ABSTRACT Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

Abstract Background The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited. Objective To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test. Methods A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate. Results At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test. Conclusion Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.

Resumo Antecedentes A doença de Parkinson (DP) está frequentemente associada a disfunções autonômicas. Porém, dados sobre a influência da DP nas respostas autonômicas às mudanças posturais são limitados. Objetivos Analisar e comparar as respostas autonômicas, avaliadas por métodos lineares e não lineares de variabilidade da frequência cardíaca e parâmetros cardiorrespiratórios em dois grupos: DP (GDP) e controle (CG), em repouso e durante o tilt test ativo. Métodos Foram analisados 48 participantes (GDP: n = 25;73,40 ± 7,01 anos/GC: n = 23; 70,17 ± 8,20 anos). A modulação autonômica e os parâmetros cardiorrespiratórios foram avaliados em repouso e durante o tilt test ativo. Para avaliar a modulação autonômica foram calculados os índices lineares, nos domínios do tempo (rMSSD, SDNN) e frequência (LF, HF, LF/HF), e os índices não lineares, obtidos através do plot de Poincaré (SD1, SD2, SD1/SD2). Os parâmetros cardiorrespiratórios avaliados foram frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD), saturação periférica de oxigênio (SpO2) e frequência respiratória. Resultados Em repouso, o GDP apresentou valores menores de rMSSD, SDNN, LF, HF, SD1, SD2 e PAD, e maiores valores de SpO2. No teste, foram observadas modificações na FC e na PAS, redução da resposta parassimpática e aumento da modulação global no GDP. A análise qualitativa do plot de Poincaré mostrou que o GDP apresentou menor dispersão dos intervalos RR no repouso e no tilt test ativo. Conclusão Indivíduos com DP apresentam redução da variabilidade global e modulação parassimpática em repouso, redução da resposta parassimpática e prejuízo na regulação da FC ao realizar o tilt test ativo, em comparação aos controles.

Abstract Background: Indoor air quality in health centers is essential to protect the health of people. In Chile, the Community Family Health Centers (CECOSF) are places with large attendance of people, favoring the dissemination of microorganisms, and there are no reports of the microbial air loading these health centers. Aim: To evaluate the microbiological indoor air quality in CECOSF-Centinela in Talcahuano, Biobío Region. Methods: Air samples were taken in 6 rooms of the CECOSF, every 15 days between July 2018 and June 2019, with the MAS-100 NT equipment using trypticase and Sabouraud agars. Different morphotypes of bacteria and fungi were identified by PCR. Results: The bacterial and fungal counts varied between 9.1 × 101 - 2.4 × 103 cfu/m3 and 10 – 1.5 × 102 cfu/m3, respectively. The air in the waiting room presented the highest counts, both for bacteria and fungi (P < 0.05). Staphylococcus, Enterococcus, Pseudomonas, Acinetobacter were identified, highlighting the species Staphylococcus aureus and Pseudomonas oryzihabitans, the latter described as a nosocomial pathogen. Among the fungi, Aspergillus, Meyerozyma and Rhodotorula were identified. Conclusion: The indoor air of the CECOSF-Centinela presents microorganisms of importance in human health. Therefore, it is necessary to formulate more regular monitoring programs for the control of air quality inside these health centers.

Resumen Introduccción: La calidad del aire en centros de salud es fundamental para resguardar la salud de las personas. En Chile, los Centros Comunitarios de Salud Familiar (CECOSF) son lugares de gran concurrencia de personas, favoreciendo la diseminación de microorganismos. Objetivo: Evaluar la calidad microbiológica del aire al interior del CECOSF-Centinela en Talcahuano, Región del Biobío. Metodología: Se tomó muestras de aire en seis salas del CECOSF, quincenalmente, entre julio de 2018 y junio de 2019, con el equipo MAS-100 NT, empleando agar tripticasa y agar Sabouraud. Diferentes morfotipos de bacterias y hongos fueron identificados mediante RPC. Resultados: Los recuentos de bacterias y hongos variaron entre 9,1 × 101 – 2,4 × 103 ufc/m3 y 10 – 1,5 × 102 ufc/m3, respectivamente. El aire de la sala de espera presentó los recuentos más altos, tanto para bacterias como hongos (P < 0,05). Se identificó Staphylococcus, Enterococcus, Pseudomonas, Acinetobacter, destacando las especies Staphylococcus aureus y Pseudomonas oryzihabitans, microrganismo este último, descrito actualmente como patógeno nosocomial. Entre los hongos se identificó Aspergillus, Meyerozyma y Rhodotorula. Conclusión: Las muestras de aire del CECOSF-Centinela presentan microrganismos de importancia en salud humana. De ahí la necesidad de formular programas de monitoreo más regulares para controlar la calidad del aire al interior de estos establecimientos.

Does ministry type influence profiles in upper-level bureaucracy? To govern, presidents need to 01. maintain control over the content of public policies, 02. make political concessions that earn them enough parliamentary support to see those policies approved, and 03. build or keep in place the bureaucratic competencies necessary to implement them. We argue that the president makes key appointments according to the nature of the policies of each ministry and their centrality in the executive branch’s decision-making process. Employing cluster analysis, we propose an objective classification of ministries into four types: ‘coordination’, ‘redistribution’ (social policy and income), ‘regulation’, and ‘distribution’. We also identify their relationship with the profiles of those who have occupied positions in the middle and upper echelons of Brazil’s federal bureaucracy – what are referred to in Brazilian nomenclature as ‘DAS roles’ (in which ‘DAS’ stands for Direção e Assessoramento Superior) – in the period from 1999 to 2016. Our findings indicate that presidents choose to professionalize the bureaucracy of the ‘coordination’ and ‘redistribution’ ministries, to appoint partisans to the bureaucracy of the ‘distribution’ and ‘regulation’ ministries, and to allocate partisans of the coalition partners to the ministries controlled by those parties.

Abstract Solidago microglossa is used as an anti-inflammatory agent in traditional Brazilian medicine, and this work evaluated the anti-inflammatory potential of the crude ethanolic extract of the flowers of S. microglossa in vivo, as assayed by paw edema models induced by carrageenan, prostaglandin E2, bradykinin and compound 48/80. In the chemical profile, we identified compounds by electrospray ionization mass spectrometry and quantified them by HPLC-DAD. Additionally, this study analyzed the potential to activate the in vitro transcriptional activity of PPARγ, which is a nuclear receptor linked to the anti-inflammatory response. It was possible to identify five compounds: quinic acid, quercetin, chlorogenic acid, hyperoside, and rutin. In the paw edema evaluation, it was possible to show the potential of reducing edema during the inflammatory process. The crude ethanolic extract of the flowers of S. microglossa activated PPARγ compared to the full agonist rosiglitazone and in a dose-response manner. It is possible to conclude that the extract of the flowers of S. microglossa showed anti-inflammatory activity, and the phenolic compounds present in this species might be responsible for this activity.

Abstract The present study aims to evaluate the uniformity of the high intensity ultrasound (US) effects on the quality of beef longissimus dorsi. For this purpose L. dorsi muscles from Hereford carcasses were cut into 2.54 cm thick slices. Each sample was marked into concentric areas of 2 cm wide. Ultrasound (37 kHz and 7 W/cm2) treatment was performed for 60 min using an ultrasonic bath and treated meat was stored at 4 °C for 0 and 7 days. pH values decreased after 7 days of aging at 4 °C with and without ultrasound application (P < 0.0001). The color parameters a* and b* and WHC increased significantly in the sonicated samples after 7 d of storage at 4 °C (P < 0.0001). No differences by US (P = 0.6711) and storage time (P = 0.4184) were found. Therefore, ultrasonic intensity was homogeneously distributed in the samples and had no negative effects on the quality of the meat. A reduction (P < 0.0001) in psychrophilic and coliform (P < 0.0001) bacteria was observed by US, while mesophilic bacteria increased (P < 0.0001) by US. US could be considered as an efficient technology to be used in beef to improve meat quality and safety.

By the end of 2016, about 65,5 million people were displaced from their homes by conflicts around the world (ACNUR, 2017). In Brazil, there was 9.555 recognized refugees out of a total of 10.308 refugees applications (BRASIL, 2017). When it comes to their social and economic re-integration the activities which this displaced people are engaged in and the new social relations that they create can also indicates potentials in order to increase tourism in the city. This research had an exploratory characteristic considering that the phenomenon is not very well known. The link between post-conflict tourism and migrations demonstrated that in São Paulo tourism can play an important role in the reconstruction of economies and societies that faced conflicts of any kind - but focused mostly in groups displaced by the effects of conflicts in other countries.

A fines de 2016, cerca de 65,6 millones de personas fueron desplazadas de sus casas por conflictos en todo el mundo (ACNUR, 2017), y más de 10.000 personas solicitaron refugio en Brasil. Actualmente, se ha concedido refugio a 9.555 personas en el país (Brasil, 2017). En lo que respecta a su (re)inserción, las actividades laborales a las que se dedican esos desplazados y también las nuevas relaciones sociales que se van tejiendo en el territorio paulistano pueden indicar potenciales para la diversificación del acervo turístico de la ciudad. La investigación tuvo un carácter eminentemente exploratorio, dado que el fenómeno que se debate es poco conocido. Se pudo observar que el flujo migratorio -incluyendo un grupo de refugiados- puede articular discusiones sobre el turismo postconflictos y las migraciones, generando nuevas posibilidades que diversifican la ciudad-destino de los migrantes, tornándola atractiva y rica culturalmente, alimentando procesos de desarrollo turístico.

Rare earths (Europium, cerium)-doped CdS nanofilms are prepared using the growth technique chemical bath deposition (CBD) at the reservoir temperature of 70±2°C varying the synthesis time in a wide range. For the rare earths doped CdS nanofilms the synthesis time was ranged from 80 to 135 min. The rare earths molar concentration was in the range 0.0≤x≤3.47, which was determined by energy dispersive X-ray spectroscopy (EDS). The X-ray diffraction (XRD) analysis reveals that CdS nanofilms showed the zinc blende (ZB) crystalline phase. The nanocrystal size was ranged from 2.67 to 2.35 nm for the CdS and 1.84-2.33 nm for rare earth-doped CdS that were determined by the Debye-Scherrer equation from ZB (111) direction and it was confirmed by transmission electron microscopy (TEM). The doped CdS exhibits a direct band gap that diminishes with the increase of the synthesis time, from 2.50 to 2.42 eV, which was obtained by transmittance. The room-temperature photoluminescence of CdS presents the band-to-band transition at 431 nm, which is associated with quantum confinement because the grain size is less than its Bohr exciton radius and a dominant band at 523 nm, which is called the optical signature of interstitial oxygen. Eu3+-doped CdS photoluminescence shows the dominant radiative peak at 576 nm that is associated to the intra-4f radiative transition of Eu3+ ions, which corresponds to the magnetic dipole transition, (5D0→7F1). For the Ce3+-doped CdS the dominant radiative transitions are clearly redshifted. Additionally, other radiative peaks associated at structural defects are observed. The passivation of the CdS by rare earths was approximately of two orders of magnitude obtaining better results with cerium.

BACKGROUND Type 2 diabetes (T2D) is a risk factor for the development of tuberculosis (TB), although the associated mechanisms are not known. OBJECTIVES To study the association between T2D and the basal phenotype of macrophages, and their immune response to Mycobacterium tuberculosis (Mtb) infection. METHODS We evaluated the influence of T2D on the response of monocyte-derived macrophages (MDM) to Mtb in patients with T2D (n = 10) compared to healthy subjects (n = 9), before and after infection with Mtb clinical isolates bearing different degrees of virulence. The levels of cell surface markers for activation secreted cytokines and chemokines, bacterial association, and intracellular bacterial growth were evaluated. FINDINGS The expression levels of HLA-DR, CD80, and CD86 were low while those of of PD-L1 were high in uninfected MDMs derived from patients with diabetes; as a result of Mtb infection, changes were only observed in the expression levels of PD-L1. The levels of cytokines (e.g., IL-6, IL-1β, IL-10, and IL-12) and chemokines (e.g., MCP-1, MIG, and RANTES) are perturbed in MDMs derived from patients with diabetes, both before infection and in response to Mtb infection. In response to the more virulent Mtb strains, the levels of association and bacterial clearance were diminished in MDMs derived from patients with diabetes. CONCLUSIONS T2D affects the basal activation state of the macrophages and its capacity to respond and control Mtb infection.

