Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: The aging of the Brazilian population already has repercussions on primary health care. Objective: Assess the perception of the elderly regarding access and quality of the Health Sistem of Bambuí, Minas Gerais. Methods: This research uses a qualitative approach. The model of signs, meanings and actions was used to collect and analyze the data. Interviews were carried out at home, the choice of which was based on criteria to guarantee the heterogeneity of the participants. Results: The analysis was based on the emic perspective. The analysis revealed elements that make up the elderly user's perception about the implantation and consolidation of SUS and the local FHS in the category “PHC challenges in the perception of the elderly user”. It was evident that, in the perception of the elderly, the public service has improved, but difficulties of access and the dissatisfaction of some with the quality of the service still remains. This leads to seek secondary care, urgency and private medicine. Conclusions: The findings point out that in the perception of the elderly, the implementation of the FHS was positive, however, primary health care can still be improved.

Introduction: Introduction: Type 2 diabetes mellitus is an important and growing health problem worldwide. Objective: This study aims to evaluate the quality of the evidence available on sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 agonists in people with diabetes mellitus and atherosclerotic cardiovascular disease. Methods: This integrative review was performed using the following databases: MEDLINE via PubMed, Embase via Cochrane Library, Cochrane Library, LILACS via VHL. The research question was structured as follows: population – people with type 2 diabetes mellitus and established cardiovascular disease; intervention – usual treatment, except insulin + sodium-glucose cotransporter 2 inhibitors or usual treatment, except insulin + and glucagon-like peptide 1 agonists; control – usual treatment, except insulin + placebo; outcome – overall mortality, mortality from cardiovascular causes, morbidity, adverse effects. Results: Two studies on empagliflozin were selected. This drug associated with the usual treatment was superior to placebo associated with the usual treatment in the primary outcome (hazard ratio — HR 0.86; 95% confidence interval — 95%CI 0.74–0.99; p=0.04), in reducing heart failure hospitalization (HR 0.65; 95%CI 0.50–0.85; p=0.002), in cardiovascular mortality (HR 0.62; 95%CI 0.49–0.77), and in overall mortality (HR 0.68; 95%CI 0.57–0.82; p<0.001). The subgroup of people with diabetes who were not on insulin benefited from using empagliflozin concerning the primary outcome (HR 0.79; 95%CI 0.64–0.97; risk difference — RD 2.5; number needed to treat — NNT 40) and cardiovascular mortality (HR 0.61; 95%CI 0.44–0.85; RD 2; NNT 49). The analysis of the subgroups showed heterogeneity. Participants aged 65 years or older (p=0.01) and those with glycated hemoglobin lower than 8.5 benefited from empagliflozin in the primary outcome. A difference (p=0.05) related to cardiovascular mortality was found, with the use of empagliflozin reducing the risk only in the subgroup with body mass index <30. No significant difference was identified with respect to placebo for fatal and nonfatal stroke nor for the composite outcome of nonfatal disabling stroke and fatal stroke (HR 0.81; 95%CI 0.43–1.50; p=0.50). More people had strokes in the intervention group in which the initial glycated hemoglobin was ≥8.5%, favoring placebo (p=0.01). Conclusions: The data found suggest the benefit of the Brazilian public health system using this drug in people with cardiovascular diseases. However, the population groups were heterogeneous, which may help outline strategies for using these medications. Further studies are necessary to assess why isolated cerebrovascular outcomes showed no benefit.

Introduction: The lesbian, gay, bisexual, transvestite and transsexual community and its health-related particularities were ignored for many years. Although homosexuality and transsexuality are no longer considered diseases, the marginalization of many lesbians, gays, bisexuals, transvestites and transsexuals at the socioeconomic-cultural level and with regard to access to health services still prevails. As to access to health care, the first contact of lesbian, gay, bisexual, transvestite and transsexual patients within the health care system can be through the family doctor. Objective: To analyze the experiences of family and community doctors with lesbian, gay, bisexual, and transgender people in the primary care scenario of the public health network in a city in southern Brazil. Methods: In July 2019, two focus groups were arranged (13 professionals in total), one of which consisted of 6 self-declared heterosexual and cisgender family doctors and another group consisting of 7 self-declared lesbian, gay, bisexual and transgender family doctors. Results: Participants considered the issue of lesbian, gay, bisexual, and transgender health in primary care important, but added that it was very little studied in their undergraduate/graduate training. They reported that the main demands of lesbian, gay, bisexual and transgender patients are mental health, violence and sexually transmitted infections. They pointed out that they have difficulties in addressing issues involving sexuality and gender identity during their office visits. Conclusions: The results reinforce the need for family and community doctors to understand better specifics of the lesbian, gay, bisexual, and transgender population. It is suggested that the health issues of the lesbian, gay, bisexual, and transgender population be more taught in undergraduate and graduate medical courses.

