Resumo Este estudo tem como objetivo analisar os atributos da Atenção Primária à Saúde (APS) abrangente a partir da atuação das equipes de Saúde da Família com foco nas doenças crônicas não transmissíveis. Pesquisa qualitativa realizada entre agosto de 2018 a julho de 2019, na APS de Vitória da Conquista, Bahia, com 40 profissionais de saúde, por meio de grupos focais e entrevistas. A partir da análise temática, os temas centrais corresponderam aos sete atributos da APS abrangente. Como resultados, as potencialidades do trabalho das equipes relacionaram-se com a priorização do acesso, ao amplo leque de serviços oferecidos e o reconhecimento da realidade comunitária/familiar. Destacaram-se obstáculos relacionados a oferta, acessibilidade e cobertura dos serviços, fragmentação na coordenação assistencial e informacional, dificuldades de desenvolvimento de práticas inclusivas com a família e etnicamente situadas, bem como na continuidade da assistência, notadamente para o contexto rural. Espera-se que os resultados apresentados possam confirmar a necessidade de investimentos e a instituição de processos sistemáticos de avaliação do trabalho das equipes de saúde da família, a fim de acompanhar a trajetória de consolidação da APS no contexto do Sistema Único de Saúde brasileiro.

Abstract This study aims to analyze the attributes of comprehensive Primary Health Care (PHC) based on the work of the family health teams focused on non-communicable chronic diseases. Qualitative research conducted from August 2018 to July 2019, in primary health care in Vitória da Conquista, Bahia, Brazil, with 40 health professionals, through interviews and focus groups. From the thematic analysis, the central themes were defined, corresponding to the seven attributes of comprehensive PHC. As a result, the potentials work of the family health teams was related to prioritizing access, the wide range of services offered and the recognition of the community and family reality. The study highlighted obstacles related to service provision, accessibility, coverage, care fragmentation and in information coordination, challenges in developing practices with the family, in practices ethnically situated, and continuity of care, notably for the rural context. It is expected that the results presented may confirm the need for investments and the institution of systematic evaluation processes regarding the work of family health teams, in order to follow the trajectory of PHC consolidation in the context of the Brazilian Unified Health System.Resumo: Este estudo tem como objetivo analisar os atributos da Atenção Primária à Saúde (APS) abrangente a partir da atuação das equipes de Saúde da Família com foco nas doenças crônicas não transmissíveis. Pesquisa qualitativa realizada entre agosto de 2018 a julho de 2019, na APS de Vitória da Conquista, Bahia, com 40 profissionais de saúde, por meio de grupos focais e entrevistas. A partir da análise temática, os temas centrais corresponderam aos sete atributos da APS abrangente. Como resultados, as potencialidades do trabalho das equipes relacionaram-se com a priorização do acesso, ao amplo leque de serviços oferecidos e o reconhecimento da realidade comunitária/familiar. Destacaram-se obstáculos relacionados a oferta, acessibilidade e cobertura dos serviços, fragmentação na coordenação assistencial e informacional, dificuldades de desenvolvimento de práticas inclusivas com a família e etnicamente situadas, bem como na continuidade da assistência, notadamente para o contexto rural. Espera-se que os resultados apresentados possam confirmar a necessidade de investimentos e a instituição de processos sistemáticos de avaliação do trabalho das equipes de saúde da família, a fim de acompanhar a trajetória de consolidação da APS no contexto do Sistema Único de Saúde brasileiro.

Abstract The aim of this study is to report an original case series of synchronous jawbone diseases. Data of patients seen over 13 years were extracted from the files of three Oral Radiology and Pathology diagnostic centers in Brazil. The clinical, radiographic, and laboratory characteristics were tabulated and analyzed by the authors; the patients were described according to lesion type. Seventy-two synchronous jawbone diseases were included in this study. Florid osseous dysplasia, Gorlin-Goltz syndrome, and cherubism were the most frequent disorders reported in this case series. In addition, the posterior mandible area was the main site of manifestation. Florid osseous dysplasia and Gorlin-Goltz syndrome represented two-thirds of our samples. With the utilization of adequate demographic, clinical, and radiologic information, it is possible to diagnose most of the synchronous lesions of jawbones. Sometimes, however, we need complementary exams, such as histopathologic and biochemical analysis or dosing of calcium, phosphorus, and alkaline phosphatase.

