A porta de entrada para o diagnóstico da tuberculose no sistema de saúde de Ribeirão Preto/SP

O primeiro contato do doente de tuberculose (TB) com o sistema de saúde se dá na porta de entrada, e é fundamental para o acesso ao diagnóstico. Objetivou-se identificar e analisar a porta de entrada no sistema de saúde de Ribeirão Preto para o diagnóstico da TB. Baseou-se em um instrumento do Primary Care Assessment Tool, adaptado para a TB no Brasil. Realizou-se entrevista estruturada com 100 doentes de TB diagnosticados entre Junho de 2006 e Julho de 2007. Destes, 61% chegaram ao local de diagnóstico por encaminhamento e apenas 29% se apresentaram espontaneamente; 66% procuraram por serviços de atenção primária, 34% por serviços de nível secundário e terciário. Ademais, 89% foram diagnosticados em serviços públicos e destes, 44% foram diagnosticados nos pronto-atendimentos. Além disso, 88% foram diagnosticados fora de sua área de abrangência. Apesar dos doentes terem procurado atendimento na atenção primária e mais próximo de suas residências, o diagnóstico se deu na atenção secundária e terciária.

Capacitação em bioética para profissionais da Saúde da Família do município de Santo André, SP

Relato de experiência da capacitação em bioética para enfermeiros e médicos da Estratégia Saúde da Família, Santo André, SP. Trata-se de trabalho calcado na problematização e bioética deliberativa, que objetivou apresentar o procedimento da deliberação para subsidiar o manejo de problemas éticos. Trabalharam-se os conteúdos transversalmente em cinco sequências de atividades, em dois momentos de concentração, intercalados por um de dispersão. Na primeira concentração, desenvolveram-se conceitos chaves e conteúdos da bioética deliberativa. Na segunda, houve sessões de deliberação para situações de conflito moral, selecionadas e preparadas durante a dispersão. Os participantes avaliaram a deliberação como um instrumental adequado para lidar com as questões éticas que vivem. A problematização mostrou-se efetiva como estratégia educativa na formação contínua em bioética deliberativa.

Pollicipes caboverdensis sp. nov. (Crustacea: Cirripedia: Scalpelliformes), an intertidal barnacle from the Cape Verde Islands

Recently, genetic evidence supported the existence of a new species of the genus Pollicipes from the Cape Verde Islands, previously considered a population of P. pollicipes. However, P. pollicipes was not sampled at its southern limit of distribution (Dakar, Senegal), which is geographically separated from the Cape Verde Islands by about 500 km. Herein we describe Pollicipes caboverdensis sp. nov. from the Cape Verde Islands and compare its morphology with the other three species of Pollicipes: P. pollicipes, P. elegans and P. polymerus. Pollicipes pollicipes was sampled at both the middle (Portugal) and southern limit (Dakar, Senegal) of its geographical distribution. The genetic divergence among and within these two regions and Cape Verde was calculated through the analysis of partial mtDNA CO1 gene sequences. Pollicipes caboverdensis sp. nov. has a single whorl of capitular plates below the subrostrum, peduncular scales pointing up toward the capitulum and multi-articulate caudal appendages (all characters shared with P. pollicipesand P. elegans), reddish-orange capitular plates (large specimens), a single rostral median latus between the median latus and the rostrolatus (both characters shared with P. elegans), and uniquely possesses peduncular scales that are approximately the same width as height. The genetic distance between the Cape Verde population and the Senegal and Portugal populations is 13–14%, whilst between Senegal and Portugal it is < 1%.

Measuring spiritual well-being in older rehabilitation patients using the facit-sp

Objectives: To determine psychometric properties of the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) in a cohort of older patients admitted to rehabilitation. Method: Patients aged 65+, with MMSE score>19, admitted consecutively over 6 months in post-acute rehabilitation were enrolled (N=144, 81.27.2 years, 68.8% women). Data on medical, functional, and mental status were systematically collected upon admission. Spiritual well-being was assessed within 3 days after admission using the FACIT-Sp (12 items, score from 0 to 48, high spiritual well-being defined as a score ≥36) and the single question "Are you at peace?" (score from 0 to 10 on a visual analog scale). Results: FACIT-Sp scores ranged from 7 to 44(mean=29.87.7). Overall, 24.3% of the patients had high spiritual well-being. Internal consistency was optimal for total score (Cronbach's alpha =0.85). Itemto- total correlations were all significant, ranging from 0.28 to 0.73. A confirmatory factorial analysis yielded a 2-factor solution, consistent with Meaning and Faith proposed subscales and accounting for 52% of the variance . FACIT-Sp total score correlated positively with the question «Are you at peace ?» (Spearman's rho 0.49, P<.001) and negatively with depressive symptoms (Spearman's rho -0.37, P<.001), confirming FACIT-Sp validity. Compared to the others, patients with higher spiritual well-being had significantly better function at admission (Barthel's score 74.817.1 vs 68.514.1, P=.014). Conclusions: The FACIT-Sp remains a reliable and valid measure to assess spiritual well-being in older patients undergoing rehabilitation. The relatively low proportion of patients with high spiritual well-being deserves further investigation.

