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Human intervention on vegetation cover has always had a negative impact on the environment, directly affecting the quality of life in urban areas. Therefore, this study aimed to develop a methodology for the construction of an urban environmental quality indicator (UEQI) that could reflect the environmental quality of urban areas considering the vegetation conditions to which the resident population is exposed. For this, the method sought to integrate data on demographic density (Dd), leaf area index (LAI), normalized difference vegetation index (NDVI), and surface temperature (St). The Mamdani fuzzy inference system was used to generate a rule base containing 108 variations and a defuzzed output with five condition classes, ranging from very bad to excellent. The results showed that the studied area is characterized by a very bad to good UEQI, with most neighbourhoods having poor conditions (64.51%) and only two with good conditions. It was found that in general the studied area has unsatisfactory environmental quality, showing the need for initiatives aimed at urban afforestation in order to improve the quality of life for the studied population. It can be concluded that UEQI proved to be an efficient tool to identify priority areas for the planning and management of vegetation cover in urbanized areas, enabling the improvement of people's living conditions.

Matas ciliares exercem funções ambientais fundamentais para o equilíbrio ecossistêmico, contudo, essas áreas são frequentemente submetidas à intensas perturbações em virtude de atividades antropogênicas. Dessa forma, o presente estudo avaliou a relação da integridade da mata ciliar da Bacia Hidrográfica do Rio Una em função da distribuição de renda da região, utilizando dados do Índice de Desenvolvimento Humano e o mapeamento da cobertura e uso da terra. Os resultados demonstraram que 23,3% da área total das áreas de preservação permanente mapeadas é composta por atividades referentes à agropecuária. Também foi verificado que as áreas com os menores valores de integridade de mata ciliar ocorrem em áreas com renda baixa e média. O estudo traz à luz a necessidade de formulação de políticas públicas que auxiliem na tomada de decisão e que sejam capazes de reverter a desigualdade de renda na região, permitindo um maior desenvolvimento econômico que não esteja vinculado à degradação do meio ambiente.

A problemática relacionada aos recursos hídricos tem sido palco de debates devido a constante deterioração da qualidade da água e aumento de sua demanda. Assim, este estudo objetivou analisar a influência do uso e ocupação da terra na qualidade da água dos principais cursos de água da Área de Proteção Ambiental (APA) Itupararanga (SP). Para tanto, foram realizadas análises dos principais parâmetros e índices de qualidade das águas, bem como o mapeamento do uso e ocupação da terra. Os resultados revelaram que as condições de esgotamento sanitário dos municípios da APA Itupararanga e as classes de usos agrícolas estão impactando negativamente na qualidade da água.

Made available in DSpace on 2022-04-28T19:41:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Socioenvironmental indexes are important mechanisms for the communication of information in a summary form. They may also be a sound source on the quality of life of human beings. In this sense, the objective of this research is to create a socioenvironmental sustainability index (SSI) applied to river basins that integrate socioenvironmental information from the river basin of the Una River in São Paulo (Brazil) by creating a fuzzy inference system in a geographic information system environment. From the results obtained, only two sub-river basins of the Una River are classified as regular. They are in the urban area to the north of the study area. The other sub-river basins are classified as in poor conditions, that is, with high socioenvironmental vulnerability. They correspond to 81% of the study area. This poor classification is justified by the low income and the high rate of illiteracy in the study area. Both factors presented very poor values. The urban area, compared to the rural area, showed a better socioenvironmental performance. It is partly justified by the access of the population in these areas to education and better work opportunities. Institute of Science and Technology São Paulo State University (UNESP) Institute of Science and Technology São Paulo State University (UNESP)

Funda??o Municipal de Sa?de de Teresina. Funda??o Municipal de Sa?de. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. P?s-gradua??o em Virologia. Ananindeua, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Bras?lia, DF, Brasil. Universidade Federal do Piau?. Departamento de Enfermagem. Teresina, PI, Brasil. Funda??o Municipal de Sa?de. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Funda??o Municipal de Sa?de. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Funda??o Municipal de Sa?de. Centro de Opera??es de Emerg?ncias em Sa?de P?blica. Teresina, PI, Brasil / Universidade Federal do Piau?. Programa de P?s-Gradua??o em Sa?de e Comunidade. Teresina, Piau?, Brasil. Instituto de Pesquisa Opinar. Teresina, PI, Brasil. Funda??o Municipal de Sa?de. Centro de Opera??es de Emerg?ncias em Sa?de P?blica. Teresina, PI, Brasil / Centro Universit?rio Uninovafapi. Programa de P?s-Gradua??o em Sa?de da Fam?lia. Teresina, PI, Brasil. Funda??o Municipal de Sa?de. Centro de Opera??es de Emerg?ncias em Sa?de P?blica. Teresina, PI, Brasil / Funda??o Oswaldo Cruz. Programa de P?s-Gradua??o em Medicina Tropical. Teresina, PI, Brasil. Funda??o Municipal de Sa?de. Centro de Opera??es de Emerg?ncias em Sa?de P?blica. Teresina, PI, Brasil. Introduction: Estimates of the number of individuals infected by severe acute respiratory syndrome coronavirus 2 are important for health planning and establishment of expectations regarding herd immunity. Methods: Seven testing rounds of a serological survey were conducted at 1-week intervals between April 19 and May 31, 2020 in Teresina municipality. Results: Over the 7 weeks, serological positivity increased from 0.56% (95% confidence interval [CI]: 0.18%?1.30%) to 8.33% (95% CI: 6.61%?10.33%), representing 33?53 persons infected for each reported case. Conclusions: Serological screening may be an important tool for understanding the immunity of a population and planning community interventions.

In this brief essay, we seek to present the outline of a future paper that will analyze the risks involved in the mechanism chosen by the Brazilian Federal Government for the granting of an Emergency Income Aid Bailout provided for in federal law no. 13982, that is, the opening of digital accounts for those who did not have bank accounts at the time of enrollment in the social program, thereby reaching the population that, at one time, was far from the State's inspection eyes in economic matters. It is about the inclusion of about 30 million new consumers in the databases that also feed the recently regulated “Cadastro Positivo de Credito”, the Brazilian version of the "Credit Reports", with the special detail that the fulfillment of certain legal requirements guarantees a greater categorization of these consumers, with direct impact on the most accurate deduction of the consumption profile of each citizen and, consequently, on the granting of credit in the country. In the study that follows, it is attempted to demonstrate how the creation of these digital accounts - a maneuver used as a solution in the “state of exception” resulting from the COVID-19 pandemic, for the distribution of emergency income aid bailout - will have implications for future analysis of credit for those who were on the margins of the automated systems regulated by the Credit Reports, reflecting as yet another tool capable of reinforcing chronic surveillance over the Brazilian consumer market.

Sexually transmitted infections are mainly caused by viruses and bacteria. They are transmitted trough sexual intercourse, without a condom, with an infected individual. The anus, vagina, and mouth may become involved. This study aimed to present six clinical cases with the diagnosis of sexually transmitted infections, but in which different treatment approaches were required. This demonstrates the dynamic and unique character of the disease in each individual. That is, the behavior of sexually transmitted infections will vary not only according to its causative microorganism (virus or bacteria), but also according to the characteristics of the combination of etiologic agent and host. Resumo: As infecções sexualmente transmissíveis são causadas, principalmente, por vírus e bactérias. Por meio do contato sexual, sem preservativo, com um indivíduo que esteja infectado. O ânus, a vagina e a boca podem se tornar órgãos acometidos. O objetivo deste trabalho é apresentar 06 casos clínicos com o diagnóstico de infecções sexualmente transmissíveis, mas que para serem tratados foram necessárias diferentes abordagens. Isso demonstra o caráter dinâmico e singular da doença em cada indivíduo. Ou seja, o comportamento das infecções sexualmente transmissíveis vai variar não somente conforme o seu microrganismo causador (vírus × bactéria), mas também de acordo com o conjunto (agente etiológico + hospedeiro). Keywords: Papilomaviridae, Infection, Podophyllin, HIV, Palavras-chave: Papilomaviridae, Infecção, Podofilina, HIV

Resumo Objetivo: descrever um protocolo simplificado para abordagem de casos suspeitos de meningite. Metodos: relato de experiencia na abordagem diagnostica das meningites no servico de referencia em doencas tropicais do estado do Piaui, Brasil, no periodo de 2007-2016; extrairam-se informacoes do Sistema de Informacao de Agravos de Notificacao (Sinan) e do livro de registro do laboratorio; utilizou-se o teste do qui-quadrado para comparar os indicadores da vigilância epidemiologica baseados na classificacao final dos casos de meningite; utilizou-se o teste de concordância Phi para verificar a correlacao entre os diagnosticos etiologicos presumidos pelo protocolo e aqueles confirmados laboratorialmente. Resultados: considerando-se 4.096 casos de meningite estudados, houve reducao na classificacao generica desses casos, de 72 para 47% (p

Resumo OBJETIVO: descrever a ocorrência e as características dos casos de microcefalia no Piauí, Brasil, durante epidemia do vírus Zika em 2015-2016. MÉTODOS: estudo descritivo com dados dos nascidos vivos no período de janeiro/2015 a janeiro/2016, obtidos do Sistema de Informações sobre Nascidos Vivos (Sinasc), do Registro de Eventos em Saúde Pública (RESP) e de busca ativa em prontuários; mães e nascidos vivos foram testados para dengue, chikungunya e Zika, além de sífilis, toxoplasmose, rubéola, citomegalovírus e herpes (STORCH). RESULTADOS: dos 75 casos de microcefalia, 34 foram relacionados a processo infeccioso congênito; a prevalência de microcefalia foi de 13,6/10 mil nascidos vivos; exames de imagem confirmaram que 34 nascidos vivos apresentavam calcificações, 23 atrofias cerebrais, 14 lisencefalia, 12 ventriculomegalia e 6 digenesias; nenhum apresentou resultado positivo para STORCH, dengue ou chikungunya; 1 referiu Zika IgM reagente. CONCLUSÃO: houve surto de microcefalia no Piauí, possivelmente relacionado à infecção gestacional pelo vírus Zika. Resumen OBJETIVO: describir la ocurrencia y las características de los casos de microcefalia en Piauí, Brasil, durante la epidemia de infección por virus Zika en 2015-2016. MÉTODOS: Estudio descriptivo incluyendo datos del Sistema de Información de Nacidos Vivos (Sinasc) y del Registro de Eventos en Salud Pública (RESP), entre enero/2015 y enero/2016; las madres fueron testadas para dengue, chikungunya, zika y STORCH. RESULTADOS: 75 recién nacidos (RN) presentaron microcefalias; de estos, 34 tenían microcefalia relacionada con una infección; la prevalencia de microcefalia fue de 13,6 casos/10.000 nacidos vivos; imágenes confirmaron que 34 RN presentaron calcificaciones, 23 atrofia cerebral, 14 lisencefalias, 12 ventriculomegalias y 6 disgenesias; ningún RN presentó STORCH, dengue o chikungunya, y 1 fue reactivo para Zika (IgM). CONCLUSIÓN: hubo un brote de microcefalia en Piauí posiblemente relacionado con infección materna previa por virus Zika. Abstract OBJECTIVE: to describe the occurrence and characteristics of microcephaly cases in Piauí, Brazil, during an epidemic of Zika virus infection in 2015-2016. METHODS: descriptive study using data of live births from January/2015 to January/2016, obtained from the Information System on Live Births (Sinasc), the Public Health Events Registry (RESP) and the active search for medical records; mothers and live births were tested for dengue, chikungunya, and Zika, besides syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes (STORCH). RESULTS: of the 75 microcephaly cases, 34 were related to congenital infectious process; microcephaly prevalence was of 13.6/10 thousand live births; imaging exams confirmed that 34 live births presented calcifications, 23 had cerebral atrophies, 14 had lissencephaly, 12 had ventriculomegaly and 6 had dysgenesis; none tested positive for STORCH, dengue or chikungunya; 1 was IgM positive for Zika. CONCLUSION: there was an outbreak of microcephaly in Piauí, possibly related to infection during pregnancy Zika virus.

The Instituto Evandro Chagas provided a grant for this study, as well as Conselho Nacional de Desenvolvimento Cient??fico e Tecnol?gico (CNPq) and Funda??o de Amparo ? Pesquisa do Estado do Piau? (FAPEPI). Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Teresina Municipal Health Secretariat. Department of Health Surveillance. Teresina, PI, Brazil / Piau? State Health Secretariat. Natan Portella Institute of Tropical Medicine. Teresina, PI, Brazil. Piau? State Health Secretariat. Department of Health Surveillance. Teresina, PI, Brazil. Teresina Municipal Health Secretariat. Department of Health Surveillance. Teresina, PI, Brazil / Piau? State Health Secretariat. Natan Portella Institute of Tropical Medicine. Teresina, PI, Brazil. Novafapi University. Medicine School. Teresina, PI, Brazil. Piau? State University Hospital. Department of Health Surveillance. Teresina, PI, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Piau? State Health Secretariat. Natan Portella Institute of Tropical Medicine. Teresina, PI, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Federal University of Piau?. Department of Mother and Child Health. Teresina, PI, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. In countries where poliomyelitis has been eradicated, Guillain?Barr? syndrome (GBS) is the leading cause of acute flaccid paralysis. The range of infections that precede GBS in Brazil is unknown. Campylobacter jejuni infection is the most frequent trigger of GBS worldwide. Given the lack of systematic surveillance of diarrheal diseases, particularly in adults, the incidence of enteritis caused by C. jejuni in developing countries is unknown. From 2014 to 2016, pretreatment serum samples from 63 GBS patients were tested by immunoglobulin M (IgM) enzyme-linked immunosorbent assay for C. jejuni. Campylobacter jejuni IgM antibodies were detected in 17% (11/63) of the samples. There was no association between serological positivity (IgM) for C. jejuni and the occurrence of diarrhea among the investigated cases (P = 0.36). Hygiene measures, basic sanitation, and precautions during handling and preparation of food of animal origin may help prevent acute flaccid paralysis.

