Horticultura no baixo curso do Rio Doce, zona norte do Natal/RN: avaliação da qualidade da água por meio de ensaios ecotoxicológicos

The research is developed in areas of horticulture in the city of Natal, in the neighborhoods of Lagoa Azul, Pajuçara and Redinha, along the Doce River, border area with Extremoz city, Rio Grande do Norte State. The region of the fluvial plain of Doce River is located in an Environmental Protection Zone (ZPA-9). This is one of the ZPA which is not under the regulatory marks and there are several environmental problems caused by use and land occupation, featuring an evident disregard of environmental laws and whose protection is hindered by the lack of specific legal mechanisms. This study aims to provide an overview of the use of pesticides in the lower course of the Doce River, in Natal, Rio Grande do Norte, and to assess environmental degradation in the area through chronic toxicity tests using the microcrustaceous Ceriodaphnia dubia Richard 1894 (Cladocera, Crustacea) as test organism. Visits were made to the area in 2009 and 2010. To obtain information a diagnosis of the local situation was accomplished based on personal observation and non-participatory photographic record, with the aim of assessing the environmental characteristics, population diversity and work processes of horticulturists. During the visits four different points of the Doce River were chosen to collect water for ecotoxicological tests and survey of physico-chemical parameters (dissolved oxygen, pH, chloride, turbidity, conductivity and temperature), which were measured in the field using Multiparameter Probe (TROLL 9500). The adverse effects of pesticide use in the lower course of the Doce River is a major problem for both the environmental and human health, since many of the substances and active principles that enter in the composition of the products are synthesized molecules whose effects can only be evaluated through different studies on their actions and behavior at short, medium or long term

Avaliação do risco ocupacional de trabalhadores expostos a agrotóxicos no município de Touros/Rio grande do Norte

The use of pesticides is being used intensively with severe consequences for exposed farmers. This study aimed to describe the socioeconomic and health profiles of 60 farmers in the city of Touros / RN through the questionnaire recommended by: (International Commission for Protection against Environmental Mutagens and Carcinogens (ICPEMC). The analysis of these data allowed to prove the importance of knowledge about the socioeconomic and health profile of rural farmers as a way to understand the reality of this population, that is vulnerable to exposure due to the lack of knowledge and conditions. Aiming to analyze the frequency of micronucleus (MN) and other nuclear abnormalities in oral mucosa cells of 54 farmers that work in the city of Touros / RN it was applied the micronucleus test (MN) in oral mucosa. Our results showed an increased frequency of MN and other nuclear abnormalities related to the exposure and effects of pesticides on health. Based on the results, it is clear that farmers are using pesticide in the wrong way and compromising their health. A Cordel has been developed as a method to taking the results to the people affected by the pesticides. Therefore this study alerts to the need for profound changes in the social, cultural and health context to reduce health risks for both people and for the environment

Comunidade fitoplanctônica como discriminador ambiental em açude eutrófico tropical semiárido (Barragem Armando Ribeiro Gonçalves, RN) e divulgação científica para reflexão social

