O conteúdo lógico da lei: conhecimento, linguagem, jurisprudência e o vínculo normativo do direito

Este artigo aborda a questão da verdade como fundamento do Direito. Para tanto, será confrontada a proposta de Tarski sobre verdade como correspondência (que se vale da metalinguagem, é atomista, representacionista e insuficiente para explicar a formação do conhecimento jurídico) com a proposta de Brandom sobre o inferencialismo (que é holístico, expressivista e explica a formação do conhecimento jurídico para o neopragmatismo). A metodologia utilizada é a revisão bibliográfica. Como proposta original, será proposto que a jurisprudência tem a função de tornar explícito o jogo processual entre os atores jurídicos de dar e receber razões, ou seja, os compromissos inferenciais; o que tem ligação direta com o vínculo normativo do Direito

AVALIAÇÃO DA ATIVIDADE BACTERICIDA DE DESINFETANTES COMERCIAIS EM AMOSTRAS BACTERIANAS ISOLADAS DE BANHEIROS PÚBLICOS

A contaminação por microrganismos patogênicos pode estar relacionada com o contato com superfícies inanimadas como vasos sanitários. Diante dessa realidade, o presente estudo teve como objetivo avaliar a atividade bactericida de cinco desinfetantes comerciais (o-benzil p-clorofenol 0,9%, quaternário de amônio - 0,45%, 0,30%, 0,28% e 0,25%), comparado a bactérias isoladas de vasos sanitários públicos. As amostras bacterianas foram coletadas usando a técnica com swabs e coradas pela coloração de Gram. Das amostras isoladas E. coli, Proteus e Staphylococcus sp. foram escolhidas para os demais testes. Foram realizados testes de esterilidade dos desinfetantes utilizando os meios MacConkey e Muller-Hinton a fim de evitar resultados não confiáveis. As atividades bactericidas de desinfetantes estéreis foram avaliadas frente as bactérias escolhidas. Os resultados mostraram que o princípio ativo a benzil - p - clorofenol 0,9% obteve eficácia contra os três microrganismos, ao passo que o princípio ativo de quaternário de amônia, em diferentes concentrações foi eficaz em algumas bactérias, mas que foi diminuindo a sua atividade durante o período de 21 dias

Development of a quantitative health inspection instrument in food and nutrition services, Brazil

O estudo visou desenvolver um Instrumento Quantitativo para Inspeção Sanitária (IQIS) em serviços de alimentação e nutrição de grande porte no Brasil. Utilizou-se a tecnologia de inspeção, no Modelo de Avaliação do Risco Potencial (MARP) e legislação sanitária brasileira. Estruturaram-se 12 dimensões, 41 módulos, 57 indicadores de controle de riscos (críticos/não críticos), numa escala de 0-5, totalizando 1.512 índices com codificação de respostas fechadas. O IQIS foi validado com o Coeficiente de Kappa, com excelente concordância para atributos de clareza e relevância (k = 0,82 e k = 0,92) e boa concordância para o atributo aplicabilidade (k = 0,78). O teste de Kruskal-Wallis mostrou inexistir diferença significativa entre as avaliações (p = 0,423), o Coeficiente de Correlação Intraclasse foi satisfatório (CCI = 0,53), o Alpha de Cronbach (α = 0,71) aceitável. O resultado final possibilitou classificar o serviço como tendo risco sanitário inaceitável. Considera-se o IQIS com conteúdo validado, tendo confiabilidade e reprodutibilidade para avaliação higiênico-sanitária, sendo uma inovação tecnológica para serviços de alimentação e nutrição e vigilância sanitária, possibilitando inspeção detalhada e rigorosa.The study aimed to develop a Quantitative Instrument for Sanitary Inspection (QISI) in large food and nutrition services in Brazil. The inspection technology, based on the Potential Risk Assessment Model (PRAM) and Brazilian sanitary legislation, was used. 12 dimensions, 41 modules, and 57 risk control indicators (critical/non-critical) were associated with an interval scale of 0-5, totaling 1,512 indexes with closed response coding. The QISI was validated with the Kappa Coefficient, with excellent agreement for attributes of clarity and relevance (k = 0.82 and k = 0.92) and good agreement for the applicability attribute (k = 0.78). The Kruskal-Wallis test showed no statistically significant difference between the evaluations (p = 0.423), the Intraclass Correlation Coefficient was satisfactory (ICC = 0.53), the Cronbach's Alpha (α = 0.71) was considered acceptable, as well as the final result of the evaluation made it possible to classify the service as having an unacceptable health risk. The QISI was considered with validated content, having reliability and reproducibility to evaluate the hygienic-sanitary conditions, being a technological innovation for food and nutrition services and sanitary surveillance, allowing a detailed and rigorous inspection.info:eu-repo/semantics/publishedVersio

