Abstract Microsatellite primers pairs were developed for the Neotropical tree Roupala montana var. brasiliensis for use in studies on genetic diversity, mating system, and gene flow. Forty-two primer pairs were developed, resulting in 27 polymorphic loci, with two to 27 alleles per locus. The primer pairs were validated against 34 R. montana var. brasiliensis adult trees from four populations. The observed (H o) and expected (H e)heterozygosities ranged among loci from 0.061 to 0.930 (mean of 0.544) and from 0.116 to 0.950 (mean of 0.700), respectively. Null alleles were observed for ten loci. No genotypic linkage disequilibrium was detected in any pair of loci. This set of loci is suitable for population genetic studies of the species.

Resumo Este artigo analisa as mudanças no arranjo produtivo da madeira oriunda da extração comunitária, no município de Boa Vista do Ramos - Amazonas, decorrentes das alterações nas políticas ambientais e normas voltadas ao manejo florestal sustentável. Trata-se de uma pesquisa descritiva baseada em um estudo de caso desenvolvido a partir de observação participante e entrevistas não estruturadas, realizados entre 1999 e 2007, período de contato direto com uma associação de produtores florestais e o ambiente. Foram verificados documentos relacionados à formalização e legalização das atividades e realizada uma revisão sobre as políticas e normas voltadas ao manejo florestal. A análise dos dados se deu a partir de 2011. Os resultados demonstram que os extratores de madeira, que desenvolviam suas atividades de maneira tradicional, tiveram de se adaptar às novas orientações políticas e técnicas. Houve uma mudança de um padrão de produção informal e ilegal para o manejo florestal comunitário juridicamente institucionalizado sob a forma de associação, com licença ambiental e certificação florestal. A coerção da sociedade visando à diminuição do desmatamento na Amazônia e o desenvolvimento de um ambiente favorável ao manejo florestal comunitário podem ser considerados como causas desta mudança. O conhecimento tradicional aliado ao técnico-científico foi o que possibilitou o desenvolvimento de um projeto de referência para a região. Por fim, a falta de estratégias específicas para o empoderamento dos manejadores florestais aliado a mudanças nas políticas públicas pode ter levado à busca por arranjos produtivos mais simples, mudando a orientação do manejo florestal de comunitário para o individual/familiar.

Abstract This paper analyses changes on the arrangements of wood production from community forestry in Boa Vista do Ramos - Amazonas, resulting from alterations in environmental policies and sustainable forest management regulations. We present a descriptive research based in a case study and carried out through participant observation and non-structured interviews during a period with direct contact with a forestry association and the environment. Documents related to the formalization and legalization of the activity were analyzed and a review in policies and regulation related to forest management was made. Results demonstrated that the wood extractors, who used to develop their activities traditionally, had to adapt to new policy and technical orientations. There were changes in the illegal and informal pattern of production to a formalized, licensed and certificated community-based forest management. The coercion of the society to reduce the deforestation in Amazonia state and the development of a favorable situation to community forestry could be considered as causes of these changes. Traditional ecological knowledge allied with technical and scientific knowledge allowed the development of a reference project to the region. At last, the lack of specific strategies to the empowerment of the forest managers and changes in public policies could have led the search for simple productive arrangements, changing from community forestry to individual/familiar scale projects.

ABSTRACT The Choosing Wisely Initiative aims to collect statements from medical societies all over the world on medical interventions that result in no benefit to patients, with the potential to cause harm. In this article we present the views of the Diagnostic Laboratory Group at the Brazilian Society of Infectious Diseases (SBI). Ten experts from SBI were asked to list 10 diagnostic tests that were perceived as unnecessary in the field of infectious diseases. After voting for the more relevant topics, a questionnaire was sent to all SBI members, in order to select for the most important items. A total of 482 votes were obtained, and the top 10 results are shown in this manuscript. The Choosing Wisely statements of SBI should facilitate clinical practice by optimizing the use of diagnostic resources in the field of infectious diseases.

