Avaliação das ações de vigilância sanitária: construção participativa de mecanismos para o monitoramento do desempenho da gestão

  Introduction: Evaluation focused on use is an important theoretical framework to be observed in proposing a pathway among those of the feld of evaluation to support the qualifcation of health management. Performance monitoring is considered a driving strategy for rationalizing management and decisions. Objective: To present the pathway carried out by the Agência Nacional de Vigilância Sanitária and the Hospital Alemão Oswaldo Cruz in the participatory construction process of mechanisms for monitoring management performance in subnational instances, as part of the implementation of the action – structural and technical mechanisms – that makes part of the frst line of execution of the Institutionalization of the project “Evaluative Practices: strategic management of the evidence-based health surveillance”. Method: Description of the participatory construction process of mechanisms for monitoring management performance in subnational instances, considering two dimensions – the involvement of the main stakeholders in the perspective of the use of monitoring and the building of theoretical and operational tools and utilization strategies. Results: The project was  implemented in four health surveillance institutions. It was permeated by the participatory feature since the strategy conception, to the modeling, to the formulation of the management devices and instruments of analysis and interpretation of the indicators. Conclusions: The project enabled the development of an institutional learning locus that valued not only the appreciation of results, but also the information production process itself. Therefore, it contributes to the institutionalization of changes and innovations in the execution of actions.Introdução: A avaliação focada na utilização constitui-se em referencial teórico importante a ser observado na proposição de um caminho entre tantos que o campo da avaliação oferece como suporte à qualifcação da gestão em saúde. O monitoramento do desempenho é considerado uma estratégia impulsionadora à racionalização da gestão e das decisões. Objetivo: Apresentar o caminho percorrido pela Agência Nacional de Vigilância Sanitária e pelo Hospital Alemão Oswaldo Cruz no processo de construção participativa de mecanismos para o monitoramento do desempenho da gestão em instâncias subnacionais, como parte da implantação da ação – mecanismos estruturais e técnicos – integrante da primeira linha de execução do projeto Institucionalização de Práticas Avaliativas: a gestão estratégica da vigilância sanitária baseada em evidências. Método: Descrição do processo de construção participativa de mecanismos para o monitoramento do desempenho da gestão em instâncias subnacionais, considerando duas dimensões – o envolvimento dos principais interessados na perspectiva do uso do monitoramento e a estruturação do instrumental teórico e operacional e de estratégias de utilização. Resultados: Projeto implantado em quatro instituições de Vigilância Sanitária, permeado pelo caráter participativo, desde a elaboração da  estratégia, à modelagem, à formulação dos dispositivos gerenciais e de instrumentos de análise e interpretação dos indicadores. Conclusões: O projeto viabilizou a instituição de um espaço de aprendizado institucional que valorizou não só a apreciação dos resultados, mas, também, o próprio processo de produção da informação, contribuindo, assim, com a instituição de mudanças e inovações na execução das ações

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

AIM: The 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. METHODS: This 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. RESULTS: Overall, 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 < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One 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

Evaluation of the surface roughness of a nanofilled composite resin submitted to different smoothing and finishing techniques

Abstract Introduction: Controlling the surface smoothness characteristics of the composite resin when performing a direct restorative technique is one of the factors involved in achieving restorative success. Objective: The purpose of this study was to evaluate the surface roughness of a nanofilled composite resin submitted to different smoothing and finishing techniques. Material and method: Fifty test specimens were made with the Z350 XT composite resin (3M ESPE) and then divided into five study groups according to the smoothing and finishing method applied, as follows: G1 (control), polyester strip; G2, composite spatula; G3, brush cleaned with absolute alcohol and dried; G4, brush cleaned with absolute alcohol, dried and moistened with Single Bond (3M ESPE); and G5, brush cleaned with absolute alcohol, dried and moistened with Natural Glaze surface sealant (DFL). After fabrication, the specimens were stored for 24 h in deionized water. The surface roughness of the specimens was measured using a profilometer. Surface roughness means were compared by analysis of variance followed by Tukey&#8217;s test at a level of significance of 5%. Result: The lowest surface roughness was observed in G1 (control group) and the highest, in G3. G5 had lower surface roughness values compared to the other test groups, and presented values similar to those of the control group. Conclusion: The smoothing and finishing techniques influenced the surface roughness of the composite resin. Application of the surface sealant by the copolymerization technique resulted in lower roughness values. The use of a clean, dry brush promoted roughness values beyond the acceptable limit, and is therefore liable to compromise the performance of composite resin restorations

Evaluation of the surface roughness of a nanofilled composite resin submitted to different smoothing and finishing techniques

Abstract Introduction: Controlling the surface smoothness characteristics of the composite resin when performing a direct restorative technique is one of the factors involved in achieving restorative success. Objective: The purpose of this study was to evaluate the surface roughness of a nanofilled composite resin submitted to different smoothing and finishing techniques. Material and method: Fifty test specimens were made with the Z350 XT composite resin (3M ESPE) and then divided into five study groups according to the smoothing and finishing method applied, as follows: G1 (control), polyester strip; G2, composite spatula; G3, brush cleaned with absolute alcohol and dried; G4, brush cleaned with absolute alcohol, dried and moistened with Single Bond (3M ESPE); and G5, brush cleaned with absolute alcohol, dried and moistened with Natural Glaze surface sealant (DFL). After fabrication, the specimens were stored for 24 h in deionized water. The surface roughness of the specimens was measured using a profilometer. Surface roughness means were compared by analysis of variance followed by Tukey’s test at a level of significance of 5%. Result: The lowest surface roughness was observed in G1 (control group) and the highest, in G3. G5 had lower surface roughness values compared to the other test groups, and presented values similar to those of the control group. Conclusion: The smoothing and finishing techniques influenced the surface roughness of the composite resin. Application of the surface sealant by the copolymerization technique resulted in lower roughness values. The use of a clean, dry brush promoted roughness values beyond the acceptable limit, and is therefore liable to compromise the performance of composite resin restorations

