Introduction: The anterior cruciate ligament is one of the main ligaments of the knee, often more susceptible to injuries due to its central position and its vital role in stabilizing this joint. The strength of the quadriceps plays a crucial role, with impact absorption function, helping to reduce load. Objective: To evaluate the volume and strength of the quadriceps muscle before and after reconstruction of the anterior cruciate ligament of the knee, their correlation and which variables predict pre- and postoperative muscle strength. Method: Prospective cohort of 37 patients evaluated preoperatively and 4 months after the operation, using magnetic resonance imaging and isokinetic dynamometry. The measurements of the limb undergoing the operation were compared to the contralateral limb as a control. Result: The volume of the quadriceps muscle was 65.2+13.4cm3 before and 63.4+15.9 cm3 after, significantly lower in the control at both moments, with a reduction of 3.0cm3 (4.1%) in the pre and 7.8 cm3 post (12.0%). Muscle strength was 105.5+29.9N/m before and 100.9+28.6N/m after, significantly lower in the operated limb (126.4+28.2N/m and 129.6+27.6N /m, p<0.001). This reduction was similar in the 2 evaluation moments, on average of 17.5N/m (16.3%) in the pre and 22.8N/m (22.5%) in the post. The loss of strength was greater than the loss of muscle volume, with muscle volume and time of anterior cruciate ligament injury being the main determinants of muscle strength in the pre-op. The strength in the post was mainly determined by that in the pre. Conclusion: The loss of muscle strength was 4 times greater than the loss of volume pre-operatively and 2 times greater post-operatively, indicating the beginning of recovery 4 months post-operatively.

Introdução: O ligamento cruzado anterior é um dos principais ligamentos do joelho, frequentemente mais suscetível às lesões devido à sua posição central e seu papel vital na estabilização desta articulação. A força do quadríceps desempenha papel crucial, com função de absorção de impacto, auxiliando na redução de carga. Objetivo: Avaliar o volume e a força do músculo quadríceps antes e após a reconstrução do ligamento cruzado anterior do joelho, sua correlação e quais as variáveis preditivas da força muscular pré e pós-operatória. Método: Coorte prospectiva de 37 pacientes avaliados no pré-operatório e com 4 meses após a operação, por meio de ressonância magnética e dinamometria isocinética. As medidas do membro submetido à operação foram comparadas ao membro contralateral como controle. Resultado: O volume do músculo quadríceps foi de 65,2+13,4cm3 antes e de 63,4+15,9 cm3 após, significativamente menor no controle nos 2 momentos, com redução de 3,0cm3 (4,1%) no pré e 7,8 cm3 no pós (12,0%). A força muscular foi de 105,5+29,9N/m antes e de 100,9+28,6N/m após, significativamente menor no membro operado (126,4+28,2N/m e 129,6+27,6N/m, p<0,001). Esta redução foi semelhante nos 2 momentos de avaliação, em média de 17,5N/m (16,3%) no pré e de 22,8N/m (22,5%) no pós. A perda de força foi maior que a perda de volume muscular, sendo que o volume muscular e o tempo da lesão do ligamento cruzado anterior foram os principais determinantes da força muscular no pré. A força no pós foi determinada principalmente pela do pré. Conclusão: A perda de força muscular foi 4 vezes maior que a perda de volume no pré e 2 vezes maior no pós, indicando início da recuperação com 4 meses no pós-operatório.

ABSTRACT: The present study described the prevalence and factors associated with the seropositivity for anti-Brucella spp. antibodies in working equids in the semiarid regionofnortheastern Brazil. Blood samples were collected from 322 equids (76 horses, 155 mules and 91 donkeys). The Rose Bengal plate test (RBPT) was used as a screening method. Samples that were reactive in the RBPT were tested for confirmation using 2-mercaptoethanol (2-ME) and the standard tube agglutination test (STAT). Overall, 7.1% (23/322) of the samples were positive according to the RBPT. After confirmatory tests, the prevalence of brucellosis was found to be 6.5% (21/322). Among these cases, 33.3% (7/21) were horses, 42.8% (9/21) were mules and 23.9% (5/21) were donkeys. In the multivariate analysis, age over 10 years was considered to be a factor associated with the seropositivity (OR: 17.17; 95% CI: 2.582-164.7, P = 0.006) for anti-Brucella spp. antibodies. The significant prevalence of anti-Brucella spp. antibodies found in working equids and the wide distribution of positive animals demonstrates a worrying epidemiological situation regarding brucellosis in the study region. Age over 10 years was a risk factor associated with the seropositivity for anti-Brucella spp. antibodies in animals.

RESUMO: O objetivo do presente estudo foi descrever a prevalência e os fatores associados à infecção por Brucellaspp. em equídeos de trabalho na região semiárida do Nordeste do Brasil. Amostras de sangue foram coletadas de 322 equídeos (76 equinos, 155 muares e 91 asininos). O teste de placa Rosa Bengala (RBPT) foi usado como método de triagem. As amostras que foram reativas no RBPT foram enviadas para confirmação usando 2-mercaptoetanol (2-ME) e o teste padrão de aglutinação em tubo (STAT). Ao todo, 7,1% (23/322) das amostras foram positivas segundo o RBPT. Após testes confirmatórios, a prevalência de brucelose foi de 6,5% (21/322). Destes casos, 33,3% (7/21) foram equinos, 42,8% (9/21) muares e 23,9% (5/21) asininos. Na análise multivariada, idade acima de 10 anos foi considerada fator associado à infecção (OR: 17,17; 95% CI: 2,582-164,7, P = 0.006) por Brucellas pp. A prevalência significativa de anticorpos anti-Brucella spp. encontrados em equídeos de trabalho e a ampla distribuição de animais positivos demonstra uma situação epidemiológica preocupante em relação à brucelose na região de estudo. A idade superior a 10 anos foi um fator de risco associado à infecção em animais.

ABSTRACT: In Brazil, urea is the most used nitrogen (N) fertilizer to improve forage production. However, their excessive use can cause environmental impacts through N losses, such as ammonia (NH3) volatilization. Therefore, the current study adjusted and estimated the NH3 volatilization from urea applied on tropical pastures in three rainfall conditions using mathematical models. Data were collected from Marandu grass (Brachiaria brizantha) fertilized with 50 kg N ha-1 during wet, intermediate, and dry conditions. Ammonia volatilization was measured in five semi-open chambers for 21 days. The linear, quadratic, exponential, Gompertz, Groot, and Richards models were tested for fitting and estimating the NH3 volatilization. The Gompertz, Groot, and Richards models generated predictions similar to the observed data, with a high determination coefficient, indicating a better fit of these equations to data, with precision and accuracy. However, the Groot model was selected due to the lowest root mean square error of prediction (0.29 % total N lost as NH3). The greatest N loss as NH3 volatilization occurred in the wet, followed by intermediate and dry conditions (20.2, 17.0, and 11.3 % total N lost as NH3, respectively). Therefore, nitrogen losses as NH3 volatilization after application of 50 kg N ha-1, as urea source, are altered according to the weather conditions, reaching 20% of N added in the wet rainfall period. The Groot model is recommended for fitting and estimating the NH3 volatilization from urea applied on Marandu grass pastures in the wet and dry rainfall conditions.

RESUMO: No Brasil, a ureia é o fertilizante nitrogenado mais utilizado para melhorar a produção de forragem. No entanto, seu uso excessivo pode causar impactos ambientais por meio de perdas de nitrogênio (N), como a volatilização da amônia (NH3). Portanto, o objetivo do presente estudo foi ajustar a volatilização de NH3 da ureia aplicada em pastos tropicais em três condições de chuva utilizando modelos matemáticos. Dados foram coletados de pastos de capim-marandu (Brachiaria brizantha) adubado com 50 kg N ha-1 em condições úmidas, intermediárias e secas. A volatilização da NH3 foi medida em cinco câmaras semiabertas durante 21 dias. Os modelos, linear, quadrático, exponencial, Gompertz, Groot e Richards foram testados para ajuste e estimativa da volatilização do NH3. Os modelos de Gompertz, Groot e Richards geraram predições semelhantes aos dados observados, com alto coeficiente de determinação, indicando um melhor ajuste dessas equações aos dados, com acurácia e precisão. No entanto, o modelo Groot foi selecionado devido ao menor erro quadrático médio das predições (0,29% de N total perdido como NH3). A maior volatilização de NH3 ocorreu em condições climáticas úmida, seguido por intermediária e seca (20,2; 17,0 e 11,3% de N total perdido como NH3, respectivamente). Portanto, as perdas de N como volatilização de NH3 após a aplicação de 50 kg N ha-1, como fonte de ureia, são alteradas de acordo com as condições climáticas, atingindo a 20% do N adicionado nas condições úmidas. O modelo Groot é recomendado para ajuste e estimativa da volatilização de NH3 da ureia aplicada em pastos de capim Marandu em condições úmidas e secas.

This article describes a proposed framework called Telehealth Service Maturity Model (TMSMM.br) for evaluating the current stage of telehealth centers in the Brazilian context. The steps included literature review, compilation and interpretation, data collection instrument, survey with center coordinators, model development, and evaluation process. The review resulted in 857 quality aspects for telehealth services, grouped into 12 themes with 34 topics. TMSMM.br consists of defining 3 foundational dimensions (themes, services, stages) and provides a standardized set of 200 requirements ordered across 5 thematic domains (structure, organization, user, operation and community) for 8 services (consultation, consultation, diagnosis, treatment and referral, education and training, social control and communication, healthcare network, and research, development, and innovation). TMSMM.br enables telehealth centers to identify and compare essential characteristics and their maturity stages.

Este artículo describe una propuesta de marco de referencia llamado Modelo de Madurez de Servicios de Telemedicina (TMSMM.br) para evaluar la etapa actual de los centros de telemedicina en el contexto brasileño. Las etapas incluyeron revisión de literatura, compilación e interpretación, instrumento de recolección, encuesta a coordinadores de centros, desarrollo del modelo y proceso de evaluación. La revisión resultó en 857 aspectos de calidad para servicios de telemedicina, agrupados en 12 temas con 34 tópicos. TMSMM.br consiste en la definición de 3 dimensiones estructurales (temas, servicios, etapas) y proporciona un conjunto estandarizado de 200 requisitos ordenados en 5 dominios temáticos (estructura, organización, usuario, operación y comunidad) para 8 servicios (consulta, asesoría, diagnóstico, tratamiento y remisión, educación y capacitación, control social y comunicación, red de atención de salud e investigación, desarrollo e innovación). TMSMM.br ayuda a los centros de telemedicina a identificar y comparar características esenciales y sus etapas de madurez

Este artigo descreve uma proposta de framework denominado Modelo de Maturidade de Serviços de Telessaúde (TMSMM.br) para avaliação do estágio corrente dos núcleos de telessaúde no contexto brasileiro. As etapas incluíram revisão da literatura, compilação e interpretação, instrumento de coleta, inquérito com coordenadores de núcleos, elaboração do modelo e do processo de avaliação. A revisão resultou 857 aspectos de qualidade para serviços de telessaúde, agrupados em 12 temas com 34 tópicos. TMSMM.br consiste na definição de 3 dimensões estruturantes (temas, serviços, estágios) e provê um conjunto padronizado de 200 requisitos ordenados em 5 domínios temáticos (estrutura, organização, usuário, operação e comunidade) para 8 serviços (consulta, consultoria, diagnóstico, tratamento e encaminhamento, formação e capacitação, controle social e comunicação, rede de atenção à saúde, e pesquisa, desenvolvimento e inovação). TMSMM.br colabora para que núcleos de telessaúde possam identificar e comparar características essenciais e seus estágios de maturidade.

ABSTRACT Introduction: The therapeutic plasma exchange (TPE) controls the systemic cytokine level and might improve the immune response in patients with severe Coronavirus (COVID-19) infection. To date, in developing countries, no study has explored the effectiveness and risk factors in a population with severe COVID-19 exposed to the TPE. Method: We described the risk factors associated with survival rates higher than 28 days and length of stay (LOS) in the intensive care unit (ICU) shorter than 15 days. Severe COVID-19 cases treated with TPE were included, from August 2020 to June 2021. Survival analysis with Kaplan-Meier curves, log-rank tests and multivariate logistic regressions were conducted to assess patient-related factors that could predict a higher survival rate and the ICU LOS. Results: A total of 99 patients with severe COVID-19 who had received TPE were followed during their hospital stay and for 28 days after discharge. The sample was composed of men (63%) aged 56 ± 16 years. The overall survival rate at 28 days was 80%. The ICU LOS (p = 0.0165) and mechanical ventilation (MV) (p = 0.00008) were considered factors that could increase the risk of death. Patient-related factors that influenced the 28-day mortality were the smoking status (OR = 5.8; 95%CI 1.5, 22) and history of oncologic or non-malignant hematologic diseases (OR = 5.9; 95%CI 1.2, 29). Conclusion: Patients with severe COVID-19 exposed to the TPE were associated with a 20% risk of death in a 28-day observation window, appearing to be lower than previous treatments. Active smoking, cancer and immunosuppressive conditions should be considered as relevant variables to be controlled in future trials on the TPE and COVID-19.

ABSTRACT Colorectal cancer (CRC) is among the most diagnosed malignancies worldwide, and it is also the second leading cause of cancer-related deaths. Despite recent progress in screening programs, noninvasive accurate biomarkers are still needed in the CRC field. In this study, we evaluated and compared the urinary proteomic profiles of patients with colorectal adenocarcinoma and patients without cancer, aiming to identify potential biomarker proteins. Urine samples were collected from 9 patients with CRC and 9 patients with normal colonoscopy results. Mass spectrometry (label-free LC—MS/MS) was used to characterize the proteomic profile of the groups. Ten proteins that were differentially regulated were identified between patients in the experimental group and in the control group, with statistical significance with a p value ≤ 0.05. The only protein that presented upregulation in the CRC group was beta-2-microglobulin (B2M). Subsequent studies are needed to evaluate patients through different analysis approaches to independently verify and validate these biomarker candidates in a larger cohort sample.

ABSTRACT BACKGROUND AND OBJECTIVES: Primary dysmenorrhea (PD) is a common gynaecological disorder characterized by pain in the abdominal region without pelvic disease. Evidence suggests that PD-related pain may not be restricted to the pelvis region, hence body mapping could be helpful in assessing the subjective location, intensity, and distribution of pain areas in women with PD. The objective of this study was to characterize dysmenorrhea-related pain location and intensity using body map. METHODS: We conducted a web-based cross-sectional study for adult women to self-report menstrual pain during three menstrual cycles. Each participant was instructed through a messaging application to paint the body map after printing it and rank their pain according to the 11-point Numerical Rating Scale. RESULTS: Seventy-three women (24.1 ± 3.0 years) participated in the study. A considerable proportion of participants reported pain in the lower abdomen (90.4%) and other body areas, such as the lower back (82.1%), head (54.6%), breasts (32.9%), upper abdomen (31.5%), and legs (28.8%). CONCLUSION: Our findings revealed that women with PD also present pain outside the uterine referral area during their period. In this way, body maps can help healthcare professionals to record specific regions of pain and track changes or patterns in the location or intensity pain during menses, helping to determine treatment strategies appropriate to the individual needs of each woman with PD. Therefore, we strongly recommend the clinical use of the self-report body map to evaluate menstrual pain and help health providers to improve PD symptoms in this population.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dismenorreia primária (DP) é um distúrbio ginecológico comum caracterizado por dor na região abdominal sem doença pélvica. Evidências sugerem que a dor relacionada à DP pode não estar restrita à região da pelve, portanto, o mapeamento corporal pode ser útil para avaliar a localização subjetiva, a intensidade e a distribuição das áreas de dor em mulheres com DP. O objetivo deste estudo foi caracterizar a localização e a intensidade da dor relacionada à dismenorreia por meio do mapa corporal. MÉTODOS: Conduziu-se um estudo transversal baseado na web para mulheres adultas para autorrelato de dor menstrual durante três ciclos menstruais. Cada participante foi instruído por meio de um aplicativo de mensagens a pintar o mapa corporal após imprimi-lo e classificar sua dor de acordo com a Escala de Avaliação Numérica de 11 pontos. RESULTADOS: Setenta e três mulheres (24,1±3,0 anos) participaram do estudo. Uma proporção considerável de participantes relatou dor na parte inferior do abdômen (90,4%) e em outras áreas do corpo, como a parte inferior das costas (82,1%), cabeça (54,6%), mamas (32,9%), parte superior do abdômen (31,5%) e pernas (28,8%). CONCLUSÃO: Os presentes achados revelaram que mulheres com DP também apresentam dor fora da área de referência uterina durante o período menstrual. Dessa forma, os mapas corporais podem ajudar os profissionais de saúde a registrar regiões específicas de dor e rastrear mudanças ou padrões na localização ou intensidade da dor durante a menstruação, ajudando a determinar estratégias de tratamento adequadas às necessidades individuais de cada mulher com DP. Portanto, recomenda-se fortemente o uso clínico do mapa corporal de autorrelato para avaliar a dor menstrual e ajudar os profissionais de saúde a melhorar os sintomas de DP nessa população.

RESUMEN Introducción. La salud ambiental infantil es la rama de la pediatría que estudia la influencia del medioambiente en la salud y la enfermedad de los niños. Las exposiciones ambientales globales representan una seria amenaza para la salud, lo que justifica una mayor investigación y acción. Objetivo. Evaluar la salud ambiental de una muestra de niños que viven en áreas urbanas y rurales de la ciudad de Uruguaiana, Brasil. Población y métodos. Se incluyeron padres/tutores (n = 714) de niños atendidos en el Policlínico Infantil de la Ciudad de Uruguaiana de enero a octubre de 2021, que respondieron la anamnesis ambiental en pediatría (Sociedad Brasileña de Pediatría). Los datos obtenidos se analizaron según la residencia en zona urbana o rural, o el ingreso familiar. Resultados. Al comparar los habitantes de la zona urbana (n = 660) con los de la zona rural (n = 54), verificamos que entre los de la zona rural fue significativamente mayor la actividad con productos químicos (15 % vs. 32,7 %; p = 0,004), vivir cerca de plantación (7,5 % vs. 74,5 %; p <0,001) o con fuente de contaminación (4,8 % vs. 32,7 %; p <0,001), tener perro (62 % vs. 87,3 %; p <0,001), usar plaguicidas (0,6 % vs. 32,7 %; p <0,001) y exposición a contaminación química (2,6 % vs. 18,2 %; p <0,001). En el área urbana predominó la exposición al tránsito de vehículos cerca de la vivienda (85 % vs. 48,1 %; p <0,001), renta media inferior a 3 salarios mínimos (90 %) y baja escolaridad. Conclusión. Realizar la anamnesis ambiental es fundamental para la detección de amenazas ambientales presentes en los lugares donde los niños y adolescentes viven, aprenden, juegan y estudian.

Objectives: Religiosity and spirituality (R/S) have been negatively associated with several mental health problems, including delinquency. The study aimed to investigate the relationship between R/S and interpersonal violence using a systematic review. Methods: We conducted a descriptive systematic review followed by meta-analyses using seven different databases. We included observational studies that assessed the relationship between R/S and different types of interpersonal violence (physical and sexual aggression and domestic violence). Results: A total of 16,599 articles were screened in the databases and, after applying the eligibility criteria, 67 were included in the systematic review and 43 were included in the meta-analysis. The results showed that higher levels of R/S were significantly associated with decreased physical and sexual aggression, but not domestic violence. All selected studies evidenced sufficient methodological quality, with 26.8% being cohort studies. In the subanalyses, the role of R/S was more prevalent among adolescents. Conclusion: There is an inverse relationship between R/S and physical and sexual aggression, suggesting a protective role. However, these results were not observed for domestic violence. Healthcare professionals and managers should be aware of their patients’ beliefs when investigating interpersonal violence to create tailored interventions for reducing violent behavior.

