Abstract This article aims to analyse the relationship between the rise of the extreme right in Brazil and violence against minorities. This is an integrative review, with a qualitative approach, with a cut-off between 2015 and 2020, which adopted the following data sources: Sage, Scopus, Wiley Online Library. The sample consisted of 52 articles and the data were processed through content analysis. The results indicate that violence, real or symbolic, constitutes an intrinsic foundation of the extreme right/populism platform in Brazil and in the world. It is noteworthy that discourses and “armed languages”, such as fake news, constitute potent strategies for colonizing the social imaginary that feed back and normalize violence.

Resumo Este artigo analisa as relações entre a ascensão da extrema-direita no Brasil e a violência contra as minorias. Trata-se de uma revisão integrativa, de abordagem qualitativa, com recorte entre 2015 e 2020, que adotou as seguintes fontes de dados: Sage, Scopus e Wiley Online Library. A amostra foi constituída por 52 artigos e os dados foram tratados por meio de análise de conteúdo. Os resultados indicam que a violência, real ou simbólica, constitui fundamento intrínseco da plataforma da extrema-direita no Brasil e no mundo. Destaca-se que os discursos e as «linguagens armadas», tais como as fake news, constituem estratégias potentes de colonização do imaginário social que retroalimentam e normalizam a violência.

Resumo Investigou-se a percepção dos usuários do serviço quanto à prática profissional dos dentistas, com base em diferenças de gênero. O Primary Care Assessment Tool (PCATool) foi aplicado a 900 usuários do Serviço Público de Curitiba, PR, Brasil. Sessenta clínicas odontológicas foram selecionadas usando amostragem aleatória, divididas entre unidades de Atenção Primária à Saúde (APS) convencional e unidades de APS com Estratégia Saúde da Família. Os atributos da APS no PCATool foram analisados. Uma questão foi adicionada acerca da preferência do usuário em relação ao gênero do dentista, gerando quatro díades derivadas da combinação do gênero do usuário/gênero do dentista (FF, FM, MM, MF). Os atributos foram ligados às díades pelo teste t para amostras independentes. Por regressão logística, as díades foram relacionadas a 23 fatores referentes aos cuidados ampliados na APS. Muitos usuários mostraram preferência por dentistas mulheres. Esses tendem a avaliar melhor os cuidados de saúde primários quanto à “escuta ativa e qualificada”, enquanto aqueles que preferem ser atendidos por homens destacam os atributos de “integração do cuidado” e “orientação comunitária”. Em outros fatores e atributos estudados, não há diferença entre o atendimento prestado por homens ou mulheres, independentemente da unidade.

Abstract It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to “active listening”, while those who prefer to be cared for by male dentists highlight the attributes of “care integration” and “community guidance”. In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

Resumo Investigou-se a percepção dos usuários do serviço quanto à prática profissional dos dentistas, com base em diferenças de gênero. O Primary Care Assessment Tool (PCATool) foi aplicado a 900 usuários do Serviço Público de Curitiba, PR, Brasil. Sessenta clínicas odontológicas foram selecionadas usando amostragem aleatória, divididas entre unidades de Atenção Primária à Saúde (APS) convencional e unidades de APS com Estratégia Saúde da Família. Os atributos da APS no PCATool foram analisados. Uma questão foi adicionada acerca da preferência do usuário em relação ao gênero do dentista, gerando quatro díades derivadas da combinação do gênero do usuário/gênero do dentista (FF, FM, MM, MF). Os atributos foram ligados às díades pelo teste t para amostras independentes. Por regressão logística, as díades foram relacionadas a 23 fatores referentes aos cuidados ampliados na APS. Muitos usuários mostraram preferência por dentistas mulheres. Esses tendem a avaliar melhor os cuidados de saúde primários quanto à “escuta ativa e qualificada”, enquanto aqueles que preferem ser atendidos por homens destacam os atributos de “integração do cuidado” e “orientação comunitária”. Em outros fatores e atributos estudados, não há diferença entre o atendimento prestado por homens ou mulheres, independentemente da unidade.