RESUMO: O objetivo deste estudo foi avaliar a composição e as atividades quimiopreventiva de câncer e antioxidante da semente, polpa e casca de uvas híbridas Maximo (IAC 138-22) colhidas em diferentes estágios de maturação. Os teores de compostos fenólicos totais, antocianinas e taninos foram determinados a partir dos extratos etanólicos. O conteúdo de fenólicos e taninos totais foi determinado pelo método de Folin-Ciocaulteau, e o teor de antocianinas totais foi determinado pelo método do pH diferencial. A atividade antioxidante foi avaliada por diferentes métodos químicos, e a viabilidade celular (macrófagos e melanomas), e atividade quimiopreventiva de câncer foi testada em culturas de células por ensaio de indução de quinona redutase, ensaio de atividade inibidora de NF-κB induzido por TNF-α e ensaio de atividade inibidora de aromatase. A uva híbrida apresentou alto teor de fenólicos nas sementes e na casca, teor que reduziu significativamente com o amadurecimento. Os resultados mostraram que o amadurecimento dos frutos afetou significativamente a composição e as atividades antioxidantes e quimiopreventivas de câncer. Com exceção do teor de antocianinas, os resultados mais significativos foram observados para as sementes verdes, com o estádio mais verde apresentando os melhores resultados. As sementes verdes apresentaram a maior atividade antioxidante, mesmo quando comparadas ao resveratrol livre. Na avaliação da atividade quimiopreventiva do câncer, as sementes verdes mostraram capacidade de inibir a atividade do NF-κB e da aromatase, fatores importantes para o estágio inicial do desenvolvimento do câncer. Além disso, nenhum extrato apresentou atividade citotóxica. Portanto, as sementes verdes desta uva apresentam resultados promissores dadas as fortes atividades antioxidantes e quimiopreventivas do câncer aqui confirmadas, sugerindo efeitos benéficos à saúde.

ABSTRACT: This study evaluated the composition and the cancer chemopreventive and antioxidant activities of the seed, skin, and pulp of Maximo hybrid grapes (IAC 138-22) harvested at different ripening stages. The content of total phenolic compounds and tannins were determined by the Folin-Ciocaulteau method, and total anthocyanins were determined using the differential pH method. Different chemical methods assessed the antioxidant activity. Cell viability (macrophage and melanoma skin cancer) and cancer chemopreventive activity were tested in cell lines by quinone reductase induction assay, TNF-α-induced NF-κB inhibitory activity assay, and aromatase inhibitory activity assay. The hybrid grape had high phenolic contents in both seeds and skin, significantly reduced upon ripening. The results showed that fruit ripening significantly affected both the composition and the antioxidant and cancer chemopreventive activities. Except for the anthocyanin content, the most significant results were observed for green seeds, with the greenest stage showing the best results. The green seeds showed the highest antioxidant activity, even when compared to free resveratrol. In the assessment of cancer chemopreventive activity, the green seeds showed the ability to inhibit N-FκB and aromatase activity, important factors for the early stage of cancer development. Besides, no extracts showed cytotoxicity. Therefore, this grape’s green seeds showed strong antioxidant and cancer chemopreventive activities confirmed herein, suggesting beneficial health effects.

Abstract Aim: The influence of sleep on the adaptability and relearning rate during learning of complex motor skills is still unknown, limiting the comprehension of the sleep role in motor memory consolidation. Thus, we aimed to investigate the nocturnal sleep influence on retention, adaptability, and relearning rate of the dart-throwing task. Methods: Sixty healthy adults were divided into two groups: SLEEP and WAKE. Both groups practiced an under-arm dart-throwing task. However, WAKE practiced in the morning and performed a retention phase in the evening, and SLEEP practiced in the evening and performed a retention phase in the morning of the next day. The practice and retention phases were separated by 12 h in both groups. There were analyses regarding retention (retention test), adaptability (delayed transfer test), and relearning rate (savings). Results: Both groups improved their performance across the acquisition phase and maintained it in the retention test. The groups did not demonstrate adaptability and did not demonstrate a significant difference in relearning rate. Conclusion: We conclude that nocturnal sleep did not modulate the consolidation of motor memories related to ballistic discrete motor skills.

Abstract During the last quarter of 2019, the beaches, mangroves, and estuaries of Northeast Brazil received an unprecedented volume of crude oil from the sea, which became the worst environmental disaster ever to reach the Brazilian coast. The oil, having reached the shores completely unnoticed, left both society and government agents completely clueless on (i) where the oil was coming from; (ii) how much oil was still in the ocean to reach the shorelines; and (iii) which beaches were going to be affected next! By exploring remote sensing data and ocean numerical modeling, along with oil dispersion chemistry on sea water, this study investigates the possible origin and path of the spill and whether it could have been detected from space. The oil dispersion modeling simulations performed for this investigation revealed a possible region and timing of the oil spill, also indicating the likelihood of it being advected toward the shoreline under the ocean surface.

Abstract The northeast Brazilian state of Alagoas harbors a rather diverse, and one of the world’s most threatened, avifauna. However, the knowledge about its avifauna is currently scattered on several publications and the state’s birds have never been comprehensively assembled into a checklist. To fill this shortfall, we present here the first critical review of all available bird records for the state of Alagoas. We present a list of 520 bird species recorded in the state, of which 503 are supported by documentary evidence. We also comment on the distribution, migratory movements, taxonomy and conservation of the region’s avifauna and correct previous misidentified or invalid records for the state.

Irrigated agriculture has become a concern, given the scarcity of freshwater. To reduce its water consumption, new techniques and technologies have been proposed. Based on this, the objective of this work was to evaluate the influence of different soil water tensions at initiation of irrigation with magnetically treated water, on 'iceberg' lettuce Lucy Brown (Lactuca Sativa L.) development and production. The experiment was conducted in a greenhouse, using a completely randomized factorial design, to evaluate two water types (magnetically treated water - MW and ordinary water - OW) and four soil water tensions at initiation of irrigation (T1 - 15 kPa, T2 - 25 kPa, T3 - 40 kPa and T4 - 70 kPa), with three replicates. Tensiometers were used to estimate soil water tension. The evaluated parameters were: aerial part fresh and dry total mass; commercial head fresh and dry mass, root fresh and dry mass; stem fresh and dry mass; stem length and diameter; percentage of leaves with tip burn, total and commercial yield; water use efficiency related to total and commercial yield; plant exposed area; and dry matter content. Despite achieving greater water use efficiency, the magnetic treatment may have hindered the removal of water from the soil by the crop, especially at increased soil water tension at initiation of irrigation.

Resumo A disfagia tem impactos negativos multidimensionais na vida do paciente disfágico e pode gerar conflitos decisórios relacionados à alimentação. O objetivo deste artigo é revisar a literatura sobre fonoaudiologia, conflitos na tomada de decisão e agentes envolvidos nas deliberações sobre a nutrição desse tipo de paciente. Trata-se de estudo exploratório-descritivo, de revisão integrativa, com análise de conteúdo conforme proposta por Bardin. As bases de dados utilizadas foram: PubMed, Scopus, Web of Science, Cochrane, Embase e Biblioteca Virtual em Saúde. Identificaram-se conflitos envolvendo o fonoaudiólogo, o paciente, a família e a equipe multidisciplinar. Nos artigos selecionados não foi possível identificar uma teoria ou método que fundamentasse a mediação desses conflitos. Não foram encontradas publicações brasileiras que respondessem à pergunta norteadora da revisão.

Abstract Dysphagia presents multidimensional negative impacts on the life of dysphagic patients and may generate decision conflicts related to their diet. This is a review of the literature on speech-language therapy, decision conflicts and the agents involved in the decision making process for deliberations related to the nutrition of this type of patient. This is an exploratory and descriptive study, with content analysis as proposed by Bardin. The databases used were PubMed, Scopus, Web of Science, Cochrane, Embase and Virtual Health Library. Conflicts involving the speech-language therapist, the patient, the family and the multidisciplinary team were identified. In the selected articles, no theory or method was identified to support the mediation of these conflicts. No Brazilian publications that answered the guiding question were found.

Resumen La disfagia tiene impactos negativos multidimensionales en la vida del paciente disfágico y puede generar conflictos de decisión relacionados con su alimentación. El objetivo de este artículo fue revisar la literatura sobre fonoaudiología, los conflictos de decisión y los agentes involucrados en el proceso de toma de decisiones para las deliberaciones relacionadas con la nutrición de este tipo de pacientes. Se trata de un estudio exploratorio y descriptivo, donde se realizó una revisión integradora con análisis de contenido y categorización por Bardin. Las bases de datos utilizadas fueron: PubMed, Scopus, Web of Science, Cochrane, Embase y Biblioteca Virtual en Salud. Se identificaron los conflictos entre fonoaudiólogo, paciente, familia y equipo multidisciplinario. En los artículos seleccionados no se identificó ninguna teoría o método que sustente la mediación de estos conflictos. No hay publicaciones nacionales que respondan a la pregunta orientadora.

Resumo: O objetivo deste trabalho foi avaliar o valor nutritivo de silagens de genótipos anões e altos de capim-elefante (Pennisetum purpureum), consorciados ou não à cunhã (Clitoria ternatea). O experimento foi realizado em delineamento de blocos ao acaso, em arranjo fatorial 4x2 (quatro genótipos × dois sistemas de plantio). Os genótipos consorciados ou não à cunhã foram: IRI-381 e Elefante B, de porte alto; e Taiwan A-146 2.37 e Mott, anões. A forragem foi colhida após 60 dias de rebrota. Na silagem do capim Mott consorciado à cunhã, foram observados menores teores de lignina (78,1 g kg-1), fibra em detergente neutro (636,0 g kg-1) e proteína insolúvel em detergente neutro (13,15 g kg-1), além de maior recuperação da matéria seca (873,3 g kg-1). A silagem de Taiwan A-146 2.37 cultivado em consórcio com a leguminosa apresentou maior teor de proteína bruta (136,1 g kg-1). Em ambas as silagens, os teores de nitrogênio amoniacal foram bastante reduzidos (26,4 g kg-1). No entanto, maiores teores residuais de carboidratos solúveis em água foram observados nas silagens do consórcio (1,85 mg g-1) e do capim Mott em monocultivo (1,51 mg g-1). Além disso, houve menor digestibilidade in vitro da matéria seca (676,7 g kg-1) na silagem do consórcio. Os genótipos anões aumentam o valor nutricional da silagem de capim-elefante, comparados aos de porte alto. O consórcio com a cunhã melhora as características fermentativas da silagem, apesar de reduzir a sua digestibilidade. Portanto, a ensilagem do capim anão Mott consorciado à cunhã apresenta resultados mais promissores.

Abstract: The objective of this work was to evaluate the nutritional value of silages from tall-sized and dwarf elephant grass (Pennisetum purpureum) genotypes, intercropped or not with butterfly pea (Clitoria ternatea). The experiment was performed in randomized complete blocks, in a 4x2 factorial arrangement (four genotypes × two cropping systems). The genotypes intercropped or not with butterfly pea were: IRI-381 and Elephant B, tall sized; and Taiwan A-146 2.37 and Mott, dwarf. Forage was harvested 60 days after regrowth. In the silage from Mott grass intercropped with butterfly pea, lower contents of lignin (78.1 g kg-1), neutral detergent fiber (636.0 g kg-1), and neutral detergent insoluble protein (13.15 g kg-1), besides a greater dry matter recovery (873.3 g kg-1), were observed. The silage from Taiwan A-146 2.37 intercropped with the legume showed a greater crude protein content (136.1 g kg-1). In both silages, the ammonia nitrogen contents were quite reduced (26.4 g kg-1). However, greater residual water-soluble carbohydrate contents were observed in the silages from the intercrop (1.85 mg g-1) and from the Mott grass monocrop (1.51 mg g-1). Moreover, there was a lower in vitro dry matter digestibility (676.7 g kg-1) for the silage from the intercrop. Dwarf genotypes increase the nutritional value of elephant grass silage, compared with the tall-sized ones. Intercropping with butterfly pea improves silage fermentation characteristics, despite reducing its digestibility. Therefore, the ensilage of dwarf Mott elephant grass intercropped with butterfly pea shows more promising results.

RESUMO: O capim-elefante (pennisetum purpureum schum.) foi durante muito tempo cultivado apenas em capineiras. porém, o interesse pelo seu manejo sob pastejo vem aumentando por conta da seleção de genótipos de porte baixo, que ganhou nova relevância a partir de 1988, com o registro do capim mott. Neste sentido, genótipos de porte alto e baixo apresentam diferenças morfológicas, produtivas e qualitativas importantes, mesmo que fatores ambientais também exerçam influência sob estes aspectos. o objetivo desta revisão foi abordar como o porte do capim-elefante pode influenciar características morfofisiológicas, decisões de manejo e formas de utilização da espécie. Os aspectos morfofisiológicos e o porte do capim-elefante são importantes para direcionar sua utilização nos diferentes sistemas de produção. os resultados de pesquisa das últimas décadas sugerem que as particularidades dos genótipos de porte alto, como elevado acúmulo de forragem, reservas orgânicas e alongamento dos colmos favorecem seu manejo sob corte e sua utilização em setores industriais. já o capim-elefante de porte baixo apresenta aspectos como elevada proporção de folhas na forragem colhida, alta relação folha: colmo e elevado perfilhamento. Estes fatores facilitam sua utilização em sistemas de produção a pasto.

ABSTRACT: Elephant grass (pennisetum purpureum schum.) has been grown only in cut-and-carry systems for a long time. However, interest in its grazing management has been increasing because of the selection of short-sized genotypes, which have gained new relevance since 1988 with the registration of ‘mott’ grass. in this sense, tall and short-sized genotypes present important differences in morphology, quality and productivity; although, environmental factors also exert influence on these aspects. This review aimed to approach how the elephant grass size can influence the morphophysiological characteristics, management decisions, and exploitation of this species. the morphophysiological aspects and the elephant grass sizes are important to direct their utilization in the different production systems. The research results from previous decades suggest that the particularities of the tall-sized genotypes, such as great forage accumulation, high organic reserves content, and stem elongation, favor their management in cut-and-carry systems and industrial sectors. Conversely, the short-sized elephant grass genotypes present aspects as higher leaf proportion in the harvested forage, leaf/stem ratio, and tillering. these factors facilitate their exploitation in grazing systems.