This study was partially supported by The Evandro Chagas Institute. The Evandro Chagas Institute provided a grant for this study, as well as CAPES (Zika fast track grant); CNPq (grants, 303999/2016-0, 439971/2016-0 and 440405/2016-5). Pedro F. C. Vasconcelos is fellow of the CNPq and supported by the above grants and plus grant 301641/2010-2. Secretaria de Estado da Sa?de do Piau?. Instituto de Doen?as Tropicais Natan Portella. Teresina, PI, Brasil / Funda??o Municipal de Sa?de de Teresina. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Programa de P?s-Gradua??o em Virologia. Ananindeua, PA, Brasil. Secretaria de Estado da Sa?de do Piau?. Hospital Infantil Luc?dio Portella. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Funda??o Municipal de Sa?de de Teresina. Hospital de Urg?ncias de Teresina Dr. Zenon Rocha Filho. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Programa de P?s-Gradua??o em Virologia. Ananindeua, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. We report a case of encephalitis associated with Zika virus infection and reactivation of varicella-zoster virus in the central nervous system of a Brazilian child. This case raises the possibility that reactivation of the latent varicella-zoster virus may be a mechanism of neurological impairment induced by acquired Zika virus infection.

Financial support: Instituto Evandro Chagas, CNPq, FAPEPI. PFCV is a fellow of the CNPq and supported by grants 301641/2010-2 and 303999/2016-0. MACSV and CHNC contributed equally to this work. Secretaria de Estado da Sa?de do Piau?. Instituto de Doen?as Tropicais Natan Portella. Departamento de Neurologia. Teresina, PI, Brasil / Funda??o Municipal de Sa?de de Teresina. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Programa de P?s-Gradua??o em Virologia. Ananindeua, PA, Brasil. Secretaria de Estado da Sa?de do Piau?. Instituto de Doen?as Tropicais Natan Portella. Departamento de Infectologia. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Funda??o Municipal de Sa?de de Teresina. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Secretaria de Estado da Sa?de do Piau?. Diretoria da Unidade de Vigil?ncia e Assist?ncia ? Sa?de. Teresina, PI, Brasil. Secretaria de Estado da Sa?de do Piau?. Diretoria da Unidade de Vigil?ncia e Assist?ncia ? Sa?de. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Programa de P?s-Gradua??o em Virologia. Ananindeua, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. This study showed that laboratory markers of recent infection by dengue, Zika or chikungunya arboviruses were detected in the biological samples of approximately one-third of patients with encephalitis, myelitis, encephalomyelitis or Guillain-Barr? syndrome, in a surveillance programme in Piau? state, Brazil, between 2015-2016. Fever and myalgia had been associated with these cases. Since in non-tropical countries most infections or parainfectious diseases associated with the nervous system are attributed to herpesviruses, enteroviruses, and Campylobacter jejuni, the present findings indicate that in tropical countries, arboviruses may now play a more important role and reinforce the need for their surveillance and systematic investigation in the tropics.

Secretaria de Estado da Sa?de do Piau?. Instituto de Doen?as Tropicais Natan Portella. Teresina, PI, Brasil / Funda??o Municipal de Sa?de de Teresina. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Secretaria de Estado da Sa?de do Piau?. Ger?ncia de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Universidade Federal do Piau?. Departamento de Medicina Especializada. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Secretaria de Estado da Sa?de do Piau?. Ger?ncia de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Funda??o Municipal de Sa?de de Teresina. Diretoria de Vigil?ncia em Sa?de. Teresina, PI, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil.

We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.8% were from outside and they were admitted more then four hours after the trauma. The mortality rate was 11.9%, but just 2.1% had undergone a surgery. The complications resulted in major risk of death when the trauma was at the cervical level and the patients were over 50 years old, especially when admitted more than four hours after the trauma. We emphasize the importance of the first health care concerning the clinical treatment, aiming to reduce the mortality rate. Estudamos 386 casos de trauma raquimedular, observando a evolução dos pacientes admitidos na maioria das vezes após quatro horas do trauma, a maioria procedente de lugar distante do serviço de saúde. Trata-se de um estudo clínico baseado em dados coletados durante a hospitalização, de pacientes operados ou não, em serviço de saúde pública no Brasil. Na maioria das vezes a lesão principal foi fratura-luxação, isolada ou em múltiplos níveis, e as complicações clínicas mais importantes foram devido à insuficiência respiratória e hipotensão, especialmente porque 73.8% dos casos eram de lugares distantes, tendo sido admitidos mais de quatro horas após o trauma. A taxa de mortalidade foi 11,9%, sendo 2,1% em pós-operatório. As complicações resultaram em maior risco de morte quando o trauma foi ao nível cervical, idade acima de 50 anos, especialmente aqueles admitidos com mais de quatro horas. Enfatizamos a importância do primeiro atendimento na admissão, sobretudo para as alterações respiratórias e hemodinâmicas, objetivando reduzir a mortalidade.

A Brazilian ranch worker with encephalitis and flaccid paralysis was evaluated in the regional Acute Encephalitis Syndromic Surveillance Program. This was the first Brazilian patient who met the Centers for Disease Control and Prevention (CDC) confirmation criteria for West Nile virus disease. Owing to the overlapping of neurological manifestations attributable to several viral infections of the central nervous system, this report exemplifies the importance of human acute encephalitis surveillance. The syndromic approach to human encephalitis cases may enable early detection of the introduction of unusual virus or endemic occurrence of potentially alarming diseases within a region.

Objective : To verify the relationship between intracranial pressure and flash visual evoked potentials (F-VEP) in patients with cryptococcal meningitis. Method The sample included adults diagnosed with cryptococcal meningitis admitted at a reference hospital for infectious diseases. The patients were subjected to F-VEP tests shortly before lumbar puncture. The Pearson’s linear correlation coefficient was calculated and the linear regression analysis was performed. Results : Eighteen individuals were subjected to a total of 69 lumbar punctures preceded by F-VEP tests. At the first lumbar puncture performed in each patient, N2 latency exhibited a strong positive correlation with intracranial pressure (r = 0.83; CI = 0.60 - 0.94; p < 0.0001). The direction of this relationship was maintained in subsequent punctures. Conclusion : The intracranial pressure measured by spinal tap manometry showed strong positive association with the N2 latency F-VEP in patients with cryptococcal meningitis. Objetivo : Verificar a relação entre pressão intracraniana e potencial evocado visual por flash (PEV-F) em pacientes com meningite criptocócica. Método A amostra incluiu pacientes admitidos em um hospital de referência para doenças infecciosas. Realizou-se PEV-F antes de cada punção lombar. Calculou-se o coeficiente de correlação de Pearson e a equação de regressão linear entre as variáveis latência N2 e pressão intracraniana inferida através de raquimanometria. Resultados Dezoito pacientes foram submetidos a um total de 69 punções lombares. A latência N2 mostrou correlação positiva forte com a pressão de abertura verificada na primeira punção lombar a que cada paciente foi submetido (r = 0,83; IC = 0,60 – 0,94; p < 0,0001). A positividade da correlação foi mantida nas aferições subsequentes. Conclusão Houve associação positiva forte entre a latência N2 do PEV-F e pressão intracraniana em pacientes com meningite criptocócica.

Schwanomas, neurinomas ou neurilemomas são tumores benignos de nervos periféricos. Podem ocorrer em associação com a neurofibromatose tipo 2. Relatamos dois casos de tumor cervical originado em plexo braquial sem associação com neurofibromatose. Uma mulher, de 31 anos apresentando uma tumefação em região supraclavicular direita, dor irradiada para o membro ipsilateral e sinal de Tinel à percussão da região. Outra mulher, 52 anos, com cervicobraquialgia persistente à direita há um ano. Ambas foram submetidas a microcirurgia, com ressecção total da lesão. O estudo histopatológico foi compatível com schwanoma. As duas pacientes tiveram boa evolução neurológica, com desaparecimento dos sinais e sintomas. Schwannomas, neurinomas or neurilemmomas are benign peripheral nerve tumors. The literature report some cases associated with neurofibromatosis 2. We report two cases of cervical schwannoma originating from the brachial plexus unassociated with neurofibromatosis. A 31-year-old woman presented with a mass in the right supraclavicular region, irradiating pain and distal tingling to percussion (Tinel's sign) for 6 months. And a 52-year-old woman presented with pain in the cervical region and right arm for one year. Both the patients underwent to a microsurgery with total resection of the lesion. Histology of the surgical specimen confirmed the diagnosis of schwannoma. Postoperatively, the patients had a good recovery.

Traumatismos orbitários podem estar associados à presença de corpos estranhos, cuja retenção leva a prejuízos, como perda da visão ou abscesso cerebral. Apresentamos o caso de um homem de 21 anos, que evoluiu com ptose palpebral, limitação dos movimentos oculares e reação inflamatória no olho direito, após colisão com um galho de árvore. A TC de órbitas evidenciou uma área de densidade aumentada no cone orbitário direito. Após a retirada neurocirúrgica do corpo estranho, um fragmento de madeira medindo 2,0x0,3 cm, o paciente evoluiu bem, sem déficit visual, com regressão da ptose e resolução do processo inflamatório. A TC de controle pós-operatório não identificou fragmentos do corpo estranho. O caso chama a atenção pelo fato de o fragmento de madeira ter sido visualizado no estudo tomográfico com densidade elevada (136 UH) 2 meses após o acidente e pela aplicação da craniotomia supra-orbitária para a sua retirada.

O presente artigo tem como propósito a analise do impacto do Novo Código de Processo Civil na usucapião, concedendo especial atenção à nova modalidade, trazida com a inserção do artigo 1.071, que prevê a possibilidade de se pleitear a usucapião em cartório de registro de imóveis. Pontua-se ainda a fundamentação nos objetivos principais do novo código, dentre os quais destaca-se a busca pela celeridade. Propõe-se o afastamento do viés pessimista que conduz a desqualificação do instituto, para adoção de uma nova perspectiva, na qual, a ata notarial é sugerida como ferramenta facilitadora na efetivação do procedimento da usucapião.

Background and Objectives: Inguinal hernia repair is among the most common procedures performed worldwide and the laparoscopic totally extraperitoneal (TEP) approach is a recognized and effective surgical technique. Although technically advantageous because of the option of no mesh fixation and no need for creation of a peritoneal flap resulting, in less postoperative pain and faster recovery, TEP has not achieved the popularity it deserves, mainly because of its complexity and steep learning curve. Minilaparoscopy was first described in the 1990s and has recently gained significantly from better instrumentation that may increase TEP's effectiveness and acceptance. We performed a prospective study, to analyze the outcomes of minilaparoscopy in pain and operative time when compared to the conventional laparoscopic technique in hernia repair. Methods: Fifty-eight laparoscopic inguinal hernia repairs were performed: 36 by traditional laparoscopic technique and 22 by minilaparoscopic instruments (mini). A study protocol was applied prospectively for data collection. Variables analyzed were early postoperative pain (at hour 6 after procedure), pain at discharge, use of on-demand analgesics, and operative time. Results: The mini group presented reduced early postoperative pain and operative time. The present study also suggests less postoperative pain at discharge with mini procedures, although this difference was not statistically significant. No difference between the groups regarding on-demand use of analgesics was found. Conclusions: This study corroborates findings in previously published papers that have shown the feasibility of minilaparoscopy in laparoscopic TEP hernia repair and its benefits regarding postoperative pain, operative time, and aesthetic outcomes.

Granuloma eosinofílico (GE) é condição benigna de proliferação histiocitária localizada ou multifocal. A ocorrência de lesões na coluna cervical pode variar entre 1,5% e 20% dos casos de GE. Relatamos caso de menina de sete anos de idade e história de cervicalgia há cerca de um mês, torcicolo persistente e postura viciosa do pescoço, com desvio cefálico para esquerda. A tomografia computadorizada revelou lesão expansiva, osteodestrutiva ao nível da hemilâmina esquerda de C2, com invasão do canal raquiano e do plano muscular a este nível. A paciente foi submetida a laminectomia cervical com retirada da lesão com pós-operatório favorável, e melhora da sintomatologia. Foi feita quimioterapia com prednisona, vinblastina e etoposide. Após seis meses, o protocolo foi mantido e associado a metotrexate. A paciente segue sem recidiva há 36 meses. Eosinophilic granuloma (EG) is a benign condition of histocytes proliferation localized or multifocal. It is presents in the cervical spine in 1.5%-20% of the cases of EG. We report the case of a seven-year-old girl that presented with a one month history of cervical pain, persistent wryneck and vicious posture of the neck. A computerized tomography was performed and confirmed the presence of spreading lesion, ostheodestructive to the level of the left laminae of C2, with invasion of the spine and the muscular tissue. A laminectomy was underwent for removal of the lesion. The patient had a good post-operative recovery with improvement of the symptoms. Chemotherapy with prednisone, vinblastine and ethoposide was administred. After six months, this protocol was repeated associaded to methotrexate.The patient improved and had no new symptoms in a follow-up of 36 months.

A Contabilidade, por meio das Demonstracoes Contabeis, objetiva subsidiar seus usuarios com informacoes gerais sobre a entidade que reporta a informacao. Porem, informacoes gerais podem nao ser uteis o suficiente para que o usuario interno possa atuar de forma mais competitiva em um novo mercado. O estudo em tela teve como objetivo geral apresentar a importância da informacao contabil-gerencial na decisao de investimentos em uma instituicao de ensino medio, analisando a troca de equipamentos de condicionamento de ar em tres salas da Instituicao, com o intuito de evidenciar a reducao de custos operacionais para a entidade. The Accounting through financial statements, aims to support its users with general information about the reporting entity information. However, general information may not be useful enough for the internal user can act more competitively in a new market. The study aimed to screen the general to present the importance of accounting information in managerial decision-investment in a secondary school, analyzing the exchange of air conditioning equipment in three rooms of the institution, in order to highlight the reduction of operating costs for the entity. Thus, it was used as the main tool for case study analyzing the Net Present Value of investment in exchange for the equipment to determine the viability of the investment or not. As a secondary tool was used to calculate Payback Time showing how long the investment will be recovered. He came to the result that the exchange of equipment in two of the three cases analyzed is feasible, from an economic standpoint. The case presented should be considered not viable from the perspective of other variables such as customer satisfaction, eg, without showing objective of this study.

Relata-se um caso de neurocisticercose por cisto gigante (3,9 x 3,4 cm), onde havia manifestações clínicas de hipertensão intracraniana e características de imagem na tomografia computadorizada de crânio de processo expansivo com efeito de massa no sistema nervoso central (SNC). Comenta-se a possibilidade da forma tumoral dessa parasitose ter apresentação clínica e radiológica semelhante à de outros processos expansivos do SNC e enfatiza-se a conduta cirúrgica como forma de tratamento e confirmação diagnóstica.

painting) Acumen (literature) Adaptive (history and humanities) Allegory moralizing (painting) Ambiguous (history and humanities) Antagonist (history and humanities, literature) Aseptic (history and humanities) Belief in miracles (history and humanities) Buck (history and humanities) Candor (history and humanities) Centred (humanistic-historical) Christian (history and humanities, literature) Collective (history and humanities) Complex (history and humanities) Concentrate (history and humanities) Constant (history and humanities) Controllable (history and humanities) Creator (history and humanities) Critical (history and humanities) Cultism (literature) Catholic (painting) Cultural assimilation (history and humanities) Curvilinear reasoning (history and humanities) Diachronic (cinema) Diaspora (history and humanities) Dogmatic (history painting) dream Themes (painting) Ecumenical (history and humanities) Elusive (history and humanities) Emblematic (literature, painting), Feeling depth (history and humanities) Fey (history and humanities) Fini-secular (literature) Folklore (history and humanities) Heroic (history and humanities, literature) Hidden (history and humanities) Honour (literature) Humble (history and humanities) Hybrid (literature) Hyper-identity (history and humanities) Idyllic (history and humanities) Imperial (history and humanities) Improvisation (history and humanities) Incremental (historical and humanistic) Intense religiosity (cinema, painting) Interstitial (literature) lyric (literature) Metamorphic (history and humanities) Militant (history and humanities) Mimetic (history and humanities) Miscegenation (literature) Moral (painting) Ancient (story) Morphological (history and humanities) Movement (history and humanities) Mystery (history and humanities, music) Naive (history and humanities) Needy (history and humanities) Nostalgia (history and humanities, literature, music) Ornamental (painting) Pantheistic (history and humanities) Parental (history and humanities) Patriotic (cinema, history and humanities) People (cinema, history and humanities) Proud (literature) Radical (history and humanities) Romantic (history and humanities, literature) Allogeneic (history and humanities) Sacred (literature) Sacrificed (history and humanities) Sadness (history and humanities, music) Sensitive (history and humanities) Sentimental (history and humanities, literature, music) Single (history and humanities, painting) Singular (cinema, history and humanities) Spiritual (history and humanities) Stubborn (history and humanities) Subjective (literature) Subversive (cinema) Sync (cinema) Theology (history and humanities, literature) Utopian (history and humanities) Water (history and humanities) Sources: Almeida (1995), Baguet (1999), Bello (2009), Borja (2005), Cabral (2003), Cademartori (2006), Cardoso & Catelli (2009), Castagna (2005), Costa (1998), Domingues (2000), Grosso (1999), Lemiere (2006), Lourenco (1994, 2001), Martins, Sousa & Cabecinhas (2006), Matos-Cruz (1999), Moreira (2005), Nascimento (2009), Neto (2005), Netto, Dias & Mello (2003), Ngai (1999), Ono (2004), Pereira (1999), Quadros (1999), Rago (2006), Ribeiro 82004), Rodrigues & Devezas (2009), Rossini (2005), Salvo (2006), Silva (1999). Table 7. Cultural aspects with a neutral nature concerning the Lusophone space (in parentheses the thematic track of the literature review from which the cultural trait was retrieved is indicated).

With the proliferation of sophisticated endovascular interventions, the need for more definitive assessment of preprocedural and postprocedural pathology and long-term outcome is acute. A new technique, intravascular ultrasound imaging, was used to provide a 1-year evaluation of iliac artery stents in a patient whose renal insufficiency contraindicated protocol-mandated arteriography. The sonogram provided adequate visualization of the functional status of the stents through cross-sectional measurements and the intimal response to the devices. This represents the first use of intravascular ultrasound imaging for long-term evaluation of iliac stents.

The proliferation of sophisticated endovascular interventions is mandating more definitive and comprehensive documentation of atherosclerotic lesions and the results of the interventional devices used in their removal. A technique with a potential to fulfill these goals, intravascular ultrasound imaging (IVUS), was evaluated against pressure gradients, arteriography, and femoral-radial indices in 11 patients with stenotic iliac lesions. The two-dimensional, real-time scans were useful in measuring pre-and posttreatment cross-sectional diameters and luminal areas for procedural assessment. Furthermore, the ultrasound scans clearly identified arterial wall calcifications, iliac veins, soft plague formations, dissections, synthetic graft anastomoses, and intravascular stents, often with definition superior to arteriography. The IVUS technique was useful in selecting interventional therapies, in particular, the need for stent implantation to control intimal flaps. Further, IVUS demonstrated its ability as a substitute for contrast arteriography in a twelfth patient with an iliac stent in whom a protocol-dictated follow-up arteriogram was contraindicated.

Relata-se sobre um homem de 36 anos com passagem quatro anos antes pela selva amazônica. Admitido após seis meses do aparecimento progressivo de tetraparesia, ataxia de marcha, disfagia, disartria, dispnéia e soluço. A ressonância magnética revelou lesão parietoccipital à direita e no bulbo, sendo esta última maior. Investigações para tuberculose e síndrome da imunodeficiência adquirida tiveram resultados negativos. Foi submetido a microcirurgia da lesão do bulbo. O estudo anatomopatológico revelou paracoccidioidomicose. Recebeu tratamento com anfotericina B até 2100 mg, e sulfametoxazol-trimetoprim por três meses, e fisioterapia. Voltou às atividades após seis meses do término do tratamento. Comenta-se sobre a participação do sistema imunológico e das citocinas (interleucinas). We report on a 36 years-old man that had been at the Amazon forest four years before. Six months before the admission he had developed a progressive quadriparesis, gait ataxia, dysphagia, dysarthria, difficulty in breathing and hiccup. The gadolinium-enhanced T1-weighted MRI showed a lesion into the right parietoccipital area and another into the medulla, that was the largest. There was any evidence of tuberculosis or AIDS. The patient was submitted to microsurgical approach to the medulla. Pathological examination revealed paracoccidioidomycosis. Treatment with anphotericin B till 2100mg was administered followed by sulfamethoxazole-trimetoprim for three months plus physical therapy. The patient went back to his activities six months after the end of the treatment. Comments are presented about the participation of the immunological system and of the cytokines (interleukines).

A 52-year-old female had acute urinary hesitancy, constipation, crural spastic asymmetric paraparesis and sensory level at T6 (hypopalesthesia left and thermo-algesic hypoesthesia on the right mainly on sacral dermatomes) one week after H1N1-trivalent immunization […] Transverse myelitis with Brown-Sequard syndrome after H1N1 immunization

The geoprocessing techniques have been increasingly recurrent in understanding the effects caused by human activities on the environment. This study aimed to apply a mapping methodology to building a probabilistic prediction model, that could be able to demonstrate through the future scenarios, changes in land use and vegetation cover, using the model of Markov Chains, enabling the analysis of the impact caused by the spatial-temporal transition level and between the land uses and the sugar cane plantation in protected areas and their buffer zones. For this, was used the Markov model for the construction of a future probabilistic prediction, to a 20 years scenario, due to the advancement of sugarcane activity in the region. Thus, we found that pastures and agriculture, especially the sugar cane activity, act incisively on the contribution of changes and advances on classes of forests and riparian forests, with probabilities over than 30% of their areas being replaced by these human activities in both the Buffer Zone, as well inside the reserve.