Efficacy of entecavir and tenofovir in chronic hepatitis B under treatment in the public health system in southern Brazil

There are about 350 million hepatitis B virus (HBV) carriers worldwide and chronic HBV is considered a major public health problem. The objective of the present study was to assess the effectiveness of the nucleos(t)ide analogues tenofovir (TDF) and entecavir (ETV) in the treatment of chronic HBV. A cross-sectional study was carried out from March-December 2013, including all patients with chronic HBV, over 18 years of age, undergoing therapy through the public health system in southern Brazil. Only the data relating to the first treatments performed with TDF or ETV were considered. Retreatment, co-infection, transplanted or immunosuppressed patients were excluded. Six hundred and forty patients were evaluated, of which 336 (52.5%) received TDF and 165 (25.8%) ETV. The other 139 (21.7%) used various combinations of nucleos(t)ide analogues and were excluded. The negativation of viral load was observed in 87.3% and 78.8% and the negativation of hepatitis B e antigen was achieved in 79% and 72% of those treated with ETV or TDF, respectively. Negativation of hepatitis B surface antigen was not observed. There was no occurrence of adverse effects. This is a real-life study demonstrating that long-term treatment with ETV and TDF is both safe and effective.

Papaya pulp gelling: is it premature ripening or problems of water accumulation in the apoplast?

Gelled aspect in papaya fruit is typically confused with premature ripening. This research reports the characterization of this physiological disorder in the pulp of papaya fruit by measuring electrolyte leakage, Pi content, lipid peroxidation, pulp firmness, mineral contents (Ca, Mg and K - in pulp and seed tissues), and histological analysis of pulp tissue. The results showed that the gelled aspect of the papaya fruit pulp is not associated with tissue premature ripening. Data indicate a reduction of the vacuole water intake as the principal cause of the loss of cellular turgor; while the waterlogged aspect of the tissue may be due to water accumulation in the apoplast.

Learning on human resources management in the radiology residency program

Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina – Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.

EVALUATION OF TECHNOLOGICAL INTENSITY OF EXPORTS IN THE FORESTRY SECTOR

ABSTRACT One of the fastest growing sectors in the domestic industry is the forestry, which has contributed significantly to economic development, job creation, income taxes, putting Brazil in a prominent position in the world market. This paper analyzes the evolution of the technological intensity of 12 main products exported by the sector, from 2000 to 2011. For that, utilizes an indicator called PRODY, which allows classifying different products according to their technological intensity or income content and considers the GDP per capita of exporting countries of each product, weighted by its revealed comparative advantage. It can be seen by the results, a continuous growth in all products' technology indicators and their decomposition into income effects, comparative advantage and joint effects, allowed to verify the main causes of this growth. Products with lower PRODY values are those that presented a higher evolution during the period studied. Products of higher processing, and those from pulp and paper industry, had greater technological advances, thanks to a joint effect, while the ones of lower processing, had a technological improvement due to the increase in GDP per capita in exporting countries. Sawn wood was the standout product, being the only one who proved to be dependent of comparative advantage effect, confirming that this industry has been reinventing itself and incorporating, in fact, more technology. This study revealed the importance of technological intensification to generate comparative advantage and be able to stand against international competition.

Mapping of use and occupation of the soil and irrigation water quality in the city of Salto do Lontra-Paraná, Brazil

The objective of this study consisted on mapping the use and soil occupation and evaluation of the quality of irrigation water used in Salto do Lontra, in the state of Paraná, Brazil. Images of the satellite SPOT-5 were used to perform the supervised classification of the Maximum Likelihood algorithm - MAXVER, and the water quality parameters analyzed were pH, EC, HCO3-, Cl-, PO4(3-), NO3-, turbidity, temperature and thermotolerant coliforms in two distinct rainfall periods. The water quality data were subjected to statistical analysis by the techniques of PCA and FA, to identify the most relevant variables in assessing the quality of irrigation water. The characterization of soil use and occupation by the classifier MAXVER allowed the identification of the following classes: crops, bare soil/stubble, forests and urban area. The PCA technique applied to irrigation water quality data explained 53.27% of the variation in water quality among the sampled points. Nitrate, thermotolerant coliforms, temperature, electrical conductivity and bicarbonate were the parameters that best explained the spatial variation of water quality.

Drought resistance of sugar-cane crop for different levels of water availability in the soil

Soil water availability is the main cause of reduced productivity, and the early development period most sensitive to water deficit. This study aimed to evaluate the drought resistance of the varieties of sugar-cane RB867515 and SP81-3250 during the early development using different levels of water deficit on four soil depths. The experiment was conducted at the Department of Biosystems at Escola Superior de Agricultura "Luiz de Queiroz" (ESALQ/USP) in a greenhouse in soil classified as Oxisol, sandy loam texture (Series "Sertãozinho"). Once exhausted the level of available water in the soil, the dry strength of the studied strains are relatively low. Water balance with values less than -13 mm cause a significant decrease in the final population of plants, regardless of the variety, and values below -35 mm, leads to the death of all plants.

Increasing the percentage of vaginal birth in the private sector in Brazil through the redesign of care model

OBJETIVO: Implantar um novo modelo de cuidado ao parto e reduzir o percentual de cesarianas entre as gestantes da UNIMED Jaboticabal.MÉTODOS: Estudo descritivo desenvolvido em uma instituição do interior paulista, que teve início em 2012 e propôs o redesenho do modelo de cuidado ao parto com a revisão de todo o processo assistencial por meio da Ciência da Melhoria Contínua. Para medir os resultados das mudanças, foram selecionados nove indicadores e suas respectivas metas.RESULTADOS: O indicador de partos vaginais atingiu a meta de 40%, após sete meses do início da intervenção. Este indicador entre as gestantes do SUS atingiu 66%. A taxa de mortalidade perinatal decresceu 25% comparando-se 2012 a 2014 e a taxa de prematuridade foi de 3/100 nascidos vivos em 2014. O percentual de gestantes da UNIMED com 6 ou mais consultas de pré-natal atingiu 95%. Em relação aos custos hospitalares per capita referentes à assistência ao parto, notou-se um decréscimo de 27%, quando comparados os anos de 2012 e 2013. Tal queda não se sustentou e o custo hospitalar per capita, em 2014, retornou aos mesmos patamares de 2012. A remuneração dos obstetras registrou um acréscimo de 72%, se comparados os anos de 2012, 2013 e 2014. Houve queda de 61% dos custos com a unidade de terapia intensiva (UTI) neonatal, comparando os anos de 2012 e 2013. A taxa de admissão em UTI neonatal acompanhou a redução dos custos e foi de 55%, se comparados os anos de 2012 a 2014, entre as gestantes da UNIMED. Não houve o alcance da meta de 80% de participação das gestantes nos cursos de preparação para o nascimento. A porcentagem de gestantes satisfeitas e muito satisfeitas com a assistência ao parto atingiu 86%.CONCLUSÃO: Este projeto atingiu seus objetivos, reduzindo o percentual de cesarianas entre as gestantes da UNIMED Jaboticabal, e constituiu-se em um exemplo concreto da realização do triplo objetivo em saúde: melhorar a experiência dos envolvidos e os resultados de saúde de populações e indivíduos e realizar estas duas tarefas com menor custo, eliminando desperdícios assistenciais.

Quality Indicators of Cervical Cytopathology Tests in the Public Service in Minas Gerais, Brazil

Objective The objective of this study is to assess the performance of cytopathology laboratories providing services to the Brazilian Unified Health System (Sistema Único de Saúde - SUS) in the State of Minas Gerais, Brazil. Methods This descriptive study uses data obtained from the Cervical Cancer Information System from January to December 2012. Three quality indicators were analyzed to assess the quality of cervical cytopathology tests: positivity index, percentage of atypical squamous cells (ASCs) in abnormal tests, and percentage of tests compatiblewith high-grade squamous intraepithelial lesions (HSILs). Laboratories were classified according to their production scale in tests per year≤5,000; from 5,001 to 10,000; from 10,001 to 15,000; and 15,001. Based on the collection of variables and the classification of laboratories according to production scale, we created and analyzed a database using Microsoft Office Excel 97-2003. Results In the Brazilian state of Minas Gerais, 146 laboratories provided services to the SUS in 2012 by performing a total of 1,277,018 cervical cytopathology tests. Half of these laboratories had production scales≤5,000 tests/year and accounted for 13.1% of all tests performed in the entire state; in turn, 13.7% of these laboratories presented production scales of > 15,001 tests/year and accounted for 49.2% of the total of tests performed in the entire state. The positivity indexes of most laboratories providing services to the SUS in 2012, regardless of production scale, were below or well below recommended limits. Of the 20 laboratories that performed more than 15,001 tests per year, only three presented percentages of tests compatible with HSILs above the lower limit recommended by the Brazilian Ministry of Health. Conclusion The majority of laboratories providing services to the SUS in Minas Gerais presented quality indicators outside the range recommended by the Brazilian Ministry of Health.