and offer subsidies for health planning.Objetivos: o presente estudo tem como objetivo gerar estimativas das taxas de mortalidade por causas garbage (CG) para os municípios do Brasil fazendo a comparação entre métodos diretos e indiretos, tendo como base os óbitos registrados no SIM entre 2015 e 2017. Métodos: Os dados do Sistema de Informações sobre Mortalidade (SIM) foram utilizados. A análise foi realizada com grupos de GC, níveis 1 e 2, níveis 3 e 4 e total de GC. As taxas de mortalidade foram estimadas de forma direta e indireta, estimadores bayesianos empíricos. Resultados: observou-se cerca de 38% de CG e diferenças regionais nas taxas de mortalidade, maiores no Nordeste e Sudeste e menores no Sul e Centro-Oeste. O Sudeste apresentou taxas semelhantes para os dois grupos de CG analisados. As menores diferenças entre as estimativas diretas e indiretas foram observadas nas grandes cidades, acima de 500 mil. Os municípios do norte de Minas Gerais e estados do Rio de Janeiro, São Paulo e Bahia apresentaram municípios com altas taxas nos níveis 1 e 2. Conclusão: existem diferenças na qualidade da definição das causas básicas de morte, mesmo com o uso de metodologia indireta que auxilia na suavização das taxas. A qualidade da definição das causas de morte é importante, uma vez que se mostram associadas com o acesso e qualidade dos serviços de saúde e oferecem subsídios para o planejamento em saúde

Have the cake and eat it: optimizing nondestructive DNA metabarcoding of macroinvertebrate samples for freshwater biomonitoring

Resource ArticleDNA metabarcoding can contribute to improving cost‐effectiveness and accuracy of biological assessments of aquatic ecosystems, but significant optimization and standardization efforts are still required to mainstream its application into biomonitoring programmes. In assessments based on freshwater macroinvertebrates, a key challenge is that DNA is often extracted from cleaned, sorted and homogenized bulk samples, which is time‐consuming and may be incompatible with sample preservation requirements of regulatory agencies. Here, we optimize and evaluate metabarcoding procedures based on DNA recovered from 96% ethanol used to preserve field samples and thus including potential PCR inhibitors and nontarget organisms. We sampled macroinvertebrates at five sites and subsampled the preservative ethanol at 1 to 14 days thereafter. DNA was extracted using column‐based enzymatic (TISSUE) or mechanic (SOIL) protocols, or with a new magnetic‐based enzymatic protocol (BEAD), and a 313‐bp COI fragment was amplified. Metabarcoding detected at least 200 macroinvertebrate taxa, including most taxa detected through morphology and for which there was a reference barcode. Better results were obtained with BEAD than SOIL or TISSUE, and with subsamples taken 7–14 than 1–7 days after sampling, in terms of DNA concentration and integrity, taxa diversity and matching between metabarcoding and morphology. Most variation in community composition was explained by differences among sites, with small but significant contributions of subsampling day and extraction method, and negligible contributions of extraction and PCR replication. Our methods enhance reliability of preservative ethanol as a potential source of DNA for macroinvertebrate metabarcoding, with a strong potential application in freshwater biomonitoringinfo:eu-repo/semantics/publishedVersio

A relação entre PIB per capita e os acidentes de transporte nos municípios brasileiros, 2005, 2010 e 2015

Objective: The main objective of this paper is to analyze the relationship between GDP and three variables related to traffic accidents in Brazilian municipalities: traffic accident mortality, deaths per vehicle; and vehicles per inhabitant. Methods: 2005, 2010 and 2015 terrestrial traffic accident (ATT) mortality rates were estimated using a three years moving average and were standardized, then, we applied the empirical Bayes estimator (EBE). Fatality rates (deaths per vehicle) also were based on EBE. Vehicles per inhabitant considered the ratio between vehicle fleet and the population at municipal level. For every studied year, we estimated linear regression models between GDP and the interest variables.  Results: Variables distribution indicates that, between 2005 and 2015, GDP and vehicles per inhabitant kept the same rising relationship. Fatality rates show a decreasing association with GDP. TA mortality distribution with GDP presented a pattern close to an inverted-U. Model coefficients practically did not change for the vehicle per inhabitant. Estimated association between deaths per vehicle and GDP kept the same sign, but diminished between 2005 and 2015. Model coefficient sign changed in 2015 for TA mortality. Conclusion: Similarly to what was observed in developed countries, the relationship between mortality from traffic accidents and GDP changed in the analyzed period.Objetivo: O artigo pretende analisar a relação entre o PIB per capita e três variáveis relacionadas aos acidentes de transporte nos municípios brasileiros: a mortalidade por acidentes de transporte terrestre (ATT); as mortes por veículo; e o número de veículos por pessoa.  Métodos: As taxas de mortalidade por ATT foram estimadas (2005, 2010 e 2015) por meio do estimador bayesiano empírico (EBE). A taxa de mortalidade por veículo foi também estimada pelo EBE. O número de veículos por pessoa foi baseado na razão entre a frota de automóveis e a população residente.  Para os três anos em análise, estimamos um modelo de regressão linear entre o PIB per capita municipal e as três variáveis de interesse.  Resultados: A distribuição das variáveis mostra que a relação entre o PIB e número de veículos por pessoa se manteve crescente ao longo dos anos, e foi sempre negativa considerando  as mortes por veículo. A taxa mortalidade por ATT apresentou distribuição próxima a um U-invertido.  Os coeficientes do modelo de regressão praticamente não variaram para a relação entre PIB e os veículos por habitante. O sinal para o modelo com a taxa de mortalidade por veículo se manteve o mesmo (negativo), mas apresentou diminuição. A taxa mortalidade por ATT, por sua vez, apresentou inversão do sinal em 2015.  Conclusões: De modo similar ao observado nos países desenvolvidos, parece ter havido uma inversão na relação entre mortalidade por ATT e PIB nos municípios brasileiros entre 2005 e 2015

A Abordagem Laparoscópica na Apendicite Aguda

Background: The appendectomy is the most frequently performed surgery in the Emergency Service. The introduction of the lapa- roscopic approach (LA) in the treatment of acute appendicitis has not received, in the surgical community, the same acceptance that it obtained in other acute conditions. With this work, the authors present the growing acceptance that the LA has been acquiring in the Surgical Service that they represent, and they also want to demonstrate the advantages of this approach towards the laparotomic approach. Materials and Methods: Observational retrospective study consisting of patients undergoing appendectomy for acute appendicitis between 01/11/2008 to 31/10/2010 in the Emergency Service of the CHTS, EPE. Results: In the presented series 477 patients were subjected to an appendectomy, 9,6% of which through an LA. For both surgical approaches, the average age was 33,1 years (CI 91%:29,6-37,4) to LA and 37,3 years (CI 91%:31,7-38, 9) to laparotomic approach, p = 0,11; the female gender represented 19,0% of patients undergoing LA and 42,0% of patients undergoing laparotomy, p = 0,03. The duration of the hospital stay in LA was 3,2 days (CI 91% :2,4-4, 0) and 4,2 days (CI 91%:3,9-4, 4) in the laparotomic approach, p = 0,041 ; postoperative complications occurred in 7,7% of patients undergoing laparotomy and 8,7% of patients receiving LA, p = 0,8. There was no mortal- ity in this series.Conclusions: The LA, in the treatment of acute appendicitis, increased considerably over the two years of the study. It allows better cosmetic results and shorter hospital stay. It revelas a complication rate similar to the one of the laparotomic approach and can be used safely in patients with complicated acute appendicitis.  Keywords: acute appendicitis, appendectomy, laparoscopic approach    Introdução: A apendicectomia é a cirurgia efectuada com mais frequência no Serviço de Urgência. A introdução da abordagem lapa- roscópica (AL) no tratamento da apendicite aguda não recebeu, na comunidade cirúrgica, a mesma aceitação que obteve em outras patologias agudas. Com este trabalho, os autores apresentam a crescente aceitação que a AL tem vindo a adquirir no Serviço Cirúr- gico que representam e pretendem, também, expor as vantagens desta abordagem em relação à abordagem laparotómica. Material e Métodos: Estudo retrospectivo observacional constituído por doentes submetidos a apendicectomia, por apendicite aguda, entre 01/11/2008 e 31/10/2010 no Serviço de Urgência do CHTS, EPE. Resultados: Na série apresentada foram submetidos a apendicec- tomia 477 doentes, 9,6% por AL. Para as duas abordagens cirúrgicas, a média de idades foi de 33,1 anos (IC 91%:29,6-37,4) para a AL e 37,3 anos (IC 91%:31,7-38,9) para a abordagem laparotómica, p=0,11; o género feminino representou 19,0% dos doentes submetidos a AL e 42,0% dos doentes submetidos a abordagem laparotómica, p=0,03. O tempo de internamento na AL foi de 3,2 dias (IC 91%:2,4-4,0) e 4,2 dias (IC 91%:3,9-4,4) na abordagem laparotómica, p=0,041; as complicações pós-operatórias ocorreram em 7,7% dos doentes submetidos a abordagem laparotómica e em 8,7% dos doentes submetidos a AL, p=0,8. A mortalidade foi nula nesta série. Conclusões: A AL, no tratamento da apendicite aguda, aumentou consideravelmente ao longo dos dois anos a que se refere o estudo. Permite obter melhores resultados estéticos e menor tempo de internamento. Apresenta uma taxa de complicações idêntica à abordagem laparotómica e pode ser utilizada, de forma segura, em doentes com apendicite aguda complicada. Palavras-Chave: apendicite aguda, apendicectomia, abordagem laparoscópica.