Introduction: The non-compliance of drug prescriptions with regulations that control this process is a reality of the health care process. Objectives: Thus, this study aimed to analyze medical and dental prescriptions of the primary health system in the city of Angicos-Rio Grande do Norte, in accordance with the current law. Methods: Accordingly, a cross-sectional descriptive-exploratory study was conducted. Second copies of prescriptions and special control prescriptions prepared by all physicians and dentists working in primary health care in this municipality, from January to June 2018, were analyzed. Information included the patient's name, age and sex. route of administration, dosage/concentration, duration of treatment, drug nomenclature, and stamp and signature of the prescriber. Results: A total of 3,725 prescriptions were analyzed, in which 566 (15.19%) were not in compliance with the law, where most problematic were user identification (68.02%), date of prescription (34.1%). drug nomenclature (DCB/DCI) (18.02%), duration of treatment (13.96%) and dosage (10.6%). Conclusions: These results point to the need for permanent education and inspection strategies regarding compliance with the law to be developed more assiduously.

Background. Microalgae and cyanobacteria are potential sources of new applications with biological activity. In our country, the research on applications of these organisms is still incipient. Objective. To test the potential of some species of microalgae and cyanobacteria as erythrocytes agglutinins (presence of lectins) and bactericides, considering the influence of the systems and media of cultivation and production of these microscopic organisms. Methods. Nine species to be tested were grown in different systems: photobioreactors of 8 and 16 L and raceway tanks of 300 and 3000 L, using Bayfoland forte ®, F / 2, UTEX, Zarrouk and modified Jourdan cultivation media, the obtained biomass was lyophilized for testing. Lectins detection (agglutination tests) was performed as recommended by Muñoz et al. (1985) and for antibiosis tests, the recommendations of Bauer et al. (1966) were followed. Results. Three species (two chlorophytes and one cyanobacteria) induced potent agglutination of erythrocytes, a dependence on the cultivation system to increase the total activity was observed when organisms were grown in raceways. Only one species of the microalgae studied showed mild antibacterial activity, this was against Pseudomonas aeruginosa. Conclusions. Bacteriostatic activity of Desmodemus quadricauda extract against Pseudomonas aeruginosa and agglutination of Tetradesmus obliquus, Desmodesmus quadricauda and Arthrospira platensis species are reported. Emphasizing that there are three potential species that provide lectins since they strongly agglutinated the erythrocytes without enzymatic treatment.

Background. The Espiritu Santo archipelago is recognized for its high biodiversity as a national park. Studies carried out on soft-bottom mollusks are of the faunistic type, and little is known about the variations in their community structure. Objective. To know the composition and the spatial variation in the structure of the assemblages of soft-bottom mollusks of the archipelago and to describe the possible incidence of the type of substrate in their structuring. Methods. In the infralittoral zone, 66 sampling sites were distributed in nine locations. The mollusks were collected by autonomous diving using a 1 m-2 metal frame and a nucleator to analyze of the sediment texture. The medium-grained sand substrate presented the highest distribution. The ecological indices of abundance, species richness (S), Shannon-Wiener diversity (H´), and Pielou evenness index (J´) were estimated. Results. 23,743 individuals were quantified, belonging to 102 species distributed in three classes, 17 orders, 39 families, and 70 genera. The bivalves were represented by 48 species, 9 orders, 17 families, and 39 genera. The gastropods by 52 species, 7 orders, 21 families and 30 genera, and the scaphopods by 1 species. Significant differences were found between localities for species richness and diversity but not for species equity. Conclusions. Spatial variations were observed in the structure of the mollusks assemblages in the archipelago, which could be due to the combined effect of the sediment texture and the presence of mangroves existing in some locations.

Background. Microalgae are being studied as a source of fatty acids to produce food with high added value. The content of oils can increase or decrease due to changes in abiotic factors such as nitrogen and phosphorus concentration in the culture medium. Goals. To determine the carbon/nitrogen and carbon/phosphorus ratio that favor biomass and fatty acid production in the native microalgae Chlorella sorokiniana. Methods. Microalgae isolated from the Parque Norte Lake in the city of Medellin, Antioquia, Colombia, was cultured in a heterotrophic way using glucose as carbon source at different carbon to nitrogen (C/N) (10/1, 25/1 y 50/1) and carbon to phosphorus (C/P) (200/1, 300/1 y 400/1) ratios. Results. The highest concentration of biomass was 9.70 gL-1 and 9.17 gL-1 at C/N 10/1 and C/P 200/1. The yields were 1.08 gL-1d-1 and 1.02 gL-1d-1. The biomass yield from glucose (were 0.43gg-1 and 0.44gg-1. Total fatty acids are favored by the C/N and C/P ratios of 50/1 and 400/1, yielding 24.27% and 20.48% total fatty acids measured over dried cell weight alongside higher fatty acid yield from biomass of 26.97m gL-1d-1 and 22.76m gL-1d-1, respectively. Conclusions. Lower C/N and C/P ratios favor the production of biomass while lowering the production of total fatty acids; conversely, higher C/N and C/P rations favor the production of total fatty acids and the lipid yield from biomass. Therefore, it is necessary to reach the highest production of biomass with low C/N ratio for enabling the elongation of the polyunsaturated fatty acid chain during the nutrient depletion stage in the culture medium as a response to the stress conditions

