Kerteszia subgenus of Anopheles associated with the Brazilian Atlantic rainforest:current knowledge and future challenges

Background: The Atlantic rainforest ecosystem, where bromeliads are abundant, provides an excellent environment for Kerteszia species, because these anophelines use the axils of those plants as larval habitat. Anopheles (K.) cruzii and Anopheles (K.) bellator are considered the primary vectors of malaria in the Atlantic forest. Although the incidence of malaria has declined in some areas of the Atlantic forest, autochthonous cases are still registered every year, with Anopheles cruzii being considered to be a primary vector of both human and simian Plasmodium. Methods: Recent publications that addressed ecological aspects that are important for understanding the involvement of Kerteszia species in the epidemiology of malaria in the Atlantic rainforest in the Neotropical Region were analysed. Conclusion: The current state of knowledge about Kerteszia species in relation to the Atlantic rainforest ecosystem was discussed. Emphasis was placed on ecological characteristics related to epidemiological aspects of this group of mosquitoes. The main objective was to investigate biological aspects of the species that should be given priority in future studie

A equipe multiprofissional da 'Saúde da Família': uma reflexão sobre o papel do fisioterapeuta 'Family health' multiprofessional teams: a reflection on the physiotherapist's role

Este artigo pretende contribuir para o debate instituído sobre a composição das equipes de Saúde da Família. Deve ser apreendido como uma reflexão sobre a possibilidade de integração do fisioterapeuta nas equipes, na intenção de mostrar os aspectos da profissão que a tornam capaz de potencializar a resolutividade da atenção básica. No estudo, foram analisados os documentos legais que aprovam as normas para habilitação ao exercício da profissão de fisioterapeuta. Nos anos setenta e oitenta, acompanhando a reforma sanitária brasileira, tais documentos oficializaram o processo que levou a fisioterapia, profissão historicamente reconhecida pela atuação clínica, a mudar seu objeto de trabalho, aproximando o fisioterapeuta de práticas preventivas e de promoção da saúde, típicas do primeiro nível do cuidado. Concluiu-se que tal mudança abriu importante espaço de integração ainda pouco trabalhado e propõe-se seu aprofundamento, direcionando a reflexão para as formas de integração e a necessidade que se impõe aos gestores de planejar suas ações de forma articulada com a comunidade, a partir da análise da situação de saúde no nível local, garantindo a intervenção sobre problemas e grupos populacionais prioritários.<br>This article is intended to contribute for the debate instituted about the composition of "Family Health" teams. It must be understood as a reflection about the possibility of integrating the physiotherapist to those teams, aiming to present some aspects of the profession that might potentially improve the outcomes of primary health care. On this study, we analyze the legal documents that approve the rules for qualifying professional physiotherapists. In the 1970s and 1980s, following Brazilian sanitary reform, those documents made official the process that led physiotherapy, which was historically recognized for its clinic acting, into a shift on its work object. This change approximated physiotherapists to preventive and health promotion practices, typical of the first level of care. We conclude that such changes opened an important space for integration still little explored. We propose to strengthen these new fields, by focusing the reflection on integration forms and on the necessity to impose to managers to plan their actions in association with the community, taking into account the local health situation and assuring intervention on problems according to priority population groups

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease