Estimativa do custo da asma em tratamento ambulatorial especializado em unidade universitária no Sistema Único de Saúde

A asma é considerada um problema de saúde pública mundial. É necessário expandir o conhecimento sobre seus custos associados em diferentes regiões. O principal objetivo foi estimar os custos do tratamento da asma em uma população de asmáticos com diferentes níveis de gravidade, sob tratamento ambulatorial especializado. Os objetivos secundários foram analisar as características clínicas e sócio-econômicas da população e o custo incremental da associação com a rinite e infecções respiratórias (IR). Asmáticos ≥ 6 anos de idade com asma persistente foram incluídos consecutivamente de março de 2011 a setembro de 2012. Todos realizaram visitas clínicas de rotina com intervalos de 3-4 meses e 2 entrevistas com intervalos de 6 meses para coleta dados. Variáveis clínicas e dados primários sobre os custos da asma, rinite e infecções respiratórias (IR) foram coletados diretamente dos pacientes ou responsáveis (< 18 anos), sob uma perspectiva da sociedade. Os custos em reais foram convertidos em dólares usando a paridade do poder de compra em 2012 (US$ 1,00 = R$ 1,71). Cento e oito pacientes completaram o estudo, sendo 73,8% mulheres. A maioria (75,0%) reside no município do RJ, sendo que 60,1% destes moram longe da unidade de saúde. Rinite crônica estava presente em 83,3%, e mais da metade tinha sobrepeso ou obesidade, nos quais a prevalência de asma grave foi maior (p = 0,001). Metade ou mais dos trabalhadores e estudantes faltaram as suas atividades em decorrência da asma. A renda familiar mensal (RFM) média foi de US$ 915,90 (DP=879,12). O custo médio estimado da asma/rinite/IR foi de US$ 1.276,72 por paciente-ano (DP=764,14) e o custo médio específico da asma foi de US$ 1.140,94 (DP=760,87). Asmáticos obesos, graves ou não controlados tiveram maiores custos em comparação aos não obesos, moderados/leves e controlados (p <0,05 em todas as comparações). A população estudada tem nível sócio-econômico médio/baixo, alta prevalência de rinite crônica e de sobrepeso/obesidade. Maior peso e menor RFM foram mais frequentes entre os graves e não controlados, respectivamente. Asmáticos obesos, graves ou não controlados tiveram maiores custos. O custo incremental da rinite e IR foi de 12%. O custo médio da asma foi equivalente à metade do relatado na União Européia e nos Estados Unidos da América, e foi maior do que a média na região Ásia-Pacífico. Num cenário ideal, onde todos os asmáticos brasileiros recebessem tratamento no Sistema Único de Saúde de acordo com a Iniciativa Global para Asma, o custo total da asma seria equivalente a 3,4-4,5% e 0,4-0,6% do Produto Interno Bruto (PIB) da saúde e do PIB brasileiro, respectivamente. Estratégias de saúde pública com programas estruturados que facilitem o melhor controle da asma e estimulem a redução de peso poderão contribuir para reduzir os custos da doença, o que poderia tornar a oferta de tratamento medicamentoso gratuito para todos os asmáticos persistentes no SUS uma meta alcançável. Recomendamos estender este estudo de custo da asma para diferentes regiões do país.

Breeding populations of seabirds in California, 1989-1991. Volume I - population estimates

In 1989-1991, the U.S. Fish and Wildlife Service surveyed breeding populations of seabirds on the entire California coast. This study was sponsored by the Minerals Management Service in relation to outer continental shelf oil and gas leasing. At 483 nesting sites (excluding terns and skimmers in southern California), we estimated 643,307 breeding birds of 21 seabird species including: 410 Fork-tailed Storm-petrel (Oceanodroma furcata); 12,551 Leach's Storm-petrel (O. leucorhoa); 7,209 Ashy Storm-petrel (O. homochroa); 274 Black Storm-petrel (O. melania); 11,916 Brown Pelican (Pelecanus occidentalis); 10,037 Double-crested Cormorant (Phalacrocorax auritus); 83,394 Brandt's Cormorant (P. penicillatus); 14,345 Pelagic Cormorant (P. pelagicus); 888 Black Oystercatcher (Haemotopus bachmani); 4,764 California Gull (Larus californicus); 61,760 Western Gull (L. occidentalis); 2,838 Caspian Tern (Sterna caspia) (excluding southern California); 3,550 Forster's Tern (S. forsteri) (excluding southern California); 272 Least Tern (S. albifrons) (excluding southern California); 351,336 Common Murre (Uria aalge); 15,470 Pigeon Guillemot (Cepphus columba); 1,821 Marbled Murrelet (Brachyramphus marmoratus); 1,760 Xantus' Murrelet (Endomychura hypoleuca); 56,562 Cassin's Auklet (Ptychoramphus aleuticus); 1,769 Rhinoceros Auklet (Cerorhinca monocerata); and 276 Tufted Puffin (Fratercula cirrhata). The inland, historical or hybrid breeding status of American White Pelican (P. erythrorynchus), American Oystercatcher (H. palliatus), Heermann's Gull (L. heermanni), Ring-billed Gull (L. delawarensis), Glaucous-winged Gull (L. glaucescens) and Black Tern (Chlidonias niger) are discussed. Estimates for Gull-billed Tern (S. nilotica), Royal Tern (S. maxima), Elegant Tern (S. elegans) and Black Skimmer (Rhynchops niger) will be included in the final draft of this report. Overall numbers were slightly lower than reported in 1975-1980 surveys (summarized in Sowls et al. 1980. Catalog of California seabird colonies. U.S. Dept. Int., Fish Wildl. Serv., Biol. Serv. Prog., FWS/OBS 37/80). Recent declines were found or suspected for Fork-tailed Storm-petrel, Leach's Storm-petrel, White Pelican, Black Tern, Caspian Tern, Least Tern, Common Murre and Marbled Murrelet. Recent increases were found or suspected for Brown Pelican, Double-crested cormorant, California Gull, Western Gull, Forster's Tern and Rhinoceros Auklet. Similar numbers were found for other species or trends could not be determined without additional surveys, studies and/or more in-depth comparisons with previous surveys. The status of terns and skimmers in southern California has not yet been finalized.

High-current adaptive impedance matching in narrowband power-line communication systems

This paper proposes a high current impedance matching method for narrowband power-line communication (NPLC) systems. The impedance of the power-line channel is time and location variant; therefore, coupling circuitry and the channel are not usually matched. This not only results in poor signal integrity at the receiving end, but also leads to a higher transmission power requirement to secure the communication process. To offset this negative effect, a high-current adaptive impedance circuit to enable impedance matching in power-line networks is reported. The approach taken is to match the channel impedance of N-PLC systems is based on the General Impedance Converter (GIC). In order to achieve high current a special coupler in which the inductive impedance can be altered by adjusting a microcontroller controlled digital resistor is demonstrated. It is shown that the coupler works well with heavy load current in power line networks. It works in both low and high transmitting current modes, a current as high as 760 mA has been obtained. Besides, compared with other adaptive impedance couplers, the advantages include higher matching resolution and a simple control interface. Experimental results are presented to demonstrate the operation of the coupler. © 2011 IEEE.

