Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD.

Objectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first-line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.

ABSTRACT. This study examined biochemical changes associated with chilling injury (CI) in sweet potato roots stored at low temperatures and reconditioned at ambient temperature. Sweet potato cultivars BRS Amélia and BRS Rubissol were stored at 6 or 13°C for 4 days at ambient temperature (“ambient reconditioning”: 21 ± 2°C). CI on the outer surface of the roots occurred earlier in BRS Amélia than in BRS Rubissol. The CI index on the inner surface of the BRS Amélia was higher when it was stored at 6°C for 40 + 4 days. BRS Amélia showed higher proline content and electrolyte leakage when stored at 6°C. Ascorbate peroxidase was induced by storage at 6°C for 30 + 4 days in BRS Amélia and from 40 + 4 days in BRS Rubissol. The malondialdehyde and phenolic compounds of BRS Rubissol increased during storage at 6°C. CI in both cultivars was associated with increased peroxidase and polyphenol oxidase activities. Storage of sweet potato cultivars at 6°C for 50 + 4 days caused severe damage to the roots. Cultivars BRS Amélia and BRS Rubissol showed similar symptoms of CI and can be characterized as being sensitive to low temperatures.

ABSTRACT Cystic fibrosis (CF) is a genetic disease that results in dysfunction of the CF transmembrane conductance regulator (CFTR) protein, which is a chloride and bicarbonate channel expressed in the apical portion of epithelial cells of various organs. Dysfunction of that protein results in diverse clinical manifestations, primarily involving the respiratory and gastrointestinal systems, impairing quality of life and reducing life expectancy. Although CF is still an incurable pathology, the therapeutic and prognostic perspectives are now totally different and much more favorable. The purpose of these guidelines is to define evidence-based recommendations regarding the use of pharmacological agents in the treatment of the pulmonary symptoms of CF in Brazil. Questions in the Patients of interest, Intervention to be studied, Comparison of interventions, and Outcome of interest (PICO) format were employed to address aspects related to the use of modulators of this protein (ivacaftor, lumacaftor+ivacaftor, and tezacaftor+ivacaftor), use of dornase alfa, eradication therapy and chronic suppression of Pseudomonas aeruginosa, and eradication of methicillin-resistant Staphylococcus aureus and Burkholderia cepacia complex. To formulate the PICO questions, a group of Brazilian specialists was assembled and a systematic review was carried out on the themes, with meta-analysis when applicable. The results obtained were analyzed in terms of the strength of the evidence compiled, the recommendations being devised by employing the GRADE approach. We believe that these guidelines represent a major advance to be incorporated into the approach to patients with CF, mainly aiming to favor the management of the disease, and could become an auxiliary tool in the definition of public policies related to CF.

RESUMO A fibrose cística (FC) é uma doença genética que resulta em disfunção da proteína reguladora de condutância transmembrana da FC (CFTR), que é um canal de cloro e bicarbonato expresso na porção apical de células epiteliais de diversos órgãos. A disfunção dessa proteína resulta em manifestações clínicas diversas, envolvendo primariamente os sistemas respiratório e gastrointestinal com redução da qualidade e expectativa de vida. A FC ainda é uma patologia incurável, porém o horizonte terapêutico e prognóstico é hoje totalmente distinto e muito mais favorável. O objetivo destas diretrizes foi definir recomendações brasileiras baseadas em evidências em relação ao emprego de agentes farmacológicos no tratamento pulmonar da FC. As perguntas PICO (acrônimo baseado em perguntas referentes aos Pacientes de interesse, Intervenção a ser estudada, Comparação da intervenção e Outcome [desfecho] de interesse) abordaram aspectos relativos ao uso de moduladores de CFTR (ivacaftor, lumacaftor + ivacaftor e tezacaftor + ivacaftor), uso de dornase alfa, terapia de erradicação e supressão crônica de Pseudomonas aeruginosa, e erradicação de Staphylococcus aureus resistente a meticilina e do complexo Burkholderia cepacia. Para a formulação das perguntas, um grupo de especialistas brasileiros foi reunido e realizou-se uma revisão sistemática sobre os temas, com meta-análise quando aplicável. Os resultados encontrados foram analisados quanto à força das evidências compiladas, sendo concebidas recomendações seguindo a metodologia GRADE. Os autores acreditam que o presente documento represente um importante avanço a ser incorporado na abordagem de pacientes com FC, objetivando principalmente favorecer seu manejo, podendo se tornar uma ferramenta auxiliar na definição de políticas públicas relacionadas à FC.

Abstract The aim of this study was to report on the presence of microfilariae of Dirofilaria immitis causing nodular pyogranulomatous dermatitis in a dog in the state of Rio Grande do Norte, northeastern Brazil. A 4-year-old male dachshund dog with lesions in the nostrils and left dorsolateral regions was treated. Tests were requested to aid in making the diagnosis, such as skin cytology, Knott's test, thick smear and histopathology of the lesions. From these, presence of a diffuse pyogranulomatous process was observed and, amidst the cellular material, microfilariae of Dirofilaria spp. A conventional polymerase chain reaction test on tissue samples from the lesions revealed the presence of the species D. immitis. Treatment based on ivermectin (3mg) was administered at a single oral dose of 0.6 mg/kg. In the first seven days there was regression of the lesions, but after 30 days there was recurrence. A new treatment was administered, consisting of 10% imidacloprid + 2.5% moxidectin (4-10 mg/kg), with one application per month for 6 months, and doxycycline (100 mg), 10 mg/kg, 1 tablet, 2 times a day, for 30 days. In conclusion, D. immitis microfilariae caused pyogranulomatous lesions in the subcutaneous tissue of a dog. This had not previously been described in Brazil.

Resumo O objetivo deste trabalho foi relatar a presença de microfilárias de Dirofilaria immitis causando dermatite nodular piogranulomatosa em cão no estado do Rio Grande do Norte, região Nordeste do Brasil. Um cão de 4 anos, da raça Dachshund, foi atendido com lesões nas regiões das narinas e dorsolateral esquerda. Foram realizados exames de citologia cutânea, teste de Knott, gota espessa e histopatologia das lesões, sendo observada a presença de um processo piogranulomatoso difuso e microfilárias de Dirofilaria spp. Na reação em cadeia da polimerase convencional constatou-se a espécie D. immitis nas amostras de tecido das lesões. Foi efetuado um tratamento à base de Ivermectina (3mg) 0,6 mg/kg – 1 aplicação, via oral. Nos sete primeiros dias, houve regressão das lesões, porém, depois de 30 dias, houve recidiva. Foi efetuado um novo tratamento com imidacloprida 10% + moxidectina 2,5% (4-10 mg/kg), 1 aplicação por mês durante 6 meses, e Doxiciclina (100 mg), 10 mg/kg, 1 comprimido, duas vezes ao dia, por 30 dias. Em conclusão, microfilárias de D. immitis causaram lesões piogranulomatosas em tecido subcutâneo de um cão, relato anteriormente não descrito no Brasil.

Resumo: Devido à sua localização, a cidade de Marília, SP, encontra-se em uma região importante para o abastecimento hídrico do oeste paulista, e sua área urbana avança sobre as nascentes, sendo necessário preservar as forestas ciliares já degradadas e fragmentadas. Assim, o objetivo foi analisar temporalmente a paisagem nas regiões de interesse hídrico, com vistas a avaliar o potencial de conservação dos fragmentos florestais responsáveis por este recurso. Foi realizada uma análise temporal nos anos 1989, 1999, 2009 e 2019, a partir de imagens dos satélites Landsat 5, 7 e 8, com 30 m de resolução espacial. No programa ArcMap 10.3, o uso do solo foi agrupado em seis classes: formação florestal, planto florestal, formação natural não florestal, agricultura, áreas não vegetadas e água. Para todo o município, foram calculadas as métricas de paisagem CA (cobertura da terra) e PLAND (proporção de cobertura da terra) para as seis classes de uso do solo. Foi realizada uma análise da cobertura florestal a partir de um buffer de 5 km no entorno da área urbana, sendo calculadas mais cinco métricas de área, borda e forma. O software Patich Analyst versão 5.2.0.16 foi utilizado para o cálculo das métricas de paisagem. As classes que mais se destacaram em tamanho de área foram agricultura (93.962,07 ha; 80,27%), formação florestal (15.682,97 ha; 13,40%) e áreas não vegetadas (5.220,63 ha; 4,46%). Os maiores aumentos proporcionais foram de planto florestal (0,11 para 1,27 ha), água (0,02 para 0,05 ha) e áreas não vegetadas (2,17 para 4,45 ha), enquanto a agricultura perdeu área (85,73 para 80,27 ha). Houve aumento das áreas forestadas nos últimos 30 anos a partir do surgimento de fragmentos pequenos e morfologicamente frágeis; além disso, com o aumento da área urbana, aumentam-se os conflitos com os remanescentes florestais mais próximos.

Abstract: Due to its locaton, the city of Marília, S P, is located in an important region for water supply in the west of São Paulo, and its urban area advances over the springs, making it necessary to preserve the already degraded and fragmented riparian forests. Thus, the objective was to temporally analyze the landscape in regions of water interest, in order to assess the potential for conservaton of the forest fragments responsible for this resource. A temporal analysis was carried out in the years 1989, 1999, 2009, and 2019, using images from the Landsat 5, 7 and 8 satellites, with 30 m of spatal resoluton. In the ArcMap 10.3 program, land use was grouped into six classes: forest formation, forest plantaton, natural non-forest formation, agriculture, non-vegetated areas, and water. For the entre municipality, landscape metrics CA (land cover) and PLAND (proporton of land cover) were calculated for the six land use classes. An analysis of the forest cover was carried out from a 5 km bufer around the urban area, and five more metrics of area, edge, and shape were calculated. Patich Analyst software version 5.2.0.16 was used to calculate landscape metrics. The classes that most stood out in terms of area size were agriculture (93,962.07 ha; 80.27%), forest formation (15,682.97 ha; 13.40%), and non-vegetated areas (5,220.63 ha; 4.46 %). The largest proportonal increases were in forest planting (0.11 to 1.27 ha), water (0.02 to 0.05 ha), and non-vegetated areas (2.17 to 4.45 ha), while agriculture lost area (85.73 to 80.27 ha). There has been an increase in forested areas in the last 30 years from the appearance of small and morphologically fragile fragments; in additon, with the increase in urban area, conflicts with the nearest forest remnants increase.

Resumen: Por su localización, la ciudad de Marília, SP, se ubica en una región importante para el abastecimiento de agua en el oeste de São Paulo, y su área urbana avanza sobre los manantales, por lo que es necesario preservar los bosques de ribera ya degradados y fragmentados. Así, el objetivo fue analizar temporalmente el paisaje en regiones de interés hídrico, con el fin de evaluar el potencial de conservación de los fragmentos de bosque responsables de este recurso. El análisis temporal se realizó en los años 1989, 1999, 2009 y 2019, utilizando imágenes de los satélites Landsat 5, 7 y 8, con 30 m de resolución espacial. En el programa ArcMap 10.3, el uso de la terra se agrupó en seis clases: formación florestal, plantación florestal, formación natural no florestal, agricultura, áreas sin vegetación y agua. Para todo el municipio, se calcularon las métricas de paisaje CA (cobertura del suelo) y PLAND (proporción de cobertura del suelo) para las seis clases de uso del suelo. Se llevó a cabo un análisis de la cobertura florestal a partir de una zona de amortiguamiento de 5 km alrededor del área urbana y se calcularon cinco métricas más de área, borde y forma. Se utilizó la versión 5.2.0.16 del software Patich Analyst para calcular las métricas del paisaje. Las clases que más se destacaron en términos de tamaño de área fueron agricultura (93,962.07 ha; 80.27%), formación de bosque (15,682.97 ha; 13.40%) y áreas sin vegetación (5,220.63 ha; 4.46%). Los mayores incrementos proporcionales se registraron en la plantación de bosques (0,11 a 1,27 ha), agua (0.02 a 0.05 ha) y áreas sin vegetación (2.17 a 4.45 ha), mientras la agricultura ha perdido área (85.73 a 80.27 ha). Se ha producido un aumento de las áreas boscosas en los últimos 30 años desde la aparición de fragmentos pequeños y morfológicamente frágiles; además, con el aumento de área urbana, aumentan los conflictos con los remanentes forestales más cercanos.

Resumen En muchos tejidos vegetales, se ha utilizado el acondicionamiento a baja temperatura (LTC) para inducir respuestas adaptativas poscosecha para superar las consecuencias del daño por frío (CI). Este estudio tuvo como objetivo investigar si el LTC es eficaz para reducir la incidencia de daño por frío (CI) en cultivares de batata. Las raíces de batata BRS Cuia y BRS Rubissol se sometieron a almacenamiento en frío (6 °C o 13 °C) y LTC (10 °C durante 7 días, seguido de un segundo almacenamiento a 6 °C). El LTC aumentó la tolerancia de las raíces de la batata al IC mediante la activación del sistema antioxidante, principalmente en el cv. BRS Rubissol, que se asoció notablemente con un mayor contenido de fenoles solubles totales y prolina, así como una mayor actividad de la fenilalanina amonio liasa. Además, no se observaron lesiones externas ni internas en las raíces de LTC, manteniendo la calidad para el procesamiento, lo que indica que el LTC es eficaz para mitigar el daño por frío en los cultivares brasileños de batata.

Abstract In many plant tissues, low-temperature conditioning (LTC) has been used to induce postharvest adaptive responses to overcome chilling injury (CI) consequences. This study aimed to investigate whether LTC is effective in reducing the incidence of chilling injury (CI) in sweet potato cultivars. Sweet potato roots BRS Cuia and BRS Rubissol were submitted to cold storage (6 °C or 13 °C) and LTC (10 °C for 7 d, followed by second storage at 6 °C). LTC increased the tolerance of sweet potato roots to CI via antioxidant system activation, mainly in cv. BRS Rubissol, which was markedly associated with higher content of both total soluble phenolics and proline, as well as increased activity of phenylalanine ammonium lyase. Moreover, no either external or internal injuries were observed in the LTC roots, maintaining the quality for processing, which indicates that the LTC is effective in mitigating chilling injury in Brazilian sweet potato cultivars.

RESUMO Em setembro de 2021, o 34º Congresso Brasileiro de Cirurgia sediou o “Painel de debates: Mulheres na Cirurgia” - o único espaço do evento composto somente por mulheres. Embora a existência de iniquidades de gênero na cirurgia seja bem reconhecida na literatura internacional, esse painel retratou como estamos distantes da almejada equidade em nosso país. Além disso, a sessão enfatizou a necessidade de ampliar o debate e identificar os mecanismos para maior inclusão e retenção das mulheres na carreira cirúrgica. Neste editorial, apresentamos panorama histórico e atual das disparidades de gênero no ecossistema cirúrgico brasileiro; destacamos os fatores que contribuem para o número reduzido de cirurgiãs e, como a estrutura das sociedades médicas influencia na ascensão de mulheres para cargos de liderança. Em seguida, discutimos os benefícios da diversidade de gênero para cirurgiões, pacientes e instituições. Ademais, analisamos a representatividade feminina no Colégio Brasileiro de Cirurgiões desde a fundação e nos espaços científicos do congresso, demonstrando que mais medidas serão necessárias para incentivar maior protagonismo feminino no colégio. Finalmente, propomos uma série de recomendações para fomentar o engajamento e contribuir para a prosperidade das cirurgiãs no Brasil.

ABSTRACT In September 2021, the 34th Brazilian Surgical Conference hosted the “Panel: Women in Surgery” - the only session in the event solely composed of female speakers. Although gender inequities in surgery are well recognized in the international literature, the panel portrayed how distant we are from the desired equity in our country. In addition, the session emphasized the need to broaden the debate and identify the mechanisms for greater inclusion and maintenance of women in the surgical career. In this editorial, we provide a historical overview of gender disparities in the Brazilian surgical ecosystem, highlight the contributing factors to a reduced number of female surgeons, and how the structure of medical societies may influence the rise of women to leadership positions. Accordingly, we discuss the benefits of gender diversity for surgeons, patients, and institutions. Furthermore, we analyze the representation of women in the Brazilian College of Surgeons since its foundation and in the scientific sessions at the conference, demonstrating that more initiatives are required to encourage female representation in the college. Finally, we propose a series of recommendations to foster engagement and contribute to the prosperity of women surgeons in Brazil.

RESUMO Objetivo analisar o conceito de telessimulação e sua aplicabilidade no contexto do ensino em saúde. Método trata-se de uma análise conceitual, realizada através de uma scoping review realizada em maio de 2021, nas seguintes bases de dados: PubMed, PMC, Educational Resources Information Center, Web of Science, Science Direct, Scopus, LILACS, Scientific Electronic Library Online e Google Scholar, mediante o uso do descritor “telessimulação” e suas respectivas traduções para inglês e espanhol. Para análise dos estudos, avaliaram-se os atributos, antecedentes e consequentes do conceito. Resultados a telessimulação é definida como uma ramificação da simulação clínica que se caracteriza pela promoção/viabilização de práticas educativas no ensino em saúde, realizadas remotamente, síncrona, através de videochamada. Tem como objetivo facilitar o contato entre instrutores e participantes em situações de necessidade de distanciamento social, acesso dificultado por razões econômicas, como a escassez de recursos humanos e materiais, e/ou geograficamente distantes, com a intenção de desenvolver e aperfeiçoar competências e habilidades pertinentes as profissões da saúde. Conclusão e implicações para a prática a telessimulação representa uma nova oportunidade na formação em saúde, ao ampliar as possibilidades de ensino e romper barreiras que vão desde as geográficas até as econômicas.

ABSTRACT Objective to analyze the “telesimulation” concept and its applicability in the context of health education. Method this is a conceptual analysis performed through a scoping review carried out in May 2021 in the following databases: PubMed, PMC, Educational Resources Information Center, Web of Science, Science Direct, Scopus, LILACS, Scientific Electronic Library Online and Google Scholar, through the use of the descriptor “telesimulação” and its respective translations into English and Spanish. To analyze the studies, the concept’s attributes, antecedents, and consequences were assessed. Results telesimulation is defined as a branch of clinical simulation that is characterized by the promotion/enabling of educational practices in health education, performed remotely, synchronously, through video call. It aims to facilitate contact between instructors and participants in situations of need for social distance, access made difficult for economic reasons, such as the scarcity of human and material resources, and/or geographically distant, aiming at developing and improving relevant skills and abilities for health professions. Conclusion and implications for practice telesimulation represents a new opportunity in health education as it expands teaching possibilities and breaks down barriers ranging from geographic to economic.

RESUMEN Objetivo analizar el concepto de “telesimulación” y su aplicabilidad en el contexto de la educación para la salud. Método se trata de un análisis conceptual realizado a través de una revisión de alcance realizada en mayo de 2021 en las siguientes bases de datos: PubMed, PMC, Educational Resources Information Center, Web of Science, Science Direct, Scopus, LILACS, Scientific Electronic Library Online y Google Scholar, mediante el uso del descriptor “telesimulación” y sus respectivas traducciones al inglés y al español. Para analizar los estudios, se evaluaron los atributos, antecedentes y consecuencias del concepto. Resultados la telesimulación se define como una rama de la simulación clínica que se caracteriza por la promoción/habilitación de prácticas educativas en educación para la salud, realizadas de forma remota, sincrónica, mediante videollamada. Tiene como objetivo facilitar el contacto entre instructores y participantes en situaciones de necesidad de distancia social, acceso dificultado por razones económicas, como la escasez de recursos humanos y materiales, y/o geográficamente distantes, con la intención de desarrollar y mejorar las habilidades y competencias relevantes. habilidades las profesiones de la salud. Conclusión e implicaciones para la práctica la telesimulación representa una nueva oportunidad en la educación para la salud, ya que amplía las posibilidades de enseñanza y rompe barreras que van desde las geográficas hasta las económicas.

Abstract Sweet potato fried chips have great acceptance and high market value. Sprouting and fresh mass loss of tuberous roots during storage compromise the quality of the processed products. The objective of this work was to evaluate the effect of 1-Methylcyclopropene (1-MCP), amino-oxyacetic acid (AOA), and ethylene on the physico-chemical quality of fresh sweet potato and its relationship with fried color score in processed chips of cv. BRS Rubissol stored at room temperature. During storage, the weight loss, sprouts number, dry matter content, non-enzymatic browning, protein content, soluble phenols fraction, reducing sugars, total amino acids, pH, soluble solids (SS), titratable acidity (TA) and SS/TA ratio were evaluated. The sweet potato roots cv. BRS Rubissol present good potential for processing as fried chips. 1-MCP and AOA treatments reduced the root sprouting, physico-chemical quality was maintained in all treatments and the fried chips showed less browning in all treatments with storage. Since the sprouting process compromises the storage of roots, AOA and 1-MCP treatments may be applied to extend the shelf-life of roots and improve the processing potential.

Resumo A Política Nacional de Atenção Básica proporcionou uma mudança significativa no que se refere às ações da saúde no território ribeirinho, criando equipes e equipamentos de saúde. As equipes de Saúde Ribeirinha e Saúde Fluvial para as áreas da Amazônia Legal e Pantanal foram inovadoras na atenção integral das populações da floresta. Esse estudo tem como objetivo analisar a atenção primária em saúde no contexto rural e ribeirinha no território amazônico, a partir da produção de ações individuais e coletivas das equipes de saúde, bem como o seu desempenho por meio de serviços ofertados nos municípios. O estudo é transversal, com delineamento descritivo-analítico e abordagem quantitativa, analisando a cobertura das ações de atenção básica de equipes da estratégia saúde da família em áreas urbanas, rurais e ribeirinhas de oito municípios situados no estado do Amazonas. Os resultados mostraram que houve aumento da cobertura da atenção básica em quase todos os municípios analisados, indicando que modelos tecnoassistenciais como das equipes ribeirinhas e fluviais produziram a inclusão de uma população que está dispersa em longas áreas do território dos municípios. Uma política de saúde com equidade produz mudanças e transformações nos modos de vida e nas condições de saúde das populações amazônicas.

Abstract The National Primary Care Policy has provided a significant change in terms of health actions in the riverside territory, establishing health teams and equipment. The Riverside and Fluvial Family Health teams for the Legal Amazon and Pantanal areas have been innovative regarding the integral care of the forest populations. This study aims to analyze primary health care in the rural and riverside context in the Amazon territory, based on the production of individual and collective actions by health teams, as well as their performance through services offered in the municipalities. The study is cross-sectional, with a descriptive-analytical design and quantitative approach, and analyzes the coverage of primary health care actions of family health strategy teams in urban, rural and riverside areas of eight municipalities located in the state of Amazonas. The results showed that there was an increase in primary care coverage in almost all analyzed municipalities, indicating that techno-assistance models such as the riverside and fluvial teams resulted in the inclusion of a population that is scattered over large areas of the territory of municipalities. A health policy that promotes equity results in changes and alterations in the ways of life and health status of the Amazonian populations.

Resumo A Política Nacional de Atenção Básica proporcionou uma mudança significativa no que se refere às ações da saúde no território ribeirinho, criando equipes e equipamentos de saúde. As equipes de Saúde Ribeirinha e Saúde Fluvial para as áreas da Amazônia Legal e Pantanal foram inovadoras na atenção integral das populações da floresta. Esse estudo tem como objetivo analisar a atenção primária em saúde no contexto rural e ribeirinha no território amazônico, a partir da produção de ações individuais e coletivas das equipes de saúde, bem como o seu desempenho por meio de serviços ofertados nos municípios. O estudo é transversal, com delineamento descritivo-analítico e abordagem quantitativa, analisando a cobertura das ações de atenção básica de equipes da estratégia saúde da família em áreas urbanas, rurais e ribeirinhas de oito municípios situados no estado do Amazonas. Os resultados mostraram que houve aumento da cobertura da atenção básica em quase todos os municípios analisados, indicando que modelos tecnoassistenciais como das equipes ribeirinhas e fluviais produziram a inclusão de uma população que está dispersa em longas áreas do território dos municípios. Uma política de saúde com equidade produz mudanças e transformações nos modos de vida e nas condições de saúde das populações amazônicas.

Abstract The National Primary Care Policy has provided a significant change in terms of health actions in the riverside territory, establishing health teams and equipment. The Riverside and Fluvial Family Health teams for the Legal Amazon and Pantanal areas have been innovative regarding the integral care of the forest populations. This study aims to analyze primary health care in the rural and riverside context in the Amazon territory, based on the production of individual and collective actions by health teams, as well as their performance through services offered in the municipalities. The study is cross-sectional, with a descriptive-analytical design and quantitative approach, and analyzes the coverage of primary health care actions of family health strategy teams in urban, rural and riverside areas of eight municipalities located in the state of Amazonas. The results showed that there was an increase in primary care coverage in almost all analyzed municipalities, indicating that techno-assistance models such as the riverside and fluvial teams resulted in the inclusion of a population that is scattered over large areas of the territory of municipalities. A health policy that promotes equity results in changes and alterations in the ways of life and health status of the Amazonian populations.

ABSTRACT Visceral leishmaniasis (VL) is a neglected tropical disease caused by the Leishmania infantum parasite. The protozoan is able to infect several domestic and wild mammals. Since the first report on Leishmania spp. infection in horses in South America, leishmaniasis in equids has been highlighted in Brazil. A molecular epidemiological survey was carried out to verify the occurrence of Leishmania spp. DNA in horses and donkeys, in leishmaniases endemic areas in Sao Paulo State, Brazil. To this end, blood samples were obtained from 107 horses and 36 donkeys and subjected to DNA extraction followed by PCR targeting the ITS-1 region. Among the horses and donkeys, 1.87% (2/107) and 8.33% (3/36) were positive by PCR, respectively. The DNA sequencing of the ITS-1 amplification products confirmed L. infantum DNA in these animals. Our results suggest that horses and donkeys from non-VL and VL endemic areas of São Paulo State may be infected by the parasite.

Abstract Background Insects can be found in numerous diverse environments, being exposed to pathogenic organisms like fungi and bacteria. Once these pathogens cross insect physical barriers, the innate immune system operates through cellular and humoral responses. Antimicrobial peptides are small molecules produced by immune signaling cascades that develop an important and generalist role in insect defenses against a variety of microorganisms. In the present work, a cecropin B-like peptide (AgCecropB) sequence was identified in the velvetbean caterpillar Anticarsia gemmatalis and cloned in a bacterial plasmid vector for further heterologous expression and antimicrobial tests. Methods AgCecropB sequence (without the signal peptide) was cloned in the plasmid vector pET-M30-MBP and expressed in the Escherichia coli BL21(DE3) expression host. Expression was induced with IPTG and a recombinant peptide was purified using two affinity chromatography steps with Histrap column. The purified peptide was submitted to high-resolution mass spectrometry (HRMS) and structural analyses. Antimicrobial tests were performed using gram-positive (Bacillus thuringiensis) and gram-negative (Burkholderia kururiensis and E. coli) bacteria. Results AgCecropB was expressed in E. coli BL21 (DE3) at 28°C with IPTG 0.5 mM. The recombinant peptide was purified and enriched after purification steps. HRMS confirmed AgCrecropB molecular mass (4.6 kDa) and circular dichroism assay showed α-helix structure in the presence of SDS. AgCrecropB inhibited almost 50% of gram-positive B. thuringiensis bacteria growth. Conclusions The first cecropin B-like peptide was described in A. gemmatalis and a recombinant peptide was expressed using a bacterial platform. Data confirmed tertiary structure as predicted for the cecropin peptide family. AgCecropB was capable to inhibit B. thuringiensis growth in vitro.

RESUMO: Leishmania infantum é agente etiológico da leishmaniose canina. Por meio de análises parasitológicas e moleculares, a presença do parasita foi investigada em órgãos reprodutivos de cães machos e fêmeas. Amostras de tecidos dos órgãos reprodutivos de 8 cães machos e 16 fêmeas diagnosticados com leishmaniose foram avaliadas por histoquímica, imunohistoquímica e PCR. Apesar de não terem sido observadas lesões macroscópicas ou microscópicas nos órgãos reprodutivos desses cães, formas amastigotas de L. infantum foram observadas em amostras teciduais do testículo e útero. A PCR e o sequenciamento do DNA extraído desses tecidos revelaram sequências 100% idênticas a L. infantum depositadas no GenBank. Nossos resultados sugerem que os testículos e o útero podem abrigar o parasita, sem associação com lesões macroscópicas ou microscópicas, o que pode ter uma grande importância na transmissão venérea e vertical da leishmaniose entre cães.

ABSTRACT: Leishmania infantum causes canine leishmaniasis. Using parasitological and molecular analyses, we identified L. infantum in the reproductive organs of male and female dogs. Using histochemistry, immunohistochemistry, and PCR, we examined tissue samples from the reproductive organs of 8 male dogs and 16 female dogs diagnosed with leishmaniasis. Despite the absence of macroscopic or microscopic lesions in these organs, we observed L. infantum amastigotes in tissue samples from the testis and the uterus. PCR and sequencing of these tissues revealed sequences that matched 100% with L. infantum DNA available at GenBank. The presence of L. infantum amastigotes and DNA in testicular and uterine tissue samples suggested that these organs can harbor the parasite without associated macroscopic or microscopic lesions, and this can be especially important in the vertical and venereal transmission of leishmaniasis in dogs.