The knowledge of the phytoplankton community, as an integral and dynamic processes of eutrophication, provides information essential for proper management and handling. A growing problem of cyanobacteria in reservoirs around the world as a result of artificial eutrophication processes, generating a particular concern, because some species produce cyanotoxins, which can cause adverse effects on human health. The present work aims to characterize the spatial and temporal dynamics of phytoplankton, assessing their potential as ecological indicator of water quality in reservoirs semiarid region. The samples of water were collected monthly between 2009 and 2011, at three points along the dam Armando Ribeiro Gonçalves / RN. In each sample were measured physico - chemical analysis of water and biological components. We conducted a scientific dissemination activity, with distribution and reading primer on eutrophication, informative talk about water quality, questionnaires and performing a play in a public school in the city of Itajá / RN. The reservoir was considered eutrophic in three points, taking into account the values of chlorophyll -a and phosphorus, adopted to characterize eutrophic environments of semi-arid areas. High density of cyanobacteria, with a maximum value of 2.227.862 cél.ml- 1 and minimum of 43.456 cél.ml- 1 was recorded in lentic and semilêntico points throughout the study, exceeding the levels of drinking water (20.000 cél.ml- 1) established in 2.914/2011 Ordinance of the Ministry of Health of Brazil. All samples contained microcystin, and 44 % had values superiores1μg L- 1. The thermal pattern of the water column showed micro stratifications with differences of less than 1 ° C from five feet deep. The distribution pattern was the type profile clinogrado with oxygen deficit in the bottom of the reservoir. Oxiclina from 10 meters depth was observed during the rainy season (May-June) in the two years of study. The phytoplankton community was represented by 10 functional groups: S1, M, H1, Lo, P, F, Sn, P, W2 and R. The assessment of the ecological status of the system by the index Q showed poor water quality. The results of the study show that the vertical variations were less pronounced than the seasonal variations of cyanobacteria and phytoplankton community in general in the reservoir. The presence of cyanotoxins confirms the need for the monitoring of water quality and measures to reduce eutrophication in water supply reservoirs semiarid RN and demonstrates the challenge for water managers and health authorities to ensure water quality and consequently minimize risks to human health. Compared to the lecture, the primer was considered more efficient in sensitizing the participants, featuring a dynamic practice, differentiated learning, create opportunities for students to rethink attitudes of respect and care for the environment, and shall have the opportunity to learn the subject content from your reality and living environment. The knowledge generated from the activity of scientific were seen as essential for raising awareness of some of the region`s environmental problems , such as eutrophication

Avaliação do potencial tóxico de águas oriundas de irrigação agrícola no Baixo-Açu/RN: um problema socioambiental

For many decades the problematic raised about the indiscriminate use of pesticides in modern agriculture has incited the interest of many researchers to discover the effects caused by such products in the environment and consequently in the life of the ones which use that products (farmers) and those people who live in places next to the agricultural areas. Facing these facts, this research had the intention of comprehend the environmental perception of habitants of the Distrito Irrigado do Baixo-Açu (DIBA), located in the semiarid of Rio Grande do Norte, by using agro toxics and its possible environmental effects, as well as evaluate the levels of toxicity of waters from agricultural runoff in this region by using eco-toxicological exams with Ceriodaphnia silvestii. Were done 86 interviews with dwellers and farmers from DIBA. With the results reached in the evaluation of the interviews it was possible to identify that one of major problems is the inappropriate discard of empty packs of the pesticides used at that place. The samples collected for eco-toxicological evaluation showed a variation in its toxicity, once that the point of collect which receives waters from different cultures presented in four out of five samples toxicity for the tested species. Therefore, it concludes that the indiscriminate use of pesticides agricultural practice presented a potential to pollute to the irrigation waters, and the absence of elucidation by the farmers about the manipulation of these products contribute to the risk of environmental contamination and the possible decrease of the quality of life of the dwellers of the region

Avaliação do potencial de toxicidade de florações de cianobactérias como subsídio para ações de gestão ambiental em açudes do semiárido potiguar