Resumo Objetivo: Avaliar em uma amostra de pacientes com distúrbios da diferenciação do sexo (DDS), dados relacionados à idade, ao encaminhamento e sua correlação com as queixas iniciais, ao sexo ao encaminhamento e ao sexo final e diagnóstico etiológico. Métodos: Revisão retrospectiva da idade por ocasião da primeira consulta e motivo dela, sexo social inicial e após definição do diagnóstico, cariótipo e diagnóstico etiológico de todos os casos atendidos em um ambulatório especializado em DDS entre 1989 e 2016. Foram excluídos casos que não compreendiam DDS e diagnósticos de DDS que não cursam comumente com ambiguidade genital, não necessitam de acompanhamento especializado. Resultados: Dos 1.793 casos atendidos, 1.139 foram diagnosticados com algum DDS. Excluíram-se 430 (272 síndrome de Turner, 66 síndrome de Klinefelter e 92 disgenesia gonadal pura), totalizando 709. Desses, 82,9% foram encaminhados por ambiguidade genital, somente um quarto ainda no primeiro mês de vida e 6,6% por atraso puberal, a maioria com 10 anos ou mais; 68,6% tiveram diagnóstico de DDS XY; 22,4% DDS XX e 9% de anomalias dos cromossomos sexuais. Conclusões: Este estudo apresenta a maior casuística na literatura de pacientes com DDS atendidos em um único serviço. O momento de encaminhamento da maioria dos pacientes com ambiguidade genital foi aquém do ideal e casos mais leves de ambiguidade e muitos com manifestações puberais foram encaminhados ainda mais tardiamente. Os resultados reforçam a importância do ensino continuado a profissionais que terão o primeiro contato com esses pacientes, principalmente pediatras e neonatologistas.

Abstract Objective: To evaluate, in a sample of patients with disorders of sex development (DSD), data related to the age at referral and their correlation with the initial complaints, gender at referral, defined gender after diagnosis and etiological diagnosis. Methods: Retrospective review of the age at the first consultation and the reason for it, initial social gender and gender after the diagnosis, karyotype and etiological diagnosis of all cases treated at a DSD outpatient clinic between 1989 and 2016. Cases that did not involve DSD and DSD diagnoses that do not usually involve ambiguous genitalia, thus not requiring specialized monitoring, were excluded. Results: Of the 1793 treated cases, 1139 were diagnosed with some type of DSD. This study excluded 430 cases (272 with Turner's syndrome, 66 with Klinefelter syndrome, and 92 with pure gonadal dysgenesis), thus a total 709 individuals were included. Of these, 82.9% were referred due to ambiguous genitalia; only one-quarter were still in the first month of life, and 6.6% were referred due to pubertal delay, with most of them aged 10 years or older. Of these patients, 68.6% had a diagnosis of XY DSD, 22.4% of XX DSD, and 9% of sex chromosome abnormalities. Conclusions: This study presents the largest series in the literature of patients with DSD treated in a single center. The time of referral of the majority of patients with ambiguous genitalia fell short of the ideal, and milder cases of ambiguous genitalia and many with pubertal manifestations were referred even later. The results reinforce the importance of continuing education for professionals who will have the first contact with these patients, mainly pediatricians and neonatologists.

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

ABSTRACT Background: Global publications on Q fever have increased after the 2007 epidemic in the Netherlands. However, the epidemiology of Q fever/coxiellosis in Brazil is still poorly understood. Accordingly, there have been few studies investigating the presence of Coxiella burnetii in dairy products around the world, especially in Brazil, where consumption of fresh cheese made from raw-milk is very high. Objective: This study was a random survey to assess the prevalence of C. burnetii by PCR in traditional Minas artisanal cheese from the Serro microregion, Brazil, which is manufactured from bovine raw-milk. Methods: DNA extracted from 53 cheese samples were analyzed by nested PCR with C. burnetii-specific primers and the products confirmed by DNA sequencing. Results: Out of the 53 cheese samples five (9.43%) were C. burnetii DNA-positive, each coming from one of the respective randomly selected manufacturing agroindustries.Based on our results, it is estimated that 1.62 tons/day of ready-to-eat cheese made from raw-milk from a total of 16.2 tons produced daily in the study region are contaminated with C. burnetii. Conclusion: To our knowledge, this is the first report of highly heat-resistant zoonotic pathogen in raw-milk Brazilian artisanal cheese. This food safety hazard has been completely neglected in ready-to-eat raw-milk Brazilian artisanal cheese and could imply potential threats to consumers, since C. burnetii survives in artisanal cheese submitted to long ripening periods. Thus, this work established random and representative baseline prevalence of C. burnetii in this food product in Brazil. Further epidemiological studies, monitoring trends and setting control targets are warranted. Finally, these results point out the importance of including C. burnetii in animal and public health surveillance programs.