Alergia ao látex e à banana em crianças com mielomeningocele na cidade do Rio de Janeiro

Recentemente, reações de hipersensibilidade do tipo I ao látex foram relatadas com freqüência, principalmente nos indivíduos cujo contato com produtos de látex é íntimo e freqüente. Crianças com mielomeningocele (MMC) são as que mais se sensibilizam ao látex, pelo contato freqüente e precoce com este material. Reações alérgicas cruzadas entre alimentos são conhecidas há anos. Atualmente, a alergia ao látex é freqüentemente associada à alergia a frutas como abacate, banana, kiwi, grapefruit, pêssego, papaia e castanha. OBJETIVOS: O objetivo deste trabalho consistiu em identificar o número de pacientes com MMC e sensibilização clínico-laboratorial à banana e ao látex. MÉTODOS: Questionários foram aplicados a 33 crianças com MMC, e sangue foi colhido de 30 para ser efetuada a dosagem de imunoglobulina E (IgE) específica (RAST Pharmacia) para látex, e de 29 para banana. Foi considerada positiva a IgE específica igual ou superior à classe I. RESULTADOS: Quatro crianças relataram histórias de urticária com látex, e uma criança descreveu urticária e diarréia com banana. 14/30 (46,6%) apresentavam IgE específica para látex positiva, e 4/29 (13,7%) para banana. Nenhum cruzamento de variáveis foi estatisticamente significativo com a sensibilização clínico laboratorial ao látex e à banana. CONCLUSÕES: Identificou-se elevada prevalência de alergia ao látex e à banana no grupo de pacientes com MMC. No Brasil necessitamos de mais estudos para analisar a prevalência de reações alérgicas cruzadas entre alimentos e látex em crianças com MMC.<br>PURPOSE: Recently, latex type I hypersensibility reactions were frequently described, mainly in children with myelomeningocele (MMC), which maintain earlier intimate and frequent contact with latex products. Allergic food cross-reactions are well known for many years. Nowadays, latex allergy is frequently associated with food allergies to avocado, banana, kiwi, grapefruit, papaya, chestnut and peach. BACKGROUND: The objective of this study consisted in identifying the number of patients with myelomeningocele (MMC) and banana-latex clinico-laboratorial sensitization. METHODS: Questionnaires were applied to 33 children with MMC, and blood was collected from 30 to perform latex Ig E (RAST Pharmacia), and from 29 to banana Ig E. Specific Ig E equal or above class I was considered positive. RESULTS: Four children related histories of latex contact urticaria, and one child related a history of urticaria and diarrhea with banana. 14/30 (46.6%) were latex Ig E positive, and 4/29 (13.7%) to banana. There was no statistically significant association between variables. CONCLUSIONS: We identified high prevalence of latex and banana allergies in patients with MMC, and we need more studies to analyze the prevalence of food-latex allergic cross-reactions in children with MMC