Human immunodeficiency virus (HIV) infection was considered a contraindication for solid organ transplantation (SOT) in the past. However, HIV management has improved since highly active antiretroviral therapy (HAART) became available in 1996, and the long-term survival of patients living with HIV has led many transplant programs to reevaluate their policies regarding the exclusion of patients with HIV infection. Based on the available data in the medical literature and the cumulative experience of transplantation in HIV-positive patients at our hospital, the aim of the present article is to outline the criteria for transplantation in HIV-positive patients as recommended by the Immunocompromised Host Committee of the Hospital das Clínicas of the University of São Paulo.

Abstract: Injuries caused by fish are common in marine and freshwater environments. Catfish of the Ariidae and Pimelodidae families cause about 80% of those injuries. One of the complications of injuries caused by fish is the retention of fragments of the stinger in the wounds. Here we report five cases (of a total of 127 injuries caused by catfish in the Brazilian coast) in which the retained fragments were detected by radiological examination. Retained fragments should be considered in patients stung by catfish. A simple X-ray is sufficient to detect fragments of stingers in the wounds.

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.

Resumo: O objetivo deste trabalho foi comparar os efeitos da pulverização pré-colheita de 1-metilciclopropeno aquoso (1-MCPa) e tratamento pós-colheita de 1-metilciclopropeno gasoso (1-MCPg) sobre a maturação e a qualidade de caqui (Diospyros kaki) 'Fuyu'. Pulverizaram-se 150 mg L-1 de 1-MCPa nas plantas, na primeira semana de colheita comercial. Os frutos foram colhidos aos 1, 7, 14 e 21 dias, após a pulverização do 1-MCPa (DAAM), e tratados ou não com 0,6 μL L-1 de 1-MCPg, um dia após a colheita. Os tratamentos constituíram-se de controle, 1-MCPa, 1-MCPg e 1-MCPa+1-MCPg. Os frutos foram armazenados por 70 dias a 0oC, em atmosfera modificada (AM), seguido por sete dias a 23ºC. O tratamento com 1-MCPa não afetou a maturação dos frutos na planta, mas reduziu o amolecimento prematuro de polpa e o distúrbio mancha translúcida em pós-colheita. A incidência de frutos moles após a armazenagem (média de três anos) foi superior a 84% no controle e inferior a 18% com 1-MCPg, independentemente da época de colheita, e de 15, 34, 40 e 75%, quando os frutos foram tratados com 1-MCPa e colhidos 1, 7, 14 e 21 DAAM, respectivamente. A eficácia do 1-MCPa em frutos colhidos 1 DAAM é semelhante à do 1-MCPg e é reduzida com o atraso da colheita dos frutos a partir da data de sua aplicação.

Abstract: The objective of this work was to compare the effects of preharvest spraying of aqueous 1-methylcyclopropene (1-MCPa) and of postharvest treatment of gaseous 1-methylcyclopropene (1-MCPg) on fruit maturity and quality of 'Fuyu' persimmon (Diospyros kaki) . Spraying of 150 mg L-1 1-MCPa was done on trees in the first week of commercial harvesting. Fruit were harvested at 1, 7, 14, and 21 days after 1-MCPa spraying (DAMS), and treated or not with 0.6 μL L-1 1-MCPg one day after harvest. The treatments consisted of a control, 1-MCPa, 1-MCPg, and 1-MCPa+1-MCPg. Fruit were stored at 0°C for 70 days in modified atmosphere, followed by seven days at 23°C. The treatment with 1-MCPa did not affect fruit maturity on trees, but reduced the premature flesh softening and the occurrence of translucent stain disorder at postharvest. The incidences of soft fruit after storage (average of three years) were higher than 84% for the control, and lower than 18% for fruit treated with 1-MCPg, regardless of fruit harvesting date, and they were 15, 34, 40, and 75% for fruit treated with 1-MCPa and harvested at 1, 7, 14, and 21 DAMS, respectively. The efficacy of 1-MCPa is equivalent to that of 1-MCPg for fruit harvested at 1 DAMS and its is reduced by delaying fruit harvest from the date of its application.

Cytomegalovirus infection is a frequent complication after transplantation. This infection occurs due to transmission from the transplanted organ, due to reactivation of latent infection, or after a primary infection in seronegative patients and can be defined as follows: latent infection, active infection, viral syndrome or invasive disease. This condition occurs mainly between 30 and 90 days after transplantation. In hematopoietic stem cell transplantation in particular, infection usually occurs within the first 30 days after transplantation and in the presence of graft-versus-host disease. The major risk factors are when the recipient is cytomegalovirus seronegative and the donor is seropositive as well as when lymphocyte-depleting antibodies are used. There are two methods for the diagnosis of cytomegalovirus infection: the pp65 antigenemia assay and polymerase chain reaction. Serology has no value for the diagnosis of active disease, whereas histology of the affected tissue and bronchoalveolar lavage analysis are useful in the diagnosis of invasive disease. Cytomegalovirus disease can be prevented by prophylaxis (the administration of antiviral drugs to all or to a subgroup of patients who are at higher risk of viral replication) or by preemptive therapy (the early diagnosis of viral replication before development of the disease and prescription of antiviral treatment to prevent the appearance of clinical disease). The drug used is intravenous or oral ganciclovir; oral valganciclovir; or, less frequently, valacyclovir. Prophylaxis should continue for 90 to 180 days. Treatment is always indicated in cytomegalovirus disease, and the gold-standard drug is intravenous ganciclovir. Treatment should be given for 2 to 3 weeks and should be continued for an additional 7 days after the first negative result for viremia.

Para se obter economia de energia por meio da melhoria da eficiência energética, é necessário fazer um diagnóstico que mostre o real desempenho energético e, assim, determinar os investimentos requeridos. Não obstante, a viabilidade econômica destes investimentos deve ser avaliada. Diversos autores afirmam que esta área é carente, especialmente na avaliação do risco. O payback é o critério mais utilizado, mas não é o mais conveniente. O objetivo deste trabalho é aplicar uma metodologia que envolve duas análises: a análise de engenharia e a análise de risco. A análise de engenharia é feita por meio do uso de ferramentas de diagnóstico que permitem identificar os investimentos em eficiência energética. A análise de risco permite avaliar sua viabilidade, considerando a incerteza associada às variáveis que determinam a economia de energia e seu efeito sobre estas, adaptando a metodologia EBaR® por meio da modelagem e simulação. A metodologia proposta foi aplicada em uma empresa do setor industrial brasileiro e permitiu identificar que a empresa pode diminuir o consumo não associado à produção em até 60%, e que o investimento proposto para melhorar a eficiência energética é viável, pois apresenta uma boa relação retorno-risco.

In order to achieve energy savings through improvements in energy efficiency, an energy diagnosis that shows the actual energy performance and determines the investments required is necessary. Nevertheless, the viability of these investments should be evaluated. The aim of this study is to adopt a method that involves two analyses: engineering analysis and risk analysis. Engineering analysis is conducted through the use of diagnostic tools to identify energy efficiency investments. Risk analysis enables the evaluation of the feasibility of these investments considering the uncertainty associated with the variables that determine energy savings and the effect on them, adapting the EBaR® approach through modeling and simulation. The method proposed was applied to a company in the Brazilian industrial sector and indicated that the company can reduce the consumption of non-production related energy by 60%, and that the investment proposed to improve energy efficiency is feasible since it has a good risk-return-ratio.

We analysed 16 variable number tandem repeats (VNTR) and three single-nucleotide polymorphisms (SNP) in Mycobacterium leprae present on 115 Ziehl-Neelsen (Z-N)-stained slides and in 51 skin biopsy samples derived from leprosy patients from Ceará (n = 23), Pernambuco (n = 41), Rio de Janeiro (n = 22) and Rondônia (RO) (n = 78). All skin biopsies yielded SNP-based genotypes, while 48 of the samples (94.1%) yielded complete VNTR genotypes. We evaluated two procedures for extracting M. leprae DNA from Z-N-stained slides: the first including Chelex and the other combining proteinase and sodium dodecyl sulfate. Of the 76 samples processed using the first procedure, 30.2% were positive for 16 or 15 VNTRs, whereas of the 39 samples processed using the second procedure, 28.2% yielded genotypes defined by at least 10 VNTRs. Combined VNTR and SNP analysis revealed large variability in genotypes, but a high prevalence of SNP genotype 4 in the Northeast Region of Brazil. Our observation of two samples from RO with an identical genotype and seven groups with similar genotypes, including four derived from residents of the same state or region, suggest a tendency to form groups according to the origin of the isolates. This study demonstrates the existence of geographically related M. leprae genotypes and that Z-N-stained slides are an alternative source for M. leprae genotyping.

INTRODUÇÃO: Os acidentes causados por peixes são comuns em comunidades de pescadores fluviais no Brasil, sendo acidentes ocupacionais na maioria das vezes. Estas populações não têm informações dos mecanismos de trauma e envenenamento. MÉTODOS: Através de um questionário aplicado aos pescadores, foram obtidos dados clínicos e epidemiológicos sobre acidentes em Rosana, Pontal do Paranapanema, Estado de São Paulo, Brasil. Estes dados foram analisados e convertidos em um programa de prevenção e tratamento de acidentes através de um folheto de fácil assimilação RESULTADOS: Trinta e nove pescadores responderam o questionário. Todos os pacientes apresentaram ferimentos causados por algum peixe. Dos peixes mencionados, mandijubas (Pimelodus maculatus) foram os mais associados aos ferimentos, mas outros também causaram traumas. Em relação às arraias, seis pescadores tinham sido envenenados. Dor intensa e úlceras foram os principais sintomas. Aproximadamente metade dos acidentados usou apenas medidas de tratamentos populares. CONCLUSÕES: Os pescadores apresentaram acidentes múltiplos por mandis, que são peçonhentos e causam dor intensa, assim como traumas por outros peixes, como surubins, traíras, corvinas de água doce e piranhas. Cerca de 16% dos entrevistados apresentaram envenenamento por arraias. Nossos dados e experiência prévia permitiram a criação de um folheto de fácil assimilação pelas populações locais que pode ajudar os pescadores de forma efetiva, em uma área extremamente carente de serviços de saúde e prevenção de doenças. Esta iniciativa é aplicável a toda a bacia do Rio da Prata, área extensa e de fauna similar.

INTRODUCTION: Accidents caused by fish are common in inland fishing communities in Brazil, being work-related injuries in the majority of cases. These populations have no information on the mechanisms of trauma or envenoming. METHODS: Through a questionnaire administered to fishermen, we obtained clinical and epidemiological data on accidents in Rosana, Pontal do Paranapanema, State of São Paulo, Brazil. These data were analyzed and converted into an easily understood prevention and treatment program for the colony. RESULTS: Thirty-nine fishermen replied to the survey. All of the patients had been hurt by fish. Of those mentioned, the yellow catfish (Pimelodus maculatus) was the main fish species associated with injuries, but others also caused trauma to the fishermen. Six fishermen had been envenomed by stingrays. Pain and ulcers were the main symptoms and were described as intolerable. Approximately half of those injured were treated using traditional folk remedies. CONCLUSIONS: The fishermen suffered multiple accidents with catfish, which are venomous and cause intense pain, as well as trauma due to other fish, such as surubins, traíras, freshwater croakers, and piranhas. Approximately 16% of those interviewed presented with envenomation from stingrays. Our data and previous experience in the area led to the creation of a pamphlet with clear language that can effectively help fishermen in the region, an area in need of health services and disease prevention. This initiative also applies to the whole La Plata River basin, which has similar fauna.