Blooms negatively compromise the aquatic environment, plants, animals and human health.Some species are toxin-producing, such as the neurotoxin saxitoxin and the hepatotoxin microcystin, which may contaminate water reservoirs, as those existing in the semiarid region of Rio Grande do Norte (Brazil) which are used to supply the population, fishing, aquiculture and recreational activities, thereby providing the risk of human exposure through water intake, dermal contact and respiratory tract. Thus, it is recommended a constant monitoring of the density of cyanobacteria with the quantification of cyanotoxins. One goal with this work was the monitoring of water in four reservoirs in semiarid of RN through the identification and enumeration of cyanobacteria and through the identification and quantification of cyanotoxins by ELISA. Furthermore, we intended to assess the environmental perception of farmers and artisanal fishers in reservoirs of semiarid of RN through semi-structured interviews with questions mostly related to water and eutrophication. Through these objectives the aim was the development of management strategies for aquaculture and prevention of risks to public health. The results showed that the highest values of microcystins were found in the rainy season. Standards for drinking water, according to the guidelines of Ministry of Health 2914/2011 and CONAMA 357/05, setting the maximum values for raw water density of cyanobacteria: 50,000 cel.mL-1; microcystin: 1 μg. L-1 and saxitoxin: 3 μg. L-1. The values found for microcystin ranged between 0.00227 μg. L-1 and 24.1954 μg. L-1. From 128 samples analyzed, 27% were above the limit. There was no clear seasonal pattern for saxitoxins and their values ranged between 0.003 μg. L-1 and 0.766 μg. L-1 with none of the values above the limit. Furthermore, 76% of the densities of cyanobacteria values were above the limit. About environmental perception, 52 interviews were conducted and the results show that the respondents recognize the main uses of water of the rervoirs, recognize the importance and have a positive view about the reservoirs. They also realize that the water has a poor quality and can cause health problems. The results provide data showing the persistence of cyanobacteria and cyanotoxins, many times over the limit, reinforcing the importance of constant monitoring. The assessment of environmental perception gives foundation for later proposed environmental education linked to public health management into the context of this particular population, making it more effective

Sistemas de dunas do parque das Dunas e Barreiras do Inferno/Natal (RN: levantamento geológico /geofísico, elaboração do modelo deterministico e avaliação da vulnerabilidade/suscetibilidade

The current work was developed on the dune systems of the Parque das Dunas and Barreira do Inferno. These places are located in the cities of Natal and Parnamirim (RN, Brazil), respectively. This project has the purpose of developing the deterministic model on a specific blowout at Parque das Dunas, based in the geophysical interpretations of the lines gotten with the Ground Penetration Radar and the planialtimetric acquisitions of the topographical surface of the land. Also analyses of the vulnerability/susceptibility of these dune systems had been done in relation to the human pressures. To develop its deterministic model, it is necessary to acquire inner and outer geometries of the cited blowout. In order to depict inner geometries underneath the surface are used the GPR observing the altimetric control for topographical correction of the GPR lines. As for the outer geometries, the geodesic GPS gives us the planialtimetric points (x, y and z points) with milimetric precision, resulting in high-resolution surfaces. Using interpolation methods of the planialtimetric points was possible create Digital Elevations Models (DEM´s) of these surfaces. As a result, 1,161.4 meters of GPR lines were acquired on the blowout at the Parque das Dunas and 3,735.27 meters on the blowout at the Barreira do Inferno. These lines had been acquired with a 200 MHz antenna, except the 7 and 8 lines, for which we had been used a 100 MHz antenna. The gotten data had been processed and interpreted, being possible to identify boundary surfaces of first, second and third order. The first order boundary surface is related with the contact of the rocks of the Barreiras Group with the aeolian deposits. These deposits had been divided in two groups (Group 1 and Group 2) which are related with the geometry of stratum and the dip of its stratifications. Group 1 presented stratum of sigmoidal and irregular geometries and involved bodies where the reflectors had presented dips that had varied of 20 to the 28 degrees for the Parque das Dunas blowout and of 22 to the 29 degrees for the Barreira do Inferno blowout. Usually, it was limited in the base for the first order surface and in the top for the second order surface. Group 2 presented stratum of trough, wedge or lens geometries, limited in the base for the second order vi surface, where the corresponding deposits had more shown smoothed reflectors or with dips of low angle. The Deterministic and Digital Elevation Models had been developed from the integration and interpretation of the 2D data with the GOCAD® program. In Digital Elevations Models it was possible to see, for the localities, corridor or trough-shaped blowouts. In Deterministic Model it was possible to see first and second order boundary surfaces. For the vulnerability/susceptibility of the dune systems it was applied the methodology proposal by Boderè al (1991); however the same one did not show adequate because it evaluates actual coastal dunes. Actual coastal dunes are dunes that are presented in balance with the current environmental conditions. Therefore, a new methodology was proposal which characterizes the supplying and activity sedimentary, as well as the human pressures. For the methodology developed in this work, both the localities had presented a good management. The Parque das Dunas was characterized as a relic dune system and the Barreira do Inferno was characterized as a palimpsestic dune system. Also two Thematic Maps had been elaborated for the environmental characterization of the studied dune systems, with software ArcGis 8.3, and its respective data bases