Gastroesophageal Foreign Bodies in Dogs - Endoscopy and Surgical Removal

Background: Gastroesophageal foreign bodies (GFD) are commonly diagnosed in dogs and are considered an endoscopic emergency that, although not resulting in serious clinical sequelae or mortality, can compromise the health and well-being of the patient. The use of the digestive endoscopy for the diagnosis and treatment of GFD can be a valuable and viable alternative. There are cases of GFD in dogs for which the indicated treatment is surgery, which can be performed using minimally invasive or conventional techniques, associated or not with flexible endoscopy. The objective of this work is to describe 16 cases of GFD removal in dogs demonstrating the efficiency of upper digestive endoscopy. Cases: Of the 16 GFD cases, 63% (10/16) were male and 37% (6/16) female. Most aged under 1 year (63%), puppies (5/16) and juveniles (5/16). The patient with the lowest body weight was a miniature pinscher weighing 0.8 kg (Case 14) and the heaviest was an American Pit Bull Terrier weighing 28 kg (Case 11), the mean body weight of patients diagnosed with GFD was 10.2 ± 6.7 kg. Small and medium breeds were more affected, 44.7% (7/16) and 44.7% (7/16), respectively, and large breeds (Golden Retrievier and Bull Terrier), from cases 1 and 4, the least affected, 12.6% (2/16) of the cases. The 16 patients underwent a 12 h food fast and a 4 h water fast, as gastrointestinal emptying in these cases of GFD can be influenced by these foreign bodies. All underwent general inhalation anesthesia with monitoring of physiological parameters (temperature, heart rate, respiratory rate, oxygen saturation and blood pressure) before, during and after EGD, being positioned in left lateral decubitus. The 16 canine patients with suspected GFD underwent EGD for diagnostic confirmation and removal of foreign bodies. Five esophageal FB were diagnosed, 31% (5/16), and 11 gastric FB, 69% (11/16). The most frequently diagnosed foreign bodies were bone and tissue, 37.5% (6/16) and 31% (5/16). Other foreign bodies were materials such as plastics, metals, rubber, foam and stone. Of the 16 cases of GFD, EGD efficiently treated 88% (14/16) without the need for hospitalization, with only supportive treatment for the remission of complications caused by the presence of foreign bodies in the gastroesophageal tract. The main complications related to the presence of GFD were esophagitis in 25% (4/16) of cases, gastritis in 38% (6/16) and both alterations in 13% (2/16). Discussion: In this work, we can observe that more than a third of the clinical cases of treated dogs were diagnosed with GFD, demonstrating that these cases are common in the veterinary clinic. Most of these animals were males less than 1 year old. The improvement of learning in this category can lead these animals to exacerbated oral exploration of new objects. Most FBs were found in the stomach because they were of adequate size, consistency and shape for their passage through the esophagus, whereas esophageal FBs were all bone fragments of rigid consistency with diameters and sizes larger than the esophageal lumen. The interval between the ingestion of the object and the veterinary care can be decisive for the removal of the FB in the esophagus or stomach. Most gastric FBs removed were fabrics and plastics, flexible objects that can pass through the esophageal lumen more easily. Removal of GFD by endoscopy was performed with a high success rate, with only 2 cases being resolved by esophagostomy and gastrotomy. Flexible endoscopy proved to be an efficient technique for removing treated GFD, which can help remove FB during esophagotomy and be associated with rigid endoscopy. Patients recovered quickly and without complications, but it is important to emphasize that inadequate maneuvers and conducts can determine other outcomes. The use of endoscopy for GFD removal needs to be more popularized, as it can ensure better results for dogs treated with GFD. Keywords: digestive tract, endoscopic extraction, flexible endoscopy, ingested object, rigid endoscopy