Resumo A qualidade de vida (QV) pode ser afetada pela presença de transtornos mentais, como o Transtorno Obsessivo-Compulsivo (TOC). Assim, a avaliação e o acompanhamento dos índices de QV em pacientes com transtornos mentais permite a identificação de suas prioridades, sendo possível a implementação de ações para a melhora desses índices nos usuários do sistema de saúde. O objetivo deste artigo é avaliar a QV em portadores de TOC usuários da atenção primária à saúde. Estudo transversal com amostragem por conveniência, incluindo todos os usuários de três Unidades Básicas de Saúde de Pelotas, RS. Para avaliar a QV foi utilizada a WHOQOL–Bref, e o TOC foi avaliado através da M.I.N.I. Foram avaliados 1081 indivíduos. A prevalência de TOC foi de 3,9%. Portadores de TOC apresentaram médias inferiores em todos os domínios da QV quando comparados aos indivíduos sem TOC (p < 0,001). Os achados deste estudo enfatizam a importância de utilizar a QV como instrumento de monitoramento da melhora do transtorno no âmbito da atenção básica à saúde.

Abstract Quality of life (QOL) can be affected by the presence of mental disorders, like Obsessive-Compulsive Disorder (OCD). Thus, the evaluation and monitoring of QOL in patients with mental disorders enables the identification of priorities, making it possible to implement actions to improve QOL among health system users. The scope of this article is to measure QOL in OCD patients in primary health care. It involves a cross-sectional study with a convenience sample including all users of three Basic Health Units of Pelotas in the State of Rio Grande do Sul, Brazil. The quality of life was measured with the WHOQOL-Bref and the OCD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) This study included 1081 individuals. The prevalence of OCD was 3.9%. OCD patients had a lower average in all domains of QOL when compared to individuals without OCD (p < 0.001). The findings of this study emphasize the importance of using QOL as a monitoring tool of the disorder in basic health care.

Resumo A qualidade de vida (QV) pode ser afetada pela presença de transtornos mentais, como o Transtorno Obsessivo-Compulsivo (TOC). Assim, a avaliação e o acompanhamento dos índices de QV em pacientes com transtornos mentais permite a identificação de suas prioridades, sendo possível a implementação de ações para a melhora desses índices nos usuários do sistema de saúde. O objetivo deste artigo é avaliar a QV em portadores de TOC usuários da atenção primária à saúde. Estudo transversal com amostragem por conveniência, incluindo todos os usuários de três Unidades Básicas de Saúde de Pelotas, RS. Para avaliar a QV foi utilizada a WHOQOL–Bref, e o TOC foi avaliado através da M.I.N.I. Foram avaliados 1081 indivíduos. A prevalência de TOC foi de 3,9%. Portadores de TOC apresentaram médias inferiores em todos os domínios da QV quando comparados aos indivíduos sem TOC (p < 0,001). Os achados deste estudo enfatizam a importância de utilizar a QV como instrumento de monitoramento da melhora do transtorno no âmbito da atenção básica à saúde.

Abstract Quality of life (QOL) can be affected by the presence of mental disorders, like Obsessive-Compulsive Disorder (OCD). Thus, the evaluation and monitoring of QOL in patients with mental disorders enables the identification of priorities, making it possible to implement actions to improve QOL among health system users. The scope of this article is to measure QOL in OCD patients in primary health care. It involves a cross-sectional study with a convenience sample including all users of three Basic Health Units of Pelotas in the State of Rio Grande do Sul, Brazil. The quality of life was measured with the WHOQOL-Bref and the OCD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) This study included 1081 individuals. The prevalence of OCD was 3.9%. OCD patients had a lower average in all domains of QOL when compared to individuals without OCD (p < 0.001). The findings of this study emphasize the importance of using QOL as a monitoring tool of the disorder in basic health care.

