Influenza among the elderly in the Americas: A consensus statement

Influenza exacts a heavy burden on the elderly, a segment of the population that is estimated to experience rapid growth in the near future. In the past decade most developed and several developing countries have recommended influenza vaccination for those > 65 years of age. The World Health Organization (WHO) set a goal of 75% influenza vaccination coverage among the elderly by 2010, but it was not achieved. In 2011, the Technical Advisory Group at the Pan American Health Organization, Regional Office of WHO for the Americas, reiterated the influenza vaccine recommendation for older adults. Relatively little information has been compiled on the immunological aspect of aging or on reducing its impact, information particularly relevant for clinicians and gerontologist with firsthand experience confronting its effects. To fill this data gap, in 2012 the Americas Health Foundation (Washington, D.C., United States) and the nonprofit, Fighting Infectious Diseases in Emerging Countries (Miami, Florida, United States), convened a panel of Latin American clinicians and gerontologists with expertise in influenza to discuss key issues and develop a consensus statement. The major recommendations were to improve influenza surveillance throughout Latin America so that its impact can be quantified; and to conduct laboratory confirmation of influenza for all patients who have flu-like symptoms and are frail, immunosuppressed, have comorbidities, are respiratory compromised, or have been admitted to a hospital. The panel also noted that: since evidence for antivirals in the elderly is unclear, their use should be handled on a case-by-case basis; despite decreased immunological response, influenza vaccination in older adults is still crucial; indirect immunization strategies should be encouraged; and traditional infection control measures are essential in long-term care facilities.

Mannanoligosaccharide (mos) and β-glucan (β-glu) in dietary supplementation for Nile tilapia juveniles dept in cages

This experiment was conducted at an aquicolous enterprise with the objective of evaluating the use of MOS and β-GLU as dietary supplements in an experimental lot in order to follow the zootechnical performance, establishing a relationship with the hematological parameters, the morphological alterations of the intestine, and the enzymatic activity (protease, lipase and amylase), and the water quality of 3,000 tilapia juveniles kept in cages (Wt = 24 ± 0.26g). Nine cages (6.0 m3) were used, with three treatments and three replications. 1: commercial feed without supplementation (control); 2: 0.1% per ton of MOS; 3: 0.03% per ton of purified β-GLU. The feed contained 36% of crude protein (CP) incorporated into the premix MOS and purified β-GLU (BIORIGIN®). The tilapia that had received the diet supplemented with β-GLU in a period of 90 days showed a favorable condition of the immune system, increase in the absorption surface of the front part of the intestine and consequently, growth in the activity of the digestive enzymes, denoting higher efficiency in the use of the nutrients in juveniles, providing satisfactory zootechnical performance in comparison with the other diets. This product may be used as a dietary supplement for this species when kept in cages.

Caracterização antigênica e genotípica de isolados do vírus rábico, de quirópteros da cidade de Botucatu-SP e região

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prevalência da língua azul em ovinos da região de Araçatuba – São Paulo, Brasil

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

Implantação de um serviço de farmacovigilância hospitalar e comparação dos algoritmos para análise de reação adversa a medicamento

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Acolhimento na estratégia saúde da família:revisão integrativa

Objective. To review the literature regarding the application of the notion of user embracement and to identify the contributions of this concept for primary health care practices in Brazil.Method. We carried out an integrative review of the literature regarding primary health care. The following databases were searched: LILACS, SciELO, and MEDLINE, covering the period from 2006 to 2010. The following search terms were used in LILACS and SciELO: acolhimento and programa saude da familia and saude. For MEDLINE, the terms user embracement and family health program and health were used. The review was performed in November 2010.Results. We identified 21 articles meeting the inclusion criteria, all of which described studies carried out in Brazil. The articles were divided into three empirical categories: integration and embracement; primary care work process; and evaluation of services. These are complementary categories that converge to two main views of embracement: the first sees embracement as a means of reorganizing the primary health care environment, and the second sees embracement as an attitude towards users. The review also shows that embracement may be a management tool that supports the Unified Health System and is associated with the principles of comprehensiveness and universality.Conclusions. Embracement is able to create a bond between health care workers and users. It promotes self-care, a better understanding of disease, as well as user co-responsibility for treatment. In addition, it facilitates universal access, strengthens multiprofessional and intersectoral work, qualifies care, humanizes practices, and encourages actions to combat prejudice. Nevertheless, the perspective of health care users regarding embracement deserves more attention and should be the focus of future studies.