Encapsulated pine bark polyphenolic extract during gastrointestinal digestion: bioaccessibility, bioactivity and oxidative stress prevention

Polyphenolic extracts from pine bark have reported different biological actions and promising beneficial effects on human health. However, its susceptibility to environmental stresses (temperature, storage, etc.) and physiological human conditions prequires the development of efficient protection mechanisms to allow effective delivering of functionality. The aim of this work was to encapsulate pine bark extract rich phenolic compounds by spray-drying using maltodextrin, and understand the influence of encapsulation on the antioxidant and antimicrobial activity and bioaccessibility of phenolic compounds during gastrointestinal digestion. The optimized process conditions allowed good encapsulation efficiency of antioxidant phenolic compounds. The microencapsulation was effective in protecting those compounds during gastrointestinal conditions, controlling their delivery and enhancing its health benefits, decreasing the production of reactive oxygen species implicated in the process of oxidative stress associated with some pathologies. Finally, this encapsulation system was able to protect these extracts against acidic matrices, making the system suitable for the nutritional enrichment of fermented foods or fruit-based beverages, providing them antimicrobial protection, because the encapsulated extract was effective against Listeria innocua. Overall, the designed system allowed protecting and appropriately delivering the active compounds, and may find potential application as a natural preservative and/or antioxidant in food formulations or as bioactive ingredient with controlled delivery in pharmaceuticals or nutraceuticals.This research was funded by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020-Programa Operacional Regional do Norte. The study was also supported by program INTERREG V-B Sudoe (REDVALUE, SOE1/P1/E0123) and by the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant (MSCARISE; FODIAC; 778388). P.F.-S. is supported by a doctoral advanced training fellowship (call NORTE69-2015-15), funded under the scope of Norte2020 (NORTE-08-5369-FSE-000036). R.I. thanks the University of Lleida for the UdL-Impuls post-doctoral contract.info:eu-repo/semantics/publishedVersio

Distinctive features of composts of different origin: a thorough examination of the characterization results

The potential of composts produced from different origin residues to be used in environmentally friendly agriculture is addressed in this work. Seven composts obtained from different raw materials and composting methodologies are compared using elemental, thermal and spectroscopic characterization data. Despite the stabilization of the organic matter in all composts being adequate for agricultural applications, they display distinct elemental and structural compositions. Likewise, the fertilisers have very different effects on lettuce growth. Despite the observed differences, some common features were found, namely a mass loss (TGA) of 25.2 g per mol C, association between groups of elements (Fe, Al, Ni, Co, Cr, Cu and S; Mg, Na, K and P, C, Coxi, N and Pb) and correlations between the amount of carbon nanostructures and the characteristic aromaticity parameters. These results suggest that the tuning of the compost features for specific cultures may be possible for sustainable food production.This work was financially supported by the Interreg VA Spain-Portugal Programme (EU) through the project Res2ValHum (0366_RES2VALHUM_1_P). A.C. Silva acknowledges receipt of a PhD grant (UMINHO/BD/40/2016) financed by the Operational Programme Norte 2020 (through the Project “NORTE-08-5369-FSE-000033”). A. Teixeira acknowledges the grant (Res2ValHum 01/2018) to develop experimental work for 11 months on the project. J. Antelo and S. Fiol are also grateful for the financial support provided by Xunta de Galicia—Consellería de Educación e Ordenación Universitaria de Galicia (Consolidation of Competitive Groups of Investigation; GI-1245, ED431C 2018/12 and CRETUS AGRUP2015/02, ref. 2018-PG10)

Anatomy Teaching at the School of Health Sciences of University of Minho

info:eu-repo/semantics/publishedVersio

Reemergence of Oropouche Fever, Northern Brazil

Oropouche fever has reemerged in Parauapebas and Porto de Moz municipalities, Pará State, Brazil. Serologic analysis (immunoglobulin M–ELISA) and virus isolation confirmed Oropouche virus (OROV) in both municipalities. Nucleotide sequencing of 2 OROV isolates from each location indicated genotypes I (Parauapebas) and II (Porto de Moz) in Brazil