Paloma Martins Mendonça

Introdução: Este artigo de revisão tem como objetivo identificar na literatura as principais tecnologias para reutilização da água de rejeito do tratamento de água para hemodiálise. Materiais e Métodos: Revisão integrativa, onde identificou 75 estudos, sendo: 01 na Lilacs, 08 na Scopus, 65 na Pubmed e 01 na Web of Science. Após exclusão dos estudos duplicados e aplicação dos critérios de elegibilidade, foram selecionados 09 estudos. Resultados: Os 09 artigos, então, foram dispostos em um quadro para melhor exposição das informações, vinculando os desfechos que podem ser incorporados na reutilização da água de rejeito do tratamento de água para hemodiálise. Discussão: É preciso destacar que, embora haja grande relevância e necessidade de implantação de ações que visem reutilização da água de rejeito do tratamento de água para hemodiálise, há poucos estudos que relatam ou discutem pesquisas dessa natureza. Considerações finais: Portanto, é necessário o incremento de ações integradoras visando promoção reutilização da água de rejeito do tratamento de água para hemodiálise, além da ampliação de estudos sobre a incorporação de novas tecnologias nesse âmbito. Palavras-chave: Hemodiálise; Reciclagem da Água; Uso de Águas Residuárias.

Introduction: The attitudes and beliefs of health professionals should be considered as elements that can influence the exacerbation and perpetuation of low back pain. Health professionals can adopt two types of treatment models, the biomedical and the biopsychosocial. Objective: To evaluate the attitudes and beliefs of primary health care physicians in the municipalities that make up the Association of Municipalities of Entre Rios de Santa Catarina (AMERIOS/SC) regarding low back pain. Methodology: This is an exploratory field study, limited to health units in the seventeen municipalities that make up AMERIOS/SC. Two questionnaires were applied to the physicians, the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS.PT). Results: The mean score of 26.47 (±6.95) in biomedical orientation was obtained through the PABS.PT questionnaire. In biopsychosocial orientation, the average was 24.57 (±4.88). There was a predominance of biomedical orientation after data analysis. Conclusion: Most Primary Health Care physicians in the municipalities that make up AMERIOS/SC present a predominance of biomedical orientation in the management of low back pain.

Diptera plays a pivotal role in forensic investigations, particularly in estimating the post-mortem interval. This can be achieved by analyzing the succession patterns of species on decomposing bodies, which requires detailed knowledge of the local fauna. In rural areas of the Rio de Janeiro state, Brazil, forensic entomological succession remains understudied. This study aimed to evaluate the ecological succession of adult and immature dipterans on decomposing pig carcasses in rural areas of Seropédica municipality during dry and rainy seasons, through the threshold indicator taxa analysis (TITAN). For adult dipterans during the rainy season, we identified 25 ‘Z-’ taxa, with change points (cp) between days 4 and 14, while one ‘Z+’ taxon showed a cp at day 16. During the dry season, 22 ‘Z-’ taxa exhibited cp between days 4 and 1, and one ‘Z+’ taxon was identified on day 13. Among immature dipterans, we identified 3 ‘Z-’ taxa with cp between days 9 and 16, while 2 ‘Z+’ taxa showed cp. at days 5 and 21.5. Our findings provide valuable insights for forensic professionals by offering continuous ecological change point analysis, which help address the challenges of interpreting heterogeneous decomposition stages, which are often difficult to delineate in forensic casework.

With more than 125,000 described species, Diptera are considered a megadiverse order. However, immatures display great morphological homogeneity, making few species of Diptera from the Cyclorrhaphan group easy to identify. The main species of medical, sanitary, and forensic importance are found in this group, highlighting the relevance of their description. The uniformity of the group limits sensitive techniques for identifying immatures; therefore, this study reports characters that can be used to identify these insects using scanning electron microscopy. Based on an investigation and analysis of the relevant scientific literature, we suggest combining techniques for accurate morphological identifications of flies.

Helicobia aurescens is a flesh fly associated with pig and rat carcasses. This study aims to describe the life cycle at two temperatures (27 ± 1 °C and 29 ± 1 °C) and analyze the morphological characteristics of the eggs, larvae, and puparia of H. aurescens using scanning electron microscopy (SEM). Temperature is an abiotic factor that greatly influences the development of insects. The larval development of H. aurescens lasts longer at 27 ± 1 °C than it does at 29 ± 1 °C, affecting the growth of newly hatched larvae into adults. The females larviposited three times more at 27 °C than they did at 29 °C, and the number of days laying larvae was also greater. At 27 °C, they laid larvae for 38 days, whereas, at 29 °C, the females larviposited for 21 days. No hatching lines or median areas were detected on the exochorion with SEM, as in the other sarcophagid species. The first-instar larva is very similar to those of the other species. The second instar has anterior spiracles present on the first thoracic segment, with six or seven ramifications aligned regularly. On the third instar, these structures have eight ramifications in a regular row and are located dorsolaterally. The puparium morphology is similar to that of the third-instar larvae.

Introduction: Clinical practice guidelines aim to assist reasoning and clinical decision-making, improve the effectiveness and efficiency of health care and standardize conduct, including care for patients with low back pain. Considering that evidence-based practice is necessary and that healthcare decisions integrate scientific evidence, knowledge and early adherence by healthcare professionals to clinical practice guidelines can accelerate recovery and reduce costs associated with low back pain. There is no informational material that is easy to read and interpret that encompasses the similarities of important national and international guidelines in the management of low back pain. Objective: To unify the similarities in the practice guidelines of low back pain clinics, involving diagnosis and request for imaging exams, to later prepare informative material for health professionals on this topic. Methods: This is a literature review, with a bibliographic survey carried out in electronic databases: National Library of Medicine (Medicine–PubMed), Medical Literature Analysis and Retrieval System (Medline), Latin American and Caribbean Literature in Health Sciences (Lilacs), Scientific Electronic Library Online (SciELO) and Google Scholar. Results: Ten guidelines were part of this study. Recommendations for taking anamnesis and physical examination were found in all guidelines. Diagnostic screening aims to identify patients with specific conditions as the cause of low back pain, in addition to the possibility of the presence of red and yellow flags. All guidelines discussed recommend that imaging should be avoided unless there is clinical suspicion of red flag pathology, or severe or progressive neurological deficit, such as radiculopathy, neurogenic claudication, or if imaging is likely to guide additional management. Conclusion: Clinical practice guidelines for low back pain present well-established similarities in the management of low back pain. Most have common information regarding anamnesis, physical and neurological examinations and request for imaging exams. All guidelines in this study agree that imaging exams should be avoided. The preparation of the informative material will be presented in a future article, which will assist health professionals in better managing low back pain.

Brazil was the first South American country to report a confirmed case of Coronavirus Disease 2019 (COVID-19), on February 26, 2020, in the state of São Paulo. Maranhão was one of the states in Brazil where the pandemic picked up speed early. Thus, the objective of this study is to report the initial experience regarding the epidemiological and clinical aspects of COVID-19 in the State of Maranhão. This is a cross-sectional study and the data used come from a database provided by the Central Laboratory of the State of Maranhão – LACEN, with the approval of the Research Ethics Committee of the State University of Maranhão according to CAAE: 32171220.0.0000.5087. The initial sample included data from 2,336 individuals, but 646 patients were excluded because they did not contain information about epidemiological data, thus totaling a final sample of 1,690 individuals. For data archiving and statistical analysis, SPSS ® version 25.0 software was used. The final sample consisted of 1690 individuals, of whom 64.9% (n=1098) tested positive for COVID-19, 52.2% (n=882) were women, 82.8% (n=1374) came from the public health sector and 82.3% (n=1400) from the metropolitan region of the state. The highest prevalence of positive cases for COVID-19 was in the state capital, with 86.5% (n=950). It was found that most patients depended directly on the unified health system as a form of priority care, which led to a strong collapse since they were not prepared for the demand arising from the pandemic. Emphasizing the importance of investments in the Unified Health System, as well as the supervision of these resources.

Los insectos son el grupo de seres vivos más abundante y diverso en el ambiente terrestre, siendo de gran importancia para la sociedad, considerando su amplia red de interacciones con el medio ambiente, con otros animales y con los seres humanos. En el contexto de la entomología forense, estos artrópodos pueden ser causa de disputas judiciales, constituir un activo de apoyo jurídico o proporcionar un valioso conjunto de informaciones para investigaciones criminales, principalmente aquellas relacionadas con múltiples aspectos de una muerte violenta, aunque también incluyen el abandono de incapacitados y malos tratos. El uso de insectos como evidencia en estos casos, en alusión a la entomología forense médico legal, resulta particularmente interesante en Brasil debido a la alarmante tasa de homicidios. Así, con el objetivo de ilustrar de manera práctica el potencial aporte de los insectos a la justicia, se realizó una revisión sistemática de la literatura, a partir de un levantamiento bibliográfico de reportes de casos cuyas resoluciones fueron asistidas por la herramienta, en las bases de datos del Portal de Revistas Capes, PubMed y SciELO. En total, se seleccionaron 18 artículos tras aplicar los criterios de inclusión y exclusión. La estimación del Intervalo Post Mortem (IPM) fue la aplicación de la herramienta más utilizada (n = 16, 88,88%), seguida de la estimación del tiempo de infestación en hospedadores vivos (n = 2, 11,11%) y el esclarecimiento de la forma de muerte (n = 1, 5,55%). El análisis de los informes mostró que además de la estimación del IPM, las observaciones sobre el desarrollo y comportamiento de los insectos pueden orientar las líneas de una investigación penal, dejando clara su relevancia para la debida resolución y aplicación de la justicia.

O descarte inadequado de resíduos é uma questão global que representa um grande desafio para a preservação do meio ambiente e da saúde pública. A implementação de políticas públicas voltadas para a gestão adequada dos resíduos sólidos é fundamental para reduzir os impactos negativos causados por essa prática. Nesse contexto, este estudo teve como objetivo verificar a diferença significativa no número de municípios que oferecem serviços de coleta seletiva no Brasil, tendo como base os dados de 2010 e 2020 disponíveis no Sistema Nacional de Informações sobre Saneamento (SNIS). Para tanto, utilizou-se o software Minitab 19 para a análise estatística dos dados. Os resultados obtidos indicam um aumento significativo no número de municípios com serviços de coleta seletiva no período analisado, o que pode ser atribuído às políticas públicas voltadas para o desenvolvimento sustentável e a Política Nacional de Resíduos Sólidos. No entanto, ainda existem desafios a serem superados, como as desigualdades regionais e a falta de uma visão abrangente sobre o tema da gestão correta de resíduos, o que pode afetar a efetividade das políticas públicas e a continuidade do avanço na gestão de resíduos sólidos. A conscientização da população sobre a importância da gestão adequada de resíduos sólidos, bem como a implementação de novas políticas de educação ambiental podem contribuir para a melhoria dos índices de coleta seletiva em todo o país e para o alcance dos objetivos e metas da Agenda 2030 e dos Objetivos do Desenvolvimento Sustentável.

A PNRS – Política Nacional de Resíduos Sólidos, instituída pela Lei n.º 12.305/2010, à luz do disposto no art. 36, II, previu que, no âmbito da responsabilidade compartilhada pelo ciclo de vida dos produtos, cabe ao titular dos serviços públicos de limpeza urbana e de manejo de resíduos sólidos, estabelecer sistema de coleta seletiva. Além disso, seu ato regulamentador, o Decreto n.º 10.936/2022, dispôs que a coleta seletiva será realizada em conformidade com as determinações dos titulares do serviço público de limpeza urbana e de manejo de resíduos sólidos, por meio da segregação prévia dos referidos resíduos, de acordo com sua constituição ou sua composição (art. 8º, caput), estabelecendo ainda que o sistema de coleta seletiva de resíduos sólidos priorizará a participação de cooperativas ou de outras formas de associação de catadores de materiais reutilizáveis e recicláveis constituídas por pessoas físicas de baixa renda. Este trabalho teve como objetivo aferir se o “Sistema de Coleta Seletiva Porta-a-Porta”, depois de implantado, conseguiu, de forma efetiva, ampliar ou não a quantidade de material reciclável (volume), levando em consideração os exercícios de 2018 a 2022, comparando-os através de análise quantitativa com auxílio do software Minitab. Os dados quantitativos foram disponibilizados pela Secretaria de Meio Ambiente de Paty do Alferes / RJ. Foi possível, ao final da pesquisa realizada, observar através das avaliações estatísticas, que a adoção do Sistema Porta-a-Porta proporcionou um aumento significativo na coleta de materiais recicláveis no período.