HBV strains harbouring resistance mutations can comprise the major population of HBV quasispecies in treatment-naive patients. In Brazil, there is a very low frequency of untreated patients who are infected with these strains. These findings suggest that the spread and natural selection of drug-resistant HBV is an uncommon event and/or most of these strains remain unstable in the absence of NA selective pressure.

Hepatitis Delta virus (HDV) is endemic worldwide, but its prevalence varies in different geographical areas. While in the Brazilian Amazon, HDV is known to be endemic and to represent a significant public health problem, few studies have assessed its prevalence in other regions in the country. This study evaluated the seroprevalence of HDV among HBsAg chronic carriers from Maranhão state, a region located in the Northeast of Brazil. Among 133 patients, 5 had anti-HD, of whom 3 had HDV RNA. HDV genotypes were characterized by Bayesian phylogenetic analysis of nucleotide sequences from the HDAg coding region. HDV-3 was identified in one patient who lives in Maranhão, but was born in Amazonas state (Western Amazon basin). Phylogenetic analysis shows that this HDV-3 sequence grouped with other HDV-3 sequences isolated in this state, which suggests that the patient probably contracted HDV infection there. Surprisingly, the other two patients were infected with HDV-8, an African genotype. These patients were born and have always lived in Urbano Santos, a rural county of Maranhão state, moreover they had never been to Africa and denied any contact with people from that continent. This is the first description of the HDV-8 in non-native African populations. This genotype may have been introduced to Brazil through the slaves brought to the country from the West Africa regions during the 16-18th centuries. Our results indicate that the need of clinical and epidemiological studies to investigate the presence of this infection in other areas in Brazil.

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Nosso objetivo neste trabalho foi conhecer a atuação da enfermeira de centro obstétrico na assistência à mulher no processo de parturição. É um estudo de campo do tipo descritivo, realizado em quatro maternidades públicas de São Luís MA, de abril a julho de 2002, após consentimento dos sujeitos, respeitando os aspectos éticos. Participaram do estudo, 21 enfermeiras de Centro Obstétrico. O agrupamento das falas feito pela técnica de Análise de Conteúdo, possibilitou a organização da categoria "atuação da enfermeira na assistência à mulher no processo de parturição" com as sub-categorias: assistência temporal na trajetória do nascimento e maneira de cuidar na trajetória natural do nascimento. Ao término do estudo, evidenciamos que a enfermeira de centro obstétrico atua junto a mulher com ações diretas e passivas (observando, protegendo); indiretas (administrando) e com participação mais efetiva, tomando decisões e influenciando a ação e o comportamento desta (oferecendo cuidado solidário e obstétrico).

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