Abstract It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to “active listening”, while those who prefer to be cared for by male dentists highlight the attributes of “care integration” and “community guidance”. In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

RESUMO Esta pesquisa objetivou detectar e intervir nas dificuldades de linguagem e comportamento em crianças de três e quatro anos de idade. Foram avaliadas 178 crianças nas áreas de comportamento, vocabulário expressivo e receptivo e processamento auditivo central. O grupo experimental, com 84 crianças, foi submetido à intervenção para o desenvolvimento e aprimoramento de linguagem e manejo de comportamentos-problema por meio de atividades desenvolvidas em aplicativos usados em tablets, jogos concretos e orientações fornecidas a seus pais e professores por uma equipe de fonoaudiólogos, psicólogos e psicopedagogos. As análises do pós-teste indicaram diferença significativa entre os resultados dos testes de vocabulário e comportamento, sugerindo que esse modelo de avaliação e intervenção precoce pode ser uma estratégia bem-sucedida em ambiente escolar.

Abstract This project had the aim of detecting and intervening in difficulties of language and behavior in children at the age of three and four. A hundred seventy-eight children were assessed in behavior, expressive and receptive vocabulary and in central auditory processing. 84 children constituted the experimental group and were engaged in an intervention for the development and refinement of language and management of behavior problems through activities developed in software used in tablets, concrete games and orientation provided to their parents and teachers by a professional team composed by speech therapists, psychologists and psycho pedagogues. Posttest analysis indicated significant difference between the vocabulary and language scores, suggesting that this model of early assessment and intervention can be a successful strategy in school environments.

Abstract INTRODUCTION: Visceral leishmaniasis (VL) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-infection has been a research topic of interest worldwide. In Brazil, it has been observed that there is a relative underreporting and failure in the understanding and management of this important association. The aim of this study was to analyze epidemiological and clinical aspects of patients with VL with and without HIV/AIDS. METHODS: We conducted an observational and analytical study of patients with VL followed in a Reference Service in the State of Maranhão, Brazil from 2007-2013. RESULTS: In total 126 patients were enrolled, of which 61 (48.4%) were co-infected with HIV/AIDS. There were more males among those with HIV/AIDS (85.2%, P>0.05) or with VL only (81.5%, P>0.05). These findings significantly differed based on age group (P<0.003); the majority of patients were aged 31-40 years (41.0%) and 21-30 years (32.3%) among those with and without HIV/AIDS co-infection, respectively. The incidence of diarrhea and splenomegaly significantly differed between the two groups (P=0.0014 and P=0.019, respectively). The myelogram parasitic examination was used most frequently among those with HIV/AIDS (91.8%), followed by those with VL only (69.2%). VL recurrences and mortality were significantly higher in the HIV/AIDS co-infected patients (P<0.0001 and P=0.012, respectively). CONCLUSIONS: Patients with VL with or without HIV/AIDS co-infection were mostly adult men. Diarrhea was more frequent in HIV/AIDS co-infected patients, whereas splenomegaly was more common in patients with VL only. In the group of HIV/AIDS co-infected patients, there was a higher rate of VL recurrence and mortality.

ABSTRACT Background Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women’s care during pregnancy, in order to prevent diseases that could compromise the mother and the child’s life. Methods This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary – prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. Results The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women’s guidance. Conclusion The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.

In this study, various commercial and native lipases, free or immobilized, were used in the enantioselective resolution of (R,S)-menthol with vinyl acetate for the preparation of menthyl acetate. Lipase from Candida rugosa (AYL) was found to be the most appropriate. When the reaction was carried out at 35 ºC, using 40 mg of AYL and a molar ratio of 1:2 (alcohol:ester), the values for the conversion degree, the enantiomeric excess of the substrate (ees) and product (eep) and the enantiomeric ratio (E) were 33.6, 50.3, > 99% and > 200, respectively. The results showed that the reaction was more efficient using toluene in comparison with other organic solvents or mixtures of toluene and ionic liquids (ILs). The best support for the AYL immobilization, was corn starch film. This system was used 4 times over 71 days of storage, and menthyl acetate was still obtained with good values of conversion degree, ees, eep, and E.