Abstract This work studies the relationship between the implementation of the Electronic Service Invoice (NFS-e) and the collection of the Tax on Services of Any Nature (ISSQN) in municipalities in four microregions of the State of Rio Grande do Norte. A panel data analysis is applied for the years 2013 to 2016 based on official information on the dates of adoption of the NFS-e and the gross collection of the ISSQN, population size, employed and salaried personnel, number of active companies and Gross Domestic Product. The results suggest that the implementation of the NFS-e, for a complete fiscal year, results in about 46% of increase in the collection of the ISSQN to the municipalities that make use of the innovation, compared to those that do not adopt this technological resource, indicating that this can be a good strategy to combat tax evasion and increase revenue for small municipalities.

Resumo Este trabalho estuda a relação entre a implantação da Nota Fiscal de Serviços Eletrônica (NFS-e) e a arrecadação do Imposto Sobre Serviços de Qualquer Natureza (ISSQN) em municípios de quatro microrregiões do Estado do Rio Grande do Norte. Aplica-se uma análise de dados em painel para os anos de 2013 a 2016 com base em informações oficiais sobre as datas de adoção da NFS-e e de arrecadação bruta do ISSQN, dimensão populacional, pessoal ocupado e assalariado, quantitativo de empresas atuantes e Produto Interno Bruto. Os resultados sugerem que a implantação da NFS-e, por todo um ano fiscal completo, repercute em cerca de 46% de acréscimo na arrecadação do ISSQN aos municípios que fazem uso da inovação, frente aos que não adotam esse recurso tecnológico, indicando que esta pode ser uma boa estratégia de combate à evasão fiscal e de aumento de arrecadação para pequenos municípios.

Abstract: The use of wood as a bioenergetic source requires knowledge of its technical properties. The rubber tree Hevea brasiliensis has an economic life cycle of 25 to 30 years in Brazil. It is used for extracting rubber and generating residual wood for fuel. Our goal was to characterize the wood quality of 10 clonal progenies as a source of raw material for bioenergy. Ten clonal progenies of 12-year-old Hevea brasiliensis from an experimental planting in Selvíria municipality were evaluated. Three trees per clone were evaluated for individual properties of Higher Heating Value, immediate chemical analysis, chemical composition, fiber dimensions, thermogravimetric analysis of wood under nitrogen atmosphere and Fourier Transform Infrared Spectroscopy analysis. We highlight clone IAC 311 for fuel because it presents elevated Higher Heating Value and fixed carbon and less volatile material. However, the other genetic materials studied also meet the specifications for energy use and can be highly viable given their physical, chemical, energy, and thermal properties.

Resumo Este estudo teve como objetivo descrever o perfil de um conjunto de programas de pós-graduação em saúde global, enfatizando a importância de promover educação e treinamento neste campo para enfrentar os desafios de saúde internacional e melhorar os desfechos de saúde. A presente revisão está de acordo com a lista de verificação Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR) e com o manual para revisões de escopo proposto pelo Joanna Briggs Institute. Os critérios de elegibilidade abarcaram um conjunto de programas de pós-graduação lato sensu ou stricto sensu em saúde global ou programas de pós-graduação lato sensu ou stricto sensu em saúde pública que apresentaram uma área de concentração em saúde global. A busca resultou em 707 estudos: Medline/PubMed, Web of Science e LILACS. Foram analisados 441 estudos e as filiações institucionais de seus autores, e foram identificadas 101 instituições que oferecem esses programas educacionais. A maioria dos programas de pós-graduação em saúde global ou saúde pública com área de concentração em saúde global são mestrados, e muitos deles são ministrados online. A maioria destes programas educacionais é oferecida por instituições na Europa e na América do Norte.

Abstract This study aimed to describe a set of global health postgraduate programs profile, emphasizing the importance of promoting education and training in this field to meet global health challenges and ameliorate health outcomes. The present review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist and the Scoping Review Methods Manual proposed by the Joanna Briggs Institute. Eligibility criteria were a set of lato sensu or stricto sensu postgraduate educational programs of global health or lato sensu or stricto sensu postgraduate programs of public health that present a global health concentration area. The search yielded 707 studies: MEDLINE/PubMed, Web of Science, and LILACS. A total of 441 studies and their authors’ institutional affiliations were analyzed and 101 institutions that offer educational programs were identified. Most postgraduate programs in Global Health or Public health with a concentration area in Global health are master’s degrees, and many of them are taught online. The majority of educational programs are offered by institutions in Europe and North America.