Infection of Anopheles aquasalis from symptomatic and asymptomatic Plasmodium vivax infections in Manaus, western Brazilian Amazon

BACKGROUND: Asymptomatic individuals are one of the major challenges for malaria elimination programs in endemic areas. In the absence of clinical symptoms and with a lower parasite density they constitute silent reservoirs considered important for maintaining transmission of human malaria. Studies from Brazil have shown that infected individuals may carry these parasites for long periods. RESULTS: Patients were selected from three periurban endemic areas of the city of Manaus, in the western Brazilian Amazon. Symptomatic and asymptomatic patients with positive thick blood smear and quantitative real-time PCR (qPCR) positive for Plasmodium vivax were invited to participate in the study. A standardised pvs25 gene amplification by qPCR was used for P. vivax gametocytes detection. Anopheles aquasalis were fed using membrane feeding assays (MFA) containing blood from malaria patients. Parasitemia of 42 symptomatic and 25 asymptomatic individuals was determined by microscopic examination of blood smears and qPCR. Parasitemia density and gametocyte density were assessed as determinants of infection rates and oocysts densities. A strong correlation between gametocyte densities (microscopy and molecular techniques) and mosquito infectivity (P < 0.001) and oocysts median numbers (P < 0.05) was found in both groups. The ability to infect mosquitoes was higher in the symptomatic group (41%), but infectivity in the asymptomatic group was also seen (1.42%). CONCLUSIONS: Although their infectivity to mosquitoes is relatively low, given the high prevalence of P. vivax asymptomatic carriers they are likely to play and important role in malaria transmission in the city of Manaus. The role of asymptomatic infections therefore needs to be considered in future malaria elimination programs in Brazil

Same-day initiation of oral pre-exposure prophylaxis among gay, bisexual, and other cisgender men who have sex with men and transgender women in Brazil, Mexico, and Peru (ImPrEP): a prospective, single-arm, open-label, multicentre implementation study.

BACKGROUND: Although gay, bisexual, and other cisgender men who have sex with men (MSM) and transgender women have the highest HIV burden in Latin America, pre-exposure prophylaxis (PrEP) implementation is poor. We aimed to assess the feasibility of same-day oral PrEP delivery in Brazil, Mexico, and Peru. METHODS: Implementation PrEP (ImPrEP) was a prospective, single-arm, open-label, multicentre PrEP implementation study conducted in Brazil (14 sites), Mexico (four sites), and Peru (ten sites). MSM and transgender women were eligible to participate if they were aged 18 years or older, HIV-negative, and reported one or more prespecified criteria. Enrolled participants received same-day initiation of daily oral PrEP (tenofovir disoproxil fumarate [300 mg] coformulated with emtricitabine [200 mg]). Follow-up visits were scheduled at week 4 and quarterly thereafter. We used logistic regression models to identify factors associated with early loss to follow-up (not returning after enrolment), PrEP adherence (medication possession ratio ≥0·6), and long-term PrEP engagement (attending three or more visits within 52 weeks). This study is registered at the Brazilian Registry of Clinical Trials, U1111-1217-6021. FINDINGS: From Feb 6, 2018, to June 30, 2021, 9979 participants were screened and 9509 were enrolled (Brazil n=3928, Mexico n=3288, and Peru n=2293). 543 (5·7%) participants were transgender women, 8966 (94·3%) were cisgender men, and 2481 (26·1%) were aged 18-24 years. There were 12 185·25 person-years of follow-up. 795 (8·4%) of 9509 participants had early loss to follow-up, 6477 (68·1%) of 9509 were adherent to PrEP, and 5783 (70·3%) of 8225 had long-term PrEP engagement. Transgender women (adjusted odds ratio 1·60, 95% CI 1·20-2·14), participants aged 18-24 years (1·80, 1·49-2·18), and participants with primary education (2·18, 1·29-3·68) had increased odds of early loss to follow-up. Transgender women (0·56, 0·46-0·70), participants aged 18-24 years (0·52, 0·46-0·58), and those with primary education (0·60, 0·40-0·91) had lower odds of PrEP adherence. Transgender women (0·56, 0·45-0·71), participants aged 18-24 years (0·56, 0·49-0·64), and those with secondary education (0·74, 0·68-0·86) had lower odds of long-term PrEP engagement. HIV incidence was 0·85 per 100 person-years (95% CI 0·70-1·03) and was higher for transgender women, participants from Peru, those aged 18-24 years, Black and mixed-race participants, and participants who were non-adherent to PrEP. INTERPRETATION: Same-day oral PrEP is feasible for MSM and transgender women in Latin America. Social and structural determinants of HIV vulnerability need to be addressed to fully achieve the benefits of PrEP. FUNDING: Unitaid, WHO, and Ministries of Health in Brazil, Mexico, and Peru. TRANSLATIONS: For the Portuguese and Spanish translations of the abstract see Supplementary Materials section