In this century, chemists find themselves with a new challenge. They need to efficiently generate materials to maintain quality of life, but they have to do so reducing the negative effects on the environment and human health. Teaching green chemistry is fundamental to promote future scientists who can create safely and efficiently non-toxic products and processes in the way for a sustainable future. The use of a multicomponent reaction, as the Passerini reaction, for the generation of new molecules as drug candidates, is described here as an experiment for undergraduate organic chemistry laboratory. It is a fast, efficient and simple process which generates a complex product using simple reactants in one step. Different metrics were determined in order to measure how environmentally friendly this reaction is, in the conditions tested. The student will be able to discuss: green chemistry, development of bioactive molecules, diversity-oriented synthesis, multicomponent reactions, and chemistry in aqueous solution.

En este siglo, los químicos se han encontrado con un nuevo desafío: producir de manera eficiente los materiales necesarios para mantener la calidad de vida de los seres vivos, reduciendo los efectos negativos sobre el medio ambiente y la salud humana. En este sentido, es fundamental el rol del docente en la formación de futuros científicos que puedan generar de manera segura y eficiente productos y procesos no tóxicos, hacia el camino de un futuro sustentable. En este trabajo se describe el uso de una reacción multicomponente, la reacción de Passerini, como un experimento de laboratorio en un curso de grado de Química Orgánica. Es un proceso rápido, eficiente y simple que permite obtener productos complejos a partir de moléculas sencillas y en un paso de reacción. Diferentes parámetros fueron analizados para determinar cuán amigable es esta reacción con el medio ambiente, en las condiciones ensayadas. El estudiante tendrá la posibilidad de discutir sobre química verde, desarrollo de moléculas bioactivas, síntesis orientada a la diversidad, reacciones multicomponente y química en disolución acuosa.

Objective: To evaluate the association between social anxiety disorder (SAD) and perceived maternal bonding styles among young women during pregnancy and 30 months after childbirth. Methods: A cohort of young women from the city of Pelotas, Brazil was followed up from pregnancy to 30 months postpartum. The Mini Neuropsychiatric Interview Plus was used to assess SAD and the Parental Bonding Instrument was administered to measure maternal bonding styles. Poisson regression with robust variance was used for multivariable analysis. Results: After adjusting for potential confounding factors, SAD prevalence was 6.39 times higher among young women who perceived their mothers as neglectful (prevalence ratio [PR] 6.39; 95% confidence interval [95%CI] 1.2-32.0), and 5.57 times higher in women who perceived their mothers as affectionless controlling (PR = 5.57; 95%CI 1.5-19.7) when compared with those who received optimal care. Conclusion: Maternal bonding style may have an influence on the development of SAD. Therefore, support and early prevention strategies should be offered to the family.

Abstract Cancer of the larynx represents a challenge for the clinician from the time of diagnosis until the time of decision-making regarding disease management. Staging is based clinically, with endoscopic and radiological assistance. Once a diagnosis is made, the following are taken into consideration: organ preservation, when possible, quality of life, voice quality, surgical team experience, and treatment cost-benefi t. These decisions are based on studies with a poor level of evidence; however, with good results. For early disease stages, there are three options: open surgery, transoral laser surgery, and radiotherapy. For advanced disease and salvage, organ preservation can be considered using a combination of these tools, without affecting survival, and offering a good quality of life. New technologies are currently being developed, such as the use of robotics in the treatment of these tumors, but wider experience and adequate instrumentation are being awaited.

Resumen El cáncer de laringe representa un reto para el clínico desde el diagnóstico hasta la toma de decisiones para el manejo. La estadifi cación se basa en la clínica, con ayuda de métodos endoscópicos y radiológicos. Una vez hecho el diagnóstico, tomamos en cuenta que: debemos procurar la preservación del órgano cuando es posible, pensar en la calidad de vida, en la calidad de la voz, la experiencia del equipo y el costo-utilidad del tratamiento. Estas decisiones se basan en estudios con un pobre nivel de evidencia, sin embargo con buenos resultados. Para las etapas tempranas tenemos tres opciones; la cirugía abierta, la cirugía láser transoral y la radioterapia. En la enfermedad avanzada y el salvamento, podemos seguir conservando el órgano con la combinación de estas herramientas, sin afectar a la supervivencia, y con una vida digna. Actualmente están en desarrollo nuevas tecnologías como el uso de robot en el tratamiento de estos tumores, pero debemos esperar a que haya más experiencia e instrumental adecuado.