Esp��cies de cigarrinhas (Hemiptera, Cicadellidae, Cicadellinae) em pomares de citros da região de Bebedouro, SP, com descrição de uma esp��cie nova de Acrogonia Stål

Sharpshooter leafhoppers (Hemiptera, Cicadellidae, Cicadellinae) in citrus groves of the area of Bebedouro, SP, with description of a new species of Acrogonia Stål. Sixteen species of Cicadellidae, subfamily Cicadellinae, were collected and identified: 11 of the tribe Cicadellini and five of the tribe Proconiini. The ten most common species, together with a new species, are characterized based on external morphology and male genitalia: Acrogonia citrina Marucci & Cavichioli sp. nov.; Bucephalogonia xanthophis (Berg, 1879); Dilobopterus costalimai Young, 1977; Ferrariana trivittata (Signoret, 1854); Hortensia similis (Walker, 1851); Macugonalia cavifrons (Stål, 1862); M. leucomelas (Walker, 1851); Oncometopia facialis (Signoret, 1854); Plesiommata corniculata Young, 1977 and P. mollicella (Fowler, 1900). The leafhopper samples were collected in citrus groves and in adjacent habitats (woods, swamp, cultivable plain, spontaneous vegetation of the grove, coffee crop and sugarcane) at the counties of Bebedouro and Monte Azul Paulista and in the district of Turvínia. The collecting methods were: insect net, yellow sticky cards, portable suction trap and Malaise trap. Identification keys were elaborated for the 16 species. There is a great diversity of Cicadellinae species in the citric groves. In the three areas sampled, it was collected a larger number of species of the tribe Cicadellini than of the tribe Proconiini. In the Bebedouro area, the vector species of Xylella fastidiosa, A. citrina sp. nov., B. xanthophis, D. costalimai and O. facialis, were collected in the citrus groves and in all adjacent habitats.

Himenópteros parasitóides (Insecta, Hymenoptera) coletados em cultura de algodão (Gossypium hirsutum L.) (Malvaceae), no município de Ribeirão Preto, SP, Brasil

Parasitoid Hymenoptera (Insecta, Hymenoptera) collected in a cotton (Gossypium hirsutum L.) (Malvaceae) plantation at the municipal district of Ribeirão Preto, SP, Brazil. Parasitoid Hymenoptera were collected by using Moericke trap placed in a cotton plantation (Gossypium hirsutum L.) of the variety Delta Pine 90, during the period of February 23rd to April 3rd, 2001. A total of 16,166 specimens of parasitoids, belonging to eight superfamilies and 22 families, were collected. Encyrtidae, Trichogrammatidae, Mymaridae and Scelionidae were the most common families, being responsible for 45.14%, 19.11%, 14.33% and 6.57% of the total number of parasitoids collected, respectively. Other eigthteen families showed the relative frequency lower than 5%.

Himenópteros parasitóides (Insecta, Hymenoptera) coletados em cultura de soja (Glycine max (L.)) Merril (Fabaceae), no município de Nuporanga, SP, Brasil

Parasitoid Hymenoptera collected in a soybean plantation (Glycine max (L.)) Merril (Fabaceae) at the municipal district of Nuporanga, SP, Brazil. Parasitoid Hymenoptera were collected by using Moericke trap placed in a soybean plantation (Glycine max (L.) Merril) (Fabaceae) of the variety Conquista, during the period of March 24th to April 7th, 2000. A total of 4,969 specimens of parasitoids, belonging to seven superfamilies and 15 families, were collected. Scelionidae, Encyrtidae, Aphelinidae and Trichogrammatidae were the most common families, being responsible for 41.66%, 19.42%, 11.19% and 7.35% of the total number of parasitoids collected, respectively. Other eleven families showed the relative frequency lower than 5%.

Análise da riqueza da fauna de Braconidae (Hymenoptera, Ichneumonoidea) em remanescentes naturais da Área de Proteção Ambiental (APA) de Descalvado, SP

Analysis of the Braconidae (Hymenoptera: Ichneumonoidea) fauna richness in natural remnants of the Área de Proteção Ambiental (APA) of Descalvado, SP. A survey of the Braconidae fauna on fragmentary natural environments at northeast São Paulo State was conducted using Malaise traps installed in five sites of Área de Proteção Ambiental of Descalvado. A total of 2,262 specimens, representing 22 subfamilies and 94 genera, was sampled throughout a period of sixteen months (from May, 1999 to August, 2000). Biological data were obtained from current literature and behavior patterns of host utilization for the studied fauna, mainly Braconidae which have been successful in control of agricultural insect pests. Statistical analyses indicated that the asymptote of the genera richness has been approached using this sampling method. This is the most complete survey yet available from natural fragmentary areas of the Descalvado Braconidae fauna. Patterns of distribution and richness of the Braconidae genera were established. Cluster Analysis was adopted taking as attribute the number of Braconidae genera.

