Avaliação da estrutura organizacional da assistência ambulatorial em HIV/Aids no Brasil

OBJETIVO: No contexto de acesso universal à terapia antiretroviral, os resultados do Programa de Aids dependem da qualidade do cuidado prestado. O objetivo do estudo foi avaliar a qualidade do cuidado dos serviços ambulatoriais que assistem pacientes de Aids. MÉTODOS: Estudo realizado em sete Estados brasileiros, em 2001 e 2002. Foi avaliada a qualidade do atendimento a pacientes com Aids quanto à disponibilidade de recursos e a organização do trabalho de assistência. Um questionário com 112 questões estruturadas abordando esses aspectos, foi enviado a 336 serviços. RESULTADOS: A taxa de resposta foi de 95,8% (322). Os indicadores de disponibilidade de recursos mostram uma adequação maior do que os indicadores de organização do trabalho. Não faltam antiretrovirais em 95,5% dos serviços, os exames de CD4 e Carga Viral estão disponíveis em quantidade adequada em 59 e 41% dos serviços, respectivamente. em 90,4% dos serviços há pelo menos um profissional não médico (psicólogo, enfermeiro ou assistente social). Quanto à organização, 80% não agendavam consulta médica com hora marcada; 40,4% agendavam mais que 10 consultas médicas por período; 17% não possuíam gerentes exclusivos na assistência e 68,6% não realizavam reuniões sistemáticas de trabalho com a equipe. CONCLUSÕES: Os resultados apontam que além de garantir a distribuição mais homogênea de recursos, o programa precisa investir no treinamento e disseminação do manejo do cuidado, conforme evidenciado nos resultados da organização de trabalho.

PREVENCAO DE TROMBOFLEBITES PELO USO DE HEPARINA EM PACIENTES TRATADOS COM ANFOTERICINA B

The authors studied the incidence of thrombophlebitis in 41 patients treated intravenously with amphotericin B. The patients were divided in two different group: Group 1: patients treated with amphotericin B and hydrocortisone with heparin (1000 UI); Group 2: patients treated with amphotericin B and hydrocortisone. The results showed 23.81% of incidence of thrombophlebitis in Group 1 and 90% in Group 2. Thrombophlebitis in Group 1 ranged from mild to moderate without any change during the drug therapy. In Group 2, the incidence was 66.67% and the thrombophlebitis were severe being necessary the withdrawn of the drugs in 35.0% of the cases. We concluded that heparin, in low doses, in association with amphotericin B, was an efficient drug preventing or reducing the development of thrombophlebitis.

Situação vacinal infantil e características individuais e familiares do interior de São Paulo

The aim of this study was to describe and analyze individual and family characteristics of children and those of health services, as well as their relationship with the immunization status for different kinds of vaccines and doses. Three sources of information were used: records from the Municipal Health Information System, immunization charts, and interviews using closed-ended questions. The families interviewed still had one or two growing children; caretakers were usually young unemployed mothers with easy access to health services. Around 30% of them were not instructed on the vaccine being given, its reactions or when to return for the next shot. The greatest levels of tardiness occurred with the vaccines against measles (6.3%) and Haemophilus influenzae B (4.2%). It was possible to observe that tardiness or absence of vaccinations seem to have a stronger relationship with service characteristics than with population characteristics.

Efficacy of topical permethrin as repellent against aedes aegypti's bites

Mosquitoes are the most important vectors of infectious diseases and their bites are related to several adverse skin reactions. Permethrin impregnated clothes are an efficient strategy against arthropods' bites; however, its topical efficacy as a repellent has not been well established. We studied the response to permethrin lotion 5 percent and N,N-Diethyl-meta-toluamide (DEET) spray 50 percent applied to the unprotected forearms of 10 volunteers. Each arm was exposed to 20 female mosquitoes of Aedes aegypti. We performed 71 bilateral comparative measurements evaluating the timing for the first bites. The average times for the arm without the product, with permethrin 5 percent, and with DEET 50 percent were: 7.9 seconds, 336.2 seconds and 7512.1 seconds. The results showed a significant difference between repellency times between either product and unprotected controls. In addition, there was a significant difference in time to first bite between permethrin and DEET treated arms (p<0.01). Permethrin affords some repellent activity against Aedes aegypti bites in this experimental setting. However, permethrin's profile of repellency was significantly inferior to that of DEET. © 2008 Dermatology Online Journal.

Desenvolvimento e caracterização de dispersão sólida com propriedade mucoadesiva para liberação de zidovudina

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Sistemas anfifílicos derivados de megiumina: uma nova abaordagtem no desenvolvimento de biomateriais supramoleculares

Pós-graduação em Química - IQ

Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report

Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.

Rubella Vaccination of Unknowingly Pregnant Women: The Sao Paulo Experience, 2001

Background. Rubella vaccination is contraindicated during pregnancy. During mass immunization of women of childbearing age against rubella, women unknowingly pregnant may be vaccinated. To evaluate the effects of rubella vaccination during pregnancy, the Brazilian state of Sao Paulo conducted a follow-up study of pregnant women vaccinated during a rubella campaign in 2001.Methods. Women vaccinated during pregnancy were reported to a national surveillance system. In the state of Sao Paulo, follow-up of vaccinated women included household interviews. Serum samples from vaccinated women were tested for antirubella antibodies to classify susceptibility to rubella infection. Children born to susceptible mothers were tested for evidence of congenital rubella infection and evaluated for signs of congenital rubella syndrome.Results. The Sao Paulo State Health Department received 6473 notifications of women vaccinated during pregnancy. Serology performed for 5580 women identified 811 (15%) that were previously susceptible. Incidence of spontaneous abortion or stillbirth among previously susceptible vaccinated women was similar to women with prior immunity. Twenty-seven (4.7%) of 580 newborns tested had evidence of congenital rubella infection; none had congenital rubella syndrome.Conclusions. Mass rubella vaccination of women of childbearing age was not associated with adverse birth outcomes or congenital rubella syndrome among children born to women vaccinated during pregnancy.

Propriedade antioxidante de compostos fenólicos: importância na dieta e na conservação de alimentos

Living organisms are constantly subjected to the action of free radicals, which are one of the causes of oxidation reactions, because they have on free electron, what makes it very reactive. They are products of organism reactions or they are produced by exogenous factors, such as tobacco. Fatty acids are the most vulnerable target, and may suffer lipid peroxidation, what affects the cell structure. Cardiovascular diseases, cancer and diseases of aging are occurrence of these reactions in the organism related. The aliments are also subjected to suffer oxidation reactions, what make them unfit for consumption and decreasing the useful life. Synthetics antioxidants are used as aliments preservatives, but they present some toxicity for the organism. Studies for the utilization of natural antioxidants have gained more importance in recent decades, due to the conservation potential and low toxicity. Phenolics compounds are largely present at the vegetable kingdom and they present high antioxidant potential due to the neutralization and kidnapping of free radicals capacity. These compounds are used by the industry at the aliments conservation, specially the phenolics acids. The consumption of aliments rich in phenolic compounds, such as teas, wines and fruits are low incidence of degenerative diseases related. This study consists in a bibliographic revision that covers these compounds importance in diet and at the food conservation, and the methodologies and difficulties in the extraction process due to variety of molecules of this group.