Gerenciamento dos resíduos de serviços de saúde da Unidade de Terapia Intensiva do Pronto Socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP

Health care waste (HCW) is the type of waste that results from activities performed in health care services during care provision to humans or animals. Presently, according to RDC 306/04, issued in 2004 by Anvisa, and Resolution no. 358/05, by CONAMA, waste groups have the following classification: Group A (biological waste), Group B (chemical waste), Group C (waste containing radionucleotides), Group D (common waste) and Group E (piercing and cutting waste). In Brazil, 149 tons of wastes are collected every day, and HCW corresponds to approximately 1% to 3 % of that total. An efficient way to adequately manage HCW is through the Health Care Waste Management Plan (HCWMP), and it is possible to reduce the risk posed by certain materials in addition to ensuring disposal in an ecologically correct and economical fashion. According to the Pan-American Health Organization (PAHO), the management process enables health care establishments to adequately manage waste. Hence, there is greater control and reduction in the health risks caused by infectious or special waste, in addition to facilitated recycling, treatment, storage, transport and final disposal of solid hospital waste in an environmentally safe fashion. To evaluate the management of HCW of Groups A and D from the Intensive Care Unit of the University Emergency Hospital - FMB - UNESP in the city of Botucatu according to the guidelines presently in force. The waste flow was followed up, and during four random days in the month of September 2011, waste was quantified by estimating daily and monthly values, according to its classification. : In 2011, the University hospital has produced an average of 57,676.8 kg/month of biological and common waste. By adding Groups A and D, during the four days, approximately 209.8 Kg of waste (202.2 Kg of Group A and 7.6 Kg of Group D) were produced in the establishment under study, which... (Complete abstract click electronic access below)

Efeito de soluções fluoretadas contendo xilitol e sorbitol no número de estreptococos do grupo mutans na saliva de seres humanos

The objective of this study was to assess the effect of 0.05% sodium fluoride solutions containing 2.5% or 12.5% xylitol on the number of Streptococcus mutans in the human mouth. Fifty boys between 8 and 16 years of age participated in this double-blind crossover study. Of the original 50 boys, 33 finished the study. Participants were randomly divided into four groups. The following solutions were employed: placebo solution; 0.05% sodium fluoride solution; 0.05% sodium fluoride + 2.5% xylitol + 2% sorbitol; 0.05% sodium fluoride + 12.5% xylitol + 2% sorbitol. Each solution was used for a 28-day period (20 mL/day, twice a day), with a 10-day washout period between solutions. There were no significant differences (P = 0.32) between the two xylitol-containing solutions (2.5% vs. 12.5%) concerning the number of Streptococcus mutans. However, there was a significant difference between these two xylitol-containing solutions and the sodium fluoride and placebo solutions (P < 0.001). Our results suggest that the 0.05% sodium fluoride solutions containing either 2.5% or 12.5% xylitol caused a significant reduction in the number of Streptococcus mutans.

Análise dos riscos físicos e ergonômicos em roçadora transversal motorizada

According to Statistical Yearbook of Social Security (2011), the number of accidents at work recorded in the agricultural sector is quite high, in the year 2010 there are records of thirty-four thousand nine hundred and ninetysix accidents, and in the year of 2011 there were thirty-one thousand and ninety-six accidents in the industry. Among so many diseases and accidents at work hearing loss is one of them. According to the Pan American Health Organization (2011) the Occupational hearing loss is then jury to the worker's health, often in the workplace. Mechanical vibrations are also present in many human activities exposing employees to an extremely aggressive agent. The combined action of these two factors can cause damage to the health of the worker, in this way, noise and vibration are the two major occupational agents present in the brush cutter operator activity. In the case there is another risk factor, the open work, which exposes the employee to the Sun’s rays and the high temperature indices. Studies have shown that: noise exceeds 115 dB (A) vibration 4.0 m/s2 and thermal stress of 29.9 o C. Ergonomic evaluations also demonstrated that the activity cause injury to workers.

A sífilis na gestação e sua influência na morbimortalidade materno-infantil

Syphilis in pregnancy is a public health problem, responsible for the high intrauterine mortality rates. This article aims to present a review of historical and epidemiological aspects, clinical manifestations, diagnosis, the treatment of maternal and congenital syphilis, and its perinatal repercussions. The manuscript also describes the Brazilian main policies in public health care for pregnant women with syphilis and for congenital syphilis eradication. The set of words used were “congenital syphilis”, “syphilis in pregnancy” and “syphilis prenatal care”. The databases searched were PubMed (National Library of Medicine - USA), SciELO (Scientific Electronic Library Online), LILACS (Latin American and Caribbean Health Sciences), PAHO (Pan American Health Organization), IBECS, and WHOLIS Cochrane Library, from 1980 to 2011. Fifty-six articles were included in this review, 18 institutional technical manuals, two textbooks and 36 articles relating to maternal and congenital syphilis. The present review showed that there is a gap between intention and action needed to control and eradicate the disease especially with regard to the expansion of access, not only in relation to the number of visits recommended male gender, it is important to assess the quality of their content as well as the actions to be carried out between appointments.

A construção do pan-americanismo na revista Em Guarda: o olhar americano pela defesa das Américas (1941-1946)

Pós-graduação em História - FCLAS

Effect of irrigation level on yield and bioactive amine content of American lettuce

The influence of four levels (25, 50, 75 and 100%) of Class A pan evaporation replenishment (PER) on the marketable yield and bioactive amine content of American lettuce (Lactuca sativa cv Lucy Brown) grown under greenhouse conditions and drip irrigation was investigated. Lettuce was planted in 1.20 m x 2.10 m plots in a completely randomised block design with three replications. Lowest fresh head weights and diameters were obtained at 25% PER. Highest marketable yields and fresh head weights were obtained at 100% PER; however, no significant difference was observed when using 75% PER. The fresh head diameter was smaller only when using 25% PER. Four amines were detected in lettuce grown under 100% PER, with a total content of 7.60 mg kg(-1). Spermidine was the prevalent amine, followed by putrescine, cadaverine and agmatine. Higher spermidine and cadaverine levels were observed in the outer layers of leaves than in the intermediate and inner leaves. The contents of every amine except agmatine increased with water stress; however, a significant difference was observed only between 100 and 25% PER. The concentrations of accumulated putrescine were not capable of negatively affecting the sensory quality of the lettuce. (c) 2005 Society of Chemical Industry.

HLA-DR in Brazilian patients with polyarteritis nodosa (PAN) and microscopic polyangiitis (MPA)

The aim of this study was to evaluate the frequency and clinical associations of HLA-DR alleles in Brazilian Caucasian patients with polyarteritis nodosa (PAN) or microscopic polyangiitis (MPA). We evaluated 29 Caucasian patients with vasculitis classified as PAN or MPA according to the American College of Rheumatology (ACR) 1990 Criteria, Chapel Hill Consensus Conference (CHCC) nomenclature for vasculitis and EULAR recommendations for conducting clinical studies in systemic vasculitis. HLA-DR alleles were typed using polymerase chain reaction-amplified DNA, hybridized with sequence-specific low resolution primers. DNA obtained from 59 Caucasian healthy blood donors were used as control. In order to evaluate if a specific HLA may have influence on the clinical profile of those diseases, we also divided the patients according to Birmingham vasculitis score (BVAS) and Five-Factors Score (FFS) at the time of diagnosis. Increased frequency of HLA-DRB1*16 (p = 0.023) and DRB4*01 (p = 0.048) was found in patients with higher disease activity at the time of diagnosis (BVAS >= 22). Patients with less severe disease (FFS = 0) had a higher frequency of HLA-DRB1*03 (p = 0.011). Patients with gastrointestinal tract involvement had significantly increased frequency of HLA-DRB1*11 or B1*12 (p = 0.046), B1*13 (p = 0.021) and B3 (p = 0.008). In contrast, patients with renal disease, had higher frequency of DRB1*15 or DRB1*16 (p = 0.035) and B5 (p = 0.035). In the subgroup of patients with MPA, increased frequency of HLA-DRB1*15 was found in patients with BVAS >= 22 (p = 0.038) and FFS >= 1 (p = 0.039) suggesting that this allele is associated with more aggressive disease. Antineutrophil cytoplasmic antibodies (ANCA) negative MPA patients had significantly increased frequency of HLA-DRB1*11 or DRB1*12 when compared to ANCA positive patients (p = 0.023). Our results suggest that HLA-DR alleles may influence PAN and MPA clinical expression and outcome and that in MPA they participate in the mechanisms involved in the development to ANCA.