一种采用海藻糖季铵盐的吸湿保湿剂及其制备方法

本发明涉及日化领域及医药行业，具体是一种采用海藻糖季铵盐的吸湿保湿剂及其制备方法。采用海藻糖季铵盐的吸湿保湿剂，以海藻糖季铵盐作为吸湿保湿剂。制备方法：所述海藻糖季铵盐由按摩尔质量比为1：4-6的经碱性异丙醇溶液处理的海藻糖与醚化剂在40℃-60℃条件下反应3-9 h,而后抽滤、烘干即得；所述醚化剂为3-氯-2-羟丙基三甲基氯化铵。本发明通过有效的合成手段得到的海藻糖季铵盐，生产成本提高甚微，吸湿保湿性能提高明显。作为一种高效的吸湿保湿因子，本发明得到的海藻糖季铵盐有望成为透明质酸的替代品用于化妆品中。

Flavobacterium anhuiense sp nov., isolated from field soil

A novel strain, D3(T), isolated from a field-soil sample obtained from Anhui Province, PR China, was characterized taxonomically by using a polyphasic approach. The cells were Gram-negative, yellow-pigmented rods devoid of flagella, but showing gliding motility. The organism was able to grow at 5-37 degrees C and at pH 4.0-10.0. A comparative 16S rRNA gene sequence analysis indicated that strain D3(T) is a member of the genus Flavobacterium, sharing highest sequence similarity with the type strain of Flavobacterium defluvii (96.7 %). The major isoprenoid quinone was MK-6 and the predominant fatty acids were iso-C-15:0, summed feature 3 (C-16:1 omega 7c and/or iso-C-15:0 2-OH) and C-16:0. The DNA G + C content was 31.4 mol%. On the basis of phylogenetic and phenotypic data, strain D3(T) represents a novel species within the genus Flavobacterium, for which the name Flavobacterium anhuiense sp. nov. is proposed. The type strain is D3(T) (=KCTC 22128(T)= CGIVICC 1.6859(T)).

Degradation of tropical forest in Hainan, China, 1991-2008: Conservation implications for Hainan Gibbon (Nomascus hainanus)

The Hainan gibbon (Nomascus hainanus) is one of the most endangered primates in the world, confined to mature natural forest in Hainan Island, China. We assessed changes in habitat condition on the island between 1991 and 2008, using vegetation maps generated by remote-sensing images. We defined forest suitable for gibbons based on composition, tree size and canopy cover. During the 17-year period, the area of suitable gibbon forest decreased by 540 km(2) (35%) across the whole island, and by 6.3 km(2) (7%) in the locality of the sole remaining gibbon population at Bawangling National Nature Reserve. The forest patches large enough (>1 km(2)) to support a gibbon group decreased from 754 km(2) to 316 km(2) in total area, and from 92 to 64 in number. Suitable natural forest was mainly replaced by plantations below 760 m, or degraded by logging, grazing and planting of pines above 760 m. Meanwhile, forests in former confirmed gibbon areas became more fragmented: mean area of patches decreased by 53%. We mapped the patches of natural forest in good condition which could potentially support gibbons. We recommend a freeze on further expansion of plantations between core patches at Bawangling, Jiaxi-Houmiling and Yinggeling Nature Reserves in accordance with forest protection regulations; establishment of nature reserves in currently unprotected natural forest patches elsewhere in line with the local government's nature reserve expansion policy; and active natural-forest restoration between remaining fragments at Bawangling. (C) 2010 Elsevier Ltd. All rights reserved.

Mitochondrial DNA Haplogroups M7b1 ' 2 and M8a Affect Clinical Expression of Leber Hereditary Optic Neuropathy in Chinese Families with the m.11778G -> A Mutation

Leber hereditary optic neuropathy (LHON) is the most extensively studied mitochondrial disease, with the majority of the cases being caused by one of three primary mitochondrial DNA (mtDNA) mutations. Incomplete disease penetrance and gender bias are two

Periglaucines A-D, anti-HBV and -HIV-1 alkaloids from Pericampylus glaucus

Four new hasubanane-type alkaloids, periglaucines A-D (1-4), and three known alkaloids, norruffscine (5), (-)-8-oxotetrahydropalmatine (6), and (-)-8-oxocanadine (7), were isolated from the aerial parts of Pericampylus glaucus. Their structures were eluci