Análise estrutural e avaliação do efeito condroitim sulfato extraído de tilápia (Oreochromis niloticus) em modelo de peritonite aguda

Chondroitin sulfate (CS) is a naturally glycosaminoglycan found in the extracellular matrix of connective tissues and it may be extracted and purified those tissues. CS is involved in various biological functions, which may be related to the having structural variability, despite the simplicity of the linear chain structure from this molecule. Researches in biotechnology and pharmaceutical field with wastes from aquaculture has been developed in Brazil. In recent decades, tilapia (Oreochromis niloticus), native fish from Africa, has been one of the most cultivated species in various regions of the world, including Brazil. The tilapia farming is a cost-effective activity, however, it generates large amount of wastes that are discarded by producers. It is understood that waste from tilapia can be used in research as a source of molecules with important biotechnological applications, which also helps in reducing environmental impacts and promote the development of an ecofriendly activity. Thus, nile tilapia viscera were subjected to proteolysis, then the glycosaminoglycans were complexed with ion exchange resin (Lewatit), it was fractionated with increasing volumes of acetone and purified by ion exchange chromatography DEAE-Sephacel. Further, the fraction was analyzed by agarose gel electrophoresis and nuclear magnetic resonance (NMR). The electrophoretic profile of the compound together the analysis of 1H NMR spectra and the HSQC correlation allow to affirm that the compound corresponds to a molecule like chondroitin sulfate. MTT assay was used to assess cell viability in the presence of CS tilapia isolated and showed that the compound is not cytotoxic to normal cells such as cells from the mouse embryo fibroblast (3T3). Then, this compound was tested for the ability to reduce the influx of leukocytes in model of acute peritonitis (in vivo) induced by sodium thioglycolate. In this context, it was done total and differential leukocytes counting in the blood and peritoneal fluid collected respectively from vena cava and the peritoneal cavity of the animals subjected to the experiment. The chondroitin sulfate for the first time isolated from tilapia (CST ) was able to reduce the migration of leukocytes to the peritoneal cavity of inflamed mice until 80.4 per cent at a dose 10µg/kg. The results also show that there was a significant reduction (p<0.001) of the population of polymorphonuclear leukocytes from peritoneal cavity in the three tested doses (0.1µg/kg; 1µg/kg and 10µg/kg) when it was compared to the positive control (just thioglycolate). Therefore, since the CST structure and mechanism of action has been completely elucidated, this compound may have potential for therapeutic use in inflammatory diseases

Influência da radiação ionizante natural no açude do boqueirão (RN): avaliação de risco saúde/ambiente

The contamination of water bodies with toxic substances causes a decrease in water quality, representing a risk to public health. In this context, human activities are generally seen as the main sources of water degradation. However, elements found naturally in the environment can also compromise water quality. Thus, the Boqueirão‘s dam, located in the municipality of Parelhas (RN, Brazil), was chosen as area for the development of this study, as its geological region is rich in the emission of natural ionizing radiation that produces byproducts like lead and Radon. Moreover, the area has a strong human influence that enhances the risks of pollutant discharge in this body of water.Thus, the objectives of this study were centered (i) in the analysis of risk perception in the city of Parelhas (RN/Brasil) due to the use of the water from the Boqueirão Dam; and (ii) in the assessment of water quality in the Dam using methods that quantify, mainly, heavy metals and radiation levels, as well as these toxics potential of inducing mutations on genetic material. The analysis of risk perception showed that the population in the city of Parelhas can perceive a risk in using the water from the dam and that they can recognize factors that influence the water quality. Regarding the second objective, the set of data point to the contamination of the Dam by heavy metals, as well as levels of radioactive parcicles and Radon – also present in high concentrations in outdoor air and on soil. Thus, it is possible to infer that the population residing in this area is subjected to injuries caused by exposure to natural and anthropogenic contamination. Our findings corroborate with the perception of the population regarding the risks associated with the use of the Dam for several types of activities. It is expected that the information gathered in this study can substantiate activities and future researches in this semiarid region in the Rio Grande do Norte/Brazil. Also, that the set of data can enable a better understanding of the specific toxicological scenario of risk found for the population and the effect of the contamination for the biota, which aids the development of a future risk assessment and a consequent management of this local issue.

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.

Análise do processo de avaliação de desempenho ambiental face às diretrizes da ISO 14031: um estudo de caso

The present dissertation aims to analyze the evaluation process of environmental performance inside an organization from the building construction section of civil construction based on the NBR ISO 14031 guidelines, which provide orientation regarding the implementation of this project towards the internal organizational management. The theoretical research has addressed concepts and historical development of environmental management inside organizations, from the emergence of the first models to the strengthening of environmental management through the standardization of the Environmental Management System caused by the publication of ISO 14001. It has also addressed the evaluation of environmental performance, the NBR ISO 14031 (concepts, types of indicators of evaluation of environmental performance, the elaboration process of such indicators, as well as its use and evaluation by the high administration). The research has an applied character, with exploratory and descriptive goals, and a qualitative approach based on case study. The data collection will be made through questionnaires, interviews, and documental analysis. Through the present research project, one expects to learn the elements taken into consideration by the organization for the elaboration and selection of indicators; to identify which interested parties contribute in the aforementioned process; to discover which sources are taken into consideration by the organization while establishing its environmental performance goals; to learn how the different kinds of environmental indicators are handled by organizations on daily basis, considering the existence of interferences on the decision making process, whether or not the interested parties are integrated, and if there is an periodical evaluation of environmental performance and how it is handled. One also expects to identify the opportunities for improvement regarding the organization that is object of study.

Benchmarking e regulação do setor de distribuição de energia elétrica nacional: proposta para avaliação dos custos operacionais eficientes

In Brazil, the National Agency of Electric Energy (ANEEL) represents the energy regulator. The rates review have been one of its main tasks, which establish a pricing practice at a level to cover the efficient operating costs and also the appropriate return of the distributors investments. The changes in the procedures to redefine the efficient costs and the several studies on the methodologies employed to regulate this segment denote the challenge faced by regulators about the best methodological strategy to be employed. In this context, this research aims to propose a benchmarking evaluation applied to the national regulation system in the establishment of efficient operating costs of electricity distribution utilities. The model is formulated to promote the electricity market development, partnering with government policies ant to society benefit. To conduct this research, an integration of Data Envelopment Analysis (DEA) with the Stochastic Frontier Analysis (SFA) is adopted in a three stages procedure to correct the efficiency in terms of environmental effects: (i) evaluation by means of DEA to measure operating costs slacks of the utilities, in which environmental variables are omitted; (ii) The slacks calculated in the first stage are regressed on a set of environmental variables by means of SFA and operating costs are adjusted to account the environmental impact and statistical noise effects; and, (iii) reassess the performance of the electric power distribution utilities by means of DEA. Based on this methodology it is possible to obtain a performance evaluation exclusively expressed in terms of management efficiency, in which the operating environment and statistical noise effects are controlled.