RESUMO Introdução: As mulheres no climatério estão suscetíveis a uma série de mudanças, entre elas a osteoporose. A osteoporose é uma doença caracterizada por uma baixa massa óssea e susceptibilidade à fratura. Atualmente, essa doença é um problema de saúde pública e é necessário reconhecer seus fatores de risco. Objetivos: Identificar os fatores de risco relacionados com a osteoporose em mulheres atendidas pelo Programa de Práticas de Integralidade em Saúde (Propis)/Proex/UFMA, traçar uma caracterização sociodemográfica e considerar o estilo de vida da comunidade. Material e métodos: Trata-se de um estudo transversal retrospectivo clínico com uma abordagem quantitativa, feito entre março e junho de 2013, em São Luís (MA), com 107 mulheres atendidas pelo Programa de Práticas de Integralidade em Saúde (Propis). O estudo foi aprovado pelo Comitê de Ética do Hospital Universitário da UFMA, sob parecer nº 362/07. Os dados foram tabulados e analisados com o software epidemiológico Epi-Info®, versão 3.4.1. Resultados: A etnia parda foi predominante, a união estável mostrou ser um fator protetor e a baixa escolaridade foi um fator de risco. A idade média do grupo com menopausa foi de 54,1 anos e a do sem menopausa de 31,3 anos (p < 0,0001). A idade média da menopausa foi de 43,7 anos. O ciclo menstrual irregular foi um fator protetor. O número médio de gestações foi de 4,56 para o grupo com menopausa e 2,45 para o grupo sem menopausa, com a maior parte dos partos normal (p < 0,0001). O tabagismo, a inatividade física e o consumo de cafeína foram fatores de risco, enquanto a ausência de alcoolismo e de ingestão de refrigerante foram fatores de proteção para a doença. Conclusão: Os pacientes seguiram o perfil socioeconômico e demográfico do Maranhão. A maior parte teve a menarca e a menopausa em períodos apropriados, não apresentava antecedentes familiares de osteoporose, não costumava ingerir bebida alcoólica, era sedentária e consumia uma elevada quantidade de cafeína.

ABSTRACT Introduction: Climacteric women are susceptible to a number of changes, among them osteoporosis. Osteoporosis is a disease characterized by low bone mass and susceptibility to fracture. Currently, this disease is a public health issue, being necessary to recognize its risk factors. Objectives: Identify risk factors related to osteoporosis in women attending Propis/Proex/UFMA, tracing a socio-demographic characterization and considering community lifestyles. Material and methods: This is a transversal retrospective clinical with a quantitative approach study conducted between March and June 2013 in São Luís (MA) with 107 women treated at the Programa de Práticas de Integralidade em Saúde (Propis - Integrality Health Practice Program). The study was approved by the University Hospital Ethics Committee of UFMA under opinion no. 362/07. Data were tabulated and analyzed in the epidemiological Epi-Info® software, version 3.4.1. Results: The brown color was predominant, consensual relationships proved to be a protective factor and low education was a risk factor. The average age of the group with menopause was 54.1 years and without menopause was 31.3 years (p < 0.0001). The average age of menopause was 43.7 years. The irregular menstrual cycle was a protective factor. The average number of pregnancies was 4.56 for the group with menopause and 2.45 for the group without menopause, with most births occurring normally (p < 0.0001). Smoking, physical inactivity and caffeine intake were risk factors, while the absence of alcoholism and of soda intake were protective factors for the disease. Conclusion: The patients followed the socioeconomic and demographic profile of Maranhão. Most had menarche and menopause in appropriate periods, showed no positive family history of osteoporosis, did not usually drink alcohol, were sedentary and the caffeine intake was high.