Diphenyl Ditelluride: Redox-Modulating and Antiproliferative Properties

Tellurium is a rare element that has been regarded as a toxic, nonessential element, and its biological role is not clearly established. In addition, the biological effects of elemental tellurium and some of its organic and inorganic derivatives have been studied, leading to a set of interesting and promising applications. Diphenyl ditelluride (DPDT), an organic tellurium derivate, showed antioxidant, antigenotoxic, antimutagenic, and anticancer properties. The antioxidant and prooxidant properties of DPDT are complex and depend on experimental conditions, which may explain the contradictory reports of these properties. In addition, DPDT may exert its effects through different pathways, including distinct ones to those responsible for chemotherapy resistance phenotypes: transcription factors, membrane receptors, adhesion, structural molecules, cell cycle regulatory components, and apoptosis pathways. This review aims to present recent advances in our understanding of the biological effects, therapeutic potential, and safety of DPDT treatment. Moreover, original results demonstrating the cytotoxic effects of DPDT in different mammalian cell lines and systems biology analysis are included, and emerging approaches for possible future applications are inferred

Chemosystematic evaluation of Amazonian freshwater sponges

Freshwater sponges can be considered a promising new source of bioactive compounds for the pharmaceutical industry; however, the research on their chemical composition is still in the incipient stage. We evaluated the most endemic Amazonian freshwater sponge species from the Drulia and Metania genera by untargeted metabolomic approaches, based on UHPCL-HRMS, in order to identify chemical markers and explore the diversity of specialized metabolites. The use of untargeted approaches allowed us to observe subsets of metabolites that enabled the characterization of, not only each genus, but also, of each species. Freshwater sponge species presented themselves as rich sources of fatty acids and sterols, which were putatively identified. These metabolites were suggested as chemical markers for further targeted metabolomic studies

PRINCIPAIS ESTRATÉGIAS PARA CONTROLE E PREVENÇÃO DA HANSENÍASE

&lt;p&gt;A hanseníase é uma doença infectocontagiosa, exposta como um grave problema de saúde pública devido aos seus altos casos e ao potencial incapacitante. À vista disso, torna-se necessário o conhecimento acerca das estratégias preventivas e controladoras de tal patologia, almejando a redução dos casos. Assim, o estudo objetiva elencar as principais estratégias controladoras e preventivas da hanseníase. Trata-se de uma revisão integrativa de literatura, descritiva, quantitativa e qualitativa. Foi realizada em setembro e outubro de 2023, nas bases: LILACS e MEDLINE, a partir da BVS, além de contar com busca complementar de artigos dispostos no Google Scholar. Utilizaram-se os DeCS combinados pelo operador booleano "AND": "Estratégias de Saúde" AND "Hanseníase" AND "Prevenção de Doenças". Foram incluídos no estudo os artigos disponíveis gratuitamente em português, inglês e espanhol, publicados entre 2018 a 2023 e excluídos os estudos duplicados nas bases e que não respondessem a pergunta de pesquisa. Na amostra inicial, obtiveram 69 artigos os quais após serem submetidos à pré-análise e leitura complementar, restaram apenas 9 para amostra final. Os estudos evidenciaram como sendo as principais estratégias preventivas e controladoras da hanseníase: facilidade ao acesso dos serviços, fortalecimento funcional dos agentes comunitários, capacitação profissional, definição de atribuições profissionais, uso de instrumentos específicos na assistência e ações de educação em saúde no âmbito pré e intra-hospitalar.&nbsp;Além disso, foi observado que a atenção primária é o melhor cenário para aplicar as intervenções, porém, as medidas não devem se limitar somente à este ambiente. As pesquisas também constataram que existem alguns fatores os quais implicam na realização das estratégias. Logo, há a necessidade de novas intervenções clínicas e preventivas para busca ativa de novos casos e erradicação da doença, como inéditos estudos científicos e capacitação dos profissionais de saúde. Assim, aspirando a interrupção da transmissão e eliminação do agente causador da hanseníase.&nbsp;&lt;/p&gt

Diversity of Brazilian Fungi

Abstract Knowledge about the Brazilian fungal diversity was, until 2010, recorded in few taxonomy and ecology publications, as well as in a handful of species lists. With the publication of the Catálogo de Plantas e Fungos do Brasil and the continued availability of an online list, it has been possible to aggregate this dispersed knowledge. The version presented here adds 2,111 species names to the 3,608 listed in 2010. A total of 5,719 species of fungi distributed in 1,246 genera, 102 orders and 13 phyla represents a considerable increase over the last five years, when only 924 genera and 78 orders were registered. Basidiomycota (2,741 species in 22 orders) and Ascomycota (1,881 species in 41 orders) predominate over other groups. The Atlantic Rainforest has the largest number of records, with 3,017 species, followed by Amazon Rainforest (1,050), Caatinga (999), Cerrado (638) and Pampa and Pantanal with 84 and 35 species, respectively. The Northeast region has the greatest richness (2,617 species), followed by Southeast (2,252), South (1,995), North (1,301) and Central-West (488 species). Regarding the States of the Federation, São Paulo with 1,846 species, Pernambuco with 1,611 and Rio Grande do Sul with 1,377 species are the most diverse