Construção e avaliação de uma unidade de ensino potencialmente significativa para o conteúdo de termoquímica

Nos dias atuais, oferecer uma educação para o exercício da cidadania é função primordial das políticas públicas educacionais, conforme estabelece a constituição brasileira e a legislação de ensino. Essa função vem sendo defendida por muitos professores no Ensino Médio, atribuindo-se a disciplina de Química o papel de proporcionar um ensino crítico, participativo, reflexivo e humano. Segundo os documentos oficiais brasileiros para o Ensino de Química, o estudo do conceito de energia deve favorecer o desenvolvimento de competências para que o aluno compreenda a produção e o seu uso em diferentes fenômenos e possam interpretá-los de acordo com modelos explicativos, além de saber avaliar e julgar os benefícios e riscos da produção e do uso de diferentes formas de energia nos sistemas naturais construídos pelo homem, articulando com outras áreas de conhecimento na procura de promover a interdisciplinaridade. As unidades de ensino potencialmente significativas (UEPS), tomam como base um conjunto de teorias de aprendizagem que tem o intuito de promover um ensino com base na aprendizagem significativa e podem ajudar os estudantes nas diferentes relações que um conceito pode ter. Neste sentido, o estudo do conceito da energia a partir do trabalho com UEPS, pode ser uma importante proposta que favorece um ensino de Química na perspectiva construtivista. Assim, o objetivo deste trabalho é construir e avaliar uma proposta didática para o conteúdo de termoquímica na perspectiva das unidades de ensino potencialmente significativas de Moreira com alunos do Ensino Médio de uma escola pública do Município de Campina Grande-PB. Inicialmente a UEPS foi avaliada por 22 professores em formação inicial de duas instituições públicas de ensino superior. Em seguida, ela foi aplicada para 15 alunos do 2° ano da Escola Estadual de Ensino Médio Prof. Raul Córdula, localizada na cidade de Campina Grande-PB. A coleta dos dados para os professores em formação inicial teve como base um instrumento de validação de elaboração de unidades didáticas baseada na Engenharia Didática proposta por Artigue (1996 apud Guimarães e Giordan, 2011). Já para os alunos do ensino médio, os dados foram coletados no decorrer da UEPS e a avaliação final sobre a proposta didática ocorreu através de um questionário tomando como base a escala de Likert e o uso de mapas conceituais. Para a descrição dos dados, foram utilizados os pressupostos da análise de conteúdo de Bardin. Como produto educacional foi elaborado a Unidade de Ensino Potencialmente Significativa e um DVD contendo orientações de como trabalhar com a proposta. Os resultados deste trabalho apontam uma avaliação positiva quanto à proposta de ensino elaborada para a Educação Básica, onde se observa através do instrumento de validação aplicado, que a maioria das respostas atribuídas pelos professores, ficou entre os itens suficiente e mais que suficiente. Em relação aos momentos de aprendizagem dos alunos do Ensino Médio durante a aplicação da UEPS, foi possível observar que a proposta gerou motivação no processo de ensino e aprendizagem dos conceitos da termoquímica, como também se percebe que os mapas conceituais apresentados pelos alunos apresentaram mais proposições conceituais em uma segunda tentativa de elaboração, logo a proposta de ensino foi aprovada por mais de 90 % dos estudantes do nível médio. Portanto fica evidente que a proposta didática contribuiu no processo de ensino aprendizagem, despertando interesse e motivação nos estudantes pelo conteúdo de Termoquímica.

Fatores de virulência, resistência ao estresse osmótico e susceptibilidade de isolados de Candida tropicalis oriundos de ambiente costeiro do nordeste brasileiro