Fenologia dos Braconidae (Hymenoptera, Ichneumonoidea) da Área de Proteção Ambiental (APA) de Descalvado, SP

Phenology of the Braconidae (Hymenoptera, Ichneumonoidea) at Área de Proteção Ambiental of Descalvado, São Paulo State. The flight phenology of the Braconidae fauna was conducted using Malaise traps in five sites of the Environmental Protected Area of Descalvado. A total of 2,792 specimens, representing 22 subfamilies, was sampled throughout a period of sixteen months from May, 1999 to August, 2000. The traps catches for koinobionts peak was in August, 1999 a month before of the idiobionts peak and in June, 2000 both peaks were simultaneous. The phenological peaks of dominant koinobiont taxa (Microgastrinae) were similar to all koinobionts, and the peaks of dominant idiobiont taxa (Doryctinae) were similar to all idiobionts, as well. December, 1999 and February, 2000 were the richer months in number of subfamilies (N= 19 and 18, respectivaly), corresponding to the same period when the subfamilies which potentially attack Lepidoptera where collected. The number of females was superior to the number of males and this relation was more accentuated in koinobionts. The peaks of both females and males were similar to dominate koinobiont and idiobionte taxa.

Isolamento e Caracterização Fenotípica e Molecular de Parasitos Leishmania sp. de Pacientes com Leishmaniose Tegumentar Americana (LTA) Atendidos no Hospital Universitário Lauro Wanderley da Universidade Federal da Paraíba

As leishmanioses são um complexo de doenças infecto-parasitárias endêmicas em 88 países que constituem um grave problema de saúde pública. Diversas esp��cies do gênero Leishmania são os agentes causadores da doença, dentre elas a esp��cie L. (V.) braziliensis associada a diferentes quadros clínicos da Leishmaniose Tegumentar Americana. No presente trabalho foram obtidos nove isolados de Leishmania sp. oriundos de LTA, sendo sete isolados (87%) oriundos de pacientes residentes no município de Pilões, um (13%) da cidade de João Pessoa, ambas regiões, do estado da Paraíba. Todos os nove isolados foram identificados como sendo da esp��cie L. (V.) braziliensis através de PCR específica. As análises de caracterização molecular pela técnica de RAPD-PCR mostraram que esses isolados compartilharam 62,63% revelando diferenças genotípicas entre elas. Contudo, os isolados AF e JSL, ambos provenientes de lesões disseminadas, tiveram o maior percentual de bandas compartilhadas dentre os isolados. Outra técnica molecular utilizada foi o SSR-PCR com o iniciador K7 que também foi capaz de demontrar polimorfismo entre os isolados. Nas análises de PCR-RLFP das regiões ITS1, foram encontradas perfis diferentes entre os isolados, onde MRSS, JMTS, AF, JCTS, JRL apresentaram o mesmo perfil de bandas e os isolados JSL, JCNS, MFTS e JAS tiveram, cada um, perfis de bandas distintos. Na análise de PCR-RLFP da região do gene hsp70, JSL, AF, JCTS, JRL, MFTS apresentaram o mesmo perfil de bandas e os isolados, MRSS, JMTS, JCNS e JAS perfis de bandas distintos. Adicionalmente foram também observadas diferenças fenotípicas entre estes isolados, visto que em dado momento de cultivo, todos apresentaram comportamento diferenciado, além de demonstrarem diferenças quanto à sensibilidade às drogas utilizadas na terapêutica das leishmanioses. Portanto estes estudos revelam que os isolados de L. (V.) braziliensis obtidos no estado da Paraíba demonstraram um significativo polimorfismo genético, revelando um alto nível de variação intraespecífica.

Description of Lutzomyia (Helcocyrtomyia) herreri sp. nov. (Diptera, Psychodidae, Phlebotominae) from the South Peruvian Andes

A new species of phlebotomine, Lutzomyia (Helcocyrtomyia) herreri sp. nov., belonging to the series osornoi, from the Department of Puno, Peru, is described. Identification keys for both sexes of the species of this series are presented.

Descrição de Hephialtes mourei sp. nov. e notas em Hephialtes Thomson e Braderochus mundus (White) (Coleoptera, Cerambycidae, Prioninae)

Hephialtes mourei sp. nov. é descrita do Brasil (Minas Gerais, Rio de Janeiro, São Paulo e Paraná). A chave para esp��cies de Braderochus e a ilustração do holótipo de B. mundus (White, 1853) fornecidas por Bleuzen (1994) são discutidas.

Lauromacromia bedei sp. nov. from the State of Minas Gerais, Brazil (Odonata, Corduliidae)

Lauromacromia bedei is described and illustrated from a single male specimen collected in a river at the "cerrado" region of the State of Minas Gerais, Brazil.

Fannia carvalhoi sp. nov.: a new species from Peru (Diptera, Fanniidae)

Fannia carvalhoi sp. nov. (Diptera, Fanniidae) from Peru is described and illustrated.