Background: Gaucher disease is an inborn, autosomal recessive error of the metabolism which belongs to the group of lysosomal storage disorders. Objective: This work reports on the treatment of Gaucher disease in several members of the same family from the countryside of Maranhão. Methods: This was an observational, retrospective and prospective, descriptive case study about the efficacy of enzyme replacement therapy. Results: The results showed that women were more affected (80% of patients) by the disease, age at diagnosis ranged from 24 to 33 years, the predominant ethnicity was mulatto (80%) and all cases were classified as type 1. The diagnosis of these patients was performed by measuring the levels of glucocerebrosidase and chitotriosidase enzymes and confirmed by genotyping. All patients suffering from Gaucher disease had low glucocerebrosidase levels. Before replacement therapy, hepatosplenomegaly was the most common clinical manifestation (100%) and osteopenia was seen in 80% of the cases. Regarding hematological manifestations, anemia and leukopenia were found in 40% of patients at diagnosis; however the hemoglobin and leukocyte levels were normalized after four years of therapy. Thrombocytopenia, observed in 20% of cases, was normalized after the second year of treatment. Conclusion: In these cases, despite gaps in the treatment as the family resides in the rural region of the state, the patients with Gaucher disease showed satisfactory therapeutic response over time.

Descreve-se caso de mielopatia associada ao HTLV-1/paraparesia espástica tropical tratada com interferon beta-1a em paciente jovem de 21 anos e com história de dermatite infecciosa na infância. Foi estabelecida clinicamente paraparesia espástica tropical (HAM/TSP), confirmada laboratorialmente pela presença de anticorpos para HTLV-1 no LCR e excluídas caxumba, citomegalovirus, Epstein-Barr, esquistossomose, herpes virus 1 e 2, rubéola, sarampo, toxoplasmose varicela-zoster, hepatite, HIV e sífilis por sorologias. Foi diagnosticada bexiga neurogênica, com quadro clínico de nictúria, urgência urinária, parestesia no membro inferior esquerdo e discreta redução de força muscular nos membros superiores, mais acentuada nos membros inferiores. Na 4a semana de tratamento com interferon beta-1a houve desaparecimento da urgência urinária e da parestesia e melhora da clínica motora.

Here a young patient (< 21 years of age) with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF). Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved.

The immobilization of enzymes and microorganisms on solid supports has been developed in recent years. These biocatalysts may be used in organic media allowing their storage and reuse, thus reducing costs of the process. Herein, lipases from various sources were immobilized in agar gel and used as catalysts in the chemo-enzymatic epoxidation of β-caryophyllene. Several experimental parameters, such as the use of different organic solvents including ionic liquids, time, temperature, and agitation rate were evaluated. The mono-epoxide was obtained as a single product. The best result was achieved using immobilized F-AP15 lipase, forming the corresponding β-caryophyllene epoxide at a conversion of 96% in an 8h reaction at 35 ºC.

Introduction: This study aimed to identify airborne fungi in São Luis, Maranhão, Brazil, to determine the prevalent genera and to correlate these genera with the area and season. Methods: In total, 1,510 colony-forming units (CFUs) of airborne fungi were isolated from the north, south, east and west sides and from the center of the city from January to December 2007. The samples were collected on Petri dishes that were exposed to the fungi by the gravitational method. Results: Twenty genera of fungi were isolated; the most common were Aspergillus (33.5%), Penicillium (18.8%), Cladosporium (14.2%), Curvularia (10.6%) and Fusarium (7.6%). The CFUs of the fungi were statistically significant (p < 0.0001). Fungal biological diversity was present all year, without any large seasonal variations but with slight increases in May, August and September. Conclusions: The fungal genera identified in this study were correlated with natural systems and could be useful when evaluating the impact of environmental changes on the region.