Background. The evaluation of the integrity of a river involves the analysis of different aspects of its environment and the ecosystem itself. Goal. In the present study, the abiotic and biotic quality of the Cupatitzio river was characterized using multiple indicators. Methods. An analysis of the coverage of the different land uses in the basin was carried out, 16 physicochemical variables of the water were measured, and aquatic invertebrates were identified and quantified in 20 monitoring sites. Water quality index (NSF-WQI) and biological indices (Shannon-Wiener, Pielou, and Indicator Species Analysis) were calculated, and multivariate statistical methods were applied. Results. Most of the sites present an important coverage of human settlements and agriculture, and the lowest value for natural vegetation. Consequently, the beginning of the river presented a modification in its channel which reduced the value of biological indicators. Overall water quality is medium for the river, related to the presence of organic matter with high values of Biochemical Oxygen Demand (maximum 22.82 mg/L) and nutrients (maximum NO3 of 12.39 mg/L and NH4 of 7.31 mg/L). The dominant families were Chironomidae, Lumbriculidae, Gammaridae, and Baetidae. A significant spatial and temporal difference in family abundance was detected (A=0.061, P=0.0007, and A=0.247, P=0.000008, respectively). Six of the 77 families were identified as significant indicators. Conclusions. Only at dry season there was more concordance between environmental quality and aquatic organisms’ indicators. A protocol of the analyses is presented for implementation in other aquatic ecosystems and it is recommended the necessity to calibrate and validate biological indicator indices (e. g., BMWP) to improve interpretation.

Background. Chydoridae is the most diverse family of cladocerans but information about their biology or life cycles is still limited, perhaps because of the hard task that their taxonomy involves or that culture in optimal conditions are not described for several species. Goals. This study examined the effects of culture conditions (algal concentration, algal species, and temperature) on the demography of Alona guttata (Sars, 1862) to obtained their maximal growth rates. Methods. Life table analysis with the chydorid A. guttata were performed as follows: five females per cohort (six replicas) were fed on either Chlorella vulgaris (Beijerinck, 1890) or Nannochloropsis oculata (Hibberd, 1981) at 0.5×106 or 2×106 cells/mL, reared at 20ºC or 25ºC and photoperiod 16:8 h (light: dark). Media was supplemented with an artificial substrate. Then, daily fertility and survival were assessed to estimate the demographic parameters: average lifespan (ALS), life expectancy at birth (LEB), generation time (GT), gross reproductive rate (GRR), longevity, net reproductive rate (NRR), and the intrinsic rate of population increase (r). Results. Significant effects were observed due to the three factors tested and their interactions. Increasing algal concentrations of either C. vulgaris or N. oculata promoted higher fertility and longer survival. Lower temperature extended the ALS and LEB when organisms were fed on the highest algal concentration. The highest r values were observed when Alona was fed on N. oculata at 2×106 cells/mL. Conclusions. The best culture conditions, in terms of the population growth rates of A. guttata, were provided by N. oculata at 2×106 cells/mL at 25°C with the supplementation of artificial substrate.

Background. Several works conducted in Mexico have addressed the Neotropical otter (Lontra longicaudis annectens), a protected subspecies (NOM-059-SEMARNAT-2010). Objectives. To know the abundance and distribution of the neotropical otter in the State of Campeche in La Lagartera Lagoon (Palizada River). Methods. During 2017 were searched the lagoon looking for indirect evidence on mangrove, collected and analyzed scats in order to identify preys. Results. Were traveled 1.49 km in each climatic season (nortes, dry, and rainy seasons), on board a small vessel, recording a total of 99 signs (85 scats, five feeding sites, five dens, and four vocalizations). We recorded the distribution of these signs across the sampling area and estimated a relative abundance of 0.30 otters/km. The analysis of 85 scats collected on logs or roots recorded six major prey groups: fish (40 %), crustaceans (26 %), reptiles (15 %), mollusks (11 %), mammals (4 %), birds (3 %) and other unidentified prey (1%). Conclusions. No evidence was found to suggest a variation in the consumption frequencies of the groups of prey by season. The presence and consumption of the “sailfincatfish” was also recorded in all seasons. The presence of four native species and five new records of prey fish was confirmed from otoliths contained in feces. This information highlights the ecological relevance of the species.