Resumo O município de São Paulo historicamente foi marcado pela heterogeneidade da implementação pela coexistência de modelos conflitivos de gestão do SUS e de atenção na Atenção Primária à Saúde (APS). Consolidou-se a administração via contratos de gestão dos serviços de saúde, associada a uma lógica produtivista. Durante a pandemia de COVID-19, as fragilidades de uma APS seletiva tendem a ser pronunciadas. Assim, o presente artigo tem como objetivo analisar a gestão do trabalho e o cuidado na APS durante a pandemia de COVID-19 no município de São Paulo, em pesquisa qualitativa multicêntrica, ancorada no referencial teórico Paideia. Foram realizadas 31 entrevistas em profundidade com usuários e trabalhadores da APS e observação participante. Observou-se postura autoritária e gerencialista da gestão municipal na condução das respostas, com pouco espaço para escuta e diálogo. Notou-se enfraquecimento dos espaços coletivos e do vínculo entre serviço e comunidade; burocratização e precarização dos processos de trabalho e desmantelamento do NASF. Neste cenário, o cuidado caracterizou-se pela redução expressiva da clínica ampliada, compartilhada e pelo distanciamento das diretrizes da APS de base territorial e comunitária.

Abstract The municipality of São Paulo has historically been marked by a heterogeneous implementation and coexistence of conflicting models of SUS management and Primary Health Care (PHC). The administration of health services management contracts was consolidated and associated with a productivist rationale. The selective PHC weaknesses tend to be pronounced during the COVID-19 pandemic. Thus, the present article aims to analyze work management and care in PHC during the COVID-19 pandemic in the municipality of São Paulo through a multicenter qualitative research anchored in the Paideia theoretical framework. We conducted 31 in-depth interviews with PHC clients and workers, along with participant observation. We noted the municipal management’s authoritarian and managerialist stance when conducting the responses, with little room for listening and dialogue. We identified weakened collective spaces and service-community bond, bureaucratization and precariousness of work processes, and NASF’s dismantling. In this setting, care was characterized by significantly reducing the expanded and shared clinical practice and the distancing from the territorial and community-based PHC guidelines.

Abstract Hydroxytyrosol (HT) is a natural phenolic compound found in leaves of olive trees. It is a photosensitive solid phytochemical constituent and an irritant substance to skin and mucosa as pure drug. HT is a lipophilic chemical constituent and shows low solubility in water, bitter taste, and instability to oxidizing atmosphere. Considering the limitations for its suitable therapeutic use, the aim of the present study was to obtain, to characterize, to quantify, and to evaluate the stability of HT-loaded poly(ԑ-caprolactone) nanocapsules for its further use in pharmaceutical and nutraceutical products. Nanocapsules were prepared by method of interfacial deposition of the preformed polymer. The formulations were characterized by morphological and spectroscopic methods. The UHPLC-PDA analytical method was developed and validated for quantifying the HT encapsulation. Physicochemical stability assay was performed for 120 days. Nanocapsules were successfully obtained by the proposed method. The morphological evaluation demonstrated the drug absence in the nanocapsule surface. Fourier-transform infrared spectroscopy demonstrated the drug nanoencapsulation. The analytical method was validated and confirmed a high HT encapsulation efficiency over 95%. Considering the physicochemical stability testing, the polydispersity index changed after 30 days for NC-2 (HT at 2 mg/mL) and after 90 days for NC-5 (HT at 5 mg/mL). Zeta potential changed after 60 days for both formulations (NC-2 and NC-5). pH values were modified after 60 days for NC-5 and after 90 days for NC-2. HT-loaded PCL nanocapsules demonstrate adequate physicochemical features and high drug encapsulation. The different formulations revealed stability changes from 30 to 90 days. Additional in vitro and in vivo evaluations may be performed in order to use these nanoformulations for treating several diseases based on oxidative-inflammatory environments.