Epidemiologia molecular e fatores de risco para aquisição de clones endêmicos de Staphylococcus aureus resistente à Meticilina (MRSA) em hospital de ensino

Os Staphylococcus aureus são os principais microrganismos causadores de infecções nosocomiais, com uma grande variedade de manifestações clínicas, a variação deste espectro de manifestações geralmente depende dos numerosos fatores de virulência que cada cepa produz, entretanto, a importância desses patógenos está inserida na combinação da virulência mediada por suas toxinas, seu caráter invasivo e seu perfil de resistência a antibióticos. O presente estudo teve por objetivos documentar a disseminação de clones endêmicos e identificar os fatores individuais relacionados à sua aquisição, e relacioná-los a prevalência de fatores de resistência e virulência em cepas de MRSA isoladas de culturas clínicas e/ou de vigilância de pacientes de um hospital de ensino. No presente trabalho 1078 amostras de Staphylococcus aureus provenientes de pacientes internados no Hospital Estadual Bauru foram identificadas e testadas fenotipicamente frente a oxacilina (1 g), cefoxitina (30 g), vancomicina (30 g), eritromicina (15 g) e gentamicina (10 g) sendo que dessas, 810 (75.1%) apresentaram perfil fenotípico para Staphylococcus aureus Resistentes a Meticilina – MRSA. A avaliação genotípica do perfil de resistência foi realizada através da amplificação do gene mecA pela técnica de PCR onde foi observado que das 443 amostras testadas foi detectado o gene mecA em 336 amostras (75.8%), e que dessas, 305 amostras (90.8%) apresentaram perfil SCCmec Tipo III ou Tipo IIIA, 6 amostras (1.8%) Tipo II e 25 amostras (7.4%) Tipo IV. A avaliação do perfil genotípico de virulência mostrou a seguinte distribuição, 15.6% (n=69) genes da Leucocidina de Panton Valentine (lukPV), 14% (n=62) gene da Síndrome do Choque Tóxico (tst), 31.8% (n=141) gene da Enterotoxina A (sea), 19.8% (n=88) gene da Enterotoxina B (seb), 38.1% (n=169) gene da...Staphylococcus aureus are the most common microorganisms causing nosocomial infections, with a wide variety of clinical manifestations, the variation of the spectrum of manifestations generally depends upon the numerous virulence factors that each strain produces, however, the importance of these pathogens is included in the combination of virulence mediated by their toxins, its invasive nature and profile of antibiotic resistance. This study aimed to document the spread of endemic clones and identify the individual factors related to its acquisition, and relate them to the prevalence of resistance and virulence factors in strains of MRSA isolated from clinical cultures and / or surveillance patients a teaching hospital. In this study 1078 samples of Staphylococcus aureus from hospitalized patients in Bauru State Hospital were identified phenotypically and tested against oxacillin (1  g), cefoxitin (30  g), vancomycin (30  g), erythromycin (15  g) and gentamicin (10  g) and that these, 810 (75.8%) showed phenotypic profile for Methicillin Resistant Staphylococcus aureus - MRSA. The evaluation of genotypic resistance profiles was performed by amplification of the mecA gene by PCR where it was observed that of 443 samples tested was detected mecA gene in 336 samples (75.8%), and that these, 305 samples (90.8%) profile were SCCmec type III or type IIIA, six samples (1.8%) type II and 25 samples (7.4%) type IV. The evaluation of virulence genotype was distributed as follows, 15.6% (n = 69) genes of Panton Valentine Leukocidin (lukPV), 14% (n = 62) gene for toxic shock syndrome (tst), 31.8% (n = 141) gene of enterotoxin A (sea), 19.8% (n = 88) gene of enterotoxin B (seb), 38.1% (n = 169) gene of enterotoxin C (sec-1), 100% (n = 443) Delta Hemolysin gene (hld), 99.5% (n = 441) Alpha Hemolysin gene (hla), 0.9% (n = 4) Exfoliative toxin A (eta), 3.6% (n = 16) Exfoliative... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES