Abstract The study analyzed the consumption of non-standard medication in the health of indigenous peoples, emphasizing the rationality of pharmacotherapy, by conducting a cross-sectional study of secondary data from 2018 and 2019 in the Minas Gerais/Espírito Santo Special Sanitary Indigenous Health Districts. These medicines were classified by Anatomical Therapeutic Chemical Classification. Non-parametric tests were applied to compare the origin of prescription and the form of acquisition, assessing access to medication. Rationality was verified through the consumption profile and the therapeutic option in the list of standardized medicines. A total of 104,928 pharmaceutical presentations were consumed, 66,967 (66%) for the alimentary tract and metabolism, 17,705 (17%) for the nervous system, and 12,961 (12%) for the cardiovascular system. With respect to medicines consumed per region, 171 (90%) out of 190 had a therapeutic option. Prescriptions were more from the SUS. Differences were found in the way the medicines were acquired. The study pointed to significant consumption of non-standard medicines, and there may be failings in therapeutic rationality. In indigenous health, ethnocultural and social issues are challenges to access to medicines with rational use.

Resumo O estudo analisou o consumo de medicamentos não padronizados na saúde indígena, enfatizando a racionalidade da farmacoterapia, por meio de um estudo transversal dos dados secundários, de 2018 e 2019, no Distrito Especial Sanitário de Saúde Indígena Minas Gerais/Espírito Santo. Esses medicamentos foram classificados pela Anatomical Therapeutic Chemical Classification. Para a comparação da origem de prescrição e da forma de aquisição, empregaram-se testes não paramétricos, avaliando o acesso a medicamentos. Verificou-se a racionalidade por meio do perfil de consumo e da opção terapêutica na lista de medicamentos padronizados. Foram consumidas 104.928 apresentações farmacêuticas, 66.967 (66%) eram para o trato alimentar e o metabolismo; 17.705 (17%) para o sistema nervoso; 12.961 (12%) para o sistema cardiovascular. Quanto aos medicamentos mais consumidos por regiões, 171 (90%) dos 190 apresentavam opção terapêutica. As prescrições foram mais provenientes do SUS. Encontraram-se diferenças na forma de aquisição dos medicamentos. O estudo apontou importante consumo de medicamentos não padronizados, podendo existir falhas na racionalidade terapêutica. Na saúde indígena, questões etnoculturais e sociais constituem desafios para o acesso aos medicamentos com uso racional.

Abstract The study analyzed the consumption of non-standard medication in the health of indigenous peoples, emphasizing the rationality of pharmacotherapy, by conducting a cross-sectional study of secondary data from 2018 and 2019 in the Minas Gerais/Espírito Santo Special Sanitary Indigenous Health Districts. These medicines were classified by Anatomical Therapeutic Chemical Classification. Non-parametric tests were applied to compare the origin of prescription and the form of acquisition, assessing access to medication. Rationality was verified through the consumption profile and the therapeutic option in the list of standardized medicines. A total of 104,928 pharmaceutical presentations were consumed, 66,967 (66%) for the alimentary tract and metabolism, 17,705 (17%) for the nervous system, and 12,961 (12%) for the cardiovascular system. With respect to medicines consumed per region, 171 (90%) out of 190 had a therapeutic option. Prescriptions were more from the SUS. Differences were found in the way the medicines were acquired. The study pointed to significant consumption of non-standard medicines, and there may be failings in therapeutic rationality. In indigenous health, ethnocultural and social issues are challenges to access to medicines with rational use.

Resumo O estudo analisou o consumo de medicamentos não padronizados na saúde indígena, enfatizando a racionalidade da farmacoterapia, por meio de um estudo transversal dos dados secundários, de 2018 e 2019, no Distrito Especial Sanitário de Saúde Indígena Minas Gerais/Espírito Santo. Esses medicamentos foram classificados pela Anatomical Therapeutic Chemical Classification. Para a comparação da origem de prescrição e da forma de aquisição, empregaram-se testes não paramétricos, avaliando o acesso a medicamentos. Verificou-se a racionalidade por meio do perfil de consumo e da opção terapêutica na lista de medicamentos padronizados. Foram consumidas 104.928 apresentações farmacêuticas, 66.967 (66%) eram para o trato alimentar e o metabolismo; 17.705 (17%) para o sistema nervoso; 12.961 (12%) para o sistema cardiovascular. Quanto aos medicamentos mais consumidos por regiões, 171 (90%) dos 190 apresentavam opção terapêutica. As prescrições foram mais provenientes do SUS. Encontraram-se diferenças na forma de aquisição dos medicamentos. O estudo apontou importante consumo de medicamentos não padronizados, podendo existir falhas na racionalidade terapêutica. Na saúde indígena, questões etnoculturais e sociais constituem desafios para o acesso aos medicamentos com uso racional.

Our work presents a comparative study of morphological characteristics and the osteogenic potential of MC3T3-E1 cells on different modified surfaces of titanium: nanostructured TiO2 with 20 and 100 nm nanotube diameter, and sandblasting and acid etching, commercially known as SLA. Nanostructured TiO2surface was prepared by anodizing of titanium plates, while SLA surface was provided by commercial supplier. Surfaces were characterized by SEM, EDS, AFM, and water contact angle measurements. In order to evaluate cell response,in vitrotests of MTT, alkaline phosphatase and staining with alizarin red were performed. From the results ofin vitro tests, 100 nm nanotubular surface showed lower levels of cell mineralization, differentiation and adhesion. In general, 20 nm TiO2nanotubular and SLA surfaces promoted similar response from osteoblasts. As a result, 20 nm nanotubular surface proved to be a possible alternative to SLA surface with potential for use in oral implantology market.

RESUMO Objetivo: identificar como a pandemia de COVID-19 tem influenciado as puérperas no aleitamento materno. Método: scoping review, com busca em sete bases de dados. Incluíram-se estudos disponíveis na íntegra, em inglês, português ou espanhol, publicados de dezembro/2019-abril/2021. A análise deu-se por categorização de temas comuns. Resultados: incluíram-se 25 estudos, agrupados em cinco categorias, apresentando a influência da pandemia: na rotina de cuidados ao aleitamento materno, evidenciando medidas preventivas contra COVID-19; nas taxas do aleitamento materno, destacando mudanças nas práticas alimentares; na rede de apoio para o aleitamento materno, apontando falta de assistência de serviços; nas emoções das puérpera, predominando preocupação e estresse; no uso da tecnologia para apoio ao aleitamento materno, com teleatendimento facilitando a assistência. Conclusão: a pandemia de COVID-19 influenciou novas formas de assistência, na oferta e no tempo de amamentação, na saúde emocional e na fragilidade da rede de apoio. Espera-se contribuir para que profissionais da saúde proporcionem assistência com maior assertividade diante dessa nova situação.

ABSTRACT Objective: to identify how the COVID-19 pandemic has influenced postpartum women in breastfeeding. Method: a scoping review, with a search in seven databases. Studies available in full, in English, Portuguese or Spanish, published from December/2019-April/2021 were included. The analysis was carried out by categorizing common themes. Results: 25 studies were included, grouped into five categories, presenting the influence of the pandemic: in the routine of breastfeeding care, evidencing preventive measures against COVID-19; in breastfeeding rates, highlighting changes in dietary practices; in the support network for breastfeeding, indicating a lack of service care; in the postpartum women’s emotions, with predominance of concern and stress; in the use of technology to support breastfeeding, with teleservice facilitating care. Conclusion: the COVID-19 pandemic has influenced new forms of care, in the offer and duration of breastfeeding, in emotional health and in the support network fragility. It is expected to contribute so that health professionals provide care with greater assertiveness in the face of this new situation.

RESUMEN Objetivo: identificar cómo la pandemia de COVID-19 ha influido en las puérperas en la lactancia. Método: scoping review, con búsqueda en siete bases de datos. Se incluyeron estudios disponibles en su totalidad, en inglés, portugués o español, publicados entre diciembre/2019 y abril/2021. El análisis se llevó a cabo mediante la categorización de temas comunes. Resultados: se incluyeron 25 estudios, agrupados en cinco categorías, que presentan la influencia de la pandemia: en la rutina de cuidados de la lactancia materna, evidenciando medidas preventivas contra la COVID-19; en las tasas de lactancia materna, destacando los cambios en las prácticas dietéticas; en la red de apoyo a la lactancia materna, indicando falta de asistencia en el servicio; en las emociones de las puérperas, con predominio de preocupación y estrés; en el uso de tecnología para apoyar la lactancia materna, con teleservicio facilitando la asistencia. Conclusión: la pandemia de COVID-19 influyó en las nuevas formas de asistencia, en la oferta y duración de la lactancia materna, en la salud emocional y en la fragilidad de la red de apoyo. Se espera contribuir para que los profesionales de la salud brinden asistencia con mayor asertividad ante esta nueva situación.

ABSTRACT Background: We evaluated different technological approaches and anti-D clones to propose the most appropriate serologic strategy in detecting the largest numbers of D variants in blood donors. Methods: We selected 101 samples from Brazilian blood donors with different expressions of D in our donor routine. The tests were performed in immediate spin (IS) with eleven commercially available anti-D reagents in a tube and microplate. The D confirmatory tests for the presence of weak D included the indirect antiglobulin test (IAT) in a tube, gel and solid-phase red blood cell adherence (SPRCA). All DNA samples were extracted from peripheral blood and the D variants were classified using different molecular assays. Results: The RHD variants identified by molecular analysis included weak D types (1, 2, 3, 11 and 38) and partial Ds (DAR1.2, DAR1, DAR3.1, DAU0, DAU2, DAU4, DAU5, DAU6, DMH and DVII). The monoclonal-monoclonal blend RUM-1/MS26 was the best anti-D reagent used in detecting the D antigen in the IS phase in a tube, reacting with 83.2% of the D variants, while the anti-D blend D175 + 415 was the best monoclonal antibody (MoAb) used in a microplate to minimize the need for an IAT, reacting with 83.2% of the D variants. The D confirmatory tests using SPRCA showed a reactivity (3 - 4+) with 100% of the D variant samples tested. Conclusion: Our results show that, even using sensitive methods and MoAbs to ensure the accurate assignment of the D antigen, at least 17% of our donor samples need a confirmatory D test in order to avoid alloimmunization in D-negative patients.

ABSTRACT Soybean looper (Chrysodeixis includens) and Spodoptera group are important defoliators insects responsible for significant yield losses in soybean, cotton and maize in Brazil. Bioinsecticides and transgenic plants expressing insecticidal proteins from Bacillus thuringiensis are among the most used sustainable control methods for pest control in agriculture, especially for several lepidopteran species. To provide new components for insect control, this study aimed to select and characterize B. thuringiensis strains toxic to C. includens, S. cosmioides, S. eridania, and S. frugiperda. We performed initial bioassays with fifty B. thuringiensis strains for C. includens and selected four strains – 1608A, 726, 773, and 775E – that caused high larval mortality (100%) to be tested against Spodoptera species. These strains harbored cry insecticidal genes, megaplasmids, absence of β-exotoxin and showed two major proteins about 65 and 130 kDa in SDS-page attributed to Cry protein classes toxic to lepidopteran species. The 1608A and 775E strains also showed high toxicity to Spodoptera species that demonstrate great potential for B. thuringiensis-based bioproduct development and as sources of new insecticidal genes for transgenic crops for multiple pest control relevant in the Brazilian agricultural system.

Lupeol, a triterpene frequently found in Asteraceae plant species, showed moderate to low activity in different strains of Plasmodium falciparum, the most virulent malaria etiological agents. In this work, lupeol was isolated from Parahancornia fasciculata, a plant that is used to treat malaria in the Amazonia region. In the search of more activity lupeol derivatives, five new 1,2,3-triazole hybrid molecules were synthetized by copper-catalyzed azide-alkyne cycloaddition. The antiplasmodial activity of the semi-synthetic compounds were evaluated by the lactate dehydrogenase assay; the lupeol propargyl ether was the only one to disclosing increased activity (half maximal inhibitory concentration-IC50-62.0 ± 1.92 µmol L-1) in relation to lupeol (IC50 117.00 µmol L-1). Therefore, this work revealed a new class of interesting lupeol derivatives that can be obtained by linking electron donors to the hydroxy group at C-3.

RESUMO O objetivo com este estudo foi investigar as características de silagens preparadas com um resíduo seco de padaria hidratado com soro ácido de leite ou água associado ou não à ureia. O experimento foi conduzido em um arranjo fatorial 3 (três níveis de hidratação: 250, 300 e 350 mL kg−1 de subproduto) × 3 (três níveis de aplicação de ureia: 0, 5 e 10 g kg−1 de subproduto) × 2 (dois líquidos usados na hidratação: soro ácido de leite ou água). Mini silos foram utilizados como silos experimentais e permaneceram fechados por 30 dias. Em geral, silagens hidratadas com soro ácido de leite apresentaram maior (P<0,01) produção de ácido lático (19,6 vs. 18,5 g kg−1 de matéria seca [MS]), ácido acético (2,5 vs. 1,8 g kg−1 de MS) e ácido propiônico (8,0 vs. 5,4 g kg−1 de MS), e menores (P<0,05) contagens de fungos (5,35 e 5,01 ufg g−1 de silagem fresca) comparadas às silagens hidratadas com água. A maior hidratação das silagens aumentou a produção total de ácidos (P<0,01) reduzindo os valores de pH; mas o aumento na hidratação reduziu (P<0,01) a recuperação de MS das silagens. Silagens hidratadas com água e soro ácido de leite a 250 mL kg−1 e combinado com 5 e 10 g kg−1 de ureia exibiram maior (P<0,05) recuperação de MS. Silagens de resíduo seco de padaria hidratadas com soro ácido de leite apresentaram melhor padrão fermentativo, podendo representar uma estratégia prática para evitar o descarte de ambos os subprodutos no ambiente.

SUMMARY The objective of this study was to investigate the characteristics of silages prepared with a dry bakery by-product hydrated with acid whey or water associated or not at urea. The trial was a 3 (hydration at three moisture levels: 250, 300, and 350 mL kg−1 of by-product) × 3 (three application rates of urea: 0, 5, and 10 g kg−1 of by-product) × 2 (liquid used at hydration: acid whey or water) factorial arrangement. Mini-silos were used as experimental silos and remained closed for 30 days. Overall, silages hydrated with acid whey had higher (P<0.01) production of lactic (19.6 vs. 18.5 g kg−1 of dry matter [DM]), acetic (2.5 vs. 1.8 g kg−1 of DM) and propionic acid (8.0 vs. 5.4 g kg−1 of DM), and lower (P<0.05) fungi counts (5.35 and 5.01 cfu g−1 of fresh silage) compared to silages hydrated with water. Increased hydration led to the higher production of total acids (P<0.01), decreasing silage pH; but increased hydration reduced DM recovery (P<0.01). Silages hydrated with water and acid whey at 250 mL kg−1 and combined at 5 and 10 g kg−1 of urea exhibited higher DM recovery (P<0.05). Silages of a dry bakery by-product hydrated with acid whey had a better fermentation pattern and could represent a practical strategy to avoid discarding both by-products into environment.

ABSTRACT This study aimed to identify clinical and epidemiological characteristics in patients with and without comorbidities from leprosy and leprosy reactions. It is quantitative, descriptive and correlational research, undertaken through 65 interviews in a specialized center in Rio Grande do Norte, Brazil, with data collected between October 2013 and March 2014. The men represented most of the group without comorbidities, while women and older adults represented the group with comorbidities. High frequencies in the two groups point to the Lepromatous form as the most common, and to some degree of disability. There was positive correlation between number of other drugs versus other comorbidities and negative correlation between number of people who live with the interviewee versus the number of comorbidities which the interviewee has. Late diagnosis was evidenced due to high frequencies of disabilities, as well as groups at risk for leprosy reactions and comorbidities, made up of women, older adults, people with low educational level, people who did not work and those who used a higher number of medications.

RESUMEN Estudio cuyo propósito fue identificar características clínicas y epidemiológicas en pacientes con y sin comorbilidades por enfermedad de Hansen y reacciones a esa enfermedad. Investigación cuantitativa, descriptiva ycorrelacional, realizada por 65 entrevistas en un centro de referencia. Los datos fueron obtenidos entre octubre de 2013 y marzo de 2014. Había más hombres en grupo sin comorbilidades, en cuanto las mujeres y los ancianos representaron más el grupo con comorbilidades. Altas frecuencias en los dos grupos apuntan para la forma Virchowiana como la con más incidencia y para algun grado de incapacidad. Hubo correlación positiva entre cantidad de otros medicamentos versus otras comorbilidades y negativa entre cantidad de personas que viven con el entrevistado versus número de comorbilidades que este presenta. Fueron evidenciados diagnósticos tardíos en función de altas frecuencias de incapacidades, así como grupos de riesgo para reacciones hansénicas y comorbilidades, compuesto por mujeres, ancianos, personas con poca escolaridad, que no trabajaban y que utilizaban mayor cantidad de medicamentos.

RESUMO Objetivou-se identificar características clínicas e epidemiológicas em pacientes com e sem comorbidades por hanseníase e reações hansênicas. Pesquisa quantitativa, descritiva e correlacional, realizada por 65 entrevistas em um centro de referência potiguar, com coleta de dados entre outubro de 2013 e março de 2014. Os homens representaram mais o grupo sem comorbidades, enquanto as mulheres e os idosos o grupo com comorbidades. Altas frequências nos dois grupos apontam para a forma Virchowiana como mais incidente e para algum grau de incapacidade. Houve correlação positiva entre quantidade de outros medicamentos versus outras comorbidades e negativa entre quantidade de pessoas que moram com o entrevistado versus número de comorbidades que este possui. Foram evidenciados diagnósticos tardios em virtude de altas frequências de incapacidades, bem como grupos de risco para reações hansênicas e comorbidades, composto por mulheres, idosos, pessoas com baixa escolaridade, que não trabalhavam e que utilizavam maior quantidade de medicamentos.

This research was undertaken with the objective of identifying and quantifying the environmental risks in a service for secondary care for health, taking into account the level of schooling of, and the activities carried out by, the participants of the study, who made up the multidisciplinary team, with a view to contributing to the achieving of better occupational health conditions. This is descriptive and exploratory research, with a quali-quantitative approach. Based on the participants' professional profiles and functions, it was possible to identify the knowledge and perceptions that these have on the risks, as well as identifying and quantifying them. The results evidence concern about questions relevant to working conditions and to the environmental risks present in their daily activities, and allow one to generate new approaches to the managerial work, principally of an educational and structural character in the work.

Esta investigación fue realizada con el objetivo de identificar y cuantificar los riesgos ambientales en servicio de atención secundaria a la salud, tomándose en cuenta el nivel de escolaridad y las actividades desarrolladas por los participantes del estudio que componen el equipo multidisciplinar, con fines de contribuir para el alcance de mejores condiciones de salud ocupacional. Es una investigación descriptiva y exploratoria, de abordaje cuali-cuantitativo. Con base en el perfil y en la actuación profesional de los participantes, fue posible identificar el conocimiento y la percepción de estes acerca de los riesgos, así como identificar y cuantificarlos. Los resultados evidencian preocupación sobre cuestiones acerca de las condiciones de trabajo y de los riesgos ambientales presentes en sus actividades diarias y permiten suscitar nuevos abordajes para el trabajo administrativo, principalmente de carácter educacional y estrutural en el servicio.

Esta pesquisa foi realizada com o objetivo de identificar e quantificar os riscos ambientais em serviço de atenção secundária à saúde, levando-se em consideração o nível de escolaridade e as atividades desenvolvidas pelos participantes do estudo que compõem a equipe multidisciplinar, visa contribuir para o alcance de melhores condições de saúde ocupacional. Trata-se de uma pesquisa descritiva e exploratória, de abordagem quali-quantitativa. A partir do perfil e atuação profissional dos participantes foi possível identificar o conhecimento e a percepção desses sobre os riscos, bem como identificar e quantificá-los. Os resultados evidenciam preocupação sobre questões relativas às condições de trabalho e aos riscos ambientais presentes em suas atividades diárias e permitem suscitar novas abordagens para o trabalho gerencial, principalmente de caráter educacional e estrutural no serviço.

BACKGROUND: The Kell blood group system expresses high and low frequency antigens with the most important in relation to transfusion including the antithetic KEL1 and KEL2; KEL3 and KEL4; KEL6 and KEL7 antigens. Kell is a clinically relevant system, as it is highly immunogenic and anti-KEL antibodies are associated with hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. Although required in some situations, Kell antigen phenotyping is restricted due to technical limitations. In these cases, molecular approaches maybe a solution. This study proposes three polymerase chain reaction genotyping protocols to analyze the single nucleotide polymorphisms responsible for six Kell antithetic antigens expressed in a Brazilian population. METHODS: DNA was extracted from 800 blood donor samples and three polymerase chain reaction-restriction fragment length polymorphism protocols were used to genotype the KEL*1/KEL*2, KEL*3/KEL*4 and KEL*6/KEL*7 alleles. KEL*3/KEL*4 and KEL*6/KEL*7 genotyping was standardized using the NlaIII and MnlI restriction enzymes and validated using sequencing. KEL*1/KEL*2 genotyping was performed using a previously reported assay. RESULTS: KEL genotyping was successfully implemented in the service; the following distribution of KEL alleles was obtained for a population from southeastern Brazil: KEL*1 (2.2%), KEL*2 (97.8%), KEL*3 (0.69%), KEL*4 (99.31%), KEL*6 (2.69%) and KEL*7 (97.31%). Additionally, two individuals with rare genotypes, KEL*1/KEL*1 and KEL*3/KEL*3, were identified. CONCLUSION: KEL allele genotyping using these methods proved to be reliable and applicable to predict Kell antigen expressions in a Brazilian cohort. This easy and efficient strategy can be employed to provide safer transfusions and to help in rare donor screening.

A ciclofosfamida é utilizada no tratamento de câncer. Este estudo visa avaliar os efeitos das diferentes doses do fármaco nos parâmetros reprodutivos de camundongos machos. A ciclofosfamida foi administrada nas doses de 100, 150, 200 e 250 mg kg-1, via intraperitoneal por seis semanas. Como resultado observou-se diminuição de massa corporal, redução no peso de testículos e rins em todos os animais tratados com a ciclofosfamida. Apenas os grupos que receberam as doses de 100 e 150 mg kg-1 do quimioterápico foram capazes de fertilizar as fêmeas. Houve maior incidência de perdas pós-implantação, reabsorção e diminuição da viabilidade fetal no grupo que recebeu a dose de 150 mg kg-1. Observou-se redução nos pesos dos epidídimos e fígado dos animais tratados com as doses de 150, 200 e 250 mg kg-1. Espermatozóides anômalos foram encontrados nas doses de 200 e 250mg kg-1. Com base na metodologia empregada e nos resultados obtidos, conclui-se que a ciclofosfamida foi tóxica considerando-se a redução de massa corporal e o peso dos testículos dos animais; promoveu hepatotoxicidade e efeito nefrotóxico; influenciou na espermatogênese dos animais de forma a levá-los a um estado de infertilidade e/ou subfertilidade; diminuiu viabilidade fetal, entretanto não causou malformações significativas na prole.

The cyclophosphamide is used in cancer treatment. The aim of this study was evaluating the effect of different doses of this drug on male mice reproductive parameters. The cyclophosphamide was administered in the doses 100, 150, 200 e 250 mg.kg-1, intraperitoneal route, for six weeks. As a result, it was observed a decrease in body mass and a decrease in testicles and kidney's weight, in all animals treated with cyclophosphamide. Only the groups that received the doses 100, 150 mg.kg-1 of cyclophosphamide were able to fertilize their females. There was higher incidence of post- implantation losses, reabsorptions and decrease in fetal viability in the group that received the dose of 150 mg.kg-1. It was observed a reduction in epididymis and liver's weight of the animals treated with the doses 150, 200 e 250 mg.kg-1. Abnormal spermatozoa were found in the doses 200 e 250 mg.kg-1. Based on the methodology used and results obtained, it was concluded that the cyclophosphamide was toxic, considering the decrease in animal's body mass and testicle's weight; promoted hepatotoxicity and nephrotoxic effect; influenced in the animals spermatogenesis taking them to infertility and/or subfertility; decreased fetal viability, despite it didn't cause significant malformations in the offspring.