Several studies have been developed regarding health risks associated with the recreational use of beaches contaminated with domestic sewage. These wastes contain various microorganisms, including Candida tropicalis, etiologic agent of both superficial infections such as systemic, as well as indicator of fecal contamination for the environment. In this context, the objective of this study was to characterize C. tropicalis isolates from the sandy beach of Ponta Negra, Natal, Rio Grande do Norte, Brazil, regarding the expression of in vitro virulence factors, adaptation to osmotic stress and susceptibility to antifungal drugs. We analyzed 62 environmental isolates of C. tropicalis and observed a great variation between them for the various virulence factors evaluated. In general, environmental isolates were more adherent to CEBH than C. tropicalis ATCC13803 reference strain, besides the fact they were also highly biofilm producers. In relation to morphogenesis, most isolates presented wrinkled phenotype in Spider medium (34 isolates, 54.8 %). When assessing enzyme activity, most isolates had higher proteinase production than C. tropicalis ATCC13803 reference strain. In addition, 35 isolates (56.4 %) had high hemolytic activity (hemolysis index > 55). With regard to C. tropicalis resistance to osmotic stress, 85.4% of the isolates were able to grow in a liquid medium containing 15% sodium chloride, corroborating to high survival capacity described for this yeast at marine environment. Finally, with regard to sensitivity to antifungal drugs, it was observed high resistance to the azoles tested, with the occurrence of the "Low-high" phenomenon and similar effect to the paradoxical growth which occurs to the echinocandins. For the three azoles tested we verified that 15 strains were resistant (24.2 %). Some strains were also resistant to amphotericin B (14 isolates, 22.6 %), while all of them were sensitive for the echinocandins tested. Therefore, our results demonstrate that C. tropicalis isolated from the sand of northeast of Brazil can fully express virulence attributes and showed a high persistence capacity on the coastal environment, in addition of being significantly resistant to most applied antifungals in current clinical practice. This constitutes a potential health risk to visitors of this environment, especially immunocompromised individuals and those with extreme age range.

Avaliação do cuidado de enfermagem na perspectiva da segurança do paciente em unidades de terapia intensiva: na visão de profissionais, pacientes e familiares

Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

Queilite actínica: expressão imuno-histoquímica da cox-2 e avaliação do diclofenaco sódico gel como uma terapia alternativa

Actinic cheilitis (AC) is a potentially malignant disorder which affects the lip vermilion and results from chronic exposure to sunlight. Currently, it is not possible to predict which cases of AC may progress to squamous cell carcinoma, and therefore, some biomolecular markers have been researched. Cyclooxygenase 2 (COX-2) is an enzyme associated with inflammatory response which is overexpressed in oral cancer; however, little is known about the role of this protein in actinic cheilitis. About the treatment of this lesion, currently available therapeutic modalities to AC may cause cytotoxic effects and deleterious results to patients. Therefore, the aim of this study was to evaluate the immunoexpression of COX-2 in AC of different risks of malignant transformation and analyse, through clinical follow-up, the efficacy of diclofenac sodium 3% gel in the treatment of this condition. Epithelial immunoexpression of COX-2 was analysed semi-quantitatively in 90 cases of AC classified as low risk (n = 55) and high risk (n = 35) of malignant transformation, in which the scores were assigned: (0) 0 to 5% of positive cells - Negative; (1) 6 to 30% of positive cells - Low expression; (2) 31 to 100% of positive cells - High expression. The chi-square test of Pearson was conducted to verify possible associations between immunoexpression of COX-2 and histologic grade of actinic cheilitis. The weighted kappa coefficient denoted a good interobserver agreement (0.677). Nineteen patients diagnosed with AC were instructed to perform topical application of the gel three times a day for a period of 90 days. In each biweekly visit, a follow-up record was accomplished through digital photographs and after treatment was completed, two researchers analysed all the images to assess clinical aspects of the lip. Furthermore, tolerability to the drug and patient satisfaction after treatment were evaluated. COX-2 was overexpressed in 74.4% of AC cases. Both low and high-risk groups revealed predominance of score 3, followed by scores 2 and 1. There was no significant association (p = 0.315) between COX-2 expression and histological grading. Among the total number of participants of this clinical study, ten showed total remission of all clinical features of the lesion and three had partial improvement of these characteristics. One participant presented worsening of the clinical condition. In five cases, the treatment was discontinued due to development of mild adverse effects at the site of gel application. Regarding analysis of satisfaction and tolerability to the drug, most patients were fully satisfied with the therapy (n = 11) and reported that the drug was not irritating to the lips (n = 9). Our study demonstrates that high expression of COX-2 is common in AC; however, this protein was not associated with malignant transformation risk of the analysed cases. Topical application of diclofenac sodium 3% gel provided a convenient and well tolerated approach in most cases, and may be a promising alternative for